Kisilak A, Fischinger A, Kristan A
University Medical Centre Ljubljana, Department of Traumatology, Slovenia.
Ann Burns Fire Disasters. 2021 Sep 30;34(3):277-282.
On August 23rd, 2012 at 7:54 am a hot air balloon crashed in Ljubljana Marshes, leaving 32 injured on site. This case report analyses the biggest multiple casualty incident attended by University Medical Centre Ljubljana in recent history. Analysis of all segments regarding the incident was conducted: mobilisation, arrivals, triage, work-up, identification, public relations and outcome. Issues such as mobilisation, diagnostics, communication, documentation and intensive care unit space are discussed. Twenty-one patients arrived over 63 minutes, 8 of those were immediate resuscitation cases and 10 of those suffered burns. The average Injury Severity Score was 15.7 (ranging 3 to 50), 28.1 for admitted patients. 90% of patients had x-ray, 23% CT and 38% ultrasound diagnostic procedures. 33% of patients required urgent surgery and 60% of admitted cases required intensive care units. A relatives and media territory was established. CT location, loss of communication, inadequate documentation and intensive care bed space were most problematic. At 7-year follow up, we had a roughly 5% hospital fatality rate, 74% of patients gained full recovery and 21% good recovery. Even though the event occurred on a weekday during regular hours, it still exposed many weaknesses. A new radio frequency system for intra-hospital communication has been implemented, the multiple casualty incident protocol has been revised, and regular drills are now performed. Our emergency department is currently undergoing renovation to include CT diagnostics on the same floor. Plans have been made to ease documentation with dictation modules, whereas bed space remains unchanged.
2012年8月23日上午7点54分，一个热气球在卢布尔雅那沼泽地坠毁，造成32人在现场受伤。本病例报告分析了卢布尔雅那大学医学中心近期历史上处理的最大规模多人伤亡事件。对该事件的所有环节进行了分析：动员、抵达、分诊、检查、身份识别、公共关系和结果。讨论了动员、诊断、沟通、记录和重症监护病房空间等问题。21名患者在63分钟内抵达，其中8例为立即复苏病例，10例烧伤。平均损伤严重度评分为15.7（范围为3至50），入院患者为28.1。90%的患者进行了X光检查，23%进行了CT检查，38%进行了超声诊断程序。33%的患者需要紧急手术，60%的入院病例需要重症监护病房。设立了家属和媒体区域。CT位置、通信中断、记录不足和重症监护床位空间是最成问题的。在7年随访中，我们的医院死亡率约为5%，74%的患者完全康复，21%恢复良好。尽管该事件发生在工作日的正常时间，但仍暴露出许多弱点。已实施了一种新的医院内通信射频系统，修订了多人伤亡事件预案，现在定期进行演练。我们的急诊科目前正在进行翻修，以便在同一楼层配备CT诊断设备。已制定计划通过听写模块简化记录，而床位空间保持不变。
