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Hospital response to a major incident: initial considerations and longer term effects

C Johnson MBBS FRCA FFICM RAMC, J F Cosgrove MBBS FRCA FFICM
DOI: http://dx.doi.org/10.1093/bjaed/mkw006 329-333 First published online: 6 May 2016

Figures

Tables

  • Table 1

    Major incident alerts

    Major incident termsDefinitionActions
    Major incident standbyAn incident has occurred but is within its early stages. It has the potential to escalate and demand the extraordinary response of the receiving trustConfirm that standby action ONLY is required. Initial key personnel on major incident call out list are contacted
    Major incident cancelledThis cancels a major incident standby callThe key personnel are again contacted and stood down
    Major incident declaredThis can be declared either with or without a preceding standby status. An event has occurred which mandates that a trusts major incident plan is activatedAll personnel on the major incident call out list are notified. They should retrieve their major incident action cards and proceed to their designated location. As further information is obtained, actions to create extra space and prepare to receive casualties are undertaken
    Major incident stand downThe major incident is perceived to be over and a plan to revert the trust to normal operation will be madePersonnel on the call out list are informed that the major incident plan is being stood down. This may be in conjunction with a recovery plan to transition the trust back to normal operational service
  • Table 2

    Combined summary of injuries, Madrid and London bombings

    Type of injuryCritically injured population (n=35)Non-critically injured population (n=235)
    Tympanic perforation26 (74%)118 (50%)
    Chest injuries27 (77%)96 (41%)
    Shrapnel wounds28 (80%)99 (42%)
    Long bone fractures13 (37%)16 (7%)
    Burns (superficial and partial thickness)18 (51%)47 (20%)
    Eye injuries7 (20%)42 (18%)
    Traumatic brain injury17 (49%)33 (14%)
    Abdominal injury10 (29%)12 (5%)
    Traumatic amputations (limbs, digits, ears)12 (34%)14 (6%)