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Disaster and Mass Casualty Management

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Acute Care Surgery

Abstract

You are the field medical director of the emergency system for your region. While patrolling an area being prepared for the upcoming state fair, a bolt of lightning strikes a concentrated area of workers who were hovering around one of the main tents.You arrive on the scene immediately and place a dispatch call for medical backup. Several fragments of the frame of the tent have impaled some of the victims.You see the following persons down:

  1. (A)

    Two workers with metal frames impaled in lower extremities who are calling out for help

  2. (B)

    One worker decapitated

  3. (C)

    One worker with no vital signs of life and no obvious injuries

  4. (D)

    One worker with abdominal evisceration who is moaning in pain

  5. (E)

    One worker who is entrapped by a large metal plate with no vital signs of life

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]References

  1. Hachiya M. Hiroshima Diary. Chapel Hill: University of North Carolina Press, 1955.

    Google Scholar 

  2. Shemer J, Shapiro SC. Terror and medicine—the challenge. In Shemer J, Shoenfeld Y, eds. Terror and Medicine: Medical Aspects of Biological, Chemical, and Radiological Terrorism. Lengerich, Germany: Pabst Science Publishers, 2003; 17–23.

    Google Scholar 

  3. American College of Surgeons Committee on Trauma. Disaster management. In Resources for Optimal Care of the Injured Patient. Chicago: American College of Surgeons, 1998; 87–91.

    Google Scholar 

  4. Hogan DE, Burstein JL. Basic physics of disasters. In Hogan DE, Burstein JL, eds. Disaster Medicine. Philadelphia: Lippincott Williams & Wilkins, 2002; 3–9.

    Google Scholar 

  5. Sheng, CY. Medical support in the Tangshan earthquake: a review of the management of mass casualties and certain major injuries. J Trauma 1987; 27:1130–1135.

    CAS  PubMed  Google Scholar 

  6. Lillehei KO, Robinson MN. A critical analysis of the fatal injuries resulting from the Continental flight 1713 airline disaster: evidence in favor of improved passenger restraint systems. J Trauma 1994; 37:826–830.

    Article  CAS  PubMed  Google Scholar 

  7. Beyersdorf SR, Nania JN, Luna GK. Community medical response to the Fairchild mass casualty event. Am J Surg 1996; 171:467–470.

    Article  CAS  PubMed  Google Scholar 

  8. Vosswinkel JA, McCormack JE, Brathwaite CEM, et al. Critical analysis of injuries sustained in the TWA flight 800 midair disaster. J Trauma 1999; 46:617–621.

    Article  Google Scholar 

  9. May AK, McGwin G, Lancaster LJ, et al. The April 8, 1998 tornado: assessment of the trauma system response and the resulting injuries. J Trauma 2000; 48:666–672.

    Article  CAS  PubMed  Google Scholar 

  10. Millie M, Senkowski C, Stuart L, et al. Tornado disaster in rural Georgia: triage response, injury patterns, lessons learned. Am Surg 2000; 66:223–228.

    CAS  PubMed  Google Scholar 

  11. Cocanour CS, Allen SJ, Mazabob J, et al. Lessons learned from the evacuation of an urban teaching hospital. Arch Surg 2002; 137:1141–1145.

    Article  PubMed  Google Scholar 

  12. Frykberg ER. Medical management of disasters and mass casualties from terrorist bombings: how can we cope? J Trauma 2002; 53:201–212.

    Article  PubMed  Google Scholar 

  13. Ciraulo DL, Frykberg ER, Feliciano DV, et al. A survey assessment of preparedness for domestic terrorism and mass casualty incidents among Eastern Association for the Surgery of Trauma members. J Trauma 2004; 56:1033–1041.

    Article  PubMed  Google Scholar 

  14. Frykberg ER. Principles of mass casualty management following terrorist disasters. Ann Surg 2004; 239:319–321.

    Article  PubMed  Google Scholar 

  15. Waeckerle JF. Disaster planning and response. N Engl J Med 1991; 324:815–821.

    Article  CAS  PubMed  Google Scholar 

  16. Quarantelli EL. Delivery of Emergency Medical Services in Disasters: Assumptions and Realities. New York: Irvington, 1983.

    Google Scholar 

  17. Sklar DP. Casualty patterns in disasters. J World Assoc Emerg Disaster Med 1987; 3:49–51.

    Google Scholar 

  18. Feliciano DV, Anderson GV, Rozycki GS, et al. Management of casualties from the bombing at the Centennial Olympics. Am J Surg 1998; 176:538–543.

