Lessons from the Musgrave Park Hospital bombing

Usefulness of the Shock Index as a secondary triage tool

“…Triage has, on occasions, been used to identify those patients who could be treated and then returned to fight in the battles to maintain the fighting strength. After the bombing of a British military medical facility, two Emergency Physicians designed the Major Incident Medical Management and Support course, MIMMS, which formalised major incident management and set a UK standard for triage; a system based on simple physiological parameters that can be taught to minimally experienced clinicians, and aims to identify those patients most in need of medical attention 4. MIMMS teaches a two-stage approach: primary triage using the Triage Sieve is conducted at the incident scene; secondary triage, performed at the casualty clearing station, or in a safe environment, uses the Triage Sort (TSO) 5.…”

Major Incident Medical Training: A Systematic International Approach

“…As co-founder of the course, the author's motivation stemmed from being present as a junior doctor in a military hospital that was the target of a terrorist bomb (Musgrave Park Hospital, Belfast, 1991) [10], and being required to take the role of medical commander with no formal training -although some experience had been gained from a terrorist car bomb and a series of bomb hoaxes requiring hospital evacuation while working in the British Military Hospital in Hanover, Germany.…”

Article 12. Major incidents, leadership, and series summary and review

“…Disasters do not just happen outside of hospitals. 13 It is amazing that internal hospital events are not more frequent. Volatile chemicals, explosive gasses, biochemical hazards, radioactive materials, and hundreds of members of the public all crammed into a high rise building, it is a disaster waiting to happen.…”