Response to major incidents and disasters: An important part of trauma management

Abstract

The possibility of situations in which available resources are insufficient for the immediate need of medical care within the health care system, defined as major incidents (MIs), has significantly increased during the last few decades, subsequent to development throughout the world, and continues to increase. Experiences from MIs since the beginning of the new millennium clearly illustrate that, regardless of where we live, we can at any time and without any warning be faced with a large number of casualties; the need for treatment highly exceeds available resources and people’s life and health depend on how well we are prepared and trained for such situations. MIs include a wide spectrum of events, from those where all patients who can normally be rescued can be saved by adapting organization and methodology to the situation (MI level 1), to those with a large number of casualties and destroyed national infrastructure, requiring international assistance (MI level 4). However, even if the demands on triage and simplified methods vary with the extent of the incident, the basic principles of management and performance are the same.The goal of the health care system in these situations is to eliminate or reduce avoidable loss of life and health, as well as physical and psychological suffering. This requires planning and preparedness; however, more important is for all staff involved in the rescue to have appropriate training. Because the dominating scenario so far has been physical trauma, this is a heavy responsibility, not only for the leaders, but for all staff involved in the management of traumatized patients.