Major Incident Medical Management and Support E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 218

Veröffentlichungsjahr: 2013

Beschreibung

This is the course book for a new ALSG course on preparation for and medical management of major incidents within the hospital. It will be a companion volume to MIMMS, which deals with the prehospital situation, and will meet an ever increasing need as natural and other disasters affect hospital staff and administrators. The course aims to provide a systematic approach for all personnel who would be involved in managing a major incident in the hospital.

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Leseprobe

Contents

Authors

Working group

Preface

Acknowledgements

Contact Details and Further Information

PART I: INTRODUCTION

Chapter 1: The epidemiology and incidence of major incidents

INTRODUCTION

THE EPIDEMIOLOGY OF MAJOR INCIDENTS IN THE UK

SUMMARY

Chapter 2: Are we ready for the next major incident?

INTRODUCTION

HOSPITAL PREPARATION FOR MAJOR INCIDENTS

CONCLUSIONS

SUMMARY

Chapter 3: The structured approach to the hospital response

INTRODUCTION

THE PHASES OF THE HOSPITAL MAJOR INCIDENT RESPONSE

SUMMARY

PART II: PREPARATION

Chapter 4: Planning for major incidents

PLANNING

IN-HOSPITAL PLANS

SUMMARY

Chapter 5: Major incident equipment

INTRODUCTION

MAJOR INCIDENT RESPONSE

STAFF PROTECTION

CLINICAL CARE

COMMUNICATIONS

SUMMARY

Chapter 6: Training

INTRODUCTION

SUMMARY

PART III: MANAGEMENT

Chapter 7: The collapsible hierarchy concept

THE RATIONALE FOR A COMMON FRAMEWORK FOR MAJOR INCIDENT PLANS

THE COLLAPSIBLE HIERARCHIES

SUMMARY

Chapter 8: The clinical hierarchy

THE ESSENTIAL CLINICAL ROLES

ADDITIONAL CLINICAL ROLES

NON-MANAGERIAL CLINICAL ROLES

SUMMARY

Chapter 9: The nursing hierarchy

THE ESSENTIAL NURSING ROLES

ADDITIONAL NURSING ROLES

SUMMARY

Chapter 10: The management hierarchy

THE ESSENTIAL MANAGEMENT ROLES

ADDITIONAL MANAGEMENT ROLES

OTHER ROLES IN THE MANAGEMENT HIERARCHY

SUMMARY

PART IV: SUPPORT

Chapter 11: Declaring a major incident and activating the plan

DECLARING A MAJOR INCIDENT

ACTIVATING THE PLAN

SUMMARY

Chapter 12: The reception phase

PREPARATION OF THE HOSPITAL

CLINICAL CARE

CLINICAL SUPPORT SERVICES

NON-CLINICAL SUPPORT SERVICES

MANAGEMENT SERVICES

OTHER SERVICES

SUMMARY

Chapter 13: Triage

INTRODUCTION

HISTORY

AIMS

TIMING

PRIORITIES

DEFINITIONS

TRIAGE METHODS

SUMMARY OF TRIAGE METHODS

TRIAGE AND ORDER OF INTERVENTION

TRIAGE LABELLING

SUMMARY

Chapter 14: The definitive care phase

THE SURGICAL RESPONSE

NON-SURGICAL (MEDICAL)

CLINICAL AND NON-CLINICAL SUPPORT SERVICES

SUMMARY

Chapter 15: The recovery phase

RESOLUTION

REFLECTION

AUDIT

SUMMARY

PART V: SPECIAL INCIDENTS

Chapter 16: Incidents involving hazardous chemicals

INTRODUCTION

RESPONSE

AFTER THE INCIDENT

Chapter 17: Incidents involving a large number of burns

INTRODUCTION

PREPARATION

PRE-HOSPITAL PHASE

RECEPTION PHASE

RECOVERY AND SUPPORT

SUMMARY

Chapter 18: Incidents involving a large number of children

INTRODUCTION

PREPARATION

RECEPTION PHASE

Glossary

Index

© 2005 by Blackwell Publishing Ltd

BMJ Books is an imprint of the BMJ Publishing Group Limited, used under license

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All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher.

First published 2005

Library of Congress Cataloging-in-Publication Data

Carley, Simon.

Major incident medical management and support: the practical approach in the hospital / Advanced Life Support Group; by Simon Carley, Kevin Mackway-Jones.

p. ; cm.

Includes index.

ISBN-13: 978-0-7279-1868-0 (ring binder : alk. paper)

ISBN-10: 0-7279-1868-0 (ring binder : alk. paper)

1. Disaster medicine. 2. Hospitals. 3. Disaster hospitals.

[DNLM: 1. Disaster Planning-organization & administration.

2. Emergency Medical Services-Organization & administration.

3. Emergency Medicine-methods. 4. Emergency Service, Hospital-

organization & administration. WX 185 C2815m 2005] I. Mackway-Jones,

Kevin. II. Advanced Life Support Group (Manchester, England) III. Title.