    Article  CAS  PubMed  Google Scholar 

  19. Mahoney LE, Reutershan TP. Catastrophic disasters and the design of disaster medical care systems. Ann Emerg Med 1987; 16:1085–1091.

    Article  CAS  PubMed  Google Scholar 

  20. Mallonee S, Shariat S, Stennies G, et al. Physical injuries and fatalities resulting from the Oklahoma City bombing. JAMA 1996; 276:382–387.

    Article  CAS  PubMed  Google Scholar 

  21. Frykberg ER, Tepas JJ. Terrorist bombings: lessons learned from Belfast to Beirut. Ann Surg 1988; 208:569–576.

    Article  CAS  PubMed  Google Scholar 

  22. Frykberg ER, Tepas JJ, Alexander RH. The 1983 Beirut Airport terrorist bombing: injury patterns and implications for disaster management. Am Surg 1989; 55:134–141.

    CAS  PubMed  Google Scholar 

  23. Murphy MF. Emergency medical services in disaster. In Hogan DE, Burstein JL, eds. Disaster Medicine. Philadelphia: Lippincott Williams & Wilkins, 2002: 90–103.

    Google Scholar 

  24. Stein M, Hirshberg A. Medical consequences of terrorism: the conventional weapons threat. Surg Clin North Am 1999; 79:1537–1552.

    Article  CAS  PubMed  Google Scholar 

  25. Berry FB. The medical management of mass casualties: the oration on trauma. Bull Am Coll Surg 1956; 41:60–66.

    CAS  PubMed  Google Scholar 

  26. Barrier G. Emergency medical services for treatment of mass casualties. Crit Care Med 1989; 17:1062–1067.

    Article  CAS  PubMed  Google Scholar 

  27. Plante DM, Walker JS. EMS response at a hazardous materials incident: some basic guidelines. J Emerg Med 1989; 7:55–64.

    Article  CAS  PubMed  Google Scholar 

  28. Jacobs LM, Ramp JM, Breay JM. An emergency medical system approach to disaster planning. J Trauma 1979; 19:157–162.

    Article  PubMed  Google Scholar 

  29. Jacobs LM, Goody MM, Sinclair A. The role of a trauma center in disaster management. J Trauma 1983; 23:697–701.

    Article  PubMed  Google Scholar 

  30. Hooft PJ, Noji EK, Van de Vorde HP. Fatality management in mass casualty incidents. Forensic Sci Int 1989; 40:3–14.

    Article  CAS  PubMed  Google Scholar 

  31. Goodman, CS, Hogan DE. Urban search and rescue. In Hogan DE, Burstein JL, ed. Disaster Medicine. Philadelphia: Lippincott Williams & Wilkins, 2002; 112–122.

    Google Scholar 

  32. Oster NS, Doyle CJ. Critical incident stress. In Hogan DE, Burstein JL, eds. Disaster Medicine. Philadelphia: Lippincott Williams & Wilkins, 2002; 41–46.

    Google Scholar 

  33. Hammond JS, Brooks J. Helping the helpers: the role of critical incident stress management. Crit Care 2001; 5:315–317.

    Article  CAS  PubMed  Google Scholar 

  34. Almogy G, Belzberg H, Rivkind AI. Suicide bombing attacks: updates and modifications to the protocol. Ann Surg 2004; 239:295–303.

    Article  PubMed  Google Scholar 

  35. Ammons MA, Moore EE, Pons PT, et al. The role of aregional trauma system in the management of a mass disaster: an analysis of the Keystone, Colorado chairlift accident. J Trauma 1988; 28:1468–1471.

    Article  CAS  PubMed  Google Scholar 

  36. Einav S, Feigenberg Z, Weissman C, et al. Evacuation priorities in mass casualty terror-related events—implications for contingency planning. Ann Surg 2004; 239:304–310.

    Article  PubMed  Google Scholar 

  37. Stein M, Hirshberg A. Limited mass casualties due to conventional weapons—the daily reality of a Level I trauma center. In Shemer J, Shoenfeld Y, eds. Terror and Medicine: Medical Aspects of Biological, Chemical and Radiological Terrorism. Lengerich, Germany: Pabst Science Publishers, 2003; 378–393.

    Google Scholar 

  38. American College of Surgeons Committee on Trauma. Advanced Trauma Life Support, 6th ed. Chicago: American College of Surgeons, 1997.

    Google Scholar 

  39. Hirshberg A, Stein M, Walden R. Surgical resource utilization in urban terrorist bombing: a computer simulation. J Trauma 1999; 47:545–550.

