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Mass Casualty Incident Management for Resource-Limited Settings: Lessons From Central Haiti

Published online by Cambridge University Press:  11 March 2021

Shada A. Rouhani Open the ORCID record for Shada A. Rouhani [Opens in a new window] ,
Linda Rimpel ,
Jean Jimmy Plantin ,
Christopher F. Calahan ,
Marc Julmisse ,
Marie Cassandre Edmond ,
Keegan A. Checkett  and
Regan H. Marsh
Shada A. Rouhani*
Affiliation:
Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts, USA Partners In Health, Boston, Massachusetts, USA
Linda Rimpel
Affiliation:
Hôpital Universitaire de Mirebalais, Mirebalais, Haiti
Jean Jimmy Plantin
Affiliation:
Hôpital Universitaire de Mirebalais, Mirebalais, Haiti
Christopher F. Calahan
Affiliation:
Partners In Health, Boston, Massachusetts, USA Department of Internal Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
Marc Julmisse
Affiliation:
Partners In Health, Boston, Massachusetts, USA Hôpital Universitaire de Mirebalais, Mirebalais, Haiti
Marie Cassandre Edmond
Affiliation:
Hôpital Universitaire de Mirebalais, Mirebalais, Haiti
Keegan A. Checkett
Affiliation:
Partners In Health, Boston, Massachusetts, USA Department of Emergency Medicine, University of Chicago, Chicago, Illinois, USA
Regan H. Marsh
Affiliation:
Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts, USA Partners In Health, Boston, Massachusetts, USA
*
Corresponding author: Shada A. Rouhani, Email: shada.rouhani@gmail.com.
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Abstract

Objective:

Mass casualty incidents (MCIs) have gained increasing attention in recent years due multiple high-profile events. MCI preparedness improves the outcomes of trauma victims, both in the hospital and prehospital settings. Yet most MCI protocols are designed for high-income countries, even though the burden of mass casualty incidents is greater in low-resource settings.

Results:

Hôpital Universitaire de Mirebalais (HUM), a 300-bed academic teaching hospital in central Haiti, developed MCI protocols in an iterative process after a large MCI in 2014. Frequent MCIs from road traffic collisions allowed protocol refinement over time. HUM’s protocols outline communication plans, triage, schematics for reorganization of the emergency department, clear delineation of human resources, patient identification systems, supply chain solutions, and security measures for MCIs. Given limited resources, protocol components are all low-cost or cost-neutral. Unique adaptations include the use of 1) social messaging for communication, 2) mass casualty carts for rapid deployment of supplies, and 3) stickers for patient identification, templated orders, and communication between providers.

Conclusion:

These low-cost solutions facilitate a systematic response to MCIs in a resource-limited environment and help providers focus on patient care. These interventions were well received by staff and are a potential model for other hospitals in similar settings.

Keywords

mass casualty incidentsemergency servicehospitalemergency medicinelow-income countryroad traffic collision
Type
Concepts in Disaster Medicine
Information
Disaster Medicine and Public Health Preparedness , Volume 16 , Issue 2 , April 2022 , pp. 770 - 776
Copyright
© 2021 Society for Disaster Medicine and Public Health, Inc.

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