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Douglas M. Bowley Paddy Rein Hendrik J. Scholtz Kenneth D. Boffard 《European Journal of Trauma》2004,30(1):51-55
Abstract On April 11, 2001, approximately 80,000 spectators tried
to cram into Ellis Park Stadium, Johannesburg, South Africa, a
venue with capacity for around 60,000 people, for a premier
league soccer match between the two most popular teams in
Johannesburg. Less than 4,000 tickets had been presold. The
ensuing crush disaster, in which 43 spectators were killed, has
been the subject of a judicial enquiry. The events at Ellis Park
were the first of three African soccer stadium disasters that
killed around 170 people in the space of 1 month. Seven fans
were killed and 51 seriously injured at the end of April 2001 in
a stampede at a match in the Democratic Republic of Congo after
police used tear gas to control rioting fans. In May 2001, at
least 120 people died in a crush at a match in the Ghanaian
capital of Accra.With the massive global interest in soccer, this report
serves as a reminder of the potential problems of the gatherings
of large partisan crowds. We focus on the injuries sustained at
Ellis Park and the hospital response to the mass casualty
situation. 相似文献
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Geoff Shapiro 《Prehospital emergency care》2013,17(6):662-668
Background: Mortality following shooting is related to time to provision of initial and definitive care. An understanding of the wounding pattern, opportunities for rescue, and incidence of possibly preventable death is needed to achieve the goal of zero preventable deaths following trauma. Methods: A retrospective study of autopsy reports for all victims involved in the Pulse Nightclub Shooting was performed. The site of injury, probable site of fatal injury, and presence of potentially survivable injury (defined as survival if prehospital care is provided within 10 minutes and trauma center care within 60 minutes of injury) was determined independently by each author. Wounds were considered fatal if they involved penetration of the heart, injury to any non-extremity major blood vessel, or bihemispheric, mid-brain, or brainstem injury. Results: There were an average of 6.9 wounds per patient. Ninety percent had a gunshot to an extremity, 78% to the chest, 47% to the abdomen/pelvis, and 39% to the head. Sixteen patients (32%) had potentially survivable wounds, 9 (56%) of whom had torso injuries. Four patients had extremity injuries, 2 involved femoral vessels and 2 involved the axilla. No patients had documented tourniquets or wound packing prior to arrival to the hospital. One patient had an isolated C6 injury and 2 victims had unihemispheric gunshots to the head. Conclusions: A comprehensive strategy starting with civilian providers to provide care at the point of wounding along with a coordinated public safety approach to rapidly evacuate the wounded may increase survival in future events. 相似文献
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Introduction. Mass casualty incidents (MCIs) are infrequent but potentially overwhelming events that can stress the capabilities of even the most organized emergency medical services (EMS) system. The Maryland EMS system has been identified as a pioneer and leader in the field of prehospital emergency care and, as with many states, Maryland's regional preparation for MCIs has been integrated into its overall EMS systems planning. Objective. To determine how successful this integration has been by examining a three-year history of response to MCIs in Maryland. Methods. A three-year case series of MCIs in Maryland was obtained from a Nexis national news publications search. These MCIs were cross-referenced with U.S. postal ZIP codes and the U.S. Census Bureau's ZIP code files. They were then mapped and summary statistics were prepared for analysis. Data obtained through the Maryland Health Services Cost Review Commission for all severely injured patients discharged from Maryland hospitals were obtained over the same three-year period for comparison. Results. Eight MCIs occurred over a three-year period, resulting in a total of 203 injuries. An average of 25.4 ± 10.7 injuries occurred per MCI. A total of 158 (77.8%) of injuries necessitated ambulance transportation. An average of 3.1 ± 1.1 hospitals were involved per MCI. Conclusions. The Maryland EMS system was effective in responding to MCIs ranging in size from 10 to nearly 40 injuries. Analyzing MCIs that reoccur on a year-to-year basis should figure into the planning process for EMS systems. 相似文献
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Hobfoll SE Mancini AD Hall BJ Canetti D Bonanno GA 《Social science & medicine (1982)》2011,72(8):1400-1408
