Policies for managing emergency medical services in mass casualty incidents

Adini, Bruria; Bodas, Moran; Nilsson, Heléne; Peleg, Kobi

doi:10.1016/j.injury.2017.05.034

Cited by 11 publications

(21 citation statements)

References 21 publications

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“…The over-commitment of several EMTs to the extrication of trapped victims endangered their own life. Although this level of commitment among the EMTs can be considered a positive opportunity for EMS managers [26], several studies have reported that over-committed behaviors can threaten EMTs’ safety [26, 27]. Establishing supervision rules and training for over-committed EMTs who put themselves in danger to save victims are suggested.…”

Section: Discussionmentioning

confidence: 99%

The Emergency Medical System (EMS) response to Iraqi pilgrims’ bus crash in Iran: a case report

Keykaleh

Sohrabizadeh

2019

BMC Emerg Med

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Background In Iran, Road Traffic Injuries (RTIs) with mass casualties occur repeatedly. Since Road Traffic Accidents (RTAs) occur far from health facilities, EMSs play an important role in reducing the disability and mortality resulting from RTIs. Thus, the study aimed to report Iraqi pilgrims’ bus which rolled over in the Malayer town. Case presentation A mass casualty event occurred on 7 September 2017 when a bus full of Iraqi pilgrims rolled over on a road 4-km outside of Malayer, Iran. A large team of responders were dispatched including 5 ambulances with 10 EMTs along with 6 police officers serving in the area. The accident resulted in 35 injured patients (21 female and 14 male) as well as 11 deaths ranging in age from 2 to 65 years. Twenty-one of the injured were transported to the hospital and 14 patients refused transport and 12 patients sustained multiple trauma. The case has been described four phases of dispatch, on-scene, hospital and post-mission. Frequent calls made by laypeople were considered as the main challenge of dispatch phase. The response on scene was hampered by large numbers of lay bystanders. The over-crowding around the emergency units disrupted the medical care procedures in hospital phase. Conclusion This case highlights over-crowding and laypeople interference at the scene disrupts the relief and rescue. To solve these challenges, the public education and police monitoring and control is recommended. Establishing a unified command post at the scene can facilitate effective coordination among relief and rescue organizations.

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Section: Discussionmentioning

confidence: 99%

The Emergency Medical System (EMS) response to Iraqi pilgrims’ bus crash in Iran: a case report

Keykaleh

Sohrabizadeh

2019

BMC Emerg Med

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“…13,20,26,27,33,43,44,46,47,51,54,74,87,96,101,104,110,118,[128][129][130] Keeping an active roster of available volunteers and required staff is often useful in rapidly building surge capacity by ensuring that personnel are both prepared and willing to participate in MCI response activities. 13,20,21,29,33,40,41,46,48,49,[68][69][70][71][72][73][74]101,104,115,118,120 Addressing the emotional trauma of the volunteers and staff in the aftermath of an MCI should be considered during an emergency medical response. 13,21,40,41,47,68,…”

Section: Safety and Securitymentioning

confidence: 99%

“…13,20,21,29,33,40,41,46,48,49,[68][69][70][71][72][73][74]101,104,115,118,120 Addressing the emotional trauma of the volunteers and staff in the aftermath of an MCI should be considered during an emergency medical response. 13,21,40,41,47,68,75,82,91,93,105,110,118,119,121,125,131 Planning, Policy, and Procedures Local planning, policies, and procedures, or a collective MCI plan, provides the framework to activate and deactivate MCI response and guide response activities. 13,22,27,32,33,39,40,53,55,58,…”

Section: Safety and Securitymentioning

confidence: 99%

“…At the local level, a physical emergency operations center (EOC) with well-defined jurisdictional responsibility is mandated for MCI management. 13,21,22,28,31,34,36,47,50,[55][56][57][58][59]61,62,[64][65][66]73,82,88,89,99,110,111,118,119,129,135,142,145,149,[151][152][153][154][155][156][157][158] EOCs play an important role by coordinating amongst organizations that need medical resources with those that can provide medical resources and delegating various emergent tasks among different entities. 39,50,54,118,151,152,155,157...…”

Section: Safety and Securitymentioning

confidence: 99%

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A Scoping Review of the Essential Components of Emergency Medical Response Systems for Mass Casualty Incidents

Usoro

Mehmood

Rapaport

et al. 2023

Disaster med. public health prep.

