How to Manage the big mass casualty in Command center from the Jungle of Western Tak

Abstract

Abstract

          Disaster management strongly affected mortality rate. Although all hospitals in Thailand planed for the mass casualty incidence, a few of them prepared for disaster that exceeded their surged capacity.

          In 2019, Tasongyang hospital, Tak province, encountered a traffic accident with numerous severely-injured patients above their capacity. This led to the collaboration among five western Tak hospitals operated under Western Tak emergency medical service center. 

The incidence was divided into 4 phases.

          1.Planing: Analysis and solid planning emphasizing on resource estimation and relocation

          2.Prehospital care: Establishing on scene management according to CSCATTT and resource management

          3.In-hospital care: Tasongyang hospital proceeded as planned. Anyway, the bottle neck was found. First, ambulances were used both in prehospital and interfacility setting and shortly ran out. Second, the patients waiting too long for transfer still consumed the same resources with newly arrival patients. The problem was solved by relocation of resources from nearby hospitals.

          4.Interfacility transfer: The process regarding to referral system was abridged. The receiving facility was well prepared.         

          There were total eleven patients total. Four of them were triaged red, three were yellow, while four were green. Three patients required intubation immediately. One patient need needle thoracostomy and intercostal drainage. Five of them required emergent and urgent surgical operation. Seven of them were admitted. All patients were safely discharged thereafter.

Keywords: disaster management, mass casualty incidence, MCI, wilderness medicine