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Feb 12, 2019 in Analysis

Mass Casualty Essay

Mass Casualty

A mass casualty incident is often shortened to MCI, and in other times called the multiple casualty incident, as well as multiple casualty situation. In such an incident emergency medical services and resources like equipment and personnel are beleaguered by the severity and number of casualties. For instance, an incident where a three-person crew is reacting a motor vehicle crash with four severely injured persons could reflect a mass casualty event. The general public commonly recognizes occurrences such as building collapses, bus and train collisions, earthquakes, as well as other large-scale disasters, as mass casualty events. Events like Oklahoma City bombing in the year 1995 and the 11th September attacks in 2001 are publicized instances of mass casualty occurrences. Therefore, this paper evaluates the importance of the mass casualty plan in the emergency medical services. 

In the planning programs established by the emergency medical services, a mass casualty occasion is defined as one that generates more patients than existing resources can manage with the use of routine procedures. This meaning has a benefit of being associated with two critical system capacity operational procedures and interrelated components. System capacity is flexible based on, , number of ambulances, number of available and qualified personnel among other probable components. The number of suitable hospital beds, personnel efficiency, minus the beds number occupied by the patients, as well as communications system aptitude, are important in this scenario (Caro, 2010). 

These activities are consolidated in the training place to upgrade responder efficiency, an algorithm of assessment, the standard field organization structure, and the initial response protocol. The next constituents of mass casualty plan include the hospital system that features a real picture. At the simplest level of analysis, Virginia has 12 Trauma Centres in a three-level system (Koenig, Dinerman & Kuehl, 1996). 

However, irrespective of their eminence in caring for a single badly injured person, all Trauma Centres are of equal strength. Only Trauma Centres can accept large quantities of patients in a mass casualty occasion. Capacity to receive large quantities of patients in a mass casualty event depends on the regional ability to direct patients to suitable facilities with the vacant beds. In Virginia, this issue has been resolved at the regional basis with regional plans, capacity tracking drills, and the exercises providing measures of readiness (Richmond, 2007). As the staffed beds in hospitals reduce in numbers to be used during times when disease outbreaks loom 100 per cent, the ability to maintain patient spreading becomes more significant. Of all the many Emergency Medical Services Regional Councils, some have established methods that have demonstrated the ability to manage regional reactions efficiently.

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In the 1988 Report of the Governor’s Task Force regarding Emergency Medical Response, Disaster Planning allocated responsibility for managing local reactions to very huge events to the regional Trauma Centres. These structures serve as the foundation for the development of the Plan for the Coordination of Medical and Health Response to the Catastrophic Casualty occurrences. It is specially designed to offer a framework for handling occurrences that generate 500 or more victims. The catastrophic fatality plan foresees four primary cases based on the sternness of the event (Gum, 2009). 

The mass casualty plan is tested on the state level medical table top exercise. This exercise emphasizes the necessity for the means of tracking patients as they move in the system. TRANSAID, which is a National Disaster Medical System patient tracking software advanced by Ed Summerfield of a Castle Point Veterans Affairs Medical Centre, is adopted as the software to be utilized for this reason in the Emergency Support Centre. Subsequently, TRANSAID tests patients’ tracking activity that is carried out by the Old Dominion Emergency Medical Services Alliance local hospitals, successfully recording victim’s movements and their status for 200 victims in a period of 45 minutes. As an outcome, at least one region should standardize TRANSAID as the victim tracking system for utilization for occurrences that may be managed utilizing the region’s capabilities. The final step in handling the mass casualty plan that should be addressed is the progression of action required, when patients surpass the statewide system capacity. The issue of the state-wide capacity is necessary because of the time needed to marshal and carry in the out-of-state capitals. In some situations cross-border ability is also essential, as patients from other regions are routinely moved to the medical services in other states, as well the local Trauma Centres. If a patient may be taken to a bed that is 300 miles away in 6 hours, that patient needs to reach the definite care faster than the waiting time of 8 to 24 hours (Ramesh & Kumar, 2010).  

However, there are scenarios in which more patients can be generated than appointed beds could hold. Medical service practices receipt of patients in an airlift application coordinated by the Central Federal Coordinating Centre. However, there is a clear shortfall in the outbound patient association planning with no recognizable federal pre-planning with the state health bureaucrats (Richmond, 2007). 

In case of the disaster the first-arriving crew conducts a triage. The pre-hospital disaster triage contains the check for instant life-threatening concerns, often lasting no more than hour for one patient. In North America, the simple triage and the rapid treatment is the major most common and simple practice. This system considers three basic elements that include breathing, consciousness, circulation and, based on the medical responder's outcomes, assigning each victim to one of four colours that mark triage extents (Ramesh & Kumar, 2010).  

Moreover, an effective mode of transport is essential in the mass casualty plan for the emergency medical services. A disaster cannot be controlled by any human being or any activity. These events occur in any part of the country without caring how many people are harmed and to what extent, or how they will be cared for. In this case, therefore, the practical mode of transport is needed in order to save life by taking the victims to the medical services (Gum, 2009). Therefore, an efficient mode of transport should be considered important in the implementation of the mass casualty plan. The more active is the mode of transportation, the more lives will be saved. Thus, an effective mass casualty plan should take into consideration how in times of a catastrophe the medical services will evacuate the victims. The mode of transport could either use the road, air transport, railway, or even water. However, the most effective means should be applied in the most applicable way in different situations (Streger, 1999). 

