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de la Fontaine N, Silberg T, Fegert JM, Tsafrir S, Weisman H, Rubin N, Ashkenazi M, Nacasch N, Polliack ML, Chen W, Herman-Raz M, Wachsberg-Lachmanovich R, Pessach-Gelblum L, Ziv A, Moshkovitz A, Shilo N, Frenkel-Nir Y, Gothelf D, Pessach IM. Acute response to the October 7th hostage release: rapid development and evaluation of the novel ReSPOND protocol implementation within a children's hospital. Child Adolesc Psychiatry Ment Health 2024; 18:76. [PMID: 38902765 PMCID: PMC11191208 DOI: 10.1186/s13034-024-00767-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 06/10/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND The decision to allocate hospitals for the initial reception of hostages abducted on the October 7th Hamas attack introduced an array of unprecedented challenges. These challenges stemmed from a paucity of existing literature and protocols, lack of information regarding captivity conditions, and variability in hostage characteristics and circumstances. OBJECTIVE To describe the rapid development, implementation and evaluation of the Hostage-ReSPOND protocol, a comprehensive trauma-informed procedure for the care of hostages, including young children, their caregivers and families, immediately following their release from prolonged captivity. METHODS A multidisciplinary expert focus group conducted a comprehensive literature review to develop the ReSPOND protocol, consisting of: Readiness of teams via multifaceted trainings, utilizing live simulations and video debriefings; Specialized professional teams experienced in providing holistic trauma-informed care; Personalized care tailored to individualized and developmentally-informed needs; Optimal safety rooted in creating a secure environment and trauma-informed response to young children, adolescents, caregivers and families; and Navigating Discharge, through coordination with community-based care systems. RESULTS A designated facility at the Children's hospital was carefully prepared for receiving 29 hostages, aged 3.9-80 years, 28% under the age of 18. Implementation of the ReSPOND protocol, which prioritized holistic psychosocial interventions above urgent medical care, proved feasible and effective in managing the diverse and complex needs of returnees as per provider report. Finally, systemic assessment of returnee's immediate and long-term mental health needs proved highly challenging. CONCLUSIONS There is currently no literature addressing the response to released hostages, especially those involving infants, young children and families within a children's hospital facility. This study has the potential to fill a crucial gap in knowledge by introducing a novel protocol which could offer valuable insights for public health organizations tasked with providing acute care to diverse individuals and families experiencing extreme, multi-layered mass traumatization.
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Affiliation(s)
- Naama de la Fontaine
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Derech Sheba 2, Ramat Gan, 5262656, Israel.
- Child Study Center, Yale School of Medicine, New Haven, CT, USA.
| | - Tamar Silberg
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Derech Sheba 2, Ramat Gan, 5262656, Israel
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
| | - Jörg M Fegert
- Department for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center, Competence Domain Mental Health Prevention, Ulm, Germany
| | - Shlomit Tsafrir
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Derech Sheba 2, Ramat Gan, 5262656, Israel
- The Faculty of Medical & Health Sciences, Tel-Aviv University, Tel Aviv, Israel
| | - Hana Weisman
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Derech Sheba 2, Ramat Gan, 5262656, Israel
| | - Noa Rubin
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Derech Sheba 2, Ramat Gan, 5262656, Israel
| | - Moshe Ashkenazi
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Derech Sheba 2, Ramat Gan, 5262656, Israel
- The Faculty of Medical & Health Sciences, Tel-Aviv University, Tel Aviv, Israel
| | - Nitsa Nacasch
- The Faculty of Medical & Health Sciences, Tel-Aviv University, Tel Aviv, Israel
- Sheba Medical Center, Ramat Gan, Israel
| | - Michael L Polliack
- The Faculty of Medical & Health Sciences, Tel-Aviv University, Tel Aviv, Israel
- Sheba Medical Center, Ramat Gan, Israel
| | - Wendy Chen
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Derech Sheba 2, Ramat Gan, 5262656, Israel
- Department of Social Services, Sheba Medical Center, Ramat Gan, Israel
| | - Meirav Herman-Raz
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Derech Sheba 2, Ramat Gan, 5262656, Israel
- Department of Social Services, Sheba Medical Center, Ramat Gan, Israel
| | | | - Liat Pessach-Gelblum
- MSR-Israel Center for Medical Simulation, Sheba Medical Center, Ramat Gan, Israel
| | - Amitai Ziv
- The Faculty of Medical & Health Sciences, Tel-Aviv University, Tel Aviv, Israel
