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Published on: November 20, 2016
In-hospital resource utilization during multiple casualty incidents
Sharon Einav1, Limor Aharonson-Daniel, Charles Weissman
1Intensive Care Unit, Shaare Zedek Medical Center, Jerusalem, Israel. bromi@md2.huji.ac.il
Annals of Surgery
|March 23, 2006
Summary
Hospital preparation for terror attacks is crucial. Immediate demand for surgical specialists and ICU beds occurs during multiple casualty incidents (MCIs), requiring robust staffing plans.
Area of Science:
- Trauma Surgery
- Emergency Medicine
- Hospital Preparedness
Background:
- Terror-related multiple casualty incidents (MCIs), primarily bombings, present unique challenges due to their unpredictable nature.
- Effective in-hospital preparation is complicated by the sporadic occurrence of these events.
Purpose of the Study:
- To establish guidelines for hospital organization during terror-related multiple casualty incidents (MCIs).
- To leverage experiences from six Level I trauma centers to inform these guidelines.
Main Methods:
- Data collected from Israel National Trauma registry for Level I Trauma centers during and after MCIs.
- Inclusion criteria: patients admitted or deceased following suicide bombings (Oct 2000–June 2003) meeting MCI criteria.
- Analysis focused on patient arrival times, diagnostic procedures, surgical interventions, and intensive care unit (ICU) admissions.
Main Results:
- 325 casualties from 32 events analyzed; 34% had Injury Severity Score >16.
- Rapid patient arrival: 33% within 10 minutes, 65% within 30 minutes.
- High surgical demand: 60% operated, 36% directly from ED to OR; peak multidisciplinary surgery within 1.5 hours, with later demand for orthopedic/plastic surgery. 33% admitted to ICU, often directly from ED.
Conclusions:
- Significant overlap in staffing needs for Emergency Department (ED), Operating Room (OR), and Intensive Care Unit (ICU).
- Immediate demand for anesthesiologists and general, thoracic, and vascular surgeons.
- Sustained demand for orthopedic, plastic surgery, and anesthesiology services exceeds 24 hours.
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