Academic Department of Vascular Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Emerg Med J. 2019 Dec;36(12):762-764. doi: 10.1136/emermed-2019-208436. Epub 2019 Aug 12.
A major incident is any emergency that requires special arrangements by the emergency services and generally involves a large number of people. Recent such events in England have included the Manchester Arena bombing and the Grenfell Tower disaster. Hospitals are required by law to keep a major incident plan (MIP) outlining the response to such an event. In a survey conducted in 2006 we found a substantial knowledge gap among key individuals that would be expected to respond to the enactment of an MIP. We set out to repeat this survey study and assess any improvement since our original report.
We identified NHS trusts in England that received more than 30 000 patients through the emergency department in the fourth quarter of the 2016/2017 period. We contacted the on-call anaesthetic, emergency, general surgery, and trauma and orthopaedic registrar at each location and asked each individual to answer a short verbal survey assessing their confidence in using their hospital's MIP.
Of those eligible for the study, 62% were able to be contacted and consented to the study. In total 50% of respondents had read all or part of their hospital's MIP, 46.8% were confident that they knew where their plan was stored, and 36% knew the role they would play if a plan came into effect. These results show less confidence among middle-grade doctors compared with 2006.
Confidence in using MIPs among specialty registrars in England is still low. In light of this, we make a number of recommendations designed to improve the education of hospital doctors in reacting to major incidents.
重大事件是指需要紧急服务部门特别安排的任何紧急情况，通常涉及大量人员。最近在英格兰发生的此类事件包括曼彻斯特竞技场爆炸事件和格伦费尔塔灾难。根据法律规定，医院必须制定重大事件计划（MIP），概述对这类事件的应对措施。在 2006 年进行的一项调查中，我们发现，在预计将对 MIP 进行响应的关键人员中，存在相当大的知识差距。我们着手重复这项调查研究，并评估自我们最初报告以来的任何改进。
我们确定了英格兰的 NHS 信托基金，这些信托基金在 2016/2017 年第四季度通过急诊部门接收了超过 30000 名患者。我们联系了每个地点的值班麻醉师、急诊医生、普通外科医生和创伤骨科医生住院医师，并要求每位个人回答一个简短的口头调查，评估他们对使用医院 MIP 的信心。
在符合研究条件的人员中，有 62%的人可以联系并同意参与研究。共有 50%的受访者阅读了全部或部分医院的 MIP，46.8%的人有信心知道他们的计划存储在哪里，36%的人知道如果计划生效，他们将扮演什么角色。这些结果表明，中级医生的信心低于 2006 年。
英格兰专科住院医师对使用 MIP 的信心仍然较低。有鉴于此，我们提出了一些建议，旨在提高医院医生应对重大事件的教育水平。