- MSR-Israel Center for Medical Simulation, Sheba Medical Center, Ramat Gan, Israel
| | - Anat Moshkovitz
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Derech Sheba 2, Ramat Gan, 5262656, Israel
| | - Noya Shilo
- The Faculty of Medical & Health Sciences, Tel-Aviv University, Tel Aviv, Israel
- Sheba Medical Center, Ramat Gan, Israel
| | - Yael Frenkel-Nir
- The Faculty of Medical & Health Sciences, Tel-Aviv University, Tel Aviv, Israel
- Sheba Medical Center, Ramat Gan, Israel
| | - Doron Gothelf
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Derech Sheba 2, Ramat Gan, 5262656, Israel
- Sagol School of Neuroscience, The Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Itai M Pessach
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Derech Sheba 2, Ramat Gan, 5262656, Israel
- The Faculty of Medical & Health Sciences, Tel-Aviv University, Tel Aviv, Israel
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Gangadharan M, Hayanga HK, Greenberg R, Schwengel D. A Call to Action: Why Anesthesiologists Must Train, Prepare, and Be at the Forefront of Disaster Response for Mass Casualty Incidents. Anesth Analg 2024; 138:893-903. [PMID: 38109852 DOI: 10.1213/ane.0000000000006719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
Disasters, both natural and man-made, continue to increase. In Spring 2023, a 3-hour workshop on mass casualty incidents was conducted at the Society for Pediatric Anesthesia-American Academy of Pediatrics Annual conference. The workshop used multiple instructional strategies to maximize knowledge transfer and learner engagement including minididactic sessions, problem-based learning discussions in 3 tabletop exercises, and 2 30-minute disaster scenarios with actors in a simulated hospital environment. Three themes became evident: (1) disasters will continue to impact hospitals and preparation is imperative, (2) anesthesiologists are extensively and comprehensively trained and their value is often underestimated as mass casualty incident responders, and (3) a need exists for longitudinal disaster preparedness education and training over the course of a career. In this special article, we have sought to further define the problem and evidence, the capacity of anesthesiologists as leaders in disaster preparedness, and the rationale for preparation with current best practices to guide how best to move forward.
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Affiliation(s)
- Meera Gangadharan
- From the Department of Anesthesiology, Critical Care and Pain Medicine, UT Houston, McGovern Medical School, Houston, Texas
| | - Heather K Hayanga
- Department of Anesthesiology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Robert Greenberg
- Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins Hospital, Baltimore, Maryland
| | - Deborah Schwengel
- Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins Hospital, Baltimore, Maryland
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Saadatmand V, Ahmadi Marzaleh M, Abbasi HR, Peyravi MR, Shokrpour N. Emergency medical services preparedness in mass casualty incidents: A qualitative study. Health Sci Rep 2023; 6:e1629. [PMID: 37867788 PMCID: PMC10587387 DOI: 10.1002/hsr2.1629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/12/2023] [Accepted: 10/05/2023] [Indexed: 10/24/2023] Open
Abstract
Background and Aims The effective response of emergency medical services in mass casualty incidents (MCIs) calls for sufficient preparation. The components of preparation must be determined first to achieve this goal. This study aimed to describe the elements of preparedness of emergency medical services for MCIs. Methods A qualitative study was carried out on emergency medical service systems in Iran (from April 2022 to mid-March 2023), using in-depth semistructured interviews with participants who were managers and members of the incident command team, experts, technicians, paramedics, and telecommunicators of emergency medical services. Interviews were carried out face-to-face and via telephone. The data were collected using voice recorder and transcript and analyzed by content analysis method. This study was conducted using the consolidated criteria for reporting qualitative research. Results Thirty-six participants were included in the study. A total of 834 codes were analyzed. Thirteen components were extracted from the study and classified as five categories including "Strengthening management and organization," "individual and group empowerment," "capacity expansion," "technology and infrastructure development," and "operational response measures." Conclusion Emergency medical service preparedness in response to MCIs is a critical issue. For improving preparedness, the main components must be identified. The study results described the elements of emergency medical service preparedness, which could be used as a framework for developing the national model of emergency medical service preparedness in MCIs.
