Haverkort J J Mark, de Jong Mirjam B, Foco Maurizio, Gui Daniele, Barhoum Masad, Hyams Gila, Bahouth Hany, Halberthal Michael, Leenen Luke P H
Major Incident Hospital, University Medical Center Utrecht, UMC Utrecht, Utrecht, CX, 3584, The Netherlands.
Major Incident Hospital, University Medical Center Utrecht, UMC Utrecht, Utrecht, CX, 3584, The Netherlands.
Injury. 2017 Feb;48(2):322-326. doi: 10.1016/j.injury.2016.11.025. Epub 2016 Nov 23.
Hospitals worldwide are preparing for mass casualty incidents (MCIs). The Major Incident Hospital in the Netherlands was constructed 25 years ago as a dedicated hospital for situations wherein a sudden increase in medical surge capacity is mandated to handle an MCI. Over the years, more initiatives of dedicated MCIs have arisen. Herein, we compared the MCI facilities from three countries considering the reasons for construction and the functionality.
Three dedicated mass casualty hospitals and one hospital with a largely fortified structure were compared. The centres were located in the Netherlands, Italy, and Israel. Between August 2015 and January 2016, structured interviews were conducted with representatives of the hospitals' medical operations. The interviews focussed on general information regarding the need for MCI preparedness and scenarios that require preparation, reasons for construction, hospital missions, and the experiences gained including training.
All dedicated MCI hospitals had a common policy wherein they sought to create normal work circumstances for the medical staff by using similar equipment and resources as in normal hospitals. The MCI hospitals' designs differed substantially, as determined by the threats faced by the country. In Europe, these hospitals are designed as a solution to surge capacity and function as buffer hospitals offering readily available, short term, additional medical capacity to the local health care system. Israel faces constant threat from long-term conflicts; during the 2006 war, several hospitals suffered direct missile impacts. Therefore, Israeli MCI hospitals are designed to be fortified structures offering shelter against both conventional and non-conventional warfare and intended as a long-term solution during siege situations.
Several dedicated MCI hospitals are presently being constructed. During construction, the local circumstances should be taken into account to determine the functionality for both short-term solutions for surge capacity and as fortified structures to withstand under-siege situations.
全球各地的医院都在为大规模伤亡事件（MCI）做准备。荷兰的重大事件医院建于25年前，是一家专门应对突发医疗需求激增以处理大规模伤亡事件的医院。多年来，出现了更多专门针对大规模伤亡事件的举措。在此，我们从建设原因和功能方面比较了三个国家的大规模伤亡事件设施。
比较了三家专门的大规模伤亡医院和一家结构坚固的医院。这些中心分别位于荷兰、意大利和以色列。2015年8月至2016年1月期间，对这些医院医疗运营的代表进行了结构化访谈。访谈重点关注有关大规模伤亡事件准备需求的一般信息、需要准备的场景、建设原因、医院任务以及包括培训在内所获得的经验。
所有专门的大规模伤亡事件医院都有一个共同政策，即通过使用与普通医院类似的设备和资源，为医务人员创造正常的工作环境。大规模伤亡事件医院的设计因各国面临的威胁而有很大差异。在欧洲，这些医院被设计为应对医疗需求激增的解决方案，并作为缓冲医院，为当地医疗系统提供随时可用的短期额外医疗能力。以色列长期面临冲突威胁；在2006年战争期间，几家医院遭受了直接导弹袭击。因此，以色列的大规模伤亡事件医院被设计为坚固的建筑，提供抵御常规和非常规战争的庇护所，并作为围困情况下的长期解决方案。
目前正在建设几家专门的大规模伤亡事件医院。在建设过程中，应考虑当地情况，以确定其作为应对医疗需求激增的短期解决方案以及作为抵御围困情况的坚固建筑的功能。
