228926 Cross-national adaptability of EMS protocols for Mass Casualty Incidents

Monday, November 8, 2010 : 10:30 AM - 10:50 AM

Adi Agiv, RN , Prepared Center for Emergency Response Research & Department of Emergency Medicine, Faculty of Health Science, Ben Gurion University of the Negev Recanati school for Community Health Professions, Beer Sheva, Israel
Isaac Ashkenazi, MD, MSc, MPA , Prepared Center for Emergency Response Research & Dept of Emergency Medicine, Recanati School for community Health Professions, Ben Gurion University, Faculty of Health Sciences, Beer Sheva, Israel
Limor Aharonson-Daniel, PhD , University Center for the Research of Preparedness and Response to Emergency and Disaster Situations, Recanatti school for commu, Ben Gurion University of the Negev, Beer Sheva, Israel
Background On March 2004, ten explosive devices on board four commuter trains were detonated in various locations in Madrid. Local Emergency Medical Services (EMS) and hospitals were overwhelmed by the outcome an excess of 2000 casualties and 191 deaths. The purpose of this study was to check whether it is possible to apply EMS protocols for Mass-Casualty-Incidents that will be adaptable to different systems worldwide. This goal was achieved through an evaluation of the response in Madrid based on extensively rehearsed Israeli EMS protocols. Methods: Detailed conduct of Madrid EMS during the terror attack was sketched. Three topics, in which shortfalls were described in literature, were chosen: Organization, Leadership and Management, communication and teams' safety. These topics were reviewed based on Israeli protocols. Results Leadership was not predefined resulting in too many or no leaders on-site. Lack of familiarity with protocols led to inaccurate triage and uneven distribution of casualties to the two nearest hospitals. Communication failed so that hospitals learned about the magnitude of the event as it progressed. Limited drills were conducted in the past years thus in a real event organizations had no prior collaboration experience hence, no familiarity with each other's needs or abilities. Protocols were not known to many of the field workers. Conclusions: Protocols existence does not ensure emergency preparedness if these are not drilled, examined and revised. Multi-organizational familiarity is of utmost importance. EMS protocols for MCIs are adaptable to different systems worldwide and international debriefing could improve emergency preparedness worldwide.

Learning Objectives:
At the end of this session, the audience should be able to: 1. Describe the broad scope of damage and disarray that a mass casualty incident may cause and its subsequent demands from local EMS 2. Identify the basic elements of successful EMS response including the elements of Leadership and Management, emergency preparedness and organization. 3. Demonstrate and explain the importance of communication within and between organizations at a time of emergency 4. Design training and practice towards a real event in his/her environment.

Keywords: Disasters, EMS/Trauma

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I supervised the student, Adi Agiv, in this study. I am familiar with the materials and guided her closely through the research process and in writing its report.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.