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Affiliation(s)
- Vahid Saadatmand
- Department of Health in Disasters and Emergencies, School of Health Management and Medical Information Sciences Shiraz University of Medical Sciences Shiraz Iran
| | - Milad Ahmadi Marzaleh
- Department of Health in Disasters and Emergencies, School of Health Management and Medical Information Sciences Faculty of Shiraz University of Medical Sciences Shiraz Iran
| | - Hamid Reza Abbasi
- Department of Surgery, School of Medicine Faculty of Shiraz University of Medical Sciences Shiraz Iran
| | - Mahmoud Reza Peyravi
- Department of Health in Disasters and Emergencies, School of Health Management and Medical Information Sciences Faculty of Shiraz University of Medical Sciences Shiraz Iran
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Weinstein ES, Cuthbertson JL, Herbert TL, Voicescu GT, Bortolin M, Magalini S, Gui D, Helou M, Lennquist Montan K, Montan C, Rafalowsky C, Ratto G, Damele S, Bazurro S, Laist I, Marzi F, Borrello A, Fransvea P, Fidanzio A, Benitez CY, Faccincani R, Ragazzoni L, Caviglia M. Advancing the scientific study of prehospital mass casualty response through a Translational Science process: the T1 scoping literature review stage. Eur J Trauma Emerg Surg 2023; 49:1647-1660. [PMID: 37060443 PMCID: PMC10449715 DOI: 10.1007/s00068-023-02266-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/26/2023] [Indexed: 04/16/2023]
Abstract
PURPOSE The European Union Horizon 2020 research and innovation funding program awarded the NIGHTINGALE grant to develop a toolkit to support first responders engaged in prehospital (PH) mass casualty incident (MCI) response. To reach the projects' objectives, the NIGHTINGALE consortium used a Translational Science (TS) process. The present work is the first TS stage (T1) aimed to extract data relevant for the subsequent modified Delphi study (T2) statements. METHODS The authors were divided into three work groups (WGs) MCI Triage, PH Life Support and Damage Control (PHLSDC), and PH Processes (PHP). Each WG conducted simultaneous literature searches following the PRISMA extension for scoping reviews. Relevant data were extracted from the included articles and indexed using pre-identified PH MCI response themes and subthemes. RESULTS The initial search yielded 925 total references to be considered for title and abstract review (MCI Triage 311, PHLSDC 329, PHP 285), then 483 articles for full reference review (MCI Triage 111, PHLSDC 216, PHP 156), and finally 152 articles for the database extraction process (MCI Triage 27, PHLSDC 37, PHP 88). Most frequent subthemes and novel concepts have been identified as a basis for the elaboration of draft statements for the T2 modified Delphi study. CONCLUSION The three simultaneous scoping reviews allowed the extraction of relevant PH MCI subthemes and novel concepts that will enable the NIGHTINGALE consortium to create scientifically anchored statements in the T2 modified Delphi study.
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Affiliation(s)
- Eric S Weinstein
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy.
| | - Joseph L Cuthbertson
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
| | - Teri Lynn Herbert
- Research and Education Services, Medical University of South Carolina Library, Charleston, SC, USA
| | - George T Voicescu
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
| | - Michelangelo Bortolin
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
| | - Sabina Magalini
- Department of Surgery, Policlinico Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | - Daniele Gui
- Department of Surgery, Policlinico Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | - Mariana Helou
- School of Medicine, Department of Emergency Medicine, Lebanese American University, Beirut, Lebanon
| | - Kristina Lennquist Montan
- MRMID-International Association for Medical Response to Major Incidents and Disasters, and Vascular Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Carl Montan
- MRMID-International Association for Medical Response to Major Incidents and Disasters, and Vascular Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Chaim Rafalowsky
- Magen David Adom, National Emergency Medical, Disaster, Ambulance and Blood Bank Service, Ashkelon, Israel
| | - Giuseppe Ratto
- Emergency Department, Azienda Sociosanitaria Ligure 2, Liguria, Italy
| | - Stefano Damele
- Emergency Department, Azienda Sociosanitaria Ligure 2, Liguria, Italy
| | - Simone Bazurro
- Emergency Department, Azienda Sociosanitaria Ligure 2, Liguria, Italy
| | - Itamar Laist
- ESTES-European Society for Trauma and Emergency Surgery, Disaster and Military Surgery Section, Milan, Italy
| | - Federica Marzi
- Department of Surgery, Policlinico Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | - Alessandro Borrello
- Department of Surgery, Policlinico Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | - Pietro Fransvea
- Department of Surgery, Policlinico Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | - Andrea Fidanzio
- Department of Surgery, Policlinico Gemelli, Catholic University of the Sacred Heart, Rome, Italy
| | - Carlos Yanez Benitez
- ESTES-European Society for Trauma and Emergency Surgery, Disaster and Military Surgery Section, Milan, Italy
| | - Roberto Faccincani
- ESTES-European Society for Trauma and Emergency Surgery, Disaster and Military Surgery Section, Milan, Italy
| | - Luca Ragazzoni
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