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Objective: Emergency medical (EM) response systems require extensive coordination, particularly during mass casualty incidents (MCIs). The recognition of preparedness gaps and contextual priorities to MCI response capacity in low- and middle-income countries (LMICs) can be better understood through the components of EM reponse systems. This study aims to delineate essential components and provide a framework for effective emergency medical response to MCIs. Methods: A scoping review was conducted using 4 databases. Title and abstract screening was followed by full-text review. Thematic analysis was conducted to identify themes pertaining to the essential components and integration of EM response systems. Results: Of 20,456 screened citations, 181 articles were included in the analysis. Seven major and 40 sub-themes emerged from the content analysis as the essential components and supportive elements of MCI medical response. The essential components of MCI response were integrated into a framework demonstrating interrelated connections between essential and supportive elements. Conclusions: Definitions of essential components of EM response to MCIs vary considerably. Most literature pertaining to MCI response originates from high income countries with far fewer reports from LMICs. Integration of essential components is needed in different geopolitical and economic contexts to ensure an effective MCI emergency medical response.

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“…For EMS personnel, dealing with uncertainty, unpredictability, and unexpected consequences of destructive disasters, more so during MCIs, is a significant challenge. As it is, managing routine day-to-day emergencies -road accidents, small fires, cardiac arrests, presents a complex challenge to EMS personnel due to the need to respond under uncertain conditions, and the need to provide an immediate www.ijsrp.org response parallel to a potential shortage of vital resources (Adini, Bodas, Nilsson, & Peleg, 2017). These challenges are amplified during MCIs because the EMS agencies must organize for high performance in settings where the potential for error and emergent secondary-hazards is overwhelming, and medical errors brought on by the unpredictable and unexpected nature of disaster response to MCIs can lead to potentially preventable death or disability.…”

Section:  Implications Of High Reliability Organizing For Ems Personnelmentioning

confidence: 99%

Organizational attributes that support reliable Emergency Medical Services response during Mass Casualty Incidents in Nairobi County, Kenya

Baru¹,

Omuterema²,

Nabiswa³

2021

IJSRP

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When disaster strikes resulting in mass casualties, the number of victims rapidly exceeds locally available intervention resources thereby necessitating exceptional response arrangements. When these tragic and traumatizing large-scale events occur, the public expects the local disaster response entities to be on hand to provide much needed assistance. Whereas the ultimate goal of any emergency medical response is to obtain the best possible intervention for the greatest number of casualties, research indicates that the efficacy of the emergency medical services (EMS) organization's response to past major incidents in Nairobi County, Kenya, has been inefficient. The aim of this study was to address this gap by examining the organizational attributes of EMS organizations that influence reliable disaster response to Mass Casualty Incidents (MCIs) in Nairobi County Kenya. The specific objective of the study was to examine EMS personnel's perceptions of organizational strategies that support reliable disaster response during MCIs in Nairobi County, Kenya. The study was guided by the high reliability theory as an approach for enhancing reliable emergency medical response performance in dynamic high-risk settings such as mass casualty disaster events. Non-probability convenience sampling approach was used to draw a target study population of 71, out of which a sample size of 54 study respondents comprising certified emergency medical technicians in fulltime employment by EMS agencies in Nairobi County was used. The study used the sequential explanatory quantitative method design. The data for the study was obtained through questionnaires and document analysis. Data were analyzed using descriptive statistics: frequency tables and diagrams were used to present quantitative data. The questionnaire measure of internal consistency yielded a reliability of Cronbach alpha α = .82. The study findings reveal that the EMS personnel in Nairobi County perceive that the EMS agencies' organizational strategies manifest HRO-like attributes to support reliable disaster response during MCIs. The study findings provide a mindfulness theoretical approach that EMS organizations can adapt to maintain reliable disaster response performance when dealing with the unexpected especially during response to MCIs. The study recommends that to support reliable disaster response performance especially during MCIs, EMS agencies should consider harnessing the existing organizational strategies using mindfulness strategies supported by disaster response policies in Nairobi County, Kenya.

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Policies for managing emergency medical services in mass casualty incidents

Cited by 11 publications

References 21 publications

The Emergency Medical System (EMS) response to Iraqi pilgrims’ bus crash in Iran: a case report

The Emergency Medical System (EMS) response to Iraqi pilgrims’ bus crash in Iran: a case report

A Scoping Review of the Essential Components of Emergency Medical Response Systems for Mass Casualty Incidents

Organizational attributes that support reliable Emergency Medical Services response during Mass Casualty Incidents in Nairobi County, Kenya

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