Major incident in Kent: a case report

Hardy, Sophie

doi:10.1186/s13049-015-0152-9

Cited by 3 publications

(2 citation statements)

References 1 publication

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“…In the Swedish context, the term major incident is used and defined "where available resources are insufficient for the immediate need of medical care" and the situation require a specific health care organization [24]. In the United Kingdom, an MCI is defined as "an emergency that requires the implementation of special arrangements by one or more of the emergency services and will generally include the involvement, either directly or indirectly, of large numbers of people" [103,104]. These definitions emphasize the initial balance between immediate medical response and access to resources, regardless of the type of incident or the number of casualties [24].…”

Section: Mass Casualty Incidentmentioning

confidence: 99%

TRIAGE : Management of the trauma patient

Lampi¹

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Triage, derived from the French word for sorting, aims to assess and prioritize injured patients, regardless of whether the injuries are sustained from everyday road traffic accident with few injured or a mass casualty incident. Triage seeks to provide the greatest benefit to the largest number of casualties in order to minimize morbidity and mortality. Triage in a pre-hospital setting entails management and sorting of patients according to an assessment of medical need, prioritization, and evacuation. In-hospital triage aims to rapidly identify the most injured and ensure timely and appropriate treatment according to the patient's clinical urgency. A number of different systems for performing triage have been established and implemented globally. The methodology is recognized and utilized but there is still a need for an evidence-based strategy to optimize training and the efficacy of the different systems.The main aim of this thesis was to determine triage performance among prehospital personnel and investigate the potential advantage of a triage system for trauma patients. The papers included in this thesis evaluated the triage skills of physicians, pre-hospital personnel, and rescue services personnel by testing their performance before and after an educational intervention. The last paper evaluated potential benefits of using a triage system for trauma patients admitted to the emergency department at MOI Teaching and Referral Hospital in Eldoret, Kenya.The results presented in this thesis illustrate that triage skills are lacking among physicians. Experienced pre-hospital personnel are more skilled in performing triage than physicians. The triage skills of the rescue services personnel improved significantly after the educational intervention. Moreover, the potential benefit to trauma patients of implementing an in-hospital triage system in a resource-poor environment was shown. In conclusion, health care personnel, especially physicians without experience but highly involved in trauma patient management, seem to be in need of triage training. How to train, how to implement, and how to evaluate triage skills must be considered in order to develop effective training. POPULÄRVETENSKAPLIG SAMMANFATTNINGOrdet triage kommer från franskans "sortera" och är ett av det första stegen i omhändertagandet av skadade när det råder resursbrist. Från 1800-talets blodiga slagfält, till dagens skadeplats och akutmottagningar har sättet att triagera patienter utvecklats. Men då, som nu, är grundtanken den samma, att sortera och prioritera de skadade utifrån tillgängliga resurser och patienternas vårdbehov. Följaktligen har begreppet kommit att bli centralt inom ämnet katastrofmedicin. Att avlida till följd av skador i samband med allvarliga händelser men också skador i till exempel vardagstrafiken är ett globalt hälsoproblem. Tiden från olycka till sjukhusbehandling är en viktig och ofta avgörande överlevnadsfaktor för en patient. I det här sammanhanget talas det om "den gyllene timmen", som påvisar vikten av att få ...

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Section: Mass Casualty Incidentmentioning

confidence: 99%

TRIAGE : Management of the trauma patient

Lampi¹

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“…Specifically, previous studies document that the presence of thick fog, smoke or dust influences roads by: (1) reducing the volume of traffic; and (2) increasing the risk of accidents despite lower traffic volumes and an overall reduction in speed-particularly accidents that involve multiple vehicles and cause a higher percentage of severe injuries (OECD 1986;Musk 1991;Ashley et al 2015;Hardy 2015;Ibrahim 2015).…”

Section: Effects Of Visibility Degradation On Surface Transportation mentioning

confidence: 99%

Visibility in airborne volcanic ash: considerations for surface transportation using a laboratory-based method

2018

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All modes of surface transportation can be disrupted by visibility degradation caused by airborne volcanic ash. Despite much qualitative evidence of low visibility on roads following historical eruptions worldwide, there have been few detailed studies that have attempted to quantify relationships between visibility conditions and observed impacts on network functionality and safety. In the absence of detailed field observations, such gaps in knowledge can be filled by developing empirical datasets through laboratory investigations. Here, we use historical eruption data to estimate a plausible range of ashsettling rates and ash particle characteristics for Auckland city, New Zealand. We propose and implement a new experimental set-up in controlled laboratory conditions, which incorporates a dual-pass transmissometer and solid aerosol generator, to reproduce these ash-settling rates and calculate visual ranges through the associated airborne volcanic ash. Our findings demonstrate that visibility is most impaired for high ash-settling rates (i.e. [ 500 g m -2 h -1 ) and particle size is deemed the most influential ash characteristic for visual range. For the samples tested (all \ 320 lm particle diameter), visibility was restricted to * 1-2 m when ash settling was replicated for very high rates (i.e. * 4000 g m -2 h -1 ) and was especially low when ash particles were fine-grained, more irregular in shape and lighter in colour. Finally, we consider potential implications for disruption to surface transportation in Auckland through comparisons with existing research which investigates the consequences of visual range reduction for other atmospheric hazards such as fog. This includes discussing how our approach might be utilised in emergency and transport management planning. Finally, we summarise strategies available -018-3205-3 for the mitigation of visibility degradation in environments contaminated with volcanic ash.

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Communication in Sudden-Onset Major Incidents: Patterns and Challenges—Scoping Review

Hansen,

Mikkelsen,

Rehn

2023

Disaster med. public health prep.

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Objective: To identify and describe patterns and challenges in communication in sudden-onset major incidents. Methods: Systematic scoping review according to Joanna Briggs Institute and PRISMA-ScR guidelines. Data sources included Cochrane Library, EMBASE, PubMed/MEDLINE, Scopus, SweMed+, Web of Science, and Google Scholar. Non-indexed literature was searched as well. The included literature went through data extraction and quality appraisal as per pre-registered protocol. Results: The scoping review comprised 32 papers from different sources. Communication breakdown was reported in 25 (78.1%) of the included papers. Inter-authority communication challenges were reported in 18 (56.3%) of the papers. System overload and incompatibility was described in 9 papers (28.1%). Study design was clearly described in 30 papers (93.8%). Conclusions: The pattern in major incident communication is reflected by frequent breakdowns with potential and actual consequences for patient survival and outcome. The challenges in communication are predominantly inter-authority communication, system overload and incompatibility, and insufficient pre-incident planning and guidelines.

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Major incident in Kent: a case report

Cited by 3 publications

References 1 publication

TRIAGE : Management of the trauma patient

TRIAGE : Management of the trauma patient

Visibility in airborne volcanic ash: considerations for surface transportation using a laboratory-based method

Communication in Sudden-Onset Major Incidents: Patterns and Challenges—Scoping Review

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