Mass casualty medicine: time for a 21st century refresh

Abstract

Mass casualty events are on the rise globally, as we face increasing pressures from scarcity of resources, population growth, systemic inequalities, geopolitical instabilities, and polarised discourse. Although they are rare events for an individual practitioner, they are going to happen to someone, somewhere, this week, this month, this year. And whilst they are often the last consideration for healthcare systems under constant pressures from daily routine work, individuals, departments, hospitals, and systems have to step up effectively in times of crisis. Failure to do so can lead to suboptimal outcomes for casualties, and even perceived failures can have crippling consequences on staff, families, and communities for years.

Virtual reality in simulation-based emergency skills training: A systematic review with a narrative synthesis

“… 74 Assessment by observation on real patients, especially in rare events such as operating room fires and mass casualty incidents, requires far greater research resource than assessments in simulation. 75 , 76 Additionally, measuring hard end points such as mortality and morbidity are simply impractical in medical education. 74 None of the included papers assess performance on real patients, however Koutitas et al described clinical skill competence following VR training as applied to knowledge of a real ambulance bus.…”

Time to Reconsider Analgesia in Mass Casualty Incidents

“…Current guidelines suggest implementing a robust command-and-control structure in major incidents, while some authors suggest that the way forward is by "supporting and facilitating" autonomous frontline teams. 4 Another suggestion for change in current practice has been that patients with minor injuries and expectant patients should also benefit from a portion of initially available care without having to wait until all critical cases have been managed and evacuated. 5 There is, to our knowledge, no existing literature on the experience, satisfaction, and/or expectations of major incident survivors concerning analgesia on the incident site.…”

Extended reality as a training method for medical first responders in mass casualty incidents: A protocol for a systematic review

“…Accordingly, MFRs are faced with difficult decisions to determine the preferential care and priority of evacuation for each patient, considering their chance of survival [ 3 , 4 ]. As MCIs and disasters are globally increasing [ 5 ], it is paramount that MFRs are prepared and adequately trained for these challenging situations/environments/settings.…”