Hardy Sophie, Fattah Sabina, Wisborg Torben, Raatiniemi Lasse, Staff Trine, Rehn Marius
Emergency Department, St George's Hospital, Tooting, London, UK.
The Norwegian Air Ambulance Foundation, Drøbak, Norway.
BMC Emerg Med. 2018 Jan 24;18(1):4. doi: 10.1186/s12873-018-0153-x.
Major incidents affect us globally, and are occurring with increasing frequency. There is still no evidence-based standard regarding the best medical emergency response to major incidents. Currently, reports on major incidents are non-standardised and variable in quality. This pilot study examines the first systematic reports from a consensus-based, freely accessible database, aiming to identify how descriptive analysis of reports submitted to this database can be used to improve the major incident response.
Majorincidentreporting.net is a website collecting reports on major incidents using a standardised template. Data from these reports were analysed to compare the emergency response to each incident.
Data from eight reports showed that effective triage by experienced individuals and the use of volunteers for transport were notable successes of the major incident response. Inadequate resources, lack of a common triage system, confusion over command and control and failure of communication were reported failures. The following trends were identified: Fires had the slowest times for several aspects of the response and the only three countries to have a single dialling number for all three emergency services had faster response times. Helicopter Emergency Medical services (HEMS) were used for transport and treatment in rural locations and for triage and treatment in urban locations. In two incidents, a major incident was declared before the arrival of the first Emergency Medical Services (EMS) personnel.
This study shows that we can obtain relevant data from major incidents by using systematic reporting. Though the sample size from this pilot study is not large enough to draw any specific conclusions it illustrates the potential for future analyses. Identified lessons could be used to improve the emergency medical response to major incidents.
重大事件在全球范围内影响着我们,且发生频率日益增加。关于应对重大事件的最佳医疗应急措施,目前仍没有基于证据的标准。当前,重大事件报告不规范,质量参差不齐。本试点研究考察了一个基于共识、免费访问的数据库中的首批系统报告,旨在确定如何利用对提交至该数据库的报告进行描述性分析来改进重大事件应对措施。
Majorincidentreporting.net是一个使用标准化模板收集重大事件报告的网站。对这些报告中的数据进行分析,以比较对各事件的应急响应情况。
八份报告的数据显示,经验丰富的人员进行有效分诊以及使用志愿者进行转运是重大事件应对的显著成功之处。报告指出资源不足、缺乏通用分诊系统、指挥控制混乱以及通信故障是应对失败的方面。确定了以下趋势:火灾在应对的几个方面耗时最长,仅有的三个为所有三个紧急服务部门设有单一拨号号码的国家响应时间更快。直升机紧急医疗服务(HEMS)在农村地区用于转运和治疗,在城市地区用于分诊和治疗。在两起事件中,在首批紧急医疗服务(EMS)人员到达之前就宣布了重大事件。
本研究表明,通过系统报告我们可以从重大事件中获取相关数据。尽管本试点研究的样本量不足以得出任何具体结论,但它说明了未来分析的潜力。所确定的经验教训可用于改进对重大事件的紧急医疗应对。