Pitfalls to avoid in the medical management of mass casualty incidents following terrorist bombings: the hospital perspective
- PMID: 26816239
- DOI: 10.1007/s00068-014-0403-x
Pitfalls to avoid in the medical management of mass casualty incidents following terrorist bombings: the hospital perspective
Abstract
Background: The unique patterns of injury following explosions together with the involvement of numerous physicians, most of whom are not experienced in trauma, may create problems in the medical management of mass casualty incidents.
Methods: Four hundred patient files admitted in 19 mass casualty events following bombing incidents were reviewed and possible areas which could impact survival were defined.
Results: Forty-nine (9.3 %) patients had an Injury Severity Score ≥16. Of 205 patients in whom triage decisions were available, 5 of 25 severely injured patients were undertriaged by the triage officers at the door of the hospital. Following primary evaluation inside the emergency department critical injuries in two patients were missed due to distracting, less serious injuries. Of 68 (16.1 %) patients who were operated, 28 were in need of either immediate, urgent or high-priority operations. Except for neurosurgical cases which needed to be transferred to other hospitals, there was no delay in surgery. One patient underwent negative laparotomy. There were 15 in-hospital deaths, 6 of which were deemed as either anticipated or unanticipated mortality with possibility for improvement.
Conclusion: Medical management should be evaluated following MCIs as this may illustrate possible problems which many need to be addressed in contingency planning.
Keywords: Mass casualty incidents; Terror bombings.
Similar articles
-
The Impact of Age upon Contingency Planning for Multiple-casualty Incidents Based on a Single Center's Experience.Prehosp Disaster Med. 2016 Oct;31(5):492-7. doi: 10.1017/S1049023X16000613. Epub 2016 Aug 17. Prehosp Disaster Med. 2016. PMID: 27530971
-
Medical consequences of suicide bombing mass casualty incidents: the impact of explosion setting on injury patterns.Injury. 2009 Jul;40(7):698-702. doi: 10.1016/j.injury.2008.06.037. Epub 2009 May 5. Injury. 2009. PMID: 19419714
-
Terrorist bombings. Lessons learned from Belfast to Beirut.Ann Surg. 1988 Nov;208(5):569-76. doi: 10.1097/00000658-198811000-00005. Ann Surg. 1988. PMID: 3056287 Free PMC article. Review.
-
Precision of in-hospital triage in mass-casualty incidents after terror attacks.Prehosp Disaster Med. 2006 Jan-Feb;21(1):20-3. doi: 10.1017/s1049023x00003277. Prehosp Disaster Med. 2006. PMID: 16602261
-
Mass-casualty, terrorist bombings: implications for emergency department and hospital emergency response (Part II).Prehosp Disaster Med. 2003 Jul-Sep;18(3):235-41. doi: 10.1017/s1049023x00001102. Prehosp Disaster Med. 2003. PMID: 15141863 Review.
Cited by
-
Terrorist incidents: strategic treatment objectives, tactical diagnostic procedures and the estimated need of blood and clotting products.Eur J Trauma Emerg Surg. 2020 Aug;46(4):695-707. doi: 10.1007/s00068-020-01399-w. Epub 2020 Jul 16. Eur J Trauma Emerg Surg. 2020. PMID: 32676714 Free PMC article.
-
Introduction to the 5th focus-on issue devoted to disaster and military surgery.Eur J Trauma Emerg Surg. 2014 Aug;40(4):419-20. doi: 10.1007/s00068-014-0428-1. Epub 2014 Jul 26. Eur J Trauma Emerg Surg. 2014. PMID: 26816236 No abstract available.
-
Lessons learned from terror attacks: thematic priorities and development since 2001-results from a systematic review.Eur J Trauma Emerg Surg. 2022 Aug;48(4):2613-2638. doi: 10.1007/s00068-021-01858-y. Epub 2022 Jan 13. Eur J Trauma Emerg Surg. 2022. PMID: 35024874 Free PMC article.
-
Qualitative Analysis of Surveyed Emergency Responders and the Identified Factors That Affect First Stage of Primary Triage Decision-Making of Mass Casualty Incidents.PLoS Curr. 2016 Aug 19;8:ecurrents.dis.d69dafcfb3ad8be88b3e655bd38fba84. doi: 10.1371/currents.dis.d69dafcfb3ad8be88b3e655bd38fba84. PLoS Curr. 2016. PMID: 27651979 Free PMC article.
References
LinkOut - more resources
Full Text Sources
Other Literature Sources