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Mass casualty incidents—are you ready? A major incident planning template for diagnostic radiology

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Abstract

Mass casualty incidents (MCIs) create a large number of casualties in a short period of time. Diagnostic radiology plays an important role in major incident responses but is often underrepresented during major incident planning (MIP) and simulation. Surveys suggest radiologists are unfamiliar with their role during an MCI. We aimed to identify key topics for radiology MIP, familiarize radiologists with their role during an MCI and identify areas for future research. The terms “radiology” and “mass casualty incident” were entered into the advanced search builder on PubMed. Abstracts from this primary search were reviewed and papers selected for inclusion. Additional studies of interest were identified upon review of reference sections of relevant articles and from the related article tab on PubMed. MCI and trauma guidelines were reviewed. Key factors that caused issues during prior MCIs were identified including staff alert mechanisms, patient identification strategies, patient tracking, scan ordering and result communication. Limitations of local imaging resources and capacity should be identified and inform plans for the utilization of diagnostic radiology in the MCI setting. Simulation can help identify areas for improvement and familiarize staff with their roles. Further development of reliable MCI alert technology and patient identification strategies are needed as well as prospective validation of trauma CT selection criteria to identify patients who will benefit most from CT. Radiology should take part in MIP to address key issues encountered during prior MCIs and in MCI simulation to optimize major incident response.

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Abbreviations

CT:

Computed tomography

CISD:

Critical Incident Stress Debriefing

ED:

Emergency department

FAST:

Focused Assessment with Sonography for Trauma

IT:

Information technology

IMA:

Instant messaging mobile phone application

MCI:

Mass casualty incident

MAC:

Minimal accepted care

MPR:

Multiplanar reconstruction

NICE:

The National Institute for Health and Care Excellence

PBRS:

Patient Barcode Registration Systems

PACS:

Picture archiving and communication system

RCR:

Royal College of Radiologists

SMS:

Short Message System

Surge capacity:

The ability of the radiology department or imaging modality to expand beyond the normal capacity to meet the increased demand for clinical care

US:

Ultrasound

USA:

United States of America

UK:

United Kingdom

WBCT:

Whole body computed tomography

WHO:

World Health Organization

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Authors and Affiliations

  1. Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland

    James W. Ryan, A. Murphy, P. J. MacMahon & F. Bolster

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  1. James W. Ryan
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  2. A. Murphy
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  4. F. Bolster
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Contributions

Ryan JW: Performed literature review, primary author of the article

Murphy A: Critically revised the work

MacMahon PJ: Critically revised the work

Bolster F: Formulated the concept of article, critically revised the work

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Correspondence to James W. Ryan.

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Ryan, J.W., Murphy, A., MacMahon, P.J. et al. Mass casualty incidents—are you ready? A major incident planning template for diagnostic radiology. Emerg Radiol 27, 321–328 (2020). https://doi.org/10.1007/s10140-020-01759-4

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