mass causality diester management sanjay.pptx

mass causality diester management

1. Mass casualty Dr. SANJAY SENIOR RESIDENT Dept. Of General Surgery, MTMC

2. S.NO DISASTER CLASS TOTAL NO.OF CASUALTY IMPLICATIONS OF TRAUMA CARE 1 Multiple Casualty Less than Emr.dept capacity Standard of care for all severe casualties 2 Mass casualty More than E.D Care of some severe casualties is delayed or suboptimal 3 Major Medical Disaster E.D + Hospital overwhelmed Most severely injured pts may die or survive without medical care

3. EFFECTS OF DISASTER POPULATION DISPLACEMENT INJURY / DEATH RISK OF EPIDEMIC DISEASES DAMANGE TO INFRASTRUCTURE FOOD SHORTAGE WATER SCARCITY SOCIOECONOMIC LOSS SHORTAGE OF DRUGS AND MEDICAL SUPPLIES

4. MASCAL mnemonic CRITICAL & CORE CONCEPTS OF MASS CASUALTY M MINIMISE CHAOS REMAIN CALM AND CONFIDENT 1 ST WAVE A ASSESS TRIAGE ,ASSESS SUPPLY STATUS AND PERSONAL S SAFETY DONOT CREATE ADDITIONAL PT’S . SELF CARE & STAFF CARE C COMMUNICATION NEVER BE ENOUGH ,MAKE IT CLEAR & CONSICE A ALERT READY FOR MORE CASUALTIES , RECONSTITUTE & RESUPPLY. 2 ND WAVE L LOST DONOT LOOSE STAFF / PATIENT TRACKING SYSTEM OF PT’S ACCOUNTABILITY OF TEAM

5. DISASTER INJURY COMMON FEATURES OF MAJOR DISASTER : Massive Casualties Damage To Infra Structure A Large No.Of People Requiring Shelter Panic And Uncertainity Among Population Limited Access To The Area Breakdown Of Communication

6. Sequence Of Relief Efforts In Major Disaster

7. Basics of trauma care Prehospital care : Initial approach Evaluate scene Perform initial assessment Make triage transport decision Initial critical interventions and transport of patient.

8. Information

9. INFORMATION From patient : AMPLE A llergies M edical history P ast history L ast meal E vents leading to trauma

10. Transport Supine position : on hard board- head , thorax , pelvis strapped to Immobilize the patient . Prone position : to prevent aspiration Don’t Transport In Lateral Position. CERVICAL / PHILADELPHIA COLLAR : Used to minimal immobilization Supports cervical spine

11. Triage : sort out

12. TRIAGE CATEGORIES PRIORITY COLOUR MEDICAL NEED CLINICAL STATUS EXAMPLES FIRST-I RED IMMEDIATE intervention needed CRITICAL, BUT SURVIVES IF Rx GIVEN EARLY SEVERE FACIAL TRAUMA, TENSION PNEUMOTHORAX, PROFUSE EXTERNAL BLEEDING,EDH ,MAJOR ABDOMINAL BLEED SECOND-II YELLOW Needs admission & stabilization . Intervention can wait for sometime. CRITICAL ,LIKELY TO SURVIVE EVEN IF Rx GIVEN WITHIN HOURS COMPOUND FRACTURES ,DEGLOVING INJURY,PERITONITIS,SPINAL INJURIES. THIRD-III GREEN NON-URGENT . Provide 1 st AID and send them home STABLE ,LIKELY TO SURVIVE EVEN IF Rx IS DELAYED FOR HOURS TO DAYS SIMPLE FRACTURE, MINOR LACERATION LAST -0 BLACK DEAD / MORIBUND NOT BREATHING ,PULSELESS,SO SEVERELY INJURED ,NO MEDICAL CARE LIKELY TO HELP SEVERE BRAIN DAMAGE , EXTENSIVE BURNS ,LOSS OF CHEST OR ABDOMINAL WALL STRUCTURES .

13. NATO NOMENCLATURE: DIME

14. PRIMARY Assessment : cABCDE

15. GOLDEN HOUR 1 ST hour following trauma . If proper care is provided within this time , mortality due to A,B,C can be reduced drastically .

16. Treatment

17. COLOR CODING ?

18. COLOR CODING ?

19. COLOR CODING ?