An epidemiological approach to mass casualty incidents in the Principality of Asturias (Spain)

Rafael Castro Delgado,Tatiana Cuartas Álvarez,Pedro Arcos González,Cecilia Naves Gómez

doi:10.1186/s13049-016-0211-x

Rafael Castro Delgado, Tatiana Cuartas Álvarez + Show 2 more

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https://doi.org/10.1186/s13049-016-0211-x

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Abstract

BackgroundMass Casualty Incidents (MCI) have been rarely studied from epidemiological approaches. The objective of this study is to establish the epidemiological profile of MCI in the autonomous region of the Principality of Asturias (Spain) and analyse ambulance deployment and severity of patients.MethodsThis is a population-based prospective study run in 2014. Inclusion criteria for MCI is “every incident with four or more people affected that requires ambulance mobilisation”.ResultsThirty-nine MCI have been identified in Asturias in 2014. Thirty-one (79 %) were road traffic accidents, three (7.5 %) fires and five (12.8 %) other types. Twenty-one incidents (56.7 %) had four patients, and only three of them (8 %) had seven or more patients. An average of 2.41 ambulances per incident were deployed (standard error = 0.18). Most of the patients per incident were minor injured patients (mean = 4; standard error = 0.2), and 0,26 were severe patients (standard error = 0.08). There was a positive significant correlation (p < 0.01) between the total number of patients and the total number of ambulances deployed and between the total number of patients and Advanced Life Support (ALS) ambulances deployed (p < 0.001). The total number of non-ALS ambulances was not related with the total number of patients.DiscussionPopulation based research in MCI is essential to define MCI profile. Quantitative definition of MCI, adapted to resources, avoid selection bias and present a more accurate profile of MCI. As espected, road traffic accidents are the most frequent MCI in our region. This aspect is essential to plan training and response to MCI. Analysis of total response to MCI shows that for almost an hour, we should plan extra resources for daily emergencies. This data is an important issue to bear in mind when planning MCI response. The fact that most patients are classified as minor injured and more advanced life support units than needed are deployed shows that analysis of resources deployment and patient severity helps us to better plan future MCI response.ConclusionsRoad traffic accidents with minor injured patients are the most frequent MCI in our region. More advanced life support units than needed have been initially deployed, which might compromise response to daily emergencies during an MCI.

Highlights

Mass Casualty Incidents (MCI) have been rarely studied from epidemiological approaches
The Department of Health’s Strategic National Guidance to the UK National Health Service for Major Incident Emergency Planning defines a major incident (MI) as “any occurrence that presents a serious threat to the health of the community, disruption to the service or causes such a number or type of casualties so as to require special arrangements to be implemented by hospitals, ambulance trusts or primary care organisations” [2]
This study aims to present the results of the first year of work of MCI register, and characterise the epidemiology of MCI that happened in the Principality of Asturias in 2014, focused on epidemiology, description of the incidents and resource mobilisation

Summary

Introduction

Mass Casualty Incidents (MCI) have been rarely studied from epidemiological approaches. The Department of Health’s Strategic National Guidance to the UK National Health Service for Major Incident Emergency Planning defines a major incident (MI) as “any occurrence that presents a serious threat to the health of the community, disruption to the service or causes such a number or type of casualties so as to require special arrangements to be implemented by hospitals, ambulance trusts or primary care organisations” [2]. These two concepts with similar definitions make difficult to standardise research and publications. We should take into consideration that the number of patients is not direct linked to the definition of MCI, which appears to be mostly related to overloaded resources

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