Schenk Ellen, Wijetunge Gamunu, Mann N Clay, Lerner E Brooke, Longthorne Anders, Dawson Drew
Prehosp Emerg Care. 2014 Jul-Sep;18(3):408-16. doi: 10.3109/10903127.2014.882999. Epub 2014 Mar 27.
We sought to characterize and estimate the frequency of mass casualty incidents (MCIs) occurring in the United States during the year 2010, as reported by emergency medical services (EMS) personnel.
Using the 2010 National EMS Database of the National Emergency Medical Services Information System (NEMSIS), containing data from 32 states and territories, we estimated and weighted the frequency of MCIs documented by EMS personnel based on their perception of the event to produce incidence rates of MCIs per 100,000 population and MCIs per 1,000 9-1-1 calls requesting EMS service. We conducted descriptive analyses to characterize the MCIs by geographic location, incident type, and time of day as well as the MCI patients by demographic and health information. We used chi-squared tests to compare response delays and two-tailed t-tests to compare system response times between EMS responses documented as MCIs and those not.
Among the 9,776,094 EMS responses in the 2010 National EMS Database, 14,504 entries were documented as MCI. These entries represented an estimated 9,913 unique MCIs from the National EMS Database: 39.1% occurred in the South Atlantic region of the United States where only 19.1% of the population resides, 60.9% occurred in an urban setting, and 58.4% occurred on a street or highway. There were an estimated 13,677 MCI patients. The prehospital EMS personnel's primary impressions of the patients ranged from electrocution (0.01%) to traumatic injury (40.7%). Of the patients with a primary impression of injury (N = 7,960), motor vehicle traffic crash was the cause of injury for 62.7%. Among the MCI EMS responses, 47.6% documented experiencing a response delay compared to only 12.3% of non-MCI EMS responses.
This study demonstrates the range of health conditions and characteristics of EMS responses that EMS personnel perceive as MCIs, suggests that response delays are common during MCIs, and indicates there may be underreporting of all persons involved in an MCI. The National EMS Database is useful for describing MCIs and may help guide national leadership in strengthening EMS system preparedness for MCIs.
我们试图描述并估算2010年美国紧急医疗服务（EMS）人员报告的大规模伤亡事件（MCI）的发生频率。
利用2010年国家紧急医疗服务信息系统（NEMSIS）的国家EMS数据库，该数据库包含来自32个州和地区的数据，我们根据EMS人员对事件的认知，估算并加权他们记录的MCI频率，以得出每10万人口的MCI发病率以及每1000次拨打911请求EMS服务的MCI发病率。我们进行描述性分析，按地理位置、事件类型和一天中的时间来描述MCI，并按人口统计学和健康信息来描述MCI患者。我们使用卡方检验比较响应延迟，使用双尾t检验比较记录为MCI的EMS响应与非MCI的EMS响应之间的系统响应时间。
在2010年国家EMS数据库的9776094次EMS响应中，有14504条记录为MCI。这些记录代表了国家EMS数据库中估计的9913起独特的MCI：39.1%发生在美国南大西洋地区，而该地区仅居住着19.1%的人口；60.9%发生在城市环境中；58.4%发生在街道或高速公路上。估计有13677名MCI患者。院前EMS人员对患者的初步印象范围从触电（0.01%）到创伤性损伤（40.7%）。在初步印象为受伤的患者中（N = 7960），机动车交通事故是62.7%的受伤原因。在MCI的EMS响应中，47.6%记录有响应延迟，而非MCI的EMS响应中只有12.3%有响应延迟。
本研究展示了EMS人员视为MCI的健康状况范围和EMS响应特征，表明在MCI期间响应延迟很常见，并指出可能存在对所有参与MCI的人员报告不足的情况。国家EMS数据库有助于描述MCI，并可能有助于指导国家领导层加强EMS系统对MCI的准备工作。
