Health Emergencies in Large Populations - The H.E.L.P. Course

1. Participants are able to explain the need for and benefit of a systematic, structured and pre-established approach to Mass Casualty Incidents (MCI)

1.1 Participants are able to list different types of MCI and explain specific needs that may be expected for these.

• Different situations that may cause mass casualties, e.g.

  • Certain natural disasters (earthquake, cyclone, floods, landslides, ...),

  • Road / air collisions, subway derailment, ....

    Accidental or intentional explosions and fires

• Armed conflict: Specific safety & security concerns to be taken into consideration.

• CBRN (chemical, biological, radiological and nuclear) incidents create a different set of issues for mass casualty management

• Need to switch from individual emergency care to emergency medical care of several (mass/multi) casualties; doing the best for the most

1.2. Participants are able to explain the benefits of a properly functioning Mass Casualty Management (MCM) approach and which actors may be involved

• Main approaches prehospital emergency medical care:

  • Basic approach (‘scoop and run') vs mass casualty management approach

• MCIs may create the need for a multiorganizational approach and coordination

  • Different actors in the pre-hospital medical field

2. Participants are able to describe the general principles of MCM, including those for triage and what might be hurdles to overcome

2.1. Participants are able to explain the basics of a mass casualty system and list the key components of a mass casualty plan

• Mass casualty management system

  • Multi-sectoral preparation and response

    • Pre-established and tested protocols and procedures, including coordination

    • Maximizing use of existing resources

  • Rescue chain

    • From impact zone to hospital emergency dept. (-> hospital disaster response plan)

    • Purpose of an (advanced) medical point

• Components of a mass casualty plan

2.2. Participants are able to explain the purpose of triage and what a classification for the priority of care might look like

• See ICRC triage classification

  • Category 1: RED

  • Category 2: YELLOW

  • Category 3: GREEN

  • Category 4: (NOT used in pre-Hospital care – BLUE)

  • Category 5: GREY

• When a health care system is not fully functional, triage will cause difficult ethical dilemmas, especially around the category of non-treatable patients -Link to module ‘Practical ethics in humanitarian action'

• Note that in certain countries casualties may have to be reported to the police (legal obligation vs ethical dilemma)

• NB. Foreign medical teams, e.g. Emergency Medical Teams: “Classification and minimum standards for foreign medical teams in sudden onset disasters”, WHO Global Health cluster 2013 (currently under revision) - Same as for Health Care Services