Challenges of Mass Casualty Management at a Regional Trauma Centre in Sub-Saharan Africa

Abstract

Background: Mass Casualty incidents usually overwhelm the capabilities of any centre. It is an event whose nature is undetermined, unexpected and disrupts the normal trauma care in a hospital. Hospitals have established protocols to deal with mass casualty when it arises. Objectives: We sought to profile the presentations of mass casualty incidents and challenges in management in a regional trauma Centre in North-West Nigeria. Methodology: A retrospective look at the records of mass casualty presentations in our centre over a 12-month period (January-December 2011) was done. A mass casualty event in our setting is the presentation to our facility of eight or more patients from the same cause at the same. Results: There were a total of 18 mass casualty presentations with an average of 1.5 per month. There were a total of 236 victims including those brought in dead (BID). Males were 203 (86%) and females 33 (16%) with an M:F ratio of 6:1. Majority of the victims 222 (94%) were above 16 years and all the victims had a common mechanism of injury which was Road traffic crashes. One hundred and forty-three (61%) of the victims sustained lacerations and bruises while 31 (13%) were polytraumatized. Sixty-two (26%) of the victims were BID’S from the scenes of the Road Crashes. The outcome was that 131 (75%) of the victims were treated and discharged while 41 (24%) were admitted for further management. Two (1%) patients died during resuscitation and within 24 hours. Conclusion: Mass casualty presentations are a regular event in our centre hence there is the need for the establishment of a protocol and regular mass casualty drills to cope with future occurrences.