ABC: časopis urgentne medicine (Jan 2016)
Mass disaster or accident with a large number of injured: Case report
Abstract
INTRODUCTION: Traffic accidents are an important medical and social problem. Adequate and quick response of the entire health system, especially the emergency medical services (EMS), is the key to reduce morbidity and mortality in the aftermath of the traumatic traffic accidents. Mass accidents represent accidents where the number of injured people exceeds the capacity of local medical centers, prompting for a quick and adequate management of the limited EMS resources. Triage protocols aim to optimize the usage of the existing health care system resources in such accidents. Proper use of the triage protocols is a key to significantly improve the health outcome of the injured people. AIM: Traffic accidents are an important medical and social problem. Adequate and quick response of the entire health system, especially the emergency medical services (EMS), is the key to reduce morbidity and mortality in the aftermath of the traumatic traffic accidents. Mass accidents represent accidents where the number of injured people exceeds the capacity of local medical centers, prompting for a quick and adequate management of the limited EMS resources. Triage protocols aim to optimize the usage of the existing health care system resources in such accidents. Proper use of the triage protocols is a key to significantly improve the health outcome of the injured people. CASE REPORT: This paper describes a mass traffic accident with 9 injured that occurred on a highway in the vicinity of Sombor. In Sombor, the emergency service has two field medical teams available 24 hours, serving the city of Sombor with 86000 residents. The EMS also has 1-2 vehicles which are used to transport immobile but vitaly stable patients. In this mass accident, the primary triage identified three injured people that need immediate medical attention (red code), a delayed medical help was allowed for two injured (yellow code), and four of the injured were with the minor injuries (green code), mainly on their legs and feet and those could wait for the secondary triage. There were no fatal injuries (black code). All the injured were taken care of by the teams from EMS Sombor, with the help of the Fire Police department, all within the 'golden hour'. No additional teams EMS were called in support. CONCLUSION: There are a number of the triage protocol used worldwide but the advantage of any of them has not been proven. In our example case, START triage protocol has shown as being very adequate: All the red code patients had life threatening injuries witch were diagnosed in general hospital. Also was the important the speed of the triage, resulting in the transport and hospital treatments of the red code patients with 20 minutes of receiving the emergency call. Although there are different procedures and protocols within the country, including proposals on the mass disaster action plans, it is opinion of the author that there is a very little work on the actual implementation of these protocols and procedures, including the lack of the EMS staff training on the subject.
