Swedish emergency hospital surgical surge capacity to mass casualty incidents

Abstract

Background: In Sweden the surgical surge capacity for mass casualty incidents (MCI) is managed by county councils within their dedicated budget. It is unclear whether healthcare budget constraints have affected the regional MCI preparedness. This study was designed to investigate the current surgical MCI preparedness at Swedish emergency hospitals. Methods: Surveys were distributed in 2015 to department heads of intensive care units (ICU) and surgery at 54 Swedish emergency hospitals. The survey contained quantitative measures as the number of (1) surgical trauma teams in hospital and available after activating the disaster plan, (2) surgical theatres suitable for multi-trauma care, and (3) surgical ICU beds. The survey was also distributed to the Armed Forces Centre for Defence Medicine. Results: 53 hospitals responded to the survey (98%). Included were 10 university hospitals (19%), 42 county hospitals (79%), and 1 private hospital (2%). Within 8 h the surgical capacity could be increased from 105 to 399 surgical teams, while 433 surgical theatres and 480 ICU beds were made available. The surgical surge capacity differed between university hospitals and county hospitals, and regional differences were identified regarding the availability of surgical theatres and ICU beds. Conclusions: The MCI preparedness of Swedish emergency care hospitals needs further attention. To improve Swedish surgical MCI preparedness a national strategy for trauma care in disaster management is necessary.

Risk factors for COVID-19-related death, hospitalization and intensive care: A population-wide study of all inhabitants in Stockholm

“…In a study from 2012, Sweden had 5.8 ICU beds/100 000 inhabitants as compared with the EU average of 11.5 (19). Notably, the Stockholm ICU bed density is even lower at 4.2/100 000 (20).…”

Regional Flexible Surge Capacity—A Flexible Response System

“…A recent publication from Sweden indicated a high willingness among civilians to participate in the management of MIDs [32]. Civilian defense conscription can be activated by the government without declaring heightened alert and can potentially contribute (at least in part) to staffing ACFs [33][34][35][36].…”

“…The content of the proposed material cache should be adapted to the size and assigned task. Stockpiling used to be a convenient method to secure the provision of essential goods, but the contemporary strategy is generally built on "just-in-time delivery" and access to international markets and imports [34,35]. Altogether, the purveyance of healthcare goods and materials to countries such as Sweden has become more vulnerable than previously recognized [34][35][36][37].…”

“…Stockpiling used to be a convenient method to secure the provision of essential goods, but the contemporary strategy is generally built on "just-in-time delivery" and access to international markets and imports [34,35]. Altogether, the purveyance of healthcare goods and materials to countries such as Sweden has become more vulnerable than previously recognized [34][35][36][37]. To compensate for resource scarcity, many county administrative boards have developed and should develop creative solutions for supplemental reinforcement, including networking with other committees for shared resource pools and infrastructure for improved response.…”

Intervention strategies against COVID-19 and their estimated impact on Swedish healthcare capacity

“…[50][51][52] For Sweden, this is in particular worrisome considering the relatively low availability of beds prior to the pandemic compared to other European countries 22 24 and recent reports challenging Swedish disaster preparedness. 53 We predict that aggressive suppressive measures can substantially reduce this healthcare capacity deficit but only if implemented in a timely manner. Whereas the predictive value of our model should become much clearer over the next two weeks, suppressive measures should be taken more immediately to have a substantial effect, especially for the Stockholm region.…”