Disasters are never the same. They occur in different ways, different places and have different magnitudes. Therefore, a mass casualty plan is necessary, since it assists the victims in various ways. Whenever the local community is overwhelmed by the effects of the disaster, mass casualty plan comes in and ensures the deaths are averted. The mass casualty plan provides the first aid to the affected victims as well as offers the required treatment for the minorly injured persons. On the other hand, with the help of the project, victims are transported to the general hospitals, where they can receive extensive and special care in time (Streger, 1999). 

Once the wounded are triaged, they may then be transported to their suitable treatment areas. Unless the patient is tagged green, the litter-bearers shall have to move patients from the incident scene to a safer and secure treatment areas based in the nearby locations. These treatment areas are always within the walking distance and shall be staffed by the adequate number of appropriately qualified people as well as medical personnel. The litter bridges also require advanced medical personnel. Their responsibility is to place the wounded directly onto the carrying device like a portable stretcher, wheeled stretcher, emergency litter or the pole stretcher. Additional transporting devices, such as the scoop stretcher or the backboard for victims with spinal damages, allow to carry them to an appropriate treatment facility. The damaged must be placed in order of the treatment importance, with the red-marked victims being transported very swiftly, followed by the yellow, green recorded, and ultimately the black-marked victims. Treatment areas are defined by the coloured tarpaulins, signs, tents, or flagging tape. Each degree of care has its treatment zone, that is the red-marked patients cannot be treated in a green-marked treatment area. Upon the appearance in the treatment zone, the victims are reassessed and given the first treatments in order to stabilize them until they can be discharged, in the case of the green-marked casualties. Yellow and red tagged victims are ransported for further treatments. Black tagged victims are as well transported to the medical examiner's amenities or to the morgue for the assessment of the dead bodies. Treatment zones can be staffed by a combination of the first responders, paramedics, nurses, emergency medical technicians and doctors. Depending on the severity of the case, fire-fighters and other available personnel receive experience in training (Streger, 1999).

 
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In addition, the mass casualty plan provides medications for the victims leading to the relieving of the pain. In this case, the victim could be in great pain that could lead to the blackout. However, through the provision of the drug by the mass casualty plan team, the life of the victim can be saved. This action shows how the plan is essential for saving human lives whenever the disasters occur. Additionally, through the provision of such drugs, the victims’ excessive bleeding can be stopped. Therefore, such approch prevents the victim from falling anaemic that can be an added illness on top of the main disease, which should be cared for. Additionally, the plan could be a great source for the persons with high blood pressure. They are offered drugs that could regulate their blood pressure (Stein, 2010). 

On the other hand, mass casualty plan is instrumental for providing the manpower that is essential in the times of emergency. The personnel and available resources should be efficient to handle persons with various degrees of injuries. Mass casualty plan is quite important, since it usually supplies the human resources that are required immediately. Essentially, it is not possible to collect an enormous multitude of persons at once, if the system is not organized. However, mass casualty plan usually allows to collect human resources needed to respond to any emergency. They provide the support needed by the victims of an emergency as well as the medical services that are required immediately (Stein, 2010). 

Furthermore, the mass casualty plan usually has an temporary care centre that allows for the treatment and assessment of patients till the time they can either be transported to the main hospital or released. The patients are  discharged if they have been proved to be recovering. These interim care centers are often placed in the gymnasiums, hotels, arenas, schools, community centers, and anywhere else where a field hospital apparatus could be supported. Permanent buildings are favored to tents as they offer shelter, running water, and electricity, but many authorities maintain complete field hospitals that could be deployed anywhere within 12–24 hours. Whilst full field hospitals need an important amount of time to deploy needed personnel to the place of an accident, temporary interim care centres may be set up by the emergency services fairly swiftly if required, using the resources and personnel on hand. These centres are staffed by doctors, paramedics, emergency, nurses, medical technicians, social workers and first responders, like those from the Red Cross, who get families reunified after a catastrophe (Richmond, 2007). 

The definitive care is often rendered at the scene of a mass casualty plan only temporary and structured to stabilize the casualties till they can get more care at the hospital or in the interim care center. Thus, the program is usually important, since it allows the victims to be transported to the hospital for more extensive care (Streger, 1999). Importantly, the definitive care unit is usually armed with the first aid gear that is used to prolong the victims’ lives before they arrive to the hospital. The patients can be treated or taken to the surgery. 

Additionally, it is equally important for the mass casualty plan to provide an on-site morgue. In some mass casualty events, it is important to have an on-site mortuary to manage the bodies of the demised persons at the scene whilst awaiting transfer to the permanent mortuary. When this site is utilized, needed care is offered with respect for the deceased and their family members at the scene. Most often, this is the apparatus on the far side of an incident, away from the public sight, and it is placed in the areas such as temporary tents or the nearby buildings (Stein, 2010).

In conclusion, operational procedures determine the effectiveness of treatment of the patients in terms of speed, outcome, and resource commitment. The mass casualty plan is necessary for the adequate emergency response. Such plan provides the initial responses that are required in all emergency situations irrespective of their scope. Standard patient care processes for a single patient are relatively inadequate in terms of resource commitment and speed. If these similar methods are utilized in a mass casualty plan, they may result in unsatisfactorily long periods for clearing the location and assisting the patients. Therefore, a mass casualty incident plan requires utilization of emergency procedures like the START triage, reduced sources to patient ratios, and the loading of manifold patients in the ambulances, for adequate management. A practical approach to mass casualty plan must address all phases, either openly through the enclosure of contemporary programs to upgrade performance, or indirectly through the presence of existing abilities in the mass casualty plan.

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