BackgroundMajor incidents affect us globally, and are occurring with increasing frequency. There is still no evidence-based standard regarding the best medical emergency response to major incidents. Currently, reports on major incidents are non-standardised and variable in quality. This pilot study examines the first systematic reports from a consensus-based, freely accessible database, aiming to identify how descriptive analysis of reports submitted to this database can be used to improve the major incident response.MethodsMajorincidentreporting.net is a website collecting reports on major incidents using a standardised template. Data from these reports were analysed to compare the emergency response to each incident.ResultsData from eight reports showed that effective triage by experienced individuals and the use of volunteers for transport were notable successes of the major incident response. Inadequate resources, lack of a common triage system, confusion over command and control and failure of communication were reported failures. The following trends were identified: Fires had the slowest times for several aspects of the response and the only three countries to have a single dialling number for all three emergency services had faster response times. Helicopter Emergency Medical services (HEMS) were used for transport and treatment in rural locations and for triage and treatment in urban locations. In two incidents, a major incident was declared before the arrival of the first Emergency Medical Services (EMS) personnel.ConclusionThis study shows that we can obtain relevant data from major incidents by using systematic reporting. Though the sample size from this pilot study is not large enough to draw any specific conclusions it illustrates the potential for future analyses. Identified lessons could be used to improve the emergency medical response to major incidents.

Why aren't we learning from them?Sophie Hardy emergency medicine trainee, Medway Maritime Hospital, Kent, UKReporting the results of every intervention is becoming the norm in medicine and provides an excellent basis for medical advancement and quality control. But major incidents have so far escaped this scrutiny. In England, agencies are not mandated to record or report major incidents. Reports that do exist are unstructured and unregulated, and it is difficult to derive useful information from them. Our understanding of major incidents and how best to respond to them is therefore limited.A major incident is one that overwhelms capacity or, in the NHS's words, "any event that cannot be managed within routine service arrangements." 1 As recent media attention on emergency departments in England has shown, routine service arrangements are easily strained. With increasing threats from global terrorism and natural disasters, 2 major incidents are becoming a more familiar part of our everyday lives. A recent Dutch study examined reports from five consecutive national disasters and noted that, despite changes in protocol, legislation, organisation, and funding, the same mistakes were being made each time. 3

ObjectiveWe describe the process of setting up a database of major incident reports and its potential future application.MethodA template for reporting on major incidents was developed using a consensus-based process involving a team of experts in the field. A website was set up as a platform from which to launch the template and as a database of submitted reports. This paper describes the processes involved in setting up a major incident reporting database. It describes how specific difficulties have been overcome and anticipates challenges for the future.ConclusionsWe have successfully set up a major incident database, the main purpose of which is to have a repository of standardised major incident reports that can be analysed and compared in order to learn from them.

A major incident was declared after a road traffic accident involving 150 cars and 200 people in Kent, England. The emergency services oversaw coordination of the scene, recovery and triage of casualties and transfer of patients to hospital. The crash was one of the worst seen on British roads and it has been hailed as a miracle that there were no deaths and very few serious injuries.This case report is a retrospective analysis of the regional health system’s response to the crash. The structure is based on the content of a report submitted using an online open access template for major incident reporting (Scand J Trauma Resusc Emerg Med 22: 5, 2014; http://www.majorincidentreporting.org). A more comprehensive analysis of the incident has also been the theme of a Masters thesis (Hardy S. Reporting Major Incidents in England: Putting Theory into Practice. England: Queen Mary’s University of London; 2014).

No abstract

No abstract

No abstract