Department of Emergency Medicine, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, UAE.
World J Emerg Surg. 2022 Jan 11;17(1):2. doi: 10.1186/s13017-022-00405-3.
Two city trains collided in an underground tunnel on 24 May 2021 at the height of COVID-19 pandemic near the Petronas Towers, Kuala Lumpur, Malaysia, immediately after the evening rush hours. We aim to evaluate the management of this mass casualty incident highlighting the lessons learned to be used in preparedness for similar incidents that may occur in other major cities worldwide.
Information regarding incident site and hospital management response were analysed. Data on demography, triaging, injuries and hospital management of patients were collected according to a designed protocol. Challenges, difficulties and their solutions were reported.
The train's emergency response team (ERT) has shut down train movements towards the incident site. Red zone (in the tunnel), yellow zone (the station platform) and green zone (outside the station entrance) were established. The fire and rescue team arrived and assisted the ERT in the red zone. Incident command system was established at the site. Medical base station was established at the yellow zone. Two hundred and fourteen passengers were in the trains. Sixty-four of them were injured. They had a median (range) ISS of 2 (1-43), and all were sent to Hospital Kuala Lumpur (HKL). Six (9.4%) patients were clinically triaged as red (critical), 19 (29.7%) as yellow (semi-critical) and 39 (60.9%) as green (non-critical). HKL's disaster plan was activated. All patients underwent temperature and epidemiology link assessment. Seven (10.9%) patients were admitted to the hospital (3 to the ICU, 3 to the ward and 1 to a private hospital as requested by the patient), while the rest 56 (87.5%) were discharged home. Six (9.4%) needed surgery. The COVID-19 tests were conducted on seven patients (10.9%) and were negative. There were no deaths.
The mass casualty incident was handled properly because of a clear standard operating procedure, smooth coordination between multi-agencies and the hospitals, presence of a 'binary' system for 'COVID-risk' and 'non-COVID-risk' areas, and the modifications of the existing disaster plan. Preparedness for MCIs is essential during pandemics.
2021 年 5 月 24 日，在 COVID-19 大流行期间，马来西亚吉隆坡双子塔附近的地下隧道中，两列城市列车在傍晚高峰后相撞。我们旨在评估这起重大伤亡事件的管理情况，重点介绍从中吸取的教训，以便为全球其他主要城市可能发生的类似事件做好准备。
分析了事件现场和医院管理应对措施的信息。根据设计的方案收集了有关人口统计学、分诊、受伤情况和患者医院管理的数据。报告了挑战、困难及其解决方案。
列车的应急响应小组（ERT）已关闭事故现场附近的列车运行。建立了红区（隧道内）、黄区（站台）和绿区（站外入口）。消防队和救援人员到达并协助ERT 在红区工作。在现场建立了事故指挥系统。在黄区建立了医疗基站。列车上有 214 名乘客。其中 64 人受伤。他们的 ISS 中位数（范围）为 2（1-43），所有人均被送往吉隆坡医院（HKL）。6 名（9.4%）患者被临床分诊为红色（危急），19 名（29.7%）为黄色（半危急），39 名（60.9%）为绿色（非危急）。HKL 的灾难计划已启动。所有患者均接受体温和流行病学链接评估。7 名（10.9%）患者住院（3 名 ICU，3 名病房，1 名按患者要求送往私立医院），其余 56 名（87.5%）出院回家。6 名（9.4%）需要手术。对 7 名（10.9%）患者进行了 COVID-19 检测，结果均为阴性。没有死亡。
由于明确的标准操作程序、多机构和医院之间的顺畅协调、“COVID 风险”和“非 COVID 风险”区域的“二元”系统以及现有灾难计划的修改，这起重大伤亡事件得到了妥善处理。大流行期间必须为重大伤亡事件做好准备。
