Irish hospitals to receive WHO training in case of mass casualty event

A programme teaching Irish healthcare workers how to respond to a disaster that results in mass injury and death is set to roll out in the next year

Hospitals across Ireland and Northern Ireland are to receive training from WHO in preparation for a mass casualty event, IMT has learned.

Arrangements are being made between the Department of Health and WHO, which will see the free initiative roll out across both jurisdictions in the coming months and years.

Dr Morgan P. McMonagle, Vascular & Trauma Surgeon, University Hospital Waterford, is the HSE lead for mass casualty planning. He says that the health service had been working to prepare hospitals for a mass casualty event for some time, but Covid slowed things down.

“It was one of the first times ever that all the people who would be involved in dealing with a mass casualty event started to come together – the clinical side, doctors, nurses, healthcare providers, with fire service and police, security, ambulance calls guys, pre-hospital rescue services,” he explains, speaking with IMT. “…But like everything else, Covid brought it to a halt.”

Now, Dr McMonagle and others are reviving the initiative. Last month, Dr McMonagle was part of a group that gave a lecture titled ‘Thinking the Unthinkable: Planning for a Mass Casualty Incident’ at the RCSI’s annual Charter Meeting, in which he explained how hospitals can quickly reorganise in the event of disaster.

“The most likely thing to create a large number of casualties in Ireland is something like a bus crash or an industrial accident – either way, a hospital still has to respond because services will get overwhelmed very quickly” he says.

“My talk is about how hospitals should be structured to deal with this. Essentially, being what I would call ‘combat ready’”.

Preparing for the worst
The WHO training initiative, which has been rolled out in numerous other countries already, began around seven years ago, partly in response to a spate of terror attacks across Europe, explains Dr Harald Veen, of the WHO Academy, who also spoke at the RCSI event.

“It was a challenge,” says Dr Veen, speaking about the organisation’s analysis of various European hospitals that dealt with mass casualty incidents. “It’s very difficult to deal when a system is overwhelmed with patients. And there are quite a few different systems in place for doing so. But when we sat together with a group of experts, we actually very quickly found out that a lot of these systems were either never validated properly or didn’t pass the validation.”

In response, WHO developed a simple, straightforward system that can be adopted by virtually any hospital. Overall, the survival rate is about 80% for patients who present to hospitals during a mass casualty event – but doctors need to be organised to ensure the figure stays high.

“Most of the patients will survive,” says Dr Veen. “But they take a lot of time and effort. And so, the challenge of any mass casualty situation is to quickly identify those patients that really are in trouble or may not survive, and to take those patients separate.”

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