Keywords:
Emergency, Trauma, Professional issues, CT, Conventional radiography, Ultrasound, Education, Education and training
Authors:
J. Ryan, B. Gibney, P. J. MacMahon, F. Bolster; Dublin/IE
DOI:
10.1594/ecr2018/C-2513
Aims and objectives
A Mass Casualty Incident (MCI) is defined as an event that produces a large number of casualties in a short period of time which temporarily overwhelms the resources of local healthcare systems1,2.
Natural disasters, accidents and terrorism can lead to MCIs1. Diagnostic radiology plays a critical role in appropriately triaging MCI victims,
Interventional Radiology can save lives in the acute trauma setting1.
"The Institute for Economics and Peace",
published "The Global Terrorism Index",
in 20153.
This index estimated the impact of terrorism on 162 countries taking into account factors such as; property damage,
lives lost and the psychological after-effects of terrorism. The Middle East,
Africa and Southeast Asia were most affected by terrorism.
Iraq ranked no.
1 on the Index. Amongst European countries,
the UK ranked highest at no.
28.
For context,
the USA ranked no.
35,
France no.
36,
Ireland no.
48, Germany no.
53 and Austria no.
793. On a global scale,
Europe bears a relatively small proportion of the worldwide burden of terrorism.
However,
over the past decade or so,
Western Europe has seen a steady increase in the number of terrorist attacks,
largely related to Islamic fundamentalism3 (Fig.
2).
The number of natural disasters in Europe has been on an upward trend since 1980,
"meteorological and hydrological" events have been largely responsible for this increase4(Fig.3).
These trends highlight the need for Major Incident Planning (MIP) in hospitals.
Staff preparedness and familiarity with local MCI protocols are "crucial requisites",
for improving patient outcomes in MCIs2.
A recent survey performed in London (England) assessed physicians knowledge of MIP and exposure to MCI training.
It showed that awareness of MIP was poor amongst physicians in general,
but was particularly poor amongst radiologists5.
A recent review article based on multinational MCI experience from several level 1 trauma centres found that radiology departments are under-represented or in many cases excluded from disaster management planning and simulation drills1.
With all of this in mind,
our aims were;
- To perform a national survey amongst Irish radiologists,
assessing MCI preparedness.
- To review the role of radiology in MIP and during an MCI.
- To provide recommendations for key MCI response factors that need to be addressed in radiology MCI protocols.