A Multicasualty Event: Out‐of‐hospital and In‐hospital Organizational Aspects

Abstract

During this MCE, the authors observed "rotating" bottleneck phenomena within out-of-hospital and in-hospital systems. For maximal efficiency, hospitals need to fully coordinate the influx and transfer of patients with out-of-hospital rescue services as well as with other hospitals. Each hospital has to immediately deploy its operational center, which will manage and monitor the hospital's resources and facilitate coordination with the relevant institutions.

Dynamic Communication Quantification Model for Measuring Information Management During Mass-Casualty Incident Simulations

“…(1) evaluation and triage, (2) treatment and preparedness for evacuation, and (3) evacuation according to triage classifications (Assa et al, 2009;Avitzour et al, 2004;Blancher et al, 2018;Busby & Witucki-Brown, 2011;Ellis & Sorene, 2008;Garner et al, 2001;Peleg et al, 2003;Raiter et al, 2008;Shapira & Shemer, 2002;Sloan, 2011;Smith & Dowell, 2000). The evaluation goal is to count the number of casualties and to quickly assess injuries throughout the entire scene.…”

“…Information management (also known as "communication" [Rimstad & Braut, 2015] or "gathering and analyzing information" [Wang et al, 2012]) is one of the core tasks of MCI commanders during the chaotic prehospital phase (Rimstad & Braut, 2015). Reports from past MCIs reveal that information gaps due to communication challenges such as excessive radio communications (Rimstad & Sollid, 2015) lead to increased mortality (Assa et al, 2009;Avitzour et al, 2004;Busby & Witucki-Brown, 2011;Raiter et al, 2008;Sloan, 2011;Turner et al, 2016), a prolonged evacuation duration (Assa et al, 2009), overflowing hospitals (Raiter et al, 2008;Turner et al, 2016), delays in hospital preparedness (Avitzour et al, 2004;Sloan, 2011), and a decrease in rescuers' safety on-site (Turner et al, 2016).…”

“…These instruments include postsimulation Likert-scale questionnaires (Gordon et al, 2016;Roper et al, 2018), sets of performance indicators scored by experienced observers (Gryth et al, 2010;Rüter et al, 2004aRüter et al, , 2004b, and postsimulation surveys (Atack et al, 2009;Jorm et al, 2016;Zinan et al, 2015). Despite efforts to improve information management between EMS team members during MCI simulations, it remains a major challenge (Assa et al, 2009;Avitzour et al, 2004;Busby & Witucki-Brown, 2011;Raiter et al, 2008;Sloan, 2011;Turner et al, 2016).…”