MASS CASUALTY MANAGEMENT SYSTEMS

DR BASARU L.B (M.D) HAVANA, CUBA

DR SUBAIR A.S (MB,BS), LAUTECH

PRESENTED BY

VICTIMS OF MASS CASUALTY INCIDENT

MASS CASUALTY RESCUE TEAM

CONTENT

INTRODUCTION DEFINITIONS FIELD MANAGEMENT TRANSFER ORGANISATION RESCUE CHAIN TRIAGE HOSPITAL MANAGEMENT CONCLUSION

INTRODUCTION Since the beginning of mankind, man has been faced with different kind of disasters, flood during era of prophet, Noah in the bible, man made disasters, like atomic bomb in Hiroshima and Nagasaki. Consequently to all aforementioned disasters

When n cci ent r is ster involving l rge numbers of injuries occurs, the first to rovi e emergency ssistance are communities closest to the site of the inci ent.

Many lives have been lost in mass casualty situations because resources were not mobilized efficiently The challenge we face is this: the more scarce the resources, the more efficient the organization must be.

This resentation escribes the steps to esigning a mass casualty management system that ill ensure the highest possible survival rate and We hope that it ill provide the necessary information

to guide disaster managers and health care professionals in establishing or reviewing their own mass casualty management system

DEFINITION

MASS ASUALTY :IS ANY LARGE NUMBER OF ASUALTIES PRODUCED IN A RELATIVELY SHORT PERIOD OF TIME,USUALLY AS THE RESULT OF A SINGLE INCIDENT SUCH AS AN EARTHQUAKE, FLOOD, HURRICANE, MASSIVE ROAD TRAFFIC ACCIDENT.

MASS CASUALTY INCIDENT

Any event resulting in a number of victims large enough to disrupt the normal course of emergency and healthcare services. E g. Chernobyl nuclear power station explosion , bomb blast in Abuja.

EMERGENCY SERVICES

Those services which are specifically designed to respond on a daily basis to emergency situations: Police, Fire Service, Ambulance Service, Accident and Emergency Department

MASS CASUALTY MANAGEMENTManagement of victims of a mass casualty event, aimed at minimizing loss of life and disabilities

The group of units, organizations and sectors which wor jointly, through institutionalized procedures, to minimize disabilities and loss of life in a mass casualty event through the efficient use of all existing resources.

MASS CASUALTY MANAGEMENT SYSTEM

THE MASS CASUALTY MANAGEMENT SYSTEM IS BASED ON:

Preestablished procedures, to be used in daily emergency activities and to be adapted to meet demands of a major incident

Maximization of the use of existing resources Multisectoral preparation and response Strong preplanned and tested coordination

FIELD MANAGEMENT

Field management encompasses procedures used to organize the disaster area in order to facilitate the management of victims

TRANSFER ORGANIZATION

The transfer organization includes those procedures implemented to ensure that victims of a mass casualty incident will be safely, uic ly, and efficiently transferred by appropriate vehicles to the appropriate and prepared health care facilities.

RESCUE CHAIN

The Rescue Chain, the essence of the Mass Casualty Management System, involves the Ministry of Health, private hospitals, police, fire service, NGOs, transport services, and communications

DIAGRAM OF RESCUE CHAINTriage Search Rescue Triage Stabilization Regulation Evacuation Definitive

Hospitalization

Transport

THE IMPLEMENTATION OF THIS RESCUE CHAIN existence of: Requires the An efficient Accident and Emergency Department A basic radio communications networ Coordination procedures among all sectors involved Skilled multisectoral rescue teams

TRIAGE

TRIAGE: is a process of determining the priority of patients' treatments based on the severity of their condition. This rations patient treatment efficiently when resources are insufficient for all to be treated immediately

TYPES OF TRIAGE

SIMPLE TRIAGE S.T.A.R.T MODEL ADVANCED TRIAGE CONTINUOUS TRIAGE PRACTICAL TRIAGE REVERSE TRIAGE

SIMPLE TRIAGE

Simple triage is usually used in a scene of a "mass-casualty incident" (MCI), in order to sort patients into those who need critical attention and immediate transport to the hospital and those with less serious injuries.

S.T.A.R.T. (Simple Triage and Rapid Treatment) separates the injured into four groups: The deceased who are beyond help The injured who can be helped by immediate transportation The injured whose transport can be delayed Those with minor injuries, who need help less urgently

S.T.A.R.T

Triage at an accident scene is performed by a paramedic or an emergency physician, using the four-level scale of Cannot wait, Has to wait, Can wait Lost.

category meaningAcute danger for life

Consequence examples sImmediate treatment, transport as soon as possibleArterial lesions, internal haemorrhage, major amputations

(T2)HAS TO WAIT

Severe injury

Constant observation and rapid treatment transport as soon as practical

Minor amputations, flesh wounds, fractures and dislocations

(T3)CAN WAIT

Minor injury or no injury

Treatment when practical, transport and/or discharge when possible Observation and if possible administratio n of analgesics

Minor lacerations, sprains, abrasions

(T4)

No or small chance of survival

Severe injuries, uncompensat ed blood loss, negative neurological assessment

SECONDARY (IN-HOSPITAL) TRIAGE Red / Immediate: They require

immediate surgery or other life-saving intervention, and have first priority for surgical teams or transport to advanced facilities; they "cannot wait" but are likely to survive with immediate treatment

Yellow / Observation: Their condition is stable for the moment but requires watching by trained persons and frequent re-triage, will need hospital care (and would receive immediate priority care under "normal" circumstances

Green / Wait (walking wounded): They will require a doctor's care in several hours or days but not immediately, may wait for a number of hours or be told to go home and come back the next day (broken bones without compound fractures, many soft tissue injuries).

White / Dismiss (walking wounded): They have minor injuries; first aid and home care are sufficient, a doctor's care is not required. Injuries are along the lines of cuts and scrapes, or minor burns.

Black / Expectant: They are so severely injured that they will die of their injuries, possibly in hours or days (large-area burns, severe trauma, lethal radiation dose), or in life-threatening medical crisis that they are unlikely to survive given the care available (cardiac arrest, septic shock. severe head or chest wounds); they should be taken to a holding area and given a painkillers as required to reduce suffering.

HOSPITAL ORGANIZATION

It is the organization to be implemented in a hospital in order to respond to a mass casualty event. This organization, utilizing preestablished and tested procedures, will allow :

Active mobilization and management of available resources (human and material) Links with prehospital organization Management of inpatients and victim flow Management of care Management of secondary evacuations Informing and updating authorities and relatives of victims

CONCLUSIONIn as much, we are leaving in a society with high percentage of crime, security instability coupled with the fact that the politicians are only interested in their next political election, I believe strongly that the issue of mass casualty management has to be prioritized by the health workers.Rom 1 :11 And this, t knowing the time, that now it is high ti w k ut f sl p: f r w is ur s lv ti r r th wh w b li v .

THE END