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. 2021 Sep 30;34(3):277-282.

Ljubljana Marshes Hot Air Balloon Crash: A Multiple Casualty Incident

A Kisilak  1 , A Fischinger  1 , A Kristan  1
Affiliations

Ljubljana Marshes Hot Air Balloon Crash: A Multiple Casualty Incident

A Kisilak et al. Ann Burns Fire Disasters. .

Abstract
in English, French

On August 23rd, 2012 at 7:54 am a hot air balloon crashed in Ljubljana Marshes, leaving 32 injured on site. This case report analyses the biggest multiple casualty incident attended by University Medical Centre Ljubljana in recent history. Analysis of all segments regarding the incident was conducted: mobilisation, arrivals, triage, work-up, identification, public relations and outcome. Issues such as mobilisation, diagnostics, communication, documentation and intensive care unit space are discussed. Twenty-one patients arrived over 63 minutes, 8 of those were immediate resuscitation cases and 10 of those suffered burns. The average Injury Severity Score was 15.7 (ranging 3 to 50), 28.1 for admitted patients. 90% of patients had x-ray, 23% CT and 38% ultrasound diagnostic procedures. 33% of patients required urgent surgery and 60% of admitted cases required intensive care units. A relatives and media territory was established. CT location, loss of communication, inadequate documentation and intensive care bed space were most problematic. At 7-year follow up, we had a roughly 5% hospital fatality rate, 74% of patients gained full recovery and 21% good recovery. Even though the event occurred on a weekday during regular hours, it still exposed many weaknesses. A new radio frequency system for intra-hospital communication has been implemented, the multiple casualty incident protocol has been revised, and regular drills are now performed. Our emergency department is currently undergoing renovation to include CT diagnostics on the same floor. Plans have been made to ease documentation with dictation modules, whereas bed space remains unchanged.

Le 23 août 2012 à 7 h 54, une montgolfière s’est écrasée dans la marais de Ljubljana, causant 32 blessés. Nous analysons ici l’afflux massif le plus important de l’histoire récente pris en charge par le CHU de Ljubljana. Tout le déroulé des interventions a été passé en revue: mobilisation, présentation, triage, prise en charge initiale, identification, relations avec le public, évolution. Au niveau hospitalier, nous avons analysé la mobilisation, les diagnostics, la communication, la tenue des dossiers et les soins intensifs. Trente et un patients sont arrivés en 63 mn dont huit ayant besoin de réanimation et 10 brûlés. L’ISS moyen était de 15,7 (3 à 50) et de 28,1 pour les patients hospitalisés (60% d’entre eux en réanimation). 90% des patients ont eu une radiographie, 23% une TDM et 38% une échographie. Le tiers des patients a eu besoin de chirurgie en urgence. Un espace de communication avec les médias et les familles a été aménagé. Les principaux problèmes rencontrés ont été la localisation du scanner, le défaut de communication, les dossiers incomplets et la place en réanimation. A 7 ans, la mortalité hospitalière est de 5%, 71% des patients ont guéri sans séquelle et 21% ont une bonne récupération. Bien que survenu en semaine et aux heures ouvrables, nous avons constaté plusieurs faiblesses, nous ayant conduit à développer un nouveau système de communication intra- hospitalière, revoir le protocole d’afflux massif avec simulations régulières. Le service des urgences est en cours de rénovation, avec un scanner à proximité immédiate. Alors que les services n’ont pas été redimensionnés, un système de dictée électronique a été mis en place, dans le but d’améliorer l’exhaustivité des dossiers.

Keywords: burns; emergency medical services; injuries; multiple casualty incident; triage.

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Figures

Table I
Table I. Arrival times and triage
See this image and copyright information in PMC

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