Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Oct 2008
Overall Asessment of the Response to Terrorist Bombings in Trains, Madrid, 11 March 2004.
To provide an overall assessment of the response to the terrorist bombings in Madrid, 11 March 2004, which were considered the deadliest terrorist attack on European soil in modern times. ⋯ There was a rapid EMS response and evacuation, but also overtriage, uneven distribution of casualties and difficulties in communication. The sizes and resources of the closest hospitals, as well as the early hour, were probably decisive in the adequacy of the overall response.
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Eur J Trauma Emerg S · Oct 2008
Protocol for Reports from Major Accidents and Disasters in the International Journal of Disaster Medicine.
The aim of this protocol is to achieve a prospective, standardized methodology for reporting results and experiences from major accidents and disasters so that the data can be used for analysis, to compare results, to exchange experiences and for international collaboration in methodological development. Using this form, the authors of the reports retain full credit for the data and the publication of them. At the same time, the data will be available in the journal and on the Internet (www.europeantrauma.net), thus providing the abovementioned possibilities for scientific analysis and development.
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Eur J Trauma Emerg S · Oct 2008
Evaluation of the Response of the Swedish Healthcare System to the Tsunami Disaster in South East Asia.
When the tsunami in South East Asia hit the coast of Thailand on December 26, 2004, approximately 20,000 Swedish tourists were in the disaster zone. Of these, 548 died or were lost and more than 1500 were injured. The aim of this study was to evaluate the response of the Swedish health care system to the disaster in terms of assessment and support in the disaster zone, evacuation back to Sweden and continued treatment in Sweden. ⋯ With increased international travelling, many countries today have large numbers of their citizens in other parts of the world. For Sweden, this has been estimated to be 400,000 at any one time, often in areas known to be risk zones for natural disasters and terrorism. This fact of modern-day life demands welldesigned plans to support both citizens in the area and the local health care in several ways: non-medical support by mediating contact between injured and local medical staff, psychological and practical support, support in evacuating own citizens from the area to release local health care and (under specific conditions) medical support. This planning has to include prepared assessment teams that can be rapidly deployed to the scene and a command structure permitting rapid and accurate decisions on a governmental level.
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In the Netherlands, major incidents are sparse, and so there is a general feeling of a relatively low risk. Upon evaluating multiple casualty events (MCEs) in the Netherlands over the last 60 years, it is worth noting 39 major events. Our objective was to report the experiences from a mass casualty incident in an urban area, performing a critical evaluation of the response and outcome related to the scenario in order to learn from our past and to train for the future. ⋯ Triage supported by one person and two trauma teams worked well. The amount of over- and undertriage was in line with the literature. Numbering the patients worked well but also caused enormous problems with the supporting facilities. Centralizing the trauma care yielded certain advantages; however, we must respect our surge capacity of 20 patients. When the number of patients surpasses 20, an alternative plan must be followed. This event has been an eye-opener for our organization; it has given us new tools to prepare for a potential new disaster.
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The aim of this paper is to review the art and science underpinning the application of effective triage. The paper also attempts to cut through the fog of confusion surrounding the topic and to point a way towards a generally-agreed unified approach. Triage needs to be understood in the context of the environment in which it is applied, and the paper deals with this in some detail.