Thames Valley Air Ambulance, Stokenchurch House, Oxford Rd, Stokenchurch, High Wycombe, HP14 3SX, UK.
Scand J Trauma Resusc Emerg Med. 2021 Jan 27;29(1):20. doi: 10.1186/s13049-021-00838-w.
The risk of COVID-19 transmission to healthcare professionals is likely to continue for the foreseeable future. The wearing of personal protective equipment (PPE) presents a number of potential challenges to responders that may impact upon the management of patients in a multi-casualty incident. This report describes a multi-agency multi-casualty incident. It identifies learning points specifically related to the challenges of conducting a conventional multi-casualty incident in COVID-19 PPE.
The multi casualty incident in Reading, UK on the 20 June 2020 involved six stab injury victims and was attended by four pre-hospital critical care teams. This was the first conventional multi-casualty incident that pre-hospital critical care teams had attended during the COVID-19 era and it was conducted in COVID-19 PPE (1). The scene was an urban park where three patients were confirmed to be in Traumatic Cardiac Arrest (TCA) from stab wounds and another three patients had also suffered stab injuries. By the time the incident had concluded three patients were pronounced dead at the scene. Two patients were transported to the local trauma unit and one patient was transported to the regional Major Trauma Centre depending on the severity of their injuries.
We conducted a semi structured telephone interview with the critical care clinicians who were involved in the incident. The interviews focused specifically on the challenges of responding whilst wearing COVID-19 PPE, rather than the wider challenges of responding to such an incident. The key learning points identified were: Improving the identifiability of clinicians in level 3 PPE wearing identification tabards using visible labelling on PPE suits Improving communication by radio using a belt to carry the radio using an earpiece and push to talk system. Training in conducting multi casualty incidents in level 3 PPE.
在可预见的未来，COVID-19 向医护人员传播的风险可能会持续存在。佩戴个人防护设备（PPE）给急救人员带来了许多潜在挑战，这可能会影响到多人伤亡事件中患者的管理。本报告描述了一起多机构多人伤亡事件。它特别确定了与在 COVID-19 PPE 中进行常规多人伤亡事件相关的挑战。
2020 年 6 月 20 日，英国雷丁市发生的多人伤亡事件涉及 6 名刺伤伤者，有 4 个院前重症监护小组参与。这是院前重症监护小组在 COVID-19 期间首次参加常规多人伤亡事件，是在 COVID-19 PPE 下进行的（1）。现场是一个城市公园，有 3 名患者被确认为因刺伤导致创伤性心脏骤停（TCA），另外 3 名患者也遭受了刺伤。当事件结束时，有 3 名患者在现场被宣布死亡。根据他们的伤势严重程度，2 名患者被送往当地创伤单位，1 名患者被送往区域重大创伤中心。
我们对参与该事件的重症监护临床医生进行了半结构化电话访谈。访谈的重点特别放在穿着 COVID-19 PPE 时应对挑战，而不是应对此类事件的更广泛挑战。确定的主要学习要点是：在穿着 3 级 PPE 时，通过在 PPE 套装上使用可见标签来提高医护人员的可识别性，通过佩戴耳机和使用按键通话系统的无线电改善沟通，在穿着 3 级 PPE 进行多人伤亡事件训练。
