DISCUSS DISASTER SURGERY.power point presentation

Disaster surgery:mass casualty

1. Dr.MOSES C
GENERAL SURGERY UNIT
FEDERAL TEACHING HOSPITAL,GOMBE

2. INTRODUCTION
AETIOLOGY
TYPES
CLASSIFICATIONS
PRINCIPLES OF MANAGEMENT
CHALLENGES IN OUR ENVIRONMENT
RECOMMENDATIONS
CONCLUSSION

3. Disaster surgery also called ‘Disaster surgical
care’ or crises management care
It is the minimally accepted surgical care in
an acute phase of disaster
The fundamental principle is to do the
greatest good for the greatest number.

5. High speed trauma
Civil disturbances
Terrorist activities
Natural disaster

6. Natural disaster;
earth quake,
tsunami,storm/flooding,neighborhoodnuclear
plant
Manmade disaster;
accidents,shooting, booming, fire arms,
bioweapon

7. In relation to numbers
Multiple casualty incidence-casualty strain
beyond daily normal but can be handled by
local health care
Mass casualty incidence-more than the
capacity
Major medical disaster-thousands of casualty
requiring support

8. A mass casualty incident is one in which a
group of patient presenting simultaneously
exceed the capacity of the local health
system.
An Epidemic of trauma

9. Rural
Urban

10. Similar to the ‘ABCs’ of trauma care, disaster
response includes the following elements
1.search and rescue
2.Triage
3.Definitive surgical care
4.Evacuation

12. French terms “ to sort into group according to
quality”
Refers to the sorting of patients according to
the severity of injury and available resources
Needs-”number of wounded and types of
wound
Resources-”facility at hand and number of
qualified personell available”

13. Team leader
Clinical triage officer
Head nurse
Nursing groups
Follow up medical group

14. Field Triage-carried out by field workers at
site of incidence
Inter-Hospital Triage-Sorting out of patient
into the hospital they will be transferred to
Hospital triage-Carried out on arrival of
casualty to the hospital

15. Black/Expectant-large body burns , cardiac
arrest
Red/immediate-cannot wait
Yellow/observation-require watching and re-
triage
Green/wait-require care in hours to days

16. CATEGORY 1-Resuscitation and immediate
surgery
CATHEGORY 2-Need surgery but can wait

18. CATHEGORY 3-Patient with wounds
requiring little or no surgery
CATHEGORY 4-Very severe wounds , no
surgery, supportive treatment

21. The cathegories are not rigid
Patient waiting for surgery may change
cathegory
A Single patient can be in more than 2
cathegories

22. ESSENTIAL STEPS ARE:
•Designate area as triage zones
•Police needed to protect and ward-off
•Ambulance may embark on initial treatment
and sorting out of patient
•Medical team engages in resuscitation,
stabilization and transporting with
interhospital triage

23. A senior Doctor should act as mass casualty
management coordinator
Another triage is performed and patient
handed over to appropriate medical unit

24. Clear a ward or two to serve as reception
Designate a triage area, often AnE
Assign personell to management area e.g
theatre,ward etc
Coordinate various zones

25. Mass casualty forms and triage labels are
used

26. Relatives should be kept in a place marked
out for them
Should donate blood
Identify patient
A respectable person with good
communication skills is asked to attend and
reassure them

27. Multidisciplinary:
Psychologist
Occupational therapist
Social workers
Supports group
Religious/Traditional leaders

28. 1.PROBLEMS:
•Lack of adequate ambulance services
•Lack of emergency preparedness
•Ineffective communication

29. All secondary and tertiary centres should
evolved a protocol for managing mass
casualty
Mass casualty boxes should contain pre-
sterilized packs to facilitates resuscitation of
large number of injured patients
Interfacility collaboration

30. Appropriate supportive legislation
Provision of infrastructures
Sponsorship of workshops and drills
exercises

31. Advanced planning and emergency
preparedness can significantly reduce the the
morbidity and mortality that is often results
of disaster surgery
It takes teamwork,dedication and
perseverance.

32. THANKS FOR LISTENING

33. Disaster surgery article marye. showstark
April 2021
Responding to crisis’ scudder oration on
trauma susanmiller 2017
Disaster and military surgery , European
Journal of trauma emergency surgery; July
2017