Hospital trauma care in multiple-casualty incidents: A critical view

During a multiple-casualty incident, a large casualty caseload adversely affects the quality of trauma care given to individual patients. From a trauma care perspective, the goal of the hospital emergency plan is to provide severely injured patients with a level of care that approximates the care gi...

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Bibliographic Details
Published in:Annals of emergency medicine 2001-06, Vol.37 (6), p.647-652
Main Authors: Hirshberg, Asher, Holcomb, John B., Mattox, Kenneth L.
Format: Article
Language:English
Subjects:
Algorithms
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Computer Simulation
Decision Trees
Disaster Planning - organization & administration
Emergency and intensive care: injuries, diseases due to physical agents. Diving. Drowning. Disaster medicine
Emergency Service, Hospital - organization & administration
Games, Experimental
Health Care Rationing - organization & administration
Hospital Bed Capacity
Humans
Inservice Training - organization & administration
Intensive care medicine
Leadership
Medical sciences
Multiple Trauma - therapy
Physician's Role
Quality of Health Care
Traumatology - education
Traumatology - organization & administration
Triage - organization & administration
Workload
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Summary:During a multiple-casualty incident, a large casualty caseload adversely affects the quality of trauma care given to individual patients. From a trauma care perspective, the goal of the hospital emergency plan is to provide severely injured patients with a level of care that approximates the care given to similar patients under normal conditions. Therefore, the realistic admitting capacity of the hospital is determined primarily by the number of trauma teams that the hospital can recruit. Effective triage of these casualties is often not straightforward, with high overtriage rates. Simplified triage algorithms may be a practical alternative to more elaborate schemes. The concept of minimal acceptable care is the key to a staged management approach during a mass-casualty incident. Discrete-event computer simulation and war game tabletop exercises for key personnel are 2 new modalities that are supplementing the traditional mock disaster drill as effective planning and training tools. [Hirshberg A, Holcomb JB, Mattox KL. Hospital trauma care in multiple-casualty incidents: a critical review. Ann Emerg Med. June 2001;37:647-652.]
ISSN:0196-0644
1097-6760
DOI:10.1067/mem.2001.115650