Pitfalls to avoid in the medical management of mass casualty incidents following terrorist bombings: the hospital perspective

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• 作者：I. Ashkenazi (1)
  F. Tur茅gano-Fuentes (2)
  S. Einav (3)
  B. Kessel (4)
  R. Alfici (1)
  O. Olsha (5)
  
• 关键词：Mass casualty incidents ; Terror bombings
• 刊名：European Journal of Trauma and Emergency Surgery
• 出版年：2014
• 出版时间：August 2014
• 年：2014
• 卷：40
• 期：4
• 页码：445-450
• 全文大小：168 KB
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• 作者单位：I. Ashkenazi (1)
  F. Tur茅gano-Fuentes (2)
  S. Einav (3)
  B. Kessel (4)
  R. Alfici (1)
  O. Olsha (5)
  
  1. Surgery Department, Hillel Yaffe Medical Center, P.O.Box 169, 38100, Hadera, Israel
  2. Emergency Surgery Department, Gregorio Mara帽on Medical Center, Madrid, Spain
  3. Intensive Care Unit, Shaare Zedek Medical Center, Jerusalem, Israel
  4. Trauma Unit, Hillel Yaffe Medical Center, Hadera, Israel
  5. Department of Surgery, Shaare Zedek Medical Center, Jerusalem, Israel
  
• ISSN：1863-9941

文摘

Background The unique patterns of injury following explosions together with the involvement of numerous physicians, most of whom are not experienced in trauma, may create problems in the medical management of mass casualty incidents. Methods Four hundred patient files admitted in 19 mass casualty events following bombing incidents were reviewed and possible areas which could impact survival were defined. Results Forty-nine (9.3 %) patients had an Injury Severity Score 鈮?6. Of 205 patients in whom triage decisions were available, 5 of 25 severely injured patients were undertriaged by the triage officers at the door of the hospital. Following primary evaluation inside the emergency department critical injuries in two patients were missed due to distracting, less serious injuries. Of 68 (16.1聽%) patients who were operated, 28 were in need of either immediate, urgent or high-priority operations. Except for neurosurgical cases which needed to be transferred to other hospitals, there was no delay in surgery. One patient underwent negative laparotomy. There were 15 in-hospital deaths, 6 of which were deemed as either anticipated or unanticipated mortality with possibility for improvement. Conclusion Medical management should be evaluated following MCIs as this may illustrate possible problems which many need to be addressed in contingency planning.