Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-22T20:35:16.315Z Has data issue: false hasContentIssue false
  • English
  • Français

Developing a Hospital Disaster Preparedness Plan for Mass Casualty Incidents: Lessons Learned From the Downtown Beirut Bombing

Published online by Cambridge University Press:  20 September 2017

Mazen El Sayed Open the ORCID record for Mazen El Sayed [Opens in a new window] ,
Ali F. Chami  and
Eveline Hitti
Mazen El Sayed
Affiliation:
Associate Professor of Emergency Medicine, American University of Beirut Medical Center, Beirut
Ali F. Chami
Affiliation:
Research Assistant, The Emergency Department, American University of Beirut Medical Center, Beirut
Eveline Hitti
Affiliation:
Chairperson & Associate Professor of Emergency Medicine, American University of Beirut Medical Center, Beirut
Get access Rights & Permissions [Opens in a new window]

Abstract

Mass casualty incidents (MCIs) are becoming more frequent worldwide, especially in the Middle East where violence in Syria has spilled over to many neighboring countries. Lebanon lacks a coordinated prehospital response system to deal with MCIs; therefore, hospital preparedness plans are essential to deal with the surge of casualties. This report describes our experience in dealing with an MCI involving a car bomb in an urban area of downtown Beirut, Lebanon. It uses general response principles to propose a simplified response model for hospitals to use during MCIs. A summary of the debriefings following the event was developed and an analysis was performed with the aim of modifying our hospital’s existing disaster preparedness plan. Casualties’ arrival to our emergency department (ED), the performance of our hospital staff during the event, communication, and the coordination of resources, in addition to the response of the different departments, were examined. In dealing with MCIs, hospital plans should focus on triage area, patient registration and tracking, communication, resource coordination, essential staff functions, as well as on security issues and crowd control. Hospitals in other countries that lack a coordinated prehospital disaster response system can use the principles described here to improve their hospital’s resilience and response to MCIs. (Disaster Med Public Health Preparedness. 2018; 12: 379–385)

