MASS CASUALTY

MANAGEMENT

SYSTEMS
DR BASARU L.B (M.D) HAVANA, CUBA DR SUBAIR A.S (MB,BS), LAUTECH

PRESENTED BY
VICTIMS OF MASS CASUALTY INCIDENT
MASS CASUALTY RESCUE TEAM
CONTENT

INTRODUCTION
DEFINITIONS
FIELD MANAGEMENT
TRANSFER ORGANISATION
RESCUE CHAIN
TRIAGE
HOSPITAL MANAGEMENT
CONCLUSION
 INTRODUCTION
Since the beginning of mankind, man
has been faced with different kind of
disasters, flood during era of prophet,
Noah in the bible, man made disasters,
like atomic bomb in Hiroshima and
Nagasaki.
Consequently to all aforementioned
disasters
When an accident or disaster
involving large numbers of injuries
occurs, the first to provide
emergency assistance are
communities closest to the site of the
incident.
Many lives have been lost in mass
casualty situations because resources
were not mobilized efficiently The
challenge we face is this: the more scarce
the resources, the more efficient the
organization must be.
This presentation describes the steps
to designing a mass casualty
management system that will ensure
the highest possible survival rate and
We hope that it will provide the
necessary information
to guide disaster managers and health
care professionals in establishing or
reviewing their own mass casualty
management system
 DEFINITION

MASS CASUALTY :IS ANY LARGE

NUMBER OF CASUALTIES PRODUCED
IN A RELATIVELY SHORT PERIOD
OF TIME,USUALLY AS THE RESULT
OF A SINGLE INCIDENT SUCH AS AN
EARTHQUAKE, FLOOD, HURRICANE,
MASSIVE ROAD TRAFFIC ACCIDENT.
 MASS CASUALTY INCIDENT

Any event resulting in a number of

victims large enough to disrupt the
normal course of emergency and
healthcare services. E g. Chernobyl
nuclear power station explosion ,
bomb blast in Abuja.
 EMERGENCY SERVICES

Those services which are specifically

designed to respond on a daily basis to
emergency situations: Police, Fire
Service, Ambulance Service, Accident
and Emergency Department
MASS CASUALTY MANAGEMENT

Management of victims of a mass

casualty event, aimed at minimizing
loss of life and disabilities
 MASS CASUALTY
MANAGEMENT SYSTEM

The group of units, organizations and

sectors which work jointly, through
institutionalized procedures, to
minimize disabilities and loss of life in a
mass casualty event through the efficient
use of all existing resources.
THE MASS CASUALTY MANAGEMENT SYSTEM
IS BASED ON:

− Pre−established procedures, to be used

in daily emergency activities and to be
adapted to
meet demands of a major incident
− Maximization of the use of existing
resources
− Multi−sectoral preparation and
response
− Strong pre−planned and tested
coordination
 FIELD MANAGEMENT

Field management encompasses procedures

used to organize the disaster area in order to
facilitate the management of victims
 TRANSFER ORGANIZATION

The transfer organization includes those

procedures implemented to ensure that
victims of a mass casualty incident will
be safely, quickly, and efficiently
transferred by appropriate vehicles to
the appropriate and prepared health care
facilities.
 RESCUE CHAIN

The Rescue Chain, the essence of the Mass

Casualty Management System, involves the
Ministry of Health, private hospitals, police,
fire service, NGOs, transport services, and
communications
DIAGRAM OF RESCUE CHAIN

Triage
Search Triage Regulation Definitive
Rescue Stabilization Evacuation

Hospitalization

Transport
THE IMPLEMENTATION OF
THIS RESCUE CHAIN
Requires the existence of:
− An efficient Accident and Emergency
Department
− A basic radio communications network
− Coordination procedures among all sectors
involved
− Skilled multi−sectoral rescue teams
 TRIAGE

TRIAGE: is a process of determining the

priority of patients' treatments based on the
severity of their condition. This rations patient
treatment efficiently when resources are
insufficient for all to be treated immediately
 TYPES OF TRIAGE

SIMPLE TRIAGE
S.T.A.R.T MODEL
ADVANCED TRIAGE
CONTINUOUS TRIAGE
PRACTICAL TRIAGE
REVERSE TRIAGE
 SIMPLE TRIAGE

Simple triage is usually used in a scene of

a "mass-casualty incident" (MCI), in
order to sort patients into those who need
critical attention and immediate transport
to the hospital and those with less serious
injuries.
 S.T.A.R.T

S.T.A.R.T. (Simple Triage and Rapid Treatment)

separates the injured into four groups:

The deceased who are beyond help

The injured who can be helped by immediate
transportation
The injured whose transport can be delayed
Those with minor injuries, who need help less
urgently
Triage at an accident scene is performed by
a paramedic or an emergency physician,
using the four-level scale of
Cannot wait,
Has to wait,
Can wait
Lost.
categor meaning Consequences examples
y
(T1) Acute Immediate Arterial lesions,
CANNOT treatment, internal
WAIT danger for haemorrhage,
life transport as
major
soon as possible amputations

(T2)HAS Severe Constant Minor

TO WAIT observation and amputations,
injury rapid treatment flesh wounds,
transport as soon fractures and
as practical dislocations
(T3)CAN Minor injury Treatment Minor
WAIT or no injury when lacerations,
practical, sprains,
transport abrasions
and/or
discharge
when
possible

(T4) No or small Observation Severe

chance of and if possible injuries,
survival administration uncompensate
of analgesics d blood loss,
negative
neurological
assessment
 SECONDARY (IN-HOSPITAL) TRIAGE

Red / Immediate: They require immediate

surgery or other life-saving
intervention, and have first priority for
surgical teams or transport to advanced
facilities; they "cannot wait" but are
likely to survive with immediate
treatment
A VIDEO OF A RED CODE
Yellow / Observation:
Their condition is stable for the moment
but requires watching by trained persons
and frequent re-triage, will need hospital
care (and would receive immediate
priority care under "normal"
circumstances
Green / Wait (walking wounded):
They will require a doctor's care in several
hours or days but not immediately, may
wait for a number of hours or be told to go
home and come back the next day (broken
bones without compound fractures, many
soft tissue injuries).
White / Dismiss (walking wounded):
They have minor injuries; first aid and
home care are sufficient, a doctor's care
is not required. Injuries are along the
lines of cuts and scrapes, or minor
burns.
Black / Expectant: They are so severely injured
that they will die of their injuries, possibly in
hours or days (large-area burns, severe trauma,
lethal radiation dose), or in life-threatening
medical crisis that they are unlikely to survive
given the care available (cardiac arrest, septic
shock. severe head or chest wounds); they
should be taken to a holding area and given a
painkillers
as required to reduce suffering.
 HOSPITAL ORGANIZATION

It is the organization to be implemented in

a hospital in order to respond to a mass
casualty event. This organization, utilizing
pre−established and tested procedures, will
allow :
− Active mobilization and management of
available resources (human and material)
− Links with pre−hospital organization
− Management of in−patients and victim
flow
− Management of care
− Management of secondary evacuations
− Informing and updating authorities and
relatives of victims
 CONCLUSION

In as much, we are leaving in a society with high

percentage of crime, security instability coupled
with the fact that the politicians are only interested
in their next political election, I believe strongly
that the issue of mass casualty management has
to be prioritized by the health workers.Rom 13:11
And this, knowing the time, that now it is high
time to awake out of sleep: for now is our
salvation nearer than when we believed.
 THE END

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