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Evacuation of casualties Decisions regarding the best destination for each patient need to be based on how far it is safe for them to travel and whether the facilities that they need for definitive treatment will be available. A quick retriage is very useful in...

Evacuation planning Evacuation of large population centres as a prelude to, or in the wake of, an impending disaster is a complex exercise. Y et it may be the most prudent course of action to remove as many people as possible from harm’s way . Clear identific...

FACTORS INFLUENCING RELIEF EFFORTS AND PROVISION OF MEDICAL AID Good communication is critical for the authorities to respond quickly to a disaster. Wireless technology and satellite imagery have revolutionised the way in which real-time information can be obt...

FACTORS INFLUENCING RELIEF EFFORTS AND PROVISION OF MEDICAL AID Good communication is critical for the authorities to respond quickly to a disaster. Wireless technology and satellite imagery have revolutionised the way in which real-time information can be obt...

FURTHER READING Bartholdson S, von Schreeb J. Natural disasters and injuries: what does a /uni00A0 surgeon need to know? Curr Trauma Rep 2018; 4 : 103–8. Ciottone GR, Biddinger PD, Darling RG et al . Ciottone’s disaster medicine , 2nd edn. Philadelphia, PA: El...

Facial injuries The management of facial injuries follows the same general principles of debridement and delayed closure as already outlined. Because of the functional and cosmetic importance of facial structures, skin and soft-tissue excisions are kept to ...

Field hospitals The decision to deploy field hospitals depends on the location, the number of casualties and the speed with which evacua tion can be organised ( Figure 33.8 ). Whether the traditional tented structure or the modular type, housed in containers, ...

Frostbite and immersion injuries (trench foot) Frostbite occurs when a part of the body freezes. The cells are disrupted and the tissue dies. It is in e ff ect a ‘cold’ burn and can be categorised according to the depth that it a ff ects in the same way as a con...

Gas gangrene (clostridial myonecrosis) Gas gangrene is a dreaded consequence of late-presenting missile wounds and crushing injuries. It is a rapidly progressive, potentially fatal condition characterised by widespread necro sis of the muscles and soft-tissue...

HANDING OVER Follow-up and secondary problems The medical aspect of disaster management does not involve a single short-term e ff ort. It requires a long-term commitment and involvement of various disciplines. Because of the large numbers of casualties, the...

Hospital reorganisation In hospitals receiving mass casualties some reorganisation of services is unavoidable. This includes transferring patients with non-urgent conditions to other facilities, augmenting surgical services, reorganising the specialist rota an...

INTRODUCTION Natural disasters provide a constant reminder of the power and capricious nature of our planet. The depletion of the ozone layer and global warming mean that the future may hold in store calamitous events with even greater magnitude than those ...

Learning objectives To recognise and understand: The common features of various disasters • The principles behind the organisation of the relief effort • and of triage in treatment and evacuation Learning objectives To recognise and understand: The common feat...

Limb salvage The Mangled Extremity Severity Score (MESS) and its modi - fications are useful in deciding about limb salvage. Extensive tissue loss, neurovascular damage and loss of long fragments of bone are traditionally indications for amputation. Curr ently...

Management in the field Field hospitals principally function in three main areas ( Table 33.2 ). Summary box 33.4 Essentials of casualty evacuation /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF Retriage to upgrade priorities among the injured Select appropriate ...

Mobilising resources The next step is mobilisation of human and material resources appropriate to the extent of the disaster. Although all modes of transport need to be considered, helicopters provide the quick est access for the first responders ( Figure 33....

Necrotising fasciitis Necrotising fasciitis is a rapidly spreading infection that produces necrosis of the subcutaneous tissues and overlying skin. It is caused by β -haemolytic streptococci and, occasionally , Staphylococcus aureus , but may take the form of...

Organisation of emergency services Emergency services such as the fire brigade, police and ambu lance service must have defined roles and areas of responsibility to ensure a coordinated response during a crisis. Members of these teams must be included in the pl...