Search

Immediate provision of information to the public is vital during mass casualty incidents (MCIs). Failure to implement rapidly a communication response system may result in the public overwhelming hospitals. This paper shares Israel's experience in developing and maintaining a national system for supplying information on the location and identification of casualties. ADAM interfaces online with hospitals' patient registration systems, and allows for immediate electronic transfer of designated data. The system permits information centres to access information on which hospital has admitted identified and unidentified casualties. The latter are photographed at the entrance to the hospital and the picture is stored in ADAM. The system enables hospitals and municipalities to ensure immediate availability and accessibility of information and thus (in our belief) mitigate the concerns of family and friends. Use of such an interface system is recommended as an integral element of emergency preparedness.

Terrorist attacks can occur in remote areas causing mass-casualty incidents MCIs far away from level-1 trauma centres. This study draws lessons from an MCI pertaining to the management of primary and secondary evacuation and the operational mode practiced. Data was collected from formal debriefings during and after the event, and the medical response, interactions and main outcomes analysed using Disastrous Incidents Systematic Analysis through Components, Interactions and Results (DISAST-CIR) methodology. A total of 112 people were evacuated from the scene-66 to the nearby level 3 Laniado hospital, including the eight critically and severely injured patients. Laniado hospital was instructed to act as an evacuation hospital but the flow of patients ended rapidly and it was decided to admit moderately injured victims. We introduce a novel concept of a 'semi-evacuation hospital'. This mode of operation should be selected for small-scale events in which the evacuation hospital has hospitalization capacity and is not geographically isolated. We suggest that level-3 hospitals in remote areas should be prepared and drilled to work in semi-evacuation mode during MCIs.