Seamless Interactions Between Medical Professionals in Stressful Environment

Abstract

In recent years, societal trends and fears have shifted the focus of governmental institutions more and more on prevention of domestic emergencies (such as natural disasters, or terrorist attacks). These catastrophic events may result in mass casualty incidents, which are defined as: “[…] An event that overwhelms the local healthcare system, with number of casualties that vastly exceeds the local resources and capabilities in a short period of time.” (Ben-Ishay et al., 2016).

If too many casualties clog the local healthcare infrastructure, victims need to be prioritized for transportation and treatment, based on the severity of their injuries. Otherwise, the number of fatalities may unnecessarily increase. Triage processes have been developed to streamline the transport and treatment of casualties, and although varieties on assignment of priorities exist, all triage processes focus on high, medium and low priorities for victims. Both the Dutch civilian and military emergency services will conduct, in case of a large incident with an overwhelming amount of casualties a ‘Scoop & Run’: The first ambulance to arrive at the scene will oversee and maintain control over the situation (Command & Control). The following ambulances and responders will then start a quick triage, establishing who will need to be transported as quickly as possible. Based upon this first triage, the most severely injured (with heavy Airway, Breathing or Circulation injuries) will be immediately transported to medical treatment facilities. This process is not necessarily meant to save all casualties, but increases the survivability rate of the total amount of casualties.

In the case of a domestic MCI, the Royal Netherlands Army may be involved along with civilian emergency services, creating a complex, hierarchical web of stakeholders. The challenge for both the impromptu established command structure as well as the first responders, is to untangle the chaotic context in order to create a clear oversight and to quickly allocate the appropriate resources.

This project therefore focuses on enhancing seamless interactions between military (medical) professionals during an MCI, as it is vital for an efficient response to an MCI that confusing and erroneous information flows are curtailed, and oversight is established as quickly as possible.