    Article  CAS  PubMed  Google Scholar 

  40. Sarkisian AE, Khondkarian RA, Amirbekian NM, et al. Sonographic screening of mass casualties for abdominal and renal injuries following the 1988 Armenian earthquake. J Trauma 1991; 31:247–250.

    CAS  PubMed  Google Scholar 

  41. Hirshberg A. Damage control for abdominal trauma. Surg Clin North Am 1997; 77:813–820.

    Article  CAS  PubMed  Google Scholar 

  42. Klein JS, Weigelt JA. Disaster management: lessons learned. Surg Clin North Am 1991; 71:257–266.

    CAS  PubMed  Google Scholar 

  43. Hirshberg A, Scott BG, Granchi T, et al. How does casualty load affect trauma care in urban bombing incidents? A quantitative analysis. J Trauma 2004; 57:446.

    Article  Google Scholar 

  44. Frykberg ER, Hutton PMJ, Balzer RH. Disaster in Beirut: an application of mass casualty principles. Milit Med 1987; 11:563–566.

    Google Scholar 

  45. Rignault DP. Recent progress in surgery for the victims of disaster, terrorism and war. World J Surg 1992; 16:885–887.

    Article  CAS  PubMed  Google Scholar 

  46. Caro D. Major disasters. Lancet 1974; 2:1309–1310.

    Article  CAS  PubMed  Google Scholar 

  47. Brismar B, Bergenwald L.The terrorist bomb explosion in Bologna, Italy, 1980: an analysis of the effects and injuries sustained. J Trauma 1982; 22:216–220.

    Article  CAS  PubMed  Google Scholar 

  48. Burris DG, Welling DR, Rich NM. Dominique Jean Larrey and the principles of humanity in warfare. J Am Coll Surg 2004; 198:831–835.

    Article  PubMed  Google Scholar 

  49. Llewellyn CH. Triage: in austere environment and echeloned medical systems. World J Surg 1992; 16:904–909.

    Article  CAS  PubMed  Google Scholar 

  50. Hogan DE, Lairet J. Triage. In Hogan DE, Burstein JL, eds. Disaster Medicine. Philadelphia: Lippincott Williams & Wilkins, 2002; 10–15.

    Google Scholar 

  51. U.S. Department of Defense. Emergency War Surgery. Washington, DC: U.S. Government Printing Office, 1975.

    Google Scholar 

  52. Kreis DJ, Fine EG, Gomez GA, et al. A prospective evaluation of field categorization of trauma patients. J Trauma 1988; 28:995–1000.

    Article  PubMed  Google Scholar 

  53. American College of Surgeons Committee on Trauma. Field categorization of trauma patients (field triage). Bull Am Coll Surg 1986; 71:17–21.

    Google Scholar 

  54. Boutros F, Redelmeier DA. Effects of trauma cases on the care of patients who have chest pain in an emergency department. J Trauma 2000; 48:649–653.

    Article  CAS  PubMed  Google Scholar 

  55. Rignault DP, Deligny MC. The 1986 terrorist bombing experience in Paris. Ann Surg 1989; 209:368–373.

    Article  CAS  PubMed  Google Scholar 

  56. Caro D, Irving M. The Old Bailey bomb explosion. Lancet 1973; 1:1433–1435.

    Article  CAS  PubMed  Google Scholar 

  57. Tucker K, Lettin A. The Tower of London bomb explosion. BMJ 1975; 3:287–290.

    Article  CAS  PubMed  Google Scholar 

  58. Waterworth TA, Carr MJT. Report on injuries sustained by patients treated at the Birmingham General Hospital following the recent bomb explosions. BMJ 1975; 2:25–27.

    Article  CAS  PubMed  Google Scholar 

  59. Pyper PC, Graham WJH. Analysis of terrorist injuries treated at Craigavon Area Hospital, Northern Ireland, 1972–1980. Injury 1982; 14:332–338.

    Article  Google Scholar 

  60. Cooper GJ, Maynard RL, Cross NL, et al. Casualties from terrorist bombings. J Trauma 1983; 23:955–967.

    Article  CAS  PubMed  Google Scholar 

  61. Henderson JV. Anatomy of a terrorist attack: the Cu Chi mess hall incident. J World Assoc Emerg Disaster Med 1986; 2:69–73.

    Google Scholar 

  62. Biancolini CA, Del Bosco CG, Jorge MA. Argentine Jewish Community Institution bomb explosion. J Trauma 1999; 47:728–732.

