Managing mass casualties

Current Opinion in Anaesthesiology

Volumn 16, Issue 2, 2003, Pages 193-199

  Bar Joseph, Gad ^a,b   Michaelson, Moshe ^a   Halberthal, Michael ^a  

^a TECHNION ISRAEL INSTITUTE OF TECHNOLOGY   (Israel)

^b RAMBAM MEDICAL CENTER   (Israel)

Author keywords

Disaster medicine; Healthcare system preparadeness; Mass casualty; Terrorism

Indexed keywords

DISASTER; HEALTH CARE SYSTEM; HOSPITAL; ISRAEL; MEDICAL LITERATURE; MEDICAL PERSONNEL; PRACTICE GUIDELINE; PRIORITY JOURNAL; PUBLIC HEALTH; REVIEW; TERRORISM;

EID: 0242668383     PISSN: 09527907     EISSN: None     Source Type: Journal    
DOI: 10.1097/00001503-200304000-00013     Document Type: Review

References (45)

1. Wallace WA. It couldn't happen to us. In: Management of disasters and their aftermath, 1st ed, Wallace WA, Rowels JM, Colton CL (editors). London: BMJ Publishing Group; 1994, pp. 1-9.
2. Frykberg ER. Medical management of disasters and mass casualties from terrorist bombings: how can we cope? J Trauma 2002; 53:201-212. An excellent review based on an analysis of past terrorist bombings and relating to patterns of injuries, severity and mortality as well as triage and management issues
3. Stein M, Hirshberg A. Medical consequences of terrorism. The conventional weapon threat. Surg Clin North Am 1999; 79:1537-1552.
4. Hirshberg A, Holcomb JB, Mattox KL. Hospital trauma care in multiple-casualty incidents: a critical view. Ann Emerg Med 2001; 37:647-652. Among others things, this excellent review makes the important distinction between 'mass casualty' and the much more prevalent 'multiple casualty' incident.
5. Holcomb JB, Helling TS, Hirshberg A. Military, civilian, and rural application of the damage control philosophy. Mil Med 2001; 166:490-493. An excellent presentation of the 'damage control philosophy' and its critical application in MCSs.
6. Levi L, Michaelson M, Admi H. et al. National strategy for mass casualty situations and its effects on the hospital. Prehosp Disaster Med 2002; 17:12-16. A thorough, yet practical review of the 'Israeli doctrine' towards MCSs, covering preparedness and management issues at the national and hospital levels.
7. Delaney JS, Drummond R. Mass casualties and triage at a sporting event. Br J Sports Med 2002; 36:85-88. This study discusses triage issues related more specifically to mass casualty sporting events, such as crush injuries, lightning and blast injuries.
8. Marghella PD. Medical planning considerations in consequence management. Front Health Serv Manage 2002; 19:15-23. How can military planners help the civilian healthcare system to continue functioning when the 'unthinkable' occurs?
9. Treat KN, Williams JM, Furbee PM, et al. Hospital preparedness for weapons of mass destruction incidents: an initial assessment. Ann Emerg Med 2001; 38:562-565. An assessment of 40 hospitals found major deficiencies in their preparedness for weapons of mass destruction incidents.
10. Risavi BL, Salen PN, Heller MB, Arcona S. A two-hour intervention using START improves pre-hospital triage of mass casualty incidents. Prehosp Emerg Care 2001; 5:197-199. A 2-h educational intervention on MCS triage resulted in a significant improvement in both the immediate and one-month ability to triage patients appropriately in MCSs.
11. Moses G, Magee JH, Bauer JJ, Leitch R. Military medical modeling and simulation in the 21st century. Stud Health Technol Inform 2001; 81:322-328. This article raises the important issue of the training of military medical personnel in battlefield trauma care skills during peacetime. Emerging medical simulation techniques may provide a solution.
12. Drenkard K, Rigotti G, Hanfling D, et al. Healthcare system disaster preparedness, part 1: readiness planning. J Nurs Admin 2002; 32:461-469. This and the next article (Ref. 13) describes the role of nursing executives in preparedness, leadership, implementation and the assessment of disaster planning.
13. Fahlgren TL, Drenkard KN. Healthcare system disaster preparedness, part 2: nursing executive role in leadership. J Nurs Admin 2002; 32:531-537.
14. Eldad A. National preparedness for biological mass casualty event: between the devil and the deep blue sea. Harefuah 2002; 141 Spec No 21:123. The formulation of dilemmas associated with preparations for biological warfare: wide scale vaccination and the stocking of antibiotics versus heightened public anxiety and a strained primary medical system.
15. Burkle FM Jr. Mass casualty management of a large-scale bioterrorist event: an epidemiological approach that shapes triage decisions. Emerg Med Clin North Am 2002; 20:409-436. An excellent review of the major issues related to bioterrorism, including epidemiological analysis and the ethics of triage.
16. Evans RG, Crutcher JM, Shadel B, et al. Terrorism from a public health perspective. Am J Med Sci 2002; 323:291-298. A comprehensive review of the public health system preparedness for the potential massive terrorist use of biological agents.
17. Domres B, Koch M, Manger A, Becker HD. Ethics and triage. Prehosp Disaster Med 2001; 16:53-58.
18. Pesik N, Keim ME, Iserson KV. Terrorism and the ethics of emergency medical care. Ann Emerg Med 2001; 37:642-646. Threats of terrorism and the use of weapons of mass destruction raise profound ethical dilemmas surrounding triage and the allocation of limited resources. This excellent review calls for the development of societal forethought to achieve the maximal potential benefit.