RA645.5.C366 2005

362.18-dc22 2005005213

ISBN-13: 978-0-727918-68-0

ISBN-10: 0-727918-68-0

A catalogue record for this title is available from the British Library

Commissioning Editor: Mary Banks

Development Editor: Veronica Pock

Production Controller: Debbie Wyer

For further information on Blackwell Publishing, visit our Web site: http://www.blackwellpublishing.com

The publisher’s policy is to use permanent paper from mills that operate a sustainable forestry policy, and which has been manufactured from pulp processed using acid-free and elementary chlorine-free practices. Furthermore, the publisher ensures that the text paper and cover board used have met acceptable environmental accreditation standards.

AUTHORS

Simon Carley MPhil MD FRCS (Ed) FFAEM DipIMC (RCSEd) Consultant in Emergency Medicine, Manchester Royal Infirmary

Kevin Mackway-Jones MA FRCP FRCS FFAEM FAEM Professor of Emergency Medicine Consultant in Emergency Medicine, Manchester Royal Infirmary Honorary Civilian Consultant Adviser, Emergency Medicine, British Army Medical Director, Greater Manchester Ambulance Service.

WORKING GROUP

Simon Carley

Consultant in Emergency Medicine, Manchester Royal Infirmary, Manchester UK

Peter Driscoll

Consultant in Emergency Medicine, Hope Hospital, Manchester, UK

Peter Johnson

Advanced Practitioner in Critical Care, Royal Cornwall Hospital Truro UK

Celia Kendrick

Lead Nurse Emergency Department/Emergency Plan­ning Nurse, Peterborough District Hospital Peterbor­ough UK

Kevin Mackway-Jones

Professor of Emergency Medicine, Manchester Royal In­firmary, Manchester UK

Elaine Metcalfe

Project & Development Manager, Advanced Life Support Group, Manchester, UK

Brendan Ryan

Executive Medical Director and Consultant in Emergency Medicine, South Manchester University Hospitals NHS Trust Manchester UK

Steve Southworth

Consultant in Emergency Medicine, Stepping Hill Hos­pital, Stockport, UK

Polly Terry

Consultant in Emergency Medicine, Leighton Hospital, Crewe, UK

Sue Wieteska

Group Manager, Advanced Life Support Group, Manchester, UK

PREFACE

It is now nearly 10 years since the Advanced Life Support Group published its first book on major incident response. That book (Major Incident Medical Management and Support: the practical approach at the scene) and its accompanying course, affectionately known as MIMMS, are now established around the world as best practice guides. The CSCATTT approach to incidents has become a standard like ABC.

For some of us, however, the focus on the first phase of the response (the pre-hospital phase), while a good place to start, did not solve all our problems. Our practice was more likely to be delivering care within the hospital environment, and a course dedicated to this seemed badly needed.

This book has been written with the aim of promulgating the disciplines and lessons of MIMMS to the hospital provider. We hope that the multi-professional team needed for a successful response can use this text and its accompanying course (to be known as Hospital MIMMS) as successfully as their pre-hospital colleagues have used MIMMS. Certainly our pilot courses have suggested that the package does fill an unmet need. We hope that those of you who read it and train with us agree.

The days spent on courses are just part of a learning process; both skills and knowledge need continual reinforcement. At the end of your HMIMMS course you will receive a logbook for you to use back at your place of work.

K Mackway JonesS Carley

ACKNOWLEDGEMENTS

Candidates attending Hospital MIMMS courses have shared their thoughts on the text with us. We are grateful to those of you who have provided constructive feedback during the development process.

The authors wish to acknowledge Mary Harrison and Helen Carruthers for the use of their line diagrams within the text.

Thanks also go to Peter-Marc Fortune and Mahil Samuel for their help and feedback on the paediatric section and Ian Crawford for his input to the hazardous materials section.

CONTACT DETAILS AND FURTHER INFORMATION

ALSG: www.alsg.org

Best bets: www.bestbets.org

For details on ALSG courses visit the website or contact:

Advanced Life Support Group

ALSG Centre for Training & Development

29-31 Ellesmere Street

Swinton, Manchester

M27 0LA

Tel: [phone]

Fax: [phone]

Email: [email protected]

UPDATES

The material contained within this book is updated on a 4 yearly cycle. However, practice may change in the interim period.

We will post any changes on the ALSG website, so we advise that you visit the website regularly to check for updates (url: www.alsg.org/updates). The website will provide you with a new page to download and replace the existing page in your book.

REFERENCES

References are available on the ALSG reference centre www.alsg.org/references.

ON-LINE FEEDBACK

It is important to ALSG that the contact with our providers continues after a course is completed. We now contact everyone six months after the course has taken place asking for on-line feedback on the course. This information is then used whenever the course is updated to ensure that the course provides optimum training to its participants.

PART I INTRODUCTION

CHAPTER 1

The epidemiology and incidence of major incidents

INTRODUCTION

A major incident is said to have occurred when an incident requires an extraordinary re­sponse by the emergency services. While major incidents may affect any of the emergency services, the health service’s focus is the resulting casualties. A major incident cannot, however, simply be defined in terms of the number of casualties—the resources available at the time of the incident are also relevant. For example, a road traffic accident in a remote area producing five multiply injured casualties may overwhelm the immediately available local resources. However, a similar incident in a major urban conurbation may require little or no additional resources. Thus, the same incident in different localities may produce a major incident in one but not in the other.