    Article  CAS  PubMed  Google Scholar 

  63. Frykberg ER. Disaster and mass casualty management: a commentary on the American College of Surgeons position statement. J Am Coll Surg 2003; 197:857–859.

    Article  PubMed  Google Scholar 

  64. Champion HR, Sacco WJ, Gainer PS, et al. The effect of medical direction on trauma triage. J Trauma 1988; 28:235–239.

    Article  CAS  PubMed  Google Scholar 

  65. Cook CH, Muscarella P, Praba AC, et al. Reducing overtriage without compromising outcomes in trauma patients. Arch Surg 2001; 136:752–756.

    Article  CAS  PubMed  Google Scholar 

  66. Peleg K, Aharonson DL, Stein M, et al. Terror-related injuries: gunshot and explosion—characteristics, outcomes, and implications for care. Ann Surg 2004; 293:311–318.

    Article  Google Scholar 

  67. Briggs SM, Brinsfield KH. Advanced Disaster Medical Response. Boston: Harvard Medical International Trauma and Disaster Institute, 2003.

    Google Scholar 

  68. Irwin RL. The incident command system (ICS). In: Auf Der Heide E, editor. Disaster Response: Principles of Preparation and Coordination. St. Louis: Mosby, 1989:133–163.

    Google Scholar 

  69. U.S. Department of State. International Terrorism. Selected documents, No. 24. Government Printing Office, 1986.

    Google Scholar 

  70. Inglesby TV, Henderson DA, Bartlett JG, et al. Anthrax as a biological weapon: medical and public health management. JAMA 1999; 281:1735–1745.

    Article  CAS  PubMed  Google Scholar 

  71. Eachampati SR, Flomenbaum N, Barie PS. Biological warfare: current concerns for the health care provider. J Trauma 2002; 52:179–186.

    Article  Google Scholar 

  72. Arnon SS, Schecter R, Inglesby TV, et al. Botulinum toxin as a biological weapon: medical and public health management. JAMA 2001; 285:1059–1070.

    Article  CAS  PubMed  Google Scholar 

  73. Henderson DA. The looming threat of bioterrorism. Science 1999; 283:1279–1282.

    Article  CAS  PubMed  Google Scholar 

  74. Green MS, Kaufman Z. Syndromic surveillance for early detection and monitoring of infectious disease outbreaks associated with bioterrorism. In Shemer J, Shoenfield Y, eds. Terror and Medicine: Medical Aspects of Biological, Chemical and Radiological Terrorism. Lengerich, Germany: Pabst Science Publishers, 2003; 81–95.

    Google Scholar 

  75. Jenkins BM. Understanding the link between motives and methods. In Roberts B, ed. Terrorism with Chemical and Biological Weapons: Calibrating Risks and Responses. Alexandria, VA: Chemical and Biological Arms Control Institute, 1997; 43–52.

    Google Scholar 

  76. Keim M. Intentional chemical disasters. In Hogan DE, Burstein JL, eds. Disaster Medicine. Philadelphia: Lippincott Williams & Wilkins, 2002; 340–349.

    Google Scholar 

  77. National Council on Radiation Protection and Measurement: Management of Terrorist Events Involving Radioactive Material. NCRP Report No. 138. Bethesda, MD: National Council on Radiation Protection and Measurement, 2001.

    Google Scholar 

  78. Mettler FA, Voelz GL. Major radiation exposure—what to expect and how to respond. N Engl J Med 2002; 346:1554–1560.

    Article  PubMed  Google Scholar 

  79. Fong FH. Medical management of radiation accidents. In Hogan DE, Burstein JL, eds. Disaster Medicine. Philadelphia: Lippincott Williams & Wilkins, 2002; 237–257.

    Google Scholar 

  80. Yehezkelli J, Lehavi O, Dushnitsky T, et al: Radiation terrorism—the medical challenge. In Shemer J, Shoenfield Y, eds. Terror and Medicine—Medical Aspects of Biological, Chemical and Radiological Terrorism. Lengerich, Germany: Pabst Science Publishers, 2003; 335–346.

    Google Scholar 

  81. Slater MS, Trunkey DD. Terrorism in America: an evolving threat. Arch Surg 1997; 132:1059–1066.

    CAS  PubMed  Google Scholar 

  82. Karmy-Jones R, Kissinger D, Golocovsky M, et al. Bombrelated injuries. Milit Med 1994; 159:536–539.

    CAS  Google Scholar 

  83. Federal Bureau of Investigation. 1997 Bomb Summary. Bomb Data Center, Washington, DC: U.S. Department of Justice, 1997.

