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Evaluation of Interaction Between Emergency Medical System and Hospital Network During a Train Derailment in Milano

Published online by Cambridge University Press:  15 February 2021

Roberto Faccincani Open the ORCID record for Roberto Faccincani [Opens in a new window] ,
Riccardo Stucchi ,
Michele Carlucci ,
Riccardo Sannicandro ,
George Formenti-Ujlaki ,
Federico Pascucci ,
Carl Montan ,
Alberto Zoli ,
Carlo Picco  and
Roberto Fumagalli
Roberto Faccincani*
Affiliation:
Pronto Soccorso, Chirurgia Generale e delle Urgenze, Ospedale San Raffaele, Milan, Italy
Riccardo Stucchi
Affiliation:
SSD SOREU Metropolitana, Dipartimento di Emergenza e Accettazione, Grande Ospedale Metropolitano Niguarda, Milan, Italy
Michele Carlucci
Affiliation:
Pronto Soccorso, Chirurgia Generale e delle Urgenze, Ospedale San Raffaele, Milan, Italy
Riccardo Sannicandro
Affiliation:
Pronto Soccorso, Chirurgia Generale e delle Urgenze, Ospedale San Raffaele, Milan, Italy
George Formenti-Ujlaki
Affiliation:
Pronto Soccorso, Chirurgia Generale e delle Urgenze, Ospedale San Raffaele, Milan, Italy
Federico Pascucci
Affiliation:
Pronto Soccorso, Chirurgia Generale e delle Urgenze, Ospedale San Raffaele, Milan, Italy
Carl Montan
Affiliation:
Department of Vascular Surgery, Karolinska University Hospital, Stockholm, Sweden
Alberto Zoli
Affiliation:
Azienda Regionale Emergenza Urgenza Lombardia, Milan, Italy
Carlo Picco
Affiliation:
Azienda Regionale Emergenza Urgenza Lombardia, Milan, Italy
Roberto Fumagalli
Affiliation:
Azienda Regionale Emergenza Urgenza Lombardia, Milan, Italy Dipartimento di Anestesia e Rianimazione, Grande Ospedale Metropolitano Niguarda, Universita degli Studi Milano Bicocca, Milan, Italy
*
Corresponding author: Roberto Faccincani, Email: [email protected]
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Abstract

On January 25, 2018 a 5-car train derailed in Pioltello, 10 kilometers North-East of Milano City. A standardized post-hoc form was distributed to the hospitals involved in the management of the victims and allowed for an evaluation of the response to the incident.

The management of the incident by EMS (Emergency Medical System) was effective in terms of organization of the scene and distribution of the patients, although the time for the first severe patient to reach the closest appropriate hospital was very long (2 hours). This can be partially explained by the extrication time.

None of the alerted hospitals exceeded their capacity, as patients were distributed carefully among the hospitals. The overall outcome was quite satisfactory; no deaths were reported except for those on scene. Some responding hospitals reported that there was an over-activation based on the services ultimately needed. However this is common in MCIs, as an over-activation is preferable to an under-estimation. To address this concern, as more data are available, activation should be scaled down based on a plan established prior to it; this mechanism of scaling down seems to have failed in this event.

It is of note that the highest performing hospitals underwent recently to an educational program on MCI management.

Keywords

Train derailmentMass Casualty IncidentsDisaster managementHospital responseDisaster report
Type
Report from the Field
Information
Disaster Medicine and Public Health Preparedness , Volume 16 , Issue 2 , April 2022 , pp. 829 - 834
Copyright
© 2021 Society for Disaster Medicine and Public Health, Inc.

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