Optimizing Medical Care during a Nerve Agent Mass Casualty Incident Using Computer Simulation.
Computer simulation
Disaster
GB
Mass casualty incident
Nerve agent
SIMEDIS
Sarin
Simulation model
Journal
Journal of medical systems
ISSN: 1573-689X
Titre abrégé: J Med Syst
Pays: United States
ID NLM: 7806056
Informations de publication
Date de publication:
05 Sep 2024
05 Sep 2024
Historique:
received:
10
12
2023
accepted:
23
07
2024
medline:
5
9
2024
pubmed:
5
9
2024
entrez:
5
9
2024
Statut:
epublish
Résumé
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. 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. 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. 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.
Identifiants
pubmed: 39235718
doi: 10.1007/s10916-024-02094-8
pii: 10.1007/s10916-024-02094-8
doi:
Substances chimiques
Sarin
B4XG72QGFM
Nerve Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
82Subventions
Organisme : Royal Higher Institute of Defence
ID : HFM/21-12
Informations de copyright
© 2024. The Author(s).
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