Mass casualty drill in a local hospital
AbstractBACKGROUND: In light of the recent political and religious upheaval in Nigeria and several incidents where large numbers of trauma patients were brought to Evangel Hospital, the Consultant staff expressed concern at the lack of organization and preparedness for these inevitable situations.
METHOD: In order to address the need for improved performance in mass casualty situations and provide an educational opportunity for the resident doctors, nurses and other hospital staff, we embarked on preparations for a planned mass casualty drill. The stated goals of the mass casualty drill were as follows: evaluate the performance of the hospital staff at every cadre, the communication systems, the adequacy of hospital supplies and equipment and provide immediate feedback to the staff for their educational benefit and improved future performance.
The Consultant staff drafted a mass casualty plan with the senior staff and then began an organized review with each cadre of staff in the hospital of their responsibilities. The drill date was announced to the staff and on the afternoon of the drill, a full mass casualty simulation exercise was enacted. The drill involved the participation of every level of staff and lasted approximately two hours. After the drill, the patient actors were polled for their reactions and there were meetings with each level of staff for both their feedback and instruction from the drill.
The feedback from the actors and staff was invaluable in evaluating the strengths and weaknesses of the mass casualty protocol.
RESULTS: A great deal was learned through the mass casualty exercise. Good communication early in the drill was critical for the entire exercise. Identifying key leaders and delegation of responsibilities to available staff proved vital as well. The drill enabled the hospital administration to evaluate and make improvements in the adequacy of hospital, equipment and supplies such as stretchers and wheelchairs. The attitudes of the staff toward the actor patients and real patients who were observing provided valuable feedback. The roles of the support services like the laboratory, x-ray, pharmacy and stores were also reviewed. Ongoing regular review of the mass casualty procedures is planned with each cadre of staff, as are biannual drills.
CONCLUSION: As in many parts of the world, Nigerian health care providers will continue to face mass casualty situations from natural disasters, road traffic accidents and political or religious upheavals. Embarking on exercises to improve our preparedness seems prudent for the benefit of the patients we serve and for our own professional integrity.
Nigerian Journal of Orthopaedics and Trauma Vol.3(1) 2004: 20-29