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Open Access Highly Accessed Research article

Consensus on items and quantities of clinical equipment required to deal with a mass casualties big bang incident: a national Delphi study

Edward A S Duncan1*, Keith Colver2, Nadine Dougall3, Kevin Swingler4, John Stephenson5 and Purva Abhyankar1

Author Affiliations

1 NMAHP Research Unit, Scion House, University of Stirling, Stirling, FK9 4LA, Scotland, UK

2 Scottish Ambulance Service, Edinburgh, Scotland, UK

3 School of Nursing Midwifery and Health, The University of Stirling, Stirling, Scotland, UK

4 Department of Maths and Computing Science, University of Stirling, Stirling FK9 4LA, Scotland, UK

5 National Ambulance Resilience Unit, Unit 9 Granada Trading Estate, Demuth Way, Oldbury B69 4LH, UK

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BMC Emergency Medicine 2014, 14:5  doi:10.1186/1471-227X-14-5

Published: 22 February 2014

Abstract

Background

Major short-notice or sudden impact incidents, which result in a large number of casualties, are rare events. However health services must be prepared to respond to such events appropriately. In the United Kingdom (UK), a mass casualties incident is when the normal response of several National Health Service organizations to a major incident, has to be supported with extraordinary measures. Having the right type and quantity of clinical equipment is essential, but planning for such emergencies is challenging. To date, the equipment stored for such events has been selected on the basis of local clinical judgment and has evolved without an explicit evidence-base. This has resulted in considerable variations in the types and quantities of clinical equipment being stored in different locations. This study aimed to develop an expert consensus opinion of the essential items and minimum quantities of clinical equipment that is required to treat 100 people at the scene of a big bang mass casualties event.

Methods

A three round modified Delphi study was conducted with 32 experts using a specifically developed web-based platform. Individuals were invited to participate if they had personal clinical experience of providing a pre-hospital emergency medical response to a mass casualties incident, or had responsibility in health emergency planning for mass casualties incidents and were in a position of authority within the sphere of emergency health planning. Each item’s importance was measured on a 5-point Likert scale. The quantity of items required was measured numerically. Data were analyzed using nonparametric statistics.

Results

Experts achieved consensus on a total of 134 items (54%) on completion of the study. Experts did not reach consensus on 114 (46%) items. Median quantities and interquartile ranges of the items, and their recommended quantities were identified and are presented.

Conclusions

This study is the first to produce an expert consensus on the items and quantities of clinical equipment that are required to treat 100 people at the scene of a big bang mass casualties event. The findings can be used, both in the UK and internationally, to support decision makers in the planning of equipment for such incidents.

Keywords:
Mass casualties; Major incident; Ambulance; Delphi method; Internet; Paramedic; Big bang; Clinical equipment