Mohanty Chitta Ranjan, Radhakrishnan Rakesh Vadakkethil, Stephen Shine, Jain Mantu, Shetty Asha P, Issac Alwin, Shaji Ijas Muhammed, Chakola Sebastian
Department of Trauma and Emergency, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
College of Nursing, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Turk J Emerg Med. 2022 Apr 11;22(2):96-103. doi: 10.4103/2452-2473.342806. eCollection 2022 Apr-Jun.
Disasters and mass casualty incidents (MCIs) that cause substantial mortality and morbidity have been increasing worldwide. The emergency department (ED) services manage MCIs by optimizing triage and providing health care with required resources. The present study attempted to describe the epidemiological characteristics and outcomes of MCIs presenting to the ED.
The present retrospective observational study was conducted at the ED of a tertiary care hospital on patients of MCI for 4 years from 2017 to 2021. The data were extracted from the ED disaster records and other paper-based patient records. Information on patient demography, date and time of arrival, mode of transport, method of arrival (direct or referral), type and mechanism of MCI, ED management, and outcome were recorded. Statistical analysis was performed using R, version 4.1.0.
Analysis of 21 MCIs was conducted. Road traffic accidents (RTAs) were the predominant cause of MCIs. The majority of MCI victims, except for those of blast injuries, were men. The victims in medical emergencies were significantly younger than those in other MCI groups ( < 0.001). The majority of patients were brought to ED through ambulance services ( = 120 [47.1%]), followed by private vehicles ( = 112 [44.2%]). Most of the MCI victims ( = 143 [56.2%]) were brought to the ED during evening hours (4 pm-8 pm). The majority of victims belonged to the "Red" triage category ( = 110 [43.3%]). The injury severity score was significantly higher ( = 0.014) in the disaster group than in other trauma MCI groups (20 vs. 17). Autorickshaw occupants were the most common victims of mass casualty RTAs ( = 38 [40%]). Suturing ( = 97 [50%]) and dressing ( = 167 [88%]) were the most common ED procedures required by the victims of trauma MCIs. Of the total, 167 (66%) patients were discharged from the ED, 47 (19%) patients were admitted to wards, 13 (5%) patients were admitted to intensive care units, and 24 (9%) patients got referred to other centers. In addition, two patients died in the ED during treatment, whereas one patient was brought dead.
RTAs dominate the MCIs and are affecting the young producative male population. The present study exhibited the severity of the cases in MCIs and their impact in the health-care setting, therefore signifying the importance of standardized MCI management protocols.
在全球范围内，导致大量伤亡的灾难和大规模伤亡事件（MCI）一直在增加。急诊科通过优化分诊并提供所需资源来管理大规模伤亡事件。本研究试图描述就诊于急诊科的大规模伤亡事件的流行病学特征和结局。
本回顾性观察性研究于一家三级医院的急诊科对2017年至2021年4年间的大规模伤亡事件患者进行。数据从急诊科灾难记录和其他纸质患者记录中提取。记录了患者人口统计学信息、到达日期和时间、交通方式、到达途径（直接或转诊）、大规模伤亡事件的类型和机制、急诊科管理情况及结局。使用R 4.1.0版本进行统计分析。
对21起大规模伤亡事件进行了分析。道路交通事故（RTA）是大规模伤亡事件的主要原因。除爆炸伤患者外，大多数大规模伤亡事件受害者为男性。医疗紧急情况中的受害者明显比其他大规模伤亡事件组的受害者年轻（<0.001）。大多数患者通过救护车服务被送往急诊科（=120例[47.1%]），其次是私家车（=112例[44.2%]）。大多数大规模伤亡事件受害者（=143例[56.2%]）在傍晚时段（下午4点至晚上8点）被送往急诊科。大多数受害者属于“红色”分诊类别（=110例[43.3%]）。灾难组的损伤严重程度评分显著高于其他创伤性大规模伤亡事件组（=0.014）（20分对17分）。人力车乘客是道路交通事故导致大规模伤亡的最常见受害者（=38例[40%]）。缝合（=97例[50%]）和包扎（=167例[88%]）是创伤性大规模伤亡事件受害者最常见的急诊科操作。总共有167例（66%）患者从急诊科出院，47例（19%）患者被收入病房，13例（5%）患者被收入重症监护病房，24例（9%）患者被转诊至其他中心。此外，两名患者在急诊科治疗期间死亡，一名患者送来时已死亡。
道路交通事故在大规模伤亡事件中占主导地位，影响着年轻的有生产能力的男性人群。本研究展示了大规模伤亡事件中病例的严重程度及其在医疗环境中的影响，因此表明标准化大规模伤亡事件管理方案的重要性。
