Castro Delgado Rafael, Naves Gómez Cecilia, Cuartas Álvarez Tatiana, Arcos González Pedro
Unit for Research in Emergency and Disaster, Department of Medicine, University of Oviedo, Campus de El Cristo, Oviedo, 33006, Spain.
SAMU-Asturias, Oviedo, Spain.
Scand J Trauma Resusc Emerg Med. 2016 Feb 24;24:18. doi: 10.1186/s13049-016-0211-x.
Mass Casualty Incidents (MCI) have been rarely studied from epidemiological approaches. The objective of this study is to establish the epidemiological profile of MCI in the autonomous region of the Principality of Asturias (Spain) and analyse ambulance deployment and severity of patients.
This is a population-based prospective study run in 2014. Inclusion criteria for MCI is "every incident with four or more people affected that requires ambulance mobilisation".
Thirty-nine MCI have been identified in Asturias in 2014. Thirty-one (79%) were road traffic accidents, three (7.5%) fires and five (12.8%) other types. Twenty-one incidents (56.7%) had four patients, and only three of them (8%) had seven or more patients. An average of 2.41 ambulances per incident were deployed (standard error = 0.18). Most of the patients per incident were minor injured patients (mean = 4; standard error = 0.2), and 0,26 were severe patients (standard error = 0.08). There was a positive significant correlation (p < 0.01) between the total number of patients and the total number of ambulances deployed and between the total number of patients and Advanced Life Support (ALS) ambulances deployed (p < 0.001). The total number of non-ALS ambulances was not related with the total number of patients.
Population based research in MCI is essential to define MCI profile. Quantitative definition of MCI, adapted to resources, avoid selection bias and present a more accurate profile of MCI. As espected, road traffic accidents are the most frequent MCI in our region. This aspect is essential to plan training and response to MCI. Analysis of total response to MCI shows that for almost an hour, we should plan extra resources for daily emergencies. This data is an important issue to bear in mind when planning MCI response. The fact that most patients are classified as minor injured and more advanced life support units than needed are deployed shows that analysis of resources deployment and patient severity helps us to better plan future MCI response.
Road traffic accidents with minor injured patients are the most frequent MCI in our region. More advanced life support units than needed have been initially deployed, which might compromise response to daily emergencies during an MCI.
大规模伤亡事件（MCI）很少从流行病学角度进行研究。本研究的目的是建立西班牙阿斯图里亚斯公国自治区MCI的流行病学概况，并分析救护车的调配情况和患者的严重程度。
这是一项于2014年开展的基于人群的前瞻性研究。MCI的纳入标准是“每起造成四人或更多人受影响且需要调动救护车的事件”。
2014年在阿斯图里亚斯共识别出39起MCI。其中31起（79%）为道路交通事故，3起（7.5%）为火灾，5起（12.8%）为其他类型。21起事件（56.7%）有4名患者，其中只有3起（8%）有7名或更多患者。每起事件平均调配2.41辆救护车（标准误差=0.18）。每起事件中的大多数患者为轻伤患者（平均=4；标准误差=0.2），0.26名是重伤患者（标准误差=0.08）。患者总数与调配的救护车总数之间以及患者总数与调配的高级生命支持（ALS）救护车总数之间存在显著正相关（p<0.01）。非ALS救护车的总数与患者总数无关。
基于人群的MCI研究对于定义MCI概况至关重要。根据资源情况对MCI进行定量定义，可避免选择偏倚并呈现更准确的MCI概况。正如预期的那样，道路交通事故是我们地区最常见的MCI。这一点对于规划MCI的培训和应对至关重要。对MCI总体应对情况的分析表明，在近一个小时的时间里，我们应为日常紧急情况规划额外资源。在规划MCI应对措施时，这一数据是一个需要牢记的重要问题。大多数患者被归类为轻伤且调配的高级生命支持单位多于所需数量，这一事实表明对资源调配和患者严重程度的分析有助于我们更好地规划未来的MCI应对措施。
轻伤患者的道路交通事故是我们地区最常见的MCI。最初调配的高级生命支持单位多于所需数量，这可能会影响在MCI期间对日常紧急情况的应对。