We examined posttraumatic stress disorder (PTSD) and depression symptom trajectories during ongoing exposure to political violence, seeking to identify psychologically resilient individuals and the factors that predict resilience. Face-to-face interviews were conducted with a random sample of 1196 Palestinian adult residents of the West Bank, Gaza, and East Jerusalem across three occasions, six months apart (September 2007-November 2008). Latent growth mixture modeling identified PTSD, and depression symptom trajectories. Results identified three PTSD trajectories: moderate-improving (73% moderate symptoms at baseline, improving over time), severe-chronic (23.2% severe and elevated symptoms over the entire year); and severe-improving (3.5% severe symptoms at baseline and marked improvement over time). Depression trajectories were moderate-improving (61.5%); severe-chronic (24.4%); severe-improving (14.4%). Predictors of relatively less severe initial symptom severity, and improvement over time for PTSD were less political violence exposure and less resource loss; and for depression were younger age, less political violence exposure, lower resource loss, and greater social support. Loss of psychosocial and material resources was associated with the level of distress experienced by participants at each time period, suggesting that resource-based interventions that target personal, social, and financial resources could benefit people exposed to chronic trauma. 相似文献
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《Australian critical care》2022,35(2):204-209
ObjectivesThe aim of the study is to understand the concept of disaster preparedness in relation to the intensive care unit through the review and critique of the peer-reviewed literature.Review method usedRodgers' method of evolutionary concept analysis was used in the study.Data sourcesHealthcare databases included in the review were Cumulative Index to Nursing and Allied Health Literature, Public MEDLINE, Scopus, and ProQuest.Review methodsElectronic data bases were searched using terms such as “intensive care unit” OR “critical care” AND prep1 OR readiness OR plan1 AND disaster1 OR “mass casualty incidents” OR “natural disaster” OR “disaster planning” NOT paed1 OR ped1 OR neonat1. Peer-reviewed articles published in English between January 2000 and April 2020 that focused on intensive care unit disaster preparedness or included intensive care unit disaster preparedness as part of a facility-wide strategy were included in the analysis.ResultsEighteen articles were included in the concept analysis. Fourteen different terms were used to describe disaster preparedness in intensive care. Space, physical resources, and human resources were attributes that relied on each other and were required in sufficient quantities to generate an adequate response to patient surges from disasters. When one attribute is extended beyond normal operational capacities, the effectiveness and capacity of the other attributes will likely be limited.ConclusionThis concept analysis has shown the varied language used when referring to disaster preparedness relating to the intensive care unit within the research literature. Attributes including space, physical resources, and human resources were all found to be integral to a disaster response. Future research into what is required of these attributes to generate an all-hazards approach in disaster preparedness in intensive care units will contribute to optimising standards of care. 相似文献
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Transfusion emergency preparedness is increasingly being recognized as an important element in the healthcare response to mass casualty events (MCE). Planning should be designed to support an integrated response between the blood services and hospitals. The lessons identified from the Manchester Arena bombing in 2017 and recent incidents in London have led to new guidance. Demand planning has been informed by the global experience of civilian MCEs and the changing trends in trauma care. Past evidence suggests that only a modest number of hospitalized patients following MCEs require transfusion. The mean blood use per patient admitted is consistently calculated at 2–3 red cell units. Most blood is used within the first 6 h. However, a small number of critically injured with multi‐trauma may require massive transfusion and ongoing support. Many blood services have reported meeting the initial overall demand for blood from stock. However, universal components may be in short supply. The demand can be managed by pre‐agreed substitutions. Early transfusion triage enables the best use of hospital laboratory and blood service support. Careful communication with donor communities is essential to manage a controlled replenishment of stocks. Future challenges for the transfusion community include the trend towards lower red cell stock holdings and the changing trends in weapon use and tactics. A standardized approach to transfusion data collection is required to support future planning. The transfusion community is encouraged to plan for MCEs, contribute to ‘after action reviews’ and work together for safe and sustainable transfusion support. 相似文献