Protocols by Hospitals & EMTs When Dealing with “Mass Casualty”
The emergency situation in the immediate aftermath of the explosion was dealt with precision. First responders were on the scene soon after, the siblings as well as the injured persons were rushed to the hospitals. The K.H.M.H. describes this type of emergency as a “mass casualty” because of the number of persons requiring medical attention and the degree of injuries they sustained. In the following story, Duane Moody looks at the protocols in place and how the hospital and the emergency medical technicians treated the situation.
Duane Moody, Reporting
Two school-aged siblings perished when a vessel exploded near the Swing Bridge in downtown Belize City. There was quick response from various departments, including police and fire officials. A total of fourteen persons were injured and rushed to public and private hospitals in the Old Capital. Aside from the deaths of the siblings, there were a total of five critically injured persons rushed to the Karl Heusner Memorial Hospital. The K.H.M.H. describes this as a mass casualty. Just after three p.m., the call was made to the K.H.M.H. and Nurse-in-Charge at the Accident and Emergency Unit; Derreck Bretaña says they sprung into action. Three nurses were assigned per patient while doctors from the wards also assisted in the emergency. An American woman was immediately taken into surgery.
Derreck Bretaña
Derreck Bretaña, Nurse in Charge, K.H.M.H.
“Three minutes after that call, someone came here in a pickup van and there’s like four patients in that van: one is R.I.P. already, a child, and three of them involved in burns from the blast and two of them are fractures. So after that we attended to them. We prioritized first the ones that are more critical than the rest. So for the R.I.P.’s we just separated in the next room and since the mother was ambulatory and stable, we put her on the side. After that, BERT called us as well and said they will be sending two more ambulance from the blast. So that’s three more patients came here critical.”
There are roughly three incidents annually that are classified as mass casualties at the national referral hospital—whether as a result of vehicular collisions or fires and in this case explosion of a watercraft. Protocol already established by the K.H.M.H. was activated to take patients from a critical stage to a stage where they can recover.
Tylon Tillett
Tylon Tillett, Communications Officer, K.H.M.H.
“During a mass casualty, we call in all of our management; we call in an amount of nurses that would complement the nurses that are currently at the A&E. We call in the necessary specialists and all of these people—even the ones that don’t physically come in to the K.H.M.H.—are put on standby that their services will be required. This incident happened at just after three o’clock; that was a critical time when our staff was changing over. So a lot of the staff that was working at the time did not go home at three o’clock. They stayed until the mass casualty was over by four o’clock.”
But the process of saving lives began at the terminal when paramedics, as well as police and fire fighters, responded to the scene. While to the general public the scene appeared to be chaotic, in the eyes of trained emergency medical technicians, it is quite the opposite. Basic first aid assistance was administered; the goal – to save as many lives as physically possible, given the situation at hand and the roles they play.
Leon Seguro
Leon Seguro, Fleet Supervisor, BERT
“In a mass casualty, they wouldn’t probably be having anybody doing CPR because CPR means that person is tied up and wouldn’t be able to help anybody else. They would just be running through and cheeking and doing basic life-saving skills as they see fit and then as the other personnel comes in and they take over individually that’s where that level of treatment will be going on. When you think about triage, you are doing the best for the greater number. I could go there, run to the scene and I find the first person and stay there and start doing CPR and the whole nine yards for that one person when I could have leave that one person and help fifteen and all fifteen die trying to save one. So it is a picture—not playing God cause a lot of people like use that term, but at the end of the day, our goal is train to do the most we can for the biggest number we can. One of the problems we have is people just want to see people jump up and go to the hospital. At the end of the day that is not necessarily the best interest of the person cause there are certain things that you need to do—life saving measures. Taking a person to the hospital that is bleeding out is going to die before they get there. We have to take the initiative to stop that, fix it and then do transportation.”
The reality on the scene was intense. Fourteen persons had various degrees of injuries including burns and fractures and were rushed to the K.H.M.H. and Belize Medical Associates for treatment. There was cooperation between BERT Ambulance and security personnel to stabilize patients for transportation to the medical facilities.
Leon Seguro
“The more information the dispatcher gets the better aware the medics are going to be to reach the situation and be prepared. The more prepared they are, the quicker they can react. Upon reaching the scene, the medic is going to then do their own assessment because unfortunately not always the information that comes in is the reality that is there. If there are going to be multiple ambulances on scene, the first ambulance that reach does not leave. They will just treat as they see fit and get them ready. Second ambulance come in is gonna go to them and take those patients as prioritized to the hospital as see if fit and they will keep doing that until they get all patients to the hospital.”
Duane Moody for News Five.
