Open AccessMass casualty incident training in a resource‐limited environment
Author(s) -
Leow J. J.,
Brundage S. I.,
Kushner A. L.,
Kamara T. B.,
Hanciles E.,
Muana A.,
Kamara M. M.,
Daoh K. S.,
Kingham T. P.
Publication year - 2012
Publication title -
british journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.202
H-Index - 201
eISSN - 1365-2168
pISSN - 0007-1323
DOI - 10.1002/bjs.7762
Subject(s) - triage , sierra leone , mass casualty incident , medicine , debriefing , medical emergency , software deployment , resource (disambiguation) , mass casualty , operations management , medical education , poison control , suicide prevention , computer science , socioeconomics , computer network , sociology , economics , operating system
Background: A mass casualty incident (MCI) occurs when a disaster involves a large number of injured people, overwhelming the capacity of local emergency medical services. This article describes the planning and execution of a MCI workshop created for use in Sierra Leone, a low‐income country. Methods: Surgeons OverSeas (SOS), an international non‐governmental organization, partnered with the Sierra Leone Office of National Security and Connaught Hospital to develop a 2‐day MCI workshop designed to meet needs specific to their resource‐limited environment. Pre‐ and post‐course questionnaires were completed. Day 1 consisted of didactic teaching focused on triage principles, resource deployment, communication/operations and tabletop drills. On day 2 a mock MCI with performance assessments by independent observers was staged, followed by post‐event debriefing. Results: Pre‐course questionnaires identified the following deficits: lack of triage training (29 per cent), and transportation (19 per cent) and communication (17 per cent) shortfalls. Only 11 per cent could define MCI. During the drill, on‐scene and hospital triage was accurate in 28 (93 per cent) and 23 (77 per cent) of 30 casualties respectively. Systematic deficiencies identified included: transport issues, no accurate system for tracking victims, and undersized triage areas. Participants identified interagency coordination (63 of 136 responses; 46·3 per cent) and triage (32 of 136; 23·5 per cent) as the most valuable lessons learned. Conclusion: Pre‐existing MCI programmes based on first‐world logistics do not account for challenges encountered when caring for casualties in resource‐constrained settings. Logistical training, rather than medical skills or knowledge, was identified as the educational priority. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.