Mass Casualty Planning Needs To Go Beyond Level 1 Trauma Centers

Dr. Rachael Callcut M.D., M.S.P.H Assistant Professor of Surgery Division of General Surgery UCSF

Dr. Rachael Callcut

MedicalResearch.com Interview with:
Dr. Rachael Callcut M.D., M.S.P.H
Assistant Professor of Surgery
Division of General Surgery
UCSF

Medical Research: What is the background for this study? What are the main findings?

Dr. Callcut: San Francisco General Hospital (SFGH) responded on July 6, 2013 to one of the larger multiple casualty events in the history of our institution.  Asiana Airlines flight 214 crashed on approach to San Francisco International Airport with 307 people on board.  192 patients were injured and SFGH received the highest total of number of patients of area hospitals. The majority of data that is available on disaster response focuses on initial scene triage or initial hospital resources required to respond to these types of major events.  Our paper focuses on some additional considerations for optimizing disaster response not typically included in literature on these events including nursing resources, blood bank needs, and radiology studies. As an example, over 370 hours of nursing overtime were needed just in the first 18 hours following the disaster to care for patients.  This type of information in traditionally not been included in disaster planning, but clearly was a critical element of providing optimum care to our patients.

Medical Research: What should clinicians and patients take away from your report?

Dr. Callcut: Multiple or mass casualty events can happen anywhere.  It is important for hospital systems to prepare, practice, and participate in full scale drills. Although trauma centers routinely do this, non-trauma centers must also take disaster planning seriously.  Systems can not just rely upon the local level one trauma center in times of true mass casualty events.  There are many places in America where the nearest level one center is far and the immediate care after a disaster will have to come from the local centers.  In large scale disasters, the level one may also not be able to accommodate the total volume of patients needing immediate care. 

Medical Research: Is there anything else you would like to add?

Dr. Callcut: Looking back on the day, I described the experience as surreal at the time.  It truly was a remarkable experience.  On one hand, the tragedy of the event was palpable for our patients and families effected and on the other hand, it was an incredibly fulfilling moment to watch the unbelievable skill  of our teams despite the immense demand.  The efforts resulted in opportunity to save so many lives.  Our staff in every aspect from our language interpreters to our food services to our blood bank to the nurses, the physicians, the social workers and so many more, all pitched in to make anything possible on that day and the long days that followed.

Citation:

Campion EM, Juillard C, Knudson M, et al. Reconsidering the Resources Needed for Multiple Casualty Events: Lessons Learned from the Crash of Asiana Airlines Flight 214.JAMA Surg. Published online January 13, 2016. doi:10.1001/jamasurg.2015.5107.

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Dr. Rachael Callcut M.D., M.S.P.H (2016). Mass Casualty Planning Needs To Go Beyond Level 1 Trauma Centers 

Last Updated on January 22, 2016 by Marie Benz MD FAAD

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