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Moulage Accessories. Casualty Evacuation. Trauma Accessories. Intraosseous Access. Personal Protection. Course Overview This certified two-day course is delivered by experienced pre-hospital emergency care practitioners and teaches a systematic approach to the medical management of major incidents in accordance with ALSG guidance. Course Dates 11th November - 12th November Cost inc. Aim MIMMS is essential training for personnel who are involved in major incident planning or providing a major incident response.

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We aim to address the challenges by designing a template that is feasible and freely accessible to allow rapid dissemination of information for practical and comparative analysis. Based on a modified nominal group technique, we conducted a consensus process to identify data variables that should be incorporated into such a template. European experts who had published previous major incident reporting templates were identified through a systematic literature review [ 12 ] and were invited to participate.

Major Incident Medical Management and Support: The Practical Approach in the Hospital

Six authors were identified and four were able to take part in the consensus process. The organizers were each asked to nominate two experts with experience as a major incident practitioner, planner or academic. Nine nominated experts were able to participate. In total 13 experts from 10 European countries participated. The four-stage consensus process was based on the Nominal Group Technique [ 19 ] modified according to the experience gained by researchers in the Norwegian Air Ambulance Foundation in undertaking recent consensus processes [ 20 — 24 ].

The process consisted of three written stages where experts worked individually and one collective meeting with verbal negotiations.

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The process began in December and final modifications were made in October The experts were each asked to suggest 30 data variables that they believed to be of greatest value concerning pre-hospital major incident medical management reporting. One month later, the experts were asked to choose the 45 most important variables from all suggested variables in stage 1. The reason for choosing 45 variables was to prevent the experts from only choosing their 30 suggested variables from stage 1.

During this stage experts were also allowed to combine variables considered to have the same core meaning. The 45 variables suggested by each expert were given a point value: a ranking of first place gave 45 points, second place 44 points and so on until the priority on 45th place received 1 point. A month later a list containing the variables that scored more than points together with their comments was sent to the experts.

This step allowed the experts to perform a second examination of relevant scientific material prior to the consensus meeting. Two weeks later the expert group attended a 2-day meeting in Torpomoen, Norway. The highest ranked variables were discussed and a draft of the final template agreed upon. Variables and definitions were collated with existing Utstein templates for reporting from trauma care and major incidents [ 22 , 25 ]. The organisers edited this draft into a consistent structure and circulated it to the experts for final revision two weeks after the consensus.

The group undertook revisions in August Experts with experience in testing questionnaires for Statistics Norway reviewed the template and provided suggestions for improvement from a user point-of-view. Most of these suggestions were incorporated into the template before it was distributed to the consensus group for final approval in October Only identical or very similar variables were merged, resulting in a total list of variables.

Stage 2 resulted in a list of 41 variables that scored more than points. These were discussed at the consensus meeting and resulted in a template consisting of 48 variables each allocated into one of six categories to create a structure for the final template Additional file 1 : Printer friendly version of template. This section gives the reader a brief overview of the geographical setting and infrastructure in the affected area before the incident occurred. It will ask for information such as the population and population density, pre-existing infrastructure stating accessibility in the area by road, train, boat, foot and the telecommunications network.

It will also allow the author to provide information on specific local issues, such as civil unrest or political situation. These variables aim to describe pre-incident EMS characteristics in the affected area before the incident, and will allow the reader to evaluate its relevance to their own EMS system.

The data includes information on the EMS, response activation, staffing of ambulance services, availability of resources, triage and major incident training. Variables describing staffing of ambulance services were modified from a previous template [ 21 ] Additional file 1 : Questions This section consists of eight variables pertaining to incident background, access, evacuation of patient, infrastructure damage, sites with separate EMS infrastructures and hazards. These variables will allow users of the database to stratify incidents by type e.

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A previously published template [ 25 ] influenced variables concerning EMS response: initial actions by first medical team, medical coordination, medical communications and medical command structure. Variables concerning timings and hospitals receiving patients are similar to another existing template [ 26 ]. Other data in this section are: personnel, transport and material resources on scene and data on patient surge.

Many of these variables will be considered quality indicators that will not only describe the response, but also allow researchers to compare medical response, and identify strengths and weaknesses Additional file 1 : Questions The variables include population at risk from the incident and actual casualties, gender, number of dead and patient distribution. The patient distribution variables include both EMS response data surge data and patient characteristics triage data. Paediatric patients were subcategorized according to existing age categories [ 27 ]. The aim of these variables will be to identify factors that may affect patient mortality and morbidity Additional file 1 : Questions This section allows the report author to communicate the key successes and problems in the major incident medical response and give the readers an overview of main lessons.

For research purposes this section together with the first category will provide data for qualitative analysis Additional file 1 : Questions Following the consensus process, a webpage allowing online reporting using the template has been developed. The editorial process for submitted reports will be described on the webpage. Front page of.

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Through this consensus process, a group of European major incident experts have developed a template for the global reporting from pre-hospital major incident medical management. The authors of several existing templates contributed to this process aiming to create a practical and accessible template focused on the pre-hospital phase of major incident response.

The template consisting of 48 variables in 6 categories can be completed and freely accessed online. An aim is that the template be widely implemented and accessible. It will be feasibility tested and revised in collaboration with experts working in this field. Informed scientific evaluation of the impact of pre-hospital interventions on patient outcomes is vital [ 28 ].

Measures of outcome used in previous studies of daily EMS have been analysed according to the six Ds: death, disease, discomfort, disability, dissatisfaction and debt cost. Death and disease were the most common outcomes evaluated and the other 4 Ds were infrequently measured [ 29 ].

Little is published regarding the validity, reliability and responsiveness of instruments for measuring outcome following major trauma [ 30 ]. In the template day mortality is included, however different definitions influence how performance outcome is evaluated [ 31 ].