Optimizing Medical Care during a Nerve Agent Mass Casualty Incident Using Computer Simulation.

Introduction: Chemical mass casualty incidents (MCIs) pose a substantial threat to public health and safety, with the capacity to overwhelm healthcare infrastructure and create societal disorder. Computer simulation systems are becoming an established mechanism to validate these plans due to their v...

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Publicado en:Journal of Medical Systems Vol. 48; no. 1; pp. 1 - 15
Autores principales: Ruben, De Rouck, Benhassine, Mehdi, Michel, Debacker, Filip, Van Utterbeeck, Erwin, Dhondt, Ives, Hubloue
Formato: questions and answers research tables/charts Journal Article
Publicado: Springer Nature 9/5/2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 9/5/2024
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s10916-024-02094-8
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        atl: Optimizing Medical Care during a Nerve Agent Mass Casualty Incident Using Computer Simulation.
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        au:
          Ruben, De Rouck
          Benhassine, Mehdi
          Michel, Debacker
          Filip, Van Utterbeeck
          Erwin, Dhondt
          Ives, Hubloue
        affil: https://ror.org/006e5kg04 Research Group on Emergency and Disaster Medicine, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Jette, Belgium
      sug:
        subj:
          Mass Casualty Incidents
          Computer Simulation
          Health Care Delivery
          Funding Source
          Human
          Descriptive Statistics
          Data Analysis Software
          Linear Regression
          Cost Effectiveness Analysis
          Medical Practice, Evidence-Based
          Health Policy
      ab: Introduction: Chemical mass casualty incidents (MCIs) pose a substantial threat to public health and safety, with the capacity to overwhelm healthcare infrastructure and create societal disorder. Computer simulation systems are becoming an established mechanism to validate these plans due to their versatility, cost-effectiveness and lower susceptibility to ethical problems. Methods: We created a computer simulation model of an urban subway sarin attack analogous to the 1995 Tokyo sarin incident. We created and combined evacuation, dispersion and victim models with the SIMEDIS computer simulator. We analyzed the effect of several possible approaches such as evacuation policy ('Scoop and Run' vs. 'Stay and Play'), three strategies (on-site decontamination and stabilization, off-site decontamination and stabilization, and on-site stabilization with off-site decontamination), preliminary triage, victim distribution methods, transport supervision skill level, and the effect of search and rescue capacity. Results: Only evacuation policy, strategy and preliminary triage show significant effects on mortality. The total average mortality ranges from 14.7 deaths in the combination of off-site decontamination and Scoop and Run policy with pretriage, to 24 in the combination of onsite decontamination with the Stay and Play and no pretriage. Conclusion: Our findings suggest that in a simulated urban chemical MCI, a Stay and Play approach with on-site decontamination will lead to worse outcomes than a Scoop and Run approach with hospital-based decontamination. Quick transport of victims in combination with on-site antidote administration has the potential to save the most lives, due to faster hospital arrival for definitive care.
      pubtype: Academic Journal
      doctype:
        questions and answers
        research
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        Journal Article
      ougenre: Article
    language: English
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