| Disaster preparedness: Experience from a smoke inhalation mass casualty incident. | |
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MedLine Citation:
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PMID: 17091053 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: We describe a modified triage system used in managing a smoke inhalation mass casualty incident that we recently encountered at our community hospital. MATERIALS AND METHODS: The patients were triaged as priority 1, 2 or 3 on the basis of their symptoms, signs and circumstances at scene. In addition, the use of fibre-optic examinations of the upper airway, chest radiography and carboxyhaemoglobin levels with arterial blood gas analyses were used to aid in disposal plans. RESULTS: Of the 22 patients evacuated, 15 were triaged as priority 2 and the remaining seven as priority 3. None of the patients was identified as priority 1. All the priority 2 patients underwent further investigations. Those with mild upper airway oedema (four patients) or raised carboxyhaemoglobin levels (two patients) were admitted. Only one patient had both. Another patient who was a known asthmatic developed bronchospasm and was admitted as well. All six were admitted to the general ward with subsequent good recovery and were discharged within 3 days. The remaining nine priority 2 and seven priority 3 patients were discharged from the emergency department. CONCLUSIONS: These modified triage criteria, with selective use of fibre-optic examinations, chest radiography and arterial blood gas analyses with carboxyhaemoglobin levels, are useful in smoke inhalation mass casualty incidents without dermal burns. Systemic injury and poisoning by toxic fumes often coexist with airway burns and should not be overlooked. Lastly, disaster planning and frequent drills at both local and national levels will optimize the response to future mass casualty incidents. |
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Authors:
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Siang-Hiong Goh; Ling Tiah; Hoon-Chin Lim; Elaine Kim-Choon Ng |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: European journal of emergency medicine : official journal of the European Society for Emergency Medicine Volume: 13 ISSN: 0969-9546 ISO Abbreviation: Eur J Emerg Med Publication Date: 2006 Dec |
Date Detail:
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Created Date: 2006-11-08 Completed Date: 2007-01-11 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9442482 Medline TA: Eur J Emerg Med Country: England |
Other Details:
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Languages: eng Pagination: 330-4 Citation Subset: IM |
Affiliation:
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Accident and Emergency Department, Changi General Hospital, Singapore, Republic of Singapore. Siang-Hiong-Goh@cgh.com.sg |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Blood Gas Analysis Bronchoscopy Carboxyhemoglobin / metabolism Child Child, Preschool Disaster Planning / organization & administration* Emergency Service, Hospital / organization & administration* Emergency Treatment / methods*, standards Health Services Needs and Demand Health Services Research Hospitals, Community Hospitals, General Humans Infant Middle Aged Outcome Assessment (Health Care) Patient Admission / statistics & numerical data Practice Guidelines as Topic Singapore Smoke Inhalation Injury / blood, diagnosis*, therapy* Triage / organization & administration* |
| Chemical | |
Reg. No./Substance:
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9061-29-4/Carboxyhemoglobin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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