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The Impact of Age upon Contingency Planning for Multiple-casualty Incidents Based on a Single Center’s Experience

Published online by Cambridge University Press:  17 August 2016

Itamar Ashkenazi ,
Sharon Einav ,
Oded Olsha ,
Fernando Turegano-Fuentes ,
Michael M. Krausz  and
Ricardo Alfici
Itamar Ashkenazi*
Affiliation:
Hillel Yaffe Medical Centre, Hadera, Israel
Sharon Einav
Affiliation:
Shaare Zedek Medical Centre, Jerusalem, Israel
Oded Olsha
Affiliation:
Shaare Zedek Medical Centre, Jerusalem, Israel
Fernando Turegano-Fuentes
Affiliation:
Hospital General Universitario Gregorio Marañon, Madrid, Spain
Michael M. Krausz
Affiliation:
Hillel Yaffe Medical Centre, Hadera, Israel
Ricardo Alfici
Affiliation:
Hillel Yaffe Medical Centre, Hadera, Israel
*
Correspondence: Itamar Ashkenazi, MD Surgery Department Hillel Yaffe Medical Center POB 169, Hadera, Israel 38100 E-mail: [email protected]
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Abstract

Introduction

Trauma patients in the extremes of age may require a specialized approach during a multiple-casualty incident (MCI).

Problem

The aim of this study was to examine the type of injuries encountered in children and elderly patients and the implications of these injuries for treatment and organization.

Methods

A review of medical record files of patients admitted in MCIs in one Level II trauma center was conducted. Patients were classified according to age: children (≤12 years), adults (between 12-65 years), and elders (≥65 years).

Results

The files of 534 were screened: 31 (5.8%) children and 54 (10.1%) elderly patients. One-third of the elderly patients were either moderately or severely injured, compared to only 6.5% of the children and 11.1% of the adults (P<.001). Elderly patients required more blood transfusions (P=.0001), more computed tomography imaging (P=.0001), and underwent more surgery (P=.0004). Elders were hospitalized longer (P=.0003). There was no mortality among injured children, compared to nine (2.0%) of the adults and seven (13.0%) of the elderly patients (P<.0001). All the adult deaths occurred early and directly related to their injuries, whereas most of the deaths among the elderly patients (four out of seven) occurred late and were due to complications and multiple organ failure.

Conclusions

Injury at an older age confers an increased risk of complications and death in victims of MCIs.

AshkenaziI, EinavS, OlshaO, Turegano-FuentesF, KrauszMM, AlficiR. The Impact of Age upon Contingency Planning for Multiple-casualty Incidents Based on a Single Center’s Experience. Prehosp Disaster Med. 2016;31(5):492–497.

Keywords

blast injuriesemergency preparednessmultiple-casualty incidentsterrorism
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 31 , Issue 5 , October 2016 , pp. 492 - 497
Copyright
© World Association for Disaster and Emergency Medicine 2016 

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