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Logistic Red Flags in Mass-Casualty Incidents and Disasters: A Problem-Based Approach

Published online by Cambridge University Press:  03 February 2022

Lorenzo Gamberini ,
Guglielmo Imbriaco Open the ORCID record for Guglielmo Imbriaco [Opens in a new window] ,
Pier Luigi Ingrassia ,
Carlo Alberto Mazzoli ,
Stefano Badiali ,
Davide Colombo ,
Luca Carenzo Open the ORCID record for Luca Carenzo [Opens in a new window] ,
Alfonso Flauto ,
Marco Tengattini  and
Federico Merlo
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Lorenzo Gamberini
Affiliation:
Department of Anesthesia, Intensive Care and Prehospital Emergency, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy
Guglielmo Imbriaco
Affiliation:
Emilia Est Emergency Dispatch Center – Helicopter Emergency Medical Service, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy Critical Care Nursing Master course, University of Bologna, Italy
Pier Luigi Ingrassia
Affiliation:
Centro di Simulazione (CeSi), Centro Professionale Sociosanitario, Lugano, Switzerland
Carlo Alberto Mazzoli
Affiliation:
Department of Anesthesia, Intensive Care and Prehospital Emergency, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy
Stefano Badiali
Affiliation:
Department of Anesthesia, Intensive Care and Prehospital Emergency, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy
Davide Colombo
Affiliation:
CRIMEDIM Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Department of Translational Medicine, Università degli Studi del Piemonte Orientale, Novara, Italy
Luca Carenzo*
Affiliation:
Department of Anesthesia and Intensive Care Medicine, IRCCS Humanitas Research Hospital, Rozzano, Italy
Alfonso Flauto
Affiliation:
Emilia Est Emergency Dispatch Center – Helicopter Emergency Medical Service, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy
Marco Tengattini
Affiliation:
CRIMEDIM Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Department of Translational Medicine, Università degli Studi del Piemonte Orientale, Novara, Italy
Federico Merlo
Affiliation:
CRIMEDIM Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Department of Translational Medicine, Università degli Studi del Piemonte Orientale, Novara, Italy
Massimo Azzaretto
Affiliation:
CRIMEDIM Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Department of Translational Medicine, Università degli Studi del Piemonte Orientale, Novara, Italy
Alessandro Monesi
Affiliation:
Critical Care Nursing Master course, University of Bologna, Italy Intensive Care Unit, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy
Fernando Candido
Affiliation:
Intensive Care Unit, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy
Carlo Coniglio
Affiliation:
Department of Anesthesia, Intensive Care and Prehospital Emergency, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy
Giovanni Gordini
Affiliation:
Department of Anesthesia, Intensive Care and Prehospital Emergency, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy
Francesco Della Corte
Affiliation:
CRIMEDIM Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Department of Translational Medicine, Università degli Studi del Piemonte Orientale, Novara, Italy
*
Correspondence: Luca Carenzo, MD, MSc, EDIC Department of Anesthesia and Intensive Care Medicine, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy E-mail: [email protected]
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Abstract

Background:

Mass-casualty incidents (MCIs) and disasters are characterized by a high heterogeneity of effects and may pose important logistic challenges that could hamper the emergency rescue operations.

The main objective of this study was to establish the most frequent logistic challenges (red flags) observed in a series of Italian disasters with a problem-based approach and to verify if the 80-20 rule of the Pareto principle is respected.

Methods:

A series of 138 major events from 1944 through 2020 with a Disaster Severity Score (DSS) ≥ four and five or more victims were analyzed for the presence of twelve pre-determined red flags.

A Pareto graph was built considering the most frequently observed red flags, and eventual correlations between the number of red flags and the components of the DSS were investigated.

Results:

Eight out of twelve red flags covered 80% of the events, therefore not respecting the 80-20 rule; the number of red flags showed a low positive correlation with most of the components of the DSS score. The Pareto analysis showed that potential hazards, casualty nest area > 2.5km2, number of victims over 50, evacuation noria over 20km, number of nests > five, need for extrication, complex access to victims, and complex nest development were the most frequently observed red flags.

Conclusions:

Logistic problems observed in MCIs and disaster scenarios do not follow the 80-20 Pareto rule; this demands for careful and early evaluation of different logistic red flags to appropriately tailor the rescue response.

Keywords

disaster medicinemajor incidentmass-casualty incidentstandardized datauniform reporting
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 37 , Issue 2 , April 2022 , pp. 197 - 204
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Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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