Preparation for Mass Casualty Incidents

Emergency imaging after a mass casualty incident: role of the radiology department during training for and activation of a disaster management plan

“…18,34 One robust method to identify patients is to write the code on the patient's skin. 3 There have been reports of internet-based or other electronic patient identification systems, but all require a working infrastructure including electricity, network connectivity or at least batteries. Depending on the mechanism of the MCI, these resources may be limited such that devices may not work properly.…”

“…This is an absolute key point in maintaining availability of radiology (and other) resources for other more urgent patients. 3 Victims triaged to category green (T3) should not undergo any imaging as long as more urgent patients are expected to arrive in the radiology department. Patients tagged yellow (T2) typically need at least some basic imaging to detect if they are undertriaged (correct to red, T1) or overtriaged (correct to green, T3).…”

“…Examples of intentional MCIs are acts of terrorism, such as mass shootings or detonation of explosives, which may release biologic, chemical or radioactive agents. 3 The reported annual number of natural MCIs alone has quadrupled in the past three decades, with some suggesting that a disaster occurs somewhere in the world every day, stressing the need to be prepared. 6 After the occurrence of a MCI, pre-hospital care on scene involves triaging victims into categories giving consideration to severity of injury, likelihood of survival and available resources.…”

“…The ability to manage a sudden influx of injured patients at any time relies on welltrained and drilled personnel. 3 Delivery of care in response to MCI events differs in many respects from the routine care provided on a daily basis. 1 Therefore, all hospitals should have a disaster management plan (DMP) in place to be activated after notification of a MCI occurrence.…”

“…1 In MCI events, the care paradigm shifts from the greatest good for each individual to the greatest good for the greatest number of victims, potentially resulting in focusing care only on the portion of the affected patients most likely to benefit. 2,3 MCI events usually present a serious threat to the health of the community, disrupting normal services and requiring implementation of special procedures by paramedical services, primary care organizations and hospitals. 4 Therefore, the World Health Organization also uses the definition of a MCI as an event resulting in a number of victims great enough to disrupt the normal course of emergency and health care services.…”