An epidemiological approach to mass casualty incidents in the Principality of Asturias (Spain)

Abstract

BackgroundMass Casualty Incidents (MCI) have been rarely studied from epidemiological approaches. The objective of this study is to establish the epidemiological profile of MCI in the autonomous region of the Principality of Asturias (Spain) and analyse ambulance deployment and severity of patients.MethodsThis is a population-based prospective study run in 2014. Inclusion criteria for MCI is “every incident with four or more people affected that requires ambulance mobilisation”.ResultsThirty-nine MCI have been identified in Asturias in 2014. Thirty-one (79 %) were road traffic accidents, three (7.5 %) fires and five (12.8 %) other types. Twenty-one incidents (56.7 %) had four patients, and only three of them (8 %) had seven or more patients. An average of 2.41 ambulances per incident were deployed (standard error = 0.18). Most of the patients per incident were minor injured patients (mean = 4; standard error = 0.2), and 0,26 were severe patients (standard error = 0.08). There was a positive significant correlation (p < 0.01) between the total number of patients and the total number of ambulances deployed and between the total number of patients and Advanced Life Support (ALS) ambulances deployed (p < 0.001). The total number of non-ALS ambulances was not related with the total number of patients.DiscussionPopulation based research in MCI is essential to define MCI profile. Quantitative definition of MCI, adapted to resources, avoid selection bias and present a more accurate profile of MCI. As espected, road traffic accidents are the most frequent MCI in our region. This aspect is essential to plan training and response to MCI. Analysis of total response to MCI shows that for almost an hour, we should plan extra resources for daily emergencies. This data is an important issue to bear in mind when planning MCI response. The fact that most patients are classified as minor injured and more advanced life support units than needed are deployed shows that analysis of resources deployment and patient severity helps us to better plan future MCI response.ConclusionsRoad traffic accidents with minor injured patients are the most frequent MCI in our region. More advanced life support units than needed have been initially deployed, which might compromise response to daily emergencies during an MCI.

Epidemiological characteristics of 13,313 emergency room patients with trauma from 2013 to 2021: a single-centre retrospective study

“…In this study, the occurrence of trauma varied with seasons and time periods, indicating that the occurrence of trauma is affected by factors such as lifestyle and production, seasons, and environmental temperature changes, which is consistent with the ndings of studies from other countries [16,19,20]. In this study, the hospitalisation peak of patients with trauma in the emergency room occurred from July to October, which may be related to the following aspects: (1) the occurrence of trauma is highly correlated with meteorological elements, and the increase in temperature and sunshine duration increases the incidence of accidental trauma [20][21][22]; (2) when the relative humidity is 50-70%, the risk of trauma is highest [21].…”

Advancing the scientific study of prehospital mass casualty response through a Translational Science process: the T1 scoping literature review stage

“…Results of the PHP scoping review stressed the importance of a common terminology to be adopted across all agencies working in the same jurisdiction, along with the urgent need to include practices that support gender diversity and are contextual to vulnerable groups and special needs populations [30,111,140,147,159,160]. Included references addressed the role of technology in supporting the different PH MCI processes, from inter-agencies communication systems, to telemedicine and information management systems to coordinate the different resources deployed (including human resources, equipment, and vehicles) and to distribute MCI casualties in different health facilities [90,92,99,146,160]. Data supported that standard trauma transportation decisions and overall MCI coordination may have to be adapted in context to the hazard impact and health system capacity, taking into account the possibility of CBRNE threats demanding from patient decontamination and personnel self-care [86,88,89,100,102,103,108,136].…”

“…Additionally, from the results emerged that frequently definitive care may require alternative care sites to include field hospitals, adapted structures such as conventions centers, schools, or religious buildings like churches and mosques that have the capacity and capability to attend the injured [105,131,151]. The concept of enhancing situational awareness through available technology (such as drones) to better guide critical decision-making during MCIs emerged in some of the included references, especially in remote areas with access constraints [90,92,99,109,117,129,133,139,146,160]. Moreover, the role of spontaneous volunteers and bystanders both in assisting relief efforts [88,107,133,134,141,144,166] and in providing information through social media that could be used for rapid situation assessment [129] consistently emerges in the included references.…”

Factors Associated with the Number of Injured and Fatalities in Motor Vehicle Intentional Mass-Casualty Incidents: A Timely Aid for Scaling the Emergency Response

“…An incident was considered an IMCI if there were five or more casualties per incident, as defined by the Spanish and French mean quantitative definition of IMCI. 20,21 The total number of injured and fatalities recorded for each incident were considered as the number of casualties. A MV was considered a weapon when intentionally used to cause a mass run over, this being the primary traumatic mechanism of the injuries.…”