Advertisement

The Emergency Room During Mass Casualty Incidents

  • Hany BahouthEmail author
Chapter
Part of the Hot Topics in Acute Care Surgery and Trauma book series (HTACST)

Abstract

Mass casualty incidents (MCIs), man-made or natural, have increased in recent years. In the 1970s, man-made events accounted for 16.5% of disasters and 4.3% of related deaths; in the 1990s, the number rose to 42.0% and 9.5%, respectively (not including “complex emergencies” involving armed conflict and a total breakdown of authority) [1]. There are different types of MCIs, primarily categorized as either progressive disasters or a sudden disaster. A progressive disaster is easier to manage in terms of preparedness and response due to its advancing nature (Hurricane storm). However, a sudden MCI is much more challenging for the entire medical system at local, regional, and national levels. The challenges are organizational, logistical, and relate to a wide range of medical and nonmedical fields through the different pre-hospital and inter-hospital phases of the event, including triage.

Abbreviations

AD

Administrative director

CEO

Chief executive officer

EMSC

Emergency medical services coordinator

ER

Emergency room

HN

Head nurse

MCI

Mass casualty incident

MedDir

Medical director

References

  1. 1.
    World Health Organization (WHO). Mass casualty management systems: strategies and guidelines for building health sector capacity. Health Action in Crises Injury and Violence Prevention. Geneva: WHO; April 2007. http://www.who.int/hac/techguidance/tools/mcm_guidelines_en.pdf.
  2. 2.
    Niska RW, Shimizu IM. Hospital preparedness for emergency response: United States, 2008. Natl Health Stat Report. 2011;37:1–14.Google Scholar
  3. 3.
    Woolard RH, Borron SW, Mackay JM. Chapter 21: Emergency department design. In: Ciottone GR, editor. Ciottone’s disaster medicine. Philadelphia: Elsevier. p. 125–9.CrossRefGoogle Scholar
  4. 4.
    Singer AJ, Singer AH, Halperin P, Kaspi G, Assaf J. Medical lessons learned from terror attacks in Israel. J Emerg Med. 2007;32(1):87–92.CrossRefGoogle Scholar
  5. 5.
    Okumura T, Suzuki K, Fukuda A, Kohama A, Takasu N, Ishimatsu S, Hinohara S. The Tokyo subway sarin attack: disaster management, Part 1: community emergency response. Acad Emerg Med. 1998;5(6):613–7.CrossRefGoogle Scholar
  6. 6.
    Almogy G, Belzberg H, Mintz Y, Pikarsky AK, Zamir G, Rivkind AI. Suicide bombing attacks: update and modifications to the protocol. Ann Surg. 2004;239(3):295–303.CrossRefGoogle Scholar
  7. 7.
    Lynn M. Mass casualty incidents: the nuts and bolts of preparedness and response for acute disasters. New York: Springer Science + Business Media; 2016.CrossRefGoogle Scholar
  8. 8.
    Sofer D, Klausner JM. Trauma system configurations in other countries: the Israeli model. Surg Clin North Am. 2012;92(4):1025–40.CrossRefGoogle Scholar
  9. 9.
    Kluger Y, Mayo A, Soffer D, Adadgem D, Halperin P. Functions and principles in the management of bombing mass casualty incidents: lessons learned at the Tel-Aviv Souraski Medical Center. Eur J Emerg Med. 2004;11(6):329–34.CrossRefGoogle Scholar
  10. 10.
    Foley E, Reisner AT. Chapter 54: Triage. In: Ciottone GR, editor. Disaster medicine. Philadelphia: Elsevier Health Sciences; 2006. p. 337–43.Google Scholar
  11. 11.
    Cushman G, Pachter HL, Beaton HL. Two New York City hospitals’ surgical response to the September 11, 2001, terrorist attack in New York City. J Trauma. 2003;54(1):147–55.CrossRefGoogle Scholar
  12. 12.
    Gale SC, Donovan CM, Tinti M, Ahmed H, Gracias VH. Organization and operations management at the health care facility. Ann Emerg Med. 2017;69(1S):S29–35.CrossRefGoogle Scholar
  13. 13.
    Nates JL. Combined external and internal hospital disaster: impact and response in a Houston trauma center intensive care unit. Crit Care Med. 2004;32(3):686–90.CrossRefGoogle Scholar
  14. 14.
    Halpern P, Goldberg SA, Keng JG, Koenig KL. Principles of Emergency Department facility design for optimal management of mass-casualty incidents. Prehosp Disaster Med. 2012;27(2):204–12.CrossRefGoogle Scholar
  15. 15.
    Benson M, Koenig KL, Schultz CH. Disaster triage: START, then SAVE—a new method of dynamic triage for victims of a catastrophic earthquake. Prehosp Disaster Med. 1996;11(2):117–24.CrossRefGoogle Scholar
  16. 16.
    Feliciano DV, Anderson GV Jr, Rozycki GS, Ingram WL, Ansley JP, Namias N, Salomone JP, Cantwell JD. Management of casualties from the bombing at the Centennial Olympics. Am J Surg. 1998;176(6):538–43.CrossRefGoogle Scholar
  17. 17.
    Vanderwagen C. Implementing the National Health Security Strategy [White paper]. Aptean website. http://www.irms360.com/vanderwagen-national-health-security-strategy. Accessed 28 Apr 2018.
  18. 18.
    D’Andrea SM, Goralnick E, Kayden SR. 2013 Boston Marathon bombings: overview of an emergency department response to a mass casualty incident. Disaster Med Public Health Prep. 2013;7(2):118–21.CrossRefGoogle Scholar
  19. 19.
    Kirschenbaum L, Keene A, O’Neill P, Westfal R, Astiz ME. The experience at St Vincent’s Hospital, Manhattan, on September 11, 2001: preparedness, response, and lessons learned. Crit Care Med. 2005;33(1 Suppl):S48–52.CrossRefGoogle Scholar
  20. 20.
    Gavagan TF, Smart K, Palacio H, Dyer C, Greenberg S, Sirbaugh P, Fishkind A, Hamilton D, Shah U, Masi G, Ivey RT, Jones J, Chiou-Tan FY, Bloodworth D, Hyman D, Whigham C, Pavlik V, Feigin RD, Mattox K. Hurricane Katrina: medical response at the Houston Astrodome/Reliant Center Complex. South Med J. 2006;99(9):933–9.CrossRefGoogle Scholar
  21. 21.
    Horton DK, Orr M, Tsongas T, Leiker R, Kapil V. Secondary contamination of medical personnel, equipment and facilities resulting from hazardous materials events, 2003-2006. Disaster Med Public Health Prep. 2008;2(2):104–13.CrossRefGoogle Scholar
  22. 22.
    Centers for Disease Control Prevention (CDC). Update: investigation of bioterrorism-related anthrax and interim guidelines for exposure management and antimicrobial therapy, October 2001. MMWR Morb Mortal Wkly Rep. 2001;50(42):909–19.Google Scholar
  23. 23.
    Sajed D. The history of point-of-care ultrasound use in disaster and mass casualty incidents. Virtual Mentor. 2010;12:744–9.PubMedGoogle Scholar
  24. 24.
    Sztajnkrycer MD, Baez AA, Luke A. FAST ultrasound as an adjunct to triage using the START mass casualty triage system: a preliminary descriptive system. Prehosp Emerg Care. 2006;10:96–102.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Trauma and Emergency SurgeryRambam Medical CenterHaifaIsrael

Personalised recommendations