Immediate radiological management of disasters

During the past 13 years, 93 civil disasters have been dealt with by the Accident and Emergency (A/E) department of the Royal Victorial Hospital, Belfast. The average number of patients requiring hospital treatment was 30 per incident. Most of these needed some form of radiographic examination. The radiological work-load in one major disaster is described. The need for senior radiological, radiographic and clerical staff at such times is emphasised. The rapid and efficient management of patients is essential to avoid life-threatening delays. Radiological priorities in the immediate phase of trauma are discussed. Chest, spinal and pelvic X-rays usually take precedence. A review of 100 patients with significant intra-abdominal trauma showed a poor correlation with the plain-film appearances. Early resort to more accurate diagnostic methods, such as angiography and computed tomography, is suggested. The need for more active participation by radiologists in the A/E department is stressed.