Keywords

mass casualty eventdisaster preparednessdisaster responsehospital
Type
Concepts in Disaster Medicine
Information
Disaster Medicine and Public Health Preparedness , Volume 12 , Issue 3 , June 2018 , pp. 379 - 385
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Edwards, DS, McMenemy, L. 40 years of terrorist bombings – a meta-analysis of the casualty and injury profile. Injury. 2016;47(3):646-652.Google Scholar
2. El Sayed, M, Bayram, JD. Prehospital emergency medical services in Lebanon: overview and prospects. Prehosp Disaster Med. 2013;28(2):163-165.Google Scholar
3. El Sayed, M. Emergency response to mass casualty incidents in Lebanon. Disaster Med Public Health Prep. 2013;7:433-438. http://dx.doi.org/10.1017/dmp.2013.48.Google Scholar
4. Garner, A, Lee, A, Harrison, K, Schultz, CH. Comparative analysis of multiple-casualty incident triage algorithms. Ann Emerg Med. 2001;38(5):541-548.Google Scholar
5. Benson, M, Koenig, KL, Schultz, CH. Disaster triage: START, then SAVE – a new method of dynamic triage for victims of a catastrophic earthquake. Prehosp Disaster Med. 1996;11(2):117-124.Google Scholar
6. de Boer, J. Order in chaos: modeling medical management in disasters. Eur J Emerg Med. 1999;6(2):141-148.10.1097/00063110-199906000-00011Google Scholar
7. Kirschenbaum, L, Keene, A, O’Neill, P, et al. The experience at St Vincent’s Hospital, Manhattan, on September 11, 2001: preparedness, response and lessons learned. Crit Care Med. 2005;33(1):48-52.Google Scholar
8. American College of Emergency Physicians. The role of the emergency physician in mass casualties: disaster management. JACEP. 1976;5:901-902.Google Scholar
9. Eitel, DR, Travers, DA, Rosenau, AM, Gilboy, N, Wuerz, RC. The Emergency Severity Index triage algorithm version 2 is reliable and valid. Acad Emerg Med. 2003;10(10):1070-1080.Google Scholar
10. Garner, A, Lee, A, Harrison, K, et al. Comparative analysis of multiple-casualty incident triage algorithms. Ann Emerg Med. 2001;38:541-548.Google Scholar
11. Gavagan, TF, Herminia, P, Sirbaugh, P, et al. Hurricane Katrina: medical response at the Houston Astrodome/Reliant Center Complex. South Med J. 2006;99(9):933-939.10.1097/00007611-200609000-00012Google Scholar
12. Okumura, T, Suzuki, K, Fukuda, A, et al. The Tokyo subway sarin attack: disaster management, Part 1: community emergency response. Acad Emerg Med. 1998;5(6):613-617.Google Scholar
13. Koenig, KL, Schultz, C. Disaster Medicine: Comprehensive Principles and Practices. New York: Cambridge University Press; 2010:40-41.Google Scholar
14. Caro, D, Irving, M. The old Bailey bomb explosion. Lancet. 1973;1:1433-1435.Google Scholar
15. Brown, MG, Marshall, SG. The Enniskillen bomb: a disaster plan. BMJ. 1988;297:1113-1116.Google Scholar
16. Halpern, P, Tsai, M-C, Arnold, J, Stok, E, Ersoy, G. Mass-casualty, terrorist bombings: Implications for emergency department and hospital emergency response (Part II). Prehosp Disaster Med. 2003;18(3):235-241.Google Scholar
17. Halpern, P, Goldberg, SA, Keng, JG, Koenig, KL. Principles of emergency department facility design for optimal management of mass-casualty incidents. Prehosp Disaster Med. 2012;27(2):204-212.Google Scholar
18 Landman, A, Teich, J, Goralnick, E. The Boston Marathon bombings mass casualty incident: one emergency department’s information systems challenges and opportunities. Ann Emerg Med. 2015;66(1):51-59.Google Scholar
19. Rutherford, WH. Experience in the Accident and Emergency Department of the Royal Victoria Hospital with patients from civil disturbances in Belfast 1969-1972, with a review of disasters in the United Kingdom 1951-1971. Injury. 4(3):189-199.Google Scholar
20. Hogan, DE, Waeckerle, JF, Dire, DJ, Lillibridge, SR. Emergency department impact of the Oklahoma City terrorist bombing. Ann Emerg Med. 1999;34:160-167.Google Scholar
21. Carley, SD, Mackway-Jones, K. The casualty profile from the Manchester bombing 1996: a proposal for the construction and dissemination of casualty profiles from major incidents. J Accid Emerg Med. 1997;14:76-80.Google Scholar
22. Arya, R, Salovich, DM, Ohman-Strickland, P, et al. Impact of scribes on performance indicators in the emergency department. Acad Emerg Med. 2010;17:490-494.Google Scholar
23. Schmaus, D. Implementing bar code technology in the OR. AORN J. 1991;54:346-351.10.1016/S0001-2092(07)69298-9Google Scholar
24. Burt, TW, Beck, HC. Computerized megacode recording. Ann Emerg Med. 1988;17(4):339-342.Google Scholar
25. Chua, RV, Cordell, WH, Ernsting, KL, et al. Accuracy of bar code versus handwriting for recording trauma resuscitation events. Ann Emerg Med. 1993;22:1545-1550.Google Scholar
26. Aghababian, RV, Goodridge, W. Uses for hand held/pen-based systems in the ambulatory setting. Annual Health Information Management Systems Society Conference, Phoenix, Arizona; 1994.Google Scholar
27. Reddy, MC, Paul, SA, Abraham, J, et al. Challenges to effective crisis management: using information and communication technologies to coordinate emergency medical services and emergency department teams. Int J Med Inform. 2009;78:259-269.Google Scholar