Major incidents in the Western Cape, South Africa: a descriptive study
Master Thesis
2014
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University of Cape Town
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Abstract
Whilst a disaster is typically thought of as a naturally occurring event (such as an earthquake or tidal wave), a mass casualty situation may occur from a natural or man-made source (such as a mass transportation collision, or industrial fire). In many higher income countries, mass casualty situations tend to be referred to as Major Incidents. Although a standard understanding of what constitutes a major incident has not been agreed, with the term being interchanged with both mass casualty incident and disaster, for health services a major incident may be considered to be: “any occurrence which presents a serious threat to the health of the community, disruption to the service or causes (or is likely to cause) such numbers or types of casualties as to require special arrangements to be implemented by hospitals, ambulance services or health authorities”. (Major incidents for services other than the Emergency Medical Services (EMS) will not affect health providers, and so are not considered in any more detail here.) This definition is intentionally broad, to cover incidents from food poisoning outbreaks to planning for mass gatherings. However, major incidents are generally regarded as events which are unpredictable, sudden and which result in a large number of injured or ill casualties presenting to the emergency services over a short period of time. The alternative term used is Mass Casualty Incidents (MCI), loosely described as “the most demanding and chaotic events a responder will ever be confronted with”, the ultimate goal being to get the greatest number of survivable patients to treatment facilities in the shortest amount of time. The point at which a major incident occurs is dependent upon the ability of health service resources at the time of the incident to cope with the patient workload. Major incidents may therefore occur with relatively small numbers of casualties if resources are scarce: this is particularly likely to occur in low and middle income countries where healthcare resources are limited at the best of times. The health services definition also takes into account the severity of injury, as an incident resulting in a small number of casualties may require a major incident response if they are all severely injured. Currently there does not exist a form of quality measurement for evaluation of a response to a major incident but emergency services aim for an early activation of sufficient personnel, rapid access to a secured scene and efficient patient evacuation to the correct facility. In the Western Cape a major incident is declared at the discretion of the most senior Emergency Medical Services (EMS) staff who are present at the scene. Usually this includes: where the resources used are more than 2 ambulances, other agencies are involved (Fire and Rescue) or 3 or more patients, 5 most commonly though the MIMMS definition is used “any incident where the location, number, severity or type of live casualties requires extraordinary resources”. The objectives of this study were (i) to describe the incident type related to total number in the study, (ii) to describe the severity in relation to total number of patients, (iii) to describe the weather conditions prevalent at incidents, (iv) to determine weather conditions associated with red triage category, and (v) to determine which vehicle types are involved in MVC’s. This is the first study to describe major incidents in an African setting. Understanding the types of incidents responded to and the injury severity of patients, will allow more robust planning for future similar incidents. Further to this prevalence of incidents in particular traffic related “hot spots” can be identified and problems rectified.
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Reference:
Lategan, H. 2014. Major incidents in the Western Cape, South Africa: a descriptive study. University of Cape Town.