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An Approach to Medical Emergencies in Forced Displacement Settings
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Natalie Roberts, Louisa Baxter, Maryam Omar, Halfdan Holger Knudsen, Clare Shortall
Appropriate contingency plans should be developed for mass casualty incidents or other causes of a major influx of patients. This may require designation of a specific circuit for use under such circumstances, along with planning for crowd control and communication with the wider community. Emergency drills may be helpful to ensure each team member’s role in such scenarios is understood.
General Radiography in the Critical Care and Trauma Environment
Published in Christopher M. Hayre, William A. S. Cox, General Radiography, 2020
A mass casualty incident (MCI) refers to any incident resulting in a higher number of casualties than reasonably expected. They may be of an intentionally violent nature, such as planned explosion or mass stabbing, or because of an incident such as a multivehicle road traffic collision, or such a collision involving a vehicle such as a bus leading to injuries to multiple people. It is important all radiographers are aware of their protocol for major incidents and mass casualty incidents, and these will often be found within the area of the department responsible for imaging for the ED. National guidance is also available from NHS England (2018).
Real-Time Physiological Data Collection and Analysis in Animal Inhalation Models: Predictive and Diagnostic Implications
Published in Brian J. Lukey, James A. Romano, Salem Harry, Chemical Warfare Agents, 2019
Benjamin Wong, Bryan. J. McCranor, Lewandowski Lewowski, Alfred. M. Sciuto
When dealing with the aftermath of a mass casualty chemical scenario, quick and effective triage of patients is crucial. Critical decisions need to be made to determine which casualties will receive immediate treatment, require surgery, or receive only supportive care, and which patients represent the “worried well”—those who are physiologically unharmed but psychologically convinced they have been injured by the chemical attack (Dhara and Dhara, 2002; Kirk and Deaton, 2007). A significant strain on the medical system can be expected in a mass casualty chemical incident due to limited resources, personnel, and information regarding the nature of the chemical agent (Dhara and Dhara, 2002; Kirk and Deaton, 2007; Okumura et al., 1998; Wax et al., 2003). To expedite standard protocol for triage of mass casualty incidents, models such as START (Simple Triage and Rapid Treatment) or SALT (Sort, Assess, Lifesaving Interventions, Treatment/Transport) are implemented to efficiently identify the degree of patient care needed (Benson et al., 1996; Anonymous, 2008). The key to these models is the rapid transition from assessment to intervention through either pulse and respiration measurements or simple yes-and-no questions. However, the physiological and psychological effects of chemical exposure complicate effective execution of these tasks. It is at this critical stage in the triage of chemical casualties that experimental results can, with contextual translation, serve to augment the triage procedure.
Immersive virtual patient simulation compared with traditional education for clinical reasoning: a pilot randomised controlled study
Published in Journal of Visual Communication in Medicine, 2023
Claire Bonnin, Dominique Pejoan, Eric Ranvial, Méryl Marchat, Nicolas Andrieux, Laurent Fourcade, Anaick Perrochon
VR is increasingly used in medical education in different fields such as i) anatomy (Ekstrand et al., 2018; Erolin et al., 2019; Kurul et al., 2020; Stepan et al., 2017; Vertemati et al., 2019; Wang et al., 2020), ii) technical and surgical procedures (e.g. laparoscopy and scoliosis surgery) (Izard et al., 2018; Sattar et al., 2019), iii) emergency situations for decision- making and mass casualty incident triage (Harrington et al., 2018; Lerner et al., 2020; Mills et al., 2020), iv) decontamination process (Farra et al., 2018), v) learning the ABCDE (Airways, Breathing, Circulation, Disability, Exposure) method (Berg & Steinsbekk, 2020), vi) communication skills with patients in view of overcoming vaccine hesitancy (Real et al., 2017). These studies also highlighted the fact that medical students have found enjoyment (Harrington et al., 2018; Kurul et al., 2020; Stepan et al., 2017), engagement (Erolin et al., 2019; Stepan et al., 2017), satisfaction (Berg & Steinsbekk, 2020) and motivation in VR (Ekstrand et al., 2018; Lerner et al., 2020; Stepan et al., 2017). VR seemed authentic, realistic and cost-effective (Farra et al., 2018; Mills et al., 2020; Vertemati et al., 2019), it could provide a sense of embodiment (Gobin Mignot et al., 2019); some participants even felt that being removed from external stimuli added to the immersive experience (Harrington et al., 2018). In these studies, VR showed better or equivalent results than traditional teaching, meaning that it could at least be an alternative (Berg & Steinsbekk, 2020; Ekstrand et al., 2018; Farra et al., 2018; Mills et al., 2020; Stepan et al., 2017).
Columbia Icefield Bus Rollover: A Case Study of Wilderness Mass Casualty Triage, Treatment, and Transport
Published in Prehospital Emergency Care, 2022
Jamin M. Mulvey, Brett H. Shaw, Michael Betzner, Eddie Chang, Mackenzie Wardle, Kevin Lobay, Joshua Bezanson
Mass casualty incidents (MCIs) are generally described as acute and discrete events that unexpectedly generate large numbers of patients and risk overwhelming local health resources. MCIs are rare in wilderness and mountainous settings but not unexpected given the trend toward increased visitation to national parks in North America (1, 2). There are few case studies on the response and management of these events within Canada, or more broadly, within the context of well-developed trauma and EMS systems (3). We have explored a case of a MCI that occurred in a wilderness setting on the Columbia Icefield at the Jasper National Park within the Canadian Rocky Mountains, Alberta, Canada. Due to the location and extreme environment and associated complexities, the response involved significant use of aeromedical resources, physician field deployment, and centralized coordination centers. It was the largest MCI in the history of Jasper National Park (JNP) (4).
Position Statement: Mass Gathering Medical Care
Published in Prehospital Emergency Care, 2021
Asa M. Margolis, Alison K. Leung, Matt S. Friedman, Sean P. McMullen, Francis X. Guyette, Nathan Woltman
Mass Casualty Incident planning:Event planners should utilize the Incident Command System for command and control of resources responding to an MCI.The ability to quickly, and efficiently, expand the scope of response to an incident should be considered in the development of all mass gathering plans.Triage algorithm(s) and casualty collection point(s) should be identified.The plan should be practiced via tabletop exercise or live drills involving all stakeholders to ensure it meets the needs for the event and possible threats.The plan should be regularly reviewed and updated.