- Department of Sustainable Development and Ecological Transition, Università del Piemonte Orientale, Vercelli, Italy
| | - Marta Caviglia
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
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Tan YT, Shin CKJ, Park B, Bharath A, Wing R, Monteilh C, Sanseau E, Boswell B, Pearce JI, Luetje M, Enriquez B, Cicero M, Thomas A. Pediatric Emergency Medicine Didactics and Simulation: JumpSTART Secondary Triage for Mass Casualty Incidents. Cureus 2023; 15:e40009. [PMID: 37425609 PMCID: PMC10322648 DOI: 10.7759/cureus.40009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/01/2023] [Indexed: 07/11/2023] Open
Abstract
Mass casualty incidents (MCI), particularly involving pediatric patients, are high-risk, low-frequency occurrences that require exceptional emergency arrangements and advanced preparation. In the aftermath of an MCI, it is essential for medical personnel to accurately and promptly triage patients according to their acuity and urgency for care. As first responders bring patients from the field to the hospital, medical personnel are responsible for prompt secondary triage of these patients to appropriately delegate hospital resources. The JumpSTART triage algorithm (a variation of the Simple Triage and Rapid Treatment, or START, triage system) was originally designed for prehospital triage by prehospital providers but can also be used for secondary triage in the emergency department setting. This technical report describes a novel simulation-based curriculum for pediatric emergency medicine residents, fellows, and attendings involving the secondary triage of patients in the aftermath of an MCI in the emergency department. This curriculum highlights the importance of the JumpSTART triage algorithm and how to effectively implement it in the MCI setting.
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Affiliation(s)
- Yongtian Tina Tan
- Pediatric Emergency Medicine, Seattle Children's Hospital, Seattle, USA
| | | | - Brian Park
- Pediatric Emergency Medicine, Seattle Children's Hospital, Seattle, USA
| | - Anita Bharath
- Pediatric Emergency Medicine, University of Arizona College of Medicine, Phoenix, USA
| | - Robyn Wing
- Pediatric Emergency Medicine, Hasbro Children's Hospital, Providence, USA
| | - Cecilia Monteilh
- Pediatric Emergency Medicine, University of Arizona College of Medicine, Phoenix, USA
| | - Elizabeth Sanseau
- Pediatric Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Brittany Boswell
- Pediatric Emergency Medicine, Stanford University School of Medicine, Palo Alto, USA
| | - Jean I Pearce
- Pediatric Emergency Medicine, Medical College of Wisconsin, Milwaukee, USA
| | - Maureen Luetje
- Pediatric Emergency Medicine, Medical College of Wisconsin, Milwaukee, USA
| | - Brianna Enriquez
- Pediatric Emergency Medicine, Seattle Children's Hospital, Seattle, USA
| | - Mark Cicero
- Pediatric Emergency Medicine, Yale School of Medicine, New Haven, USA
| | - Anita Thomas
- Pediatric Emergency Medicine, Seattle Children's Hospital, Seattle, USA
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Leclerc T, Sjöberg F, Jennes S, Martinez-Mendez JR, van der Vlies CH, Battistutta A, Lozano-Basanta JA, Moiemen N, Almeland SK. European Burns Association guidelines for the management of burn mass casualty incidents within a European response plan. Burns 2023; 49:275-303. [PMID: 36702682 DOI: 10.1016/j.burns.2022.12.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 12/19/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND A European response plan to burn mass casualty incidents has been jointly developed by the European Commission and the European Burn Association. Upon request for assistance by an affected country, the plan outlines a mechanism for coordinated international assistance, aiming to alleviate the burden of care in the affected country and to offer adequate specialized care to all patients who can benefit from it. To that aim, Burn Assessment Teams are deployed to assess and triage patients. Their transportation priority recommendations are used to distribute outnumbering burn casualties to foreign burn centers. Following an appropriate medical evacuation, these casualties receive specialized care in those facilities. METHODS The European Burns Association's disaster committee developed medical-organizational guidelines to support this European plan. The experts identified fields of interest, defined questions to be addressed, performed relevant literature searches, and added their expertise in burn disaster preparedness and response. Due to the lack of high-level evidence in the available literature, recommendations and specially designed implementation tools were provided from expert opinion. The European Burns Association officially endorsed the draft recommendations in 2019, and the final full text was approved by the EBA executive committee in 2022. RECOMMENDATIONS The resulting 46 recommendations address four fields. Field 1 underlines the need for national preparedness plans and the necessary core items within such plans, including coordination and integration with an international response. Field 2 describes Burn Assessment Teams' roles, composition, training requirements, and reporting goals. Field 3 addresses the goals of specialized in-hospital triage, appropriate severity criteria, and their effects on priorities and triage. Finally, field 4 covers medical evacuations, including their timing and organization, the composition of evacuation teams and their assets, preparation, and the principles of en route care.