19. Priel IE, Dolev E. Ethical considerations in mass casualty situation [in Hebrew]. Harefuah 2001; 140:574-577.
20. Humphrey JC. Casualty management: scud missile attack, Dhahran, Saudi Arabia. Mil Med 1999; 164:322-326.
21. Alexander D. The health effects of earthquakes in the mid-1990s. Disasters 1996; 20:231-247.
22. Adler J. Mass casualty management in earthquakes and air crashes. Israel Med Assoc J 2002; 4:373-374.
23. Peleg K, Reuveni H, Stein M. Earthquake disasters - lessons to be learned. Israel Med Assoc J 2002; 4:361-365. A review of the clinical and organizational aspects of disasters caused by earthquakes. The authors point out very practical, somewhat unexpected and therefore unprepared-for problems.
24. Chen WK, Cheng YC, Ng KC, et al. Were there enough physicians in an emergency department in the affected area after a major earthquake? An analysis of the Taiwan Chi-Chi earthquake in 1999. Ann Emerg Med 2001; 38:556-561. An analysis of patient load versus physician availability in a large urban hospital after a major earthquake. Conclusion: physicians did not show up!
25. Liang NJ, Shih YT, Shih FY, et al. Disaster epidemiology and medical response in the Chi-Chi earthquake in Taiwan. Ann Emerg Med 2001; 38:549-555. An epidemiological study of a major earthquake identified patient populations that require special considerations. This analysis is helpful in establishing strategies for faster, more efficient medical care.
26. Lee WH, Chiu TF, Ng CJ, Chen JC. Emergency medical preparedness and response to a Singapore airliner crash. Acad Emerg Med 2002; 9:194-198. A detailed account of an MCS resulting from an airliner crash boldly depicts major flaws in the design and execution of a newly devised MCS plan. Important reading!
27. Branas CC, Sing RF, Perron AD. A case series analysis of mass casualty incidents. Prehosp Emerg Care 2000; 4:299-304.
28. Nwadiaro HC, Yiltok SJ, Kidmas AT. Immediate mass casualty management in Jos University Teaching Hospital: a successful trial of Jos protocol. West Afr J Med 2000; 19:230-234.
29. Woltering HP, Schneider BM. Great damage event of the Dutch Enschede on May 13th, 2000. Unfallchirurg 2002; 105:961-967. An account of a major industrial explosion resulting in over 900 casualties, reporting mainly organizational and logistical issues. Of interest: close cooperation between Dutch and German rescue forces.
30. Schwerin MJ, Kennedy K, Wardlaw M. Counseling support within the Navy Mass Casualty Assistance Team post-September 11. Mil Med 2002; 167:76-78. A report of the objectives, implementation and impact of a US Navy counseling support cell during the September 11 events.
31. Hoge CW, Orman DT, Robichaux RJ, et al. Operation Solace: overview of the mental health intervention following the September 11, 2001 Pentagon attack. Mil Med 2002; 167:44-47. A description of the goals, rationale and methods used to develop a pro-active intervention plan to minimize adverse behavioral health effects after the September 11 attack on the Pentagon.
32. Gelling JA. Overview of command and control issues: setting the stage. Mil Med 2002; 167:3-5. Disasters tend to produce relatively standard and predictable consequences. This important review assesses how this information helped prepare and oversee medical responses to the September 11 attack on the Pentagon.
33. Brazle EM. MCI (mass casualty incident) success story. How an EMS system improved its MCI-response strategy through planning & practice. J Emerg Med Serv 2001; 26:58-71.
34. Cook L. The World Trade Center attack. The paramedic response: an insider's view. Crit Care 2001; 5:301-303.
35. Murray V, Goodfellow F. Mass casualty chemical incidents - towards guidance for public health management. Public Health 2002; 116:2-14. A review of worldwide mass casualty chemical incidents. A major finding: most incidents were unprecedented and therefore health services had access to very little information during the first hours.
36. The International Policy Institute for Counter-Terrorism. 2001 (Accessed November 30, 2002). Internet Communication: www.ict.org.il. An academic website with an extensive, well-organized database regarding worldwide terror activities.
37. Biancolini CA, Del Bosco CG, Jorge MA. Argentine Jewish community institution bomb explosion. J Trauma 1999; 47:728-732.
38. Caro D. Major disasters. Lancet 1974; 2:1309-1310.
39. Rignault DP. Recent progress in surgery for the victims of disaster, terrorism, and war. World J Surg 1992; 16:885-887.
40. Champion HR, Sacco WJ, Gainer PS, Patow SM. The effect of medical direction on trauma triage. J Trauma 1988; 28:235-239.
41. Cook CH, Muscarella P, Praba AC, et al. Reducing overtriage without compromising outcomes in trauma patients. Arch Surg 2001; 136:752-756. A significant reduction in overtriage and improved resource allocation by changing triage criteria, using more physiological and anatomical indicators rather than mechanism of injury criteria.
42. Brismar B, Bergenwald L. The terrorist bomb explosion in Bologna, Italy, 1980: an analysis of the effects and injuries sustained. J Trauma 1982; 22:216-220.
43. Sarkisian AE, Khondkarian RA, Amirbekian NM, et al. Sonographic screening of mass casualties for abdominal and renal injuries following the 1988 Armenian earthquake. J Trauma 1991; 31:247-250.
44. Bouman JH, Schouwerwou RJ, Van der Eijk KJ, et al. Computerization of patient tracking and tracing during mass casualty incidents. Eur J Emerg Med 2000; 7:211-216.
45. Nocera A. Disasters, the media and doctors. Med J Aust 2000; 172:137-139.