Major Incident Hospital Development of a Permanen

Authors: Geertruid Marres Michael Bemelman John van der Eijk Luke Leenen

Publish Date: 2009/03/16

Volume: 35, Issue: 3, Pages: 203-211

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Abstract

Preparation is essential to cope with the challenge of providing optimal care when there is a sudden unexpected surge of casualties due to a disaster or major incident By definition the requirements of such cases exceed the standard care facilities of hospitals in qualitative or quantitative respects and interfere with the care of regular patients To meet the growing demands to be prepared for disasters a permanent facility to provide structured prepared relief in such situations was developedA permanent but reserved Major Incident Hospital MIH has been developed through cooperation between a large academic medical institution a trauma center a military hospital and the National Poison Information Centre NVIC The infrastructure organization support systems training and systematic working methods of the MIH are designed to create order in a chaotic unexpected situation and to optimize care and logistics in any possible scenario Focus points are patient flow and triage registration communication evaluation and training Research and the literature are used to identify characteristic pitfalls due to the chaos associated with and the unexpected nature of disasters and to adapt our organizationAt the MIH the exceptional has become the core business and preparation for disaster and largescale emergency care is a daily occupation An Emergency Response Protocol enables admittance to the normally dormant hospital of up to 100 in exceptional cases even 300 patients after a startup time of only 15 min The Patient Barcode Registration System PBR with EAN codes guarantees quick and adequate registration of patient data in order to facilitate good medical coordination and followup during a major incidentThe fact that the hospital is strictly reserved for this type of care guarantees availability and minimizes impact on normal care When it is not being used during a major incident there is time to address training and research Collaboration with the NVIC and infrastructural adjustments enable us to not only care for patients with physical trauma but also to provide centralized care of patients under quarantine conditions for say MRSA SARS smallpox chemical or biological hazards Triage plays an important role in medical disaster management and is therefore key to organization and infrastructure Caps facilitate role distribution and recognizibility The PBR resulted in more accurate registration and realtime availability of patient and group information Infrastructure and a plan is not enough training research and evaluation are necessary to continuously work on disaster preparednessThe MIH in Utrecht Netherlands is a globally unique facility that can provide immediate emergency care for multiple casualties under exceptional circumstances Resulting from the cooperation between a large academic medical institution a trauma center a military hospital and the NVIC the MIH offers not only a good and complete infrastructure but also the expertise required to provide largescale emergency care during disasters and major incidents

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