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Affiliation(s)
- Thomas Leclerc
- Percy Military Teaching Hospital, Clamart, France; Val-de-Grâce Military Medical Academy, Paris, France
| | | | - Serge Jennes
- Charleroi Burn Wound Center, Skin-burn-reconstruction Pole, Grand Hôpital de Charleroi, Charleroi, Belgium
| | | | - Cornelis H van der Vlies
- Department of Trauma and Burn Surgery, Maasstad Hospital, Rotterdam, the Netherlands; Trauma Research Unit Department of Surgery, Erasmus MC, Rotterdam, the Netherlands
| | - Anna Battistutta
- Directorate-General for European Civil Protection and Humanitarian Aid Operations (DG-ECHO), European Commission, Brussels, Belgium
| | - J Alfonso Lozano-Basanta
- Emergency Response Coordination Center, Directorate-General for European Civil Protection and Humanitarian Aid Operations (DG-ECHO), European Commission, Brussels, Belgium
| | - Naiem Moiemen
- University Hospitals Birmingham Foundation Trust, Birmingham, UK; University of Birmingham, College of Medical and Dental Sciences, Birmingham, UK
| | - Stian Kreken Almeland
- Norwegian National Burn Center, Department of Plastic, Hand, and Reconstructive Surgery, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Norway; Norwegian Directorate of Health, Department of Preparedness and Emergency Medical Services, Oslo, Norway.
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Widya S, Hewitson R, Patel T, Roland D, Dadnam C. Fifteen-minute consultation: An overview of major incidents. Arch Dis Child Educ Pract Ed 2022:archdischild-2022-323785. [PMID: 35705326 DOI: 10.1136/archdischild-2022-323785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 05/27/2022] [Indexed: 11/04/2022]
Abstract
Major incidents are rare but require a large amount of preparation, co-ordination and communication across different emergency services and specialities. This ensures that casualties are efficiently managed within the constraints of limited clinical resources. This article aims to provide a brief understanding of what constitutes as a major incident, how it is declared and the chain of command in communication and action, focusing specifically on the paediatric process. It also aims to highlight important considerations that could potentially be missed (eg, the mental health impact, forensic evidence and so on).
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Affiliation(s)
- Stefani Widya
- General Paediatrics, Leicester Royal Infirmary, Leicester, UK
| | - Rebecca Hewitson
- Paediatric Emergency Department, Cardiff and Vale University Healthboard, Cardiff, UK
| | - Tulsi Patel
- Paediatric Emergency Department, Leicester Royal Infirmary, Leicester, UK
| | - Damian Roland
- Paediatric Emergency Department, Leicester Royal Infirmary, Leicester, UK
| | - Christopher Dadnam
- Paediatric Emergency Department, Leicester Royal Infirmary, Leicester, UK
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Mass casualty medicine: time for a 21st century refresh. Br J Anaesth 2021; 128:e65-e67. [PMID: 34949438 DOI: 10.1016/j.bja.2021.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/01/2021] [Accepted: 12/05/2021] [Indexed: 11/20/2022] Open
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.
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