Crisis-Responsive Imaging: Lessons from a High-Volume Mass Casualty Incident.

Area of Science:

• Radiology
• Emergency Medicine
• Health Care Management

Background:

• Mass casualty incidents (MCIs) severely strain healthcare systems, necessitating rapid adaptation of radiology department workflows and resources.
• Effective imaging is critical for timely clinical decisions in high-stakes MCI scenarios.
• Real-time learning and response improvement are essential for radiology teams during mass casualty events.

Purpose of the Study:

• To evaluate the radiology department's response and operational impact during an MCI following the October 7, 2023 attack in southern Israel.
• To analyze workflow adaptations and identify key factors in managing imaging services during a mass casualty incident.
• To provide recommendations for enhancing radiology preparedness for future crises.

Main Methods:

• Retrospective analysis of imaging use and workflow at Soroka University Medical Center, a level 1 trauma center.
• Inclusion of data from 673 injured patients within the first 24 hours, analyzing demographics, injuries, imaging modalities (radiography, CT), turnaround times, and protocol adaptations.
• Comparison of crisis data with a 12-month baseline to assess operational changes.

Main Results:

• Of 461 patients imaged, 93.5% were related to the MCI. The median CT turnaround time decreased from 54 to 28 minutes (P = .03).
• Radiography turnaround time increased modestly from 43 to 49 minutes (P < .001).
• Enhanced staffing (fourfold increase) and flexible resource reallocation, including repurposing CT scanners, were vital for managing patient surge and optimizing workflows.

Conclusions:

• Dynamic in-hospital triage protocols, rapid staff mobilization, and versatile imaging resource management are critical for effective MCI response.
• These strategies are essential components for improving patient outcomes during future high-casualty incidents.
• The study highlights the importance of adaptive strategies in radiology preparedness for mass casualty events.