    Google Scholar 

  84. Clemedsson CJ. Blast injury. Physiol Rev 1956; 36:336–354.

    Google Scholar 

  85. Hill JF. Blast injury with particular reference to recent terrorist bombing incidents. Ann R Coll Surg Engl 1979; 61:4–11.

    CAS  PubMed  Google Scholar 

  86. Dire DJ, Gatrell CB. Conventional terrorist bombings. In Hogan DE, Burstein JL, eds. Disaster Medicine. Philadelphia: Lippincott Williams & Wilkins, 2002; 301–316.

    Google Scholar 

  87. Candole CA. Blast injury. Can Med Assoc J 1967; 96:207–214.

    PubMed  Google Scholar 

  88. Leibovici D, Gofrit ON, Stein M, et al. Blast injuries: bus versus open-air bombings—a comparative study of injuries in survivors of open-air versus confined-space explosions. J Trauma 1996; 41:1030–1035.

    Article  CAS  PubMed  Google Scholar 

  89. Phillips YY. Primary blast injuries. Ann Emerg Med 1986; 15:1446–1450.

    Article  CAS  PubMed  Google Scholar 

  90. Gutierrez de Ceballos P, Fuentes T, Diaz P, et al. The terrorist bomb explosions in Madrid, Spain. An analysis of the logistics, injuries sustained, and clinical management of casualties treated at the closest hospital. Crit Care 2005; 9:490–499.

    Article  Google Scholar 

  91. Clemedsson CJ, Hultman HI. Air embolism and the cause of death in blast injury. Milit Surg 1954; 114:424–437.

    Google Scholar 

  92. Rawlins JSP. Physical and pathophysiological effects of blast. Injury 1977; 9:313–320.

    Article  Google Scholar 

  93. Boffard KD, MacFarlane C. Urban bomb blast injuries: patterns of injury and treatment. Surg Ann 1993; 25:29–47.

    Google Scholar 

  94. Rutherford WH. Experience in the accident and emergency department of the Royal Victoria Hospital with patients from civil disturbances in Belfast, 1969-1972, with a review of disasters in the United Kingdom, 1951–1071. Injury 1972; 4:189–199.

    Article  Google Scholar 

  95. Kennedy TL, Johnston GW. Civilian bomb injuries. BMJ 1975; 1:382–383.

    Article  CAS  PubMed  Google Scholar 

  96. Hadden WA, Rutherford WH, Merrett JD. The injuries of terrorist bombing: a study of 1,532 consecutive patients. Br J Surg 1978; 65:525–531.

    Article  CAS  PubMed  Google Scholar 

  97. Thompson D, Brown S, Mallonee S, et al. Fatal and nonfatal injuries among U.S. Air Force personnel resulting from the terrorist bombing of the Khobar Towers. J Trauma 2004; 57:208–215.

    Article  PubMed  Google Scholar 

  98. Auf Der Heide E. Disaster Response: Principles of Preparation and Coordination. St. Louis, MO: CV Mosby, 1989.

    Google Scholar 

  99. Shamir MY, Weiss YG, Willner D, et al. Multiple casualty terror events: the anesthesiologist’s perspective. Anesth Analg 2004; 98:1746–1752.

    Article  PubMed  Google Scholar 

  100. Jacobs LM, Burns KJ, Gross RI.Terrorism: a public health threat with a trauma system response. J Trauma 2003; 55:1014–1021.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, University of Florida College of Medicine, Shands Jacksonville Medical Center, Jacksonville, FL, USA

    Eric R. Frykberg MD

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  1. Eric R. Frykberg MD
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Editors and Affiliations

  1. Department of Surgery, Eastern Virginia Medical School, Norfolk, VA, USA

    L. D. Britt MD, MPH (Brickhouse Professor of Surgery and Chairman) (Brickhouse Professor of Surgery and Chairman)

  2. Department of Surgery, Oregon Health Sciences University, Portland, OR, USA

    Donald D. Trunkey MD (Professor) (Professor)

  3. Emory University School of Medicine, Grady Memorial Hospital, Atlanta, GA, USA

    David V. Feliciano MD (Professor of Surgery, Chief of Surgery) (Professor of Surgery, Chief of Surgery)

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Frykberg, E.R. (2007). Disaster and Mass Casualty Management. In: Britt, L.D., Trunkey, D.D., Feliciano, D.V. (eds) Acute Care Surgery. Springer, New York, NY. https://doi.org/10.1007/978-0-387-69012-4_16

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