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Emergency Medicine Australasia

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Vol 26 (6 Issues in 2014)
Edited by: Geoff Hughes
Print ISSN: 1742-6731 Online ISSN: 1742-6723
Impact Factor: 0.993

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August 15, 2012

Group SMS use proves an advantage in management of disaster casualties – new study

Use of SMS messages in emergencies is just one of the positives to have resulted from the experience in managing two burns disasters at Royal Perth Hospital, a new study has found.

Published in the latest issue of Emergency Medicine Australasia, the study by Dr Mark Little and colleagues from the Emergency Department at Royal Perth Hospital and the Disaster Preparedness and Management Unit of the West Australian Department of Health analysed their response to the Bali bombing disaster, and developed initiatives which were then utilised in the Ashmore Reef disaster.

In both events, Royal Perth Hospital was the receiving facility for burns patients.

In 2002, Royal Perth Hospital received 28 severely injured burns patients after the Bali bombing, and in 2009 RPH received 23 significantly burnt patients as a result of an explosion on board a foreign vessel in the remote Ashmore Reef Islands, 840 km west of Darwin.

“The implementation of initiatives learned from the Bali bombings was effective in improving the hospital response to the reception and care of patients following the similar burns disaster at Ashmore Reef,” Dr Little said.

“This structured whole-of-hospital approach to disaster preparedness has seen ‘lessons observed’ actually become ‘lessons learned’.”

Dr Little said many of the interventions are generic and can be applied equally well to other disaster types and some, such as group SMS messages, may be of additional benefit in incidents with less lead in time.

“The implementation of regular ED disaster response planning and training, early Code Brown notification of the entire hospital with regular updates, early clearing of inpatient beds, use of SMS to communicate regularly with ED staff, control of the public and media access to the ED, visual identification of staff within the ED, early tests to ascertain intubation needs, and senior clinical decision makers in all areas of the ED were all acknowledged as effective based on the debrief reports.”

Dr Little said the lessons learned from Bali resulted in a reduction in ED length of stay – from 150 to 55 minutes, and no deaths occurred.

“The important thing is not the identification of these issues, but rather the opportunity to implement interventions in the same system and improve healthcare to victims of disasters.

“Disaster planning is an eternal cycle of improvement. 

“Despite the success of these interventions, there remain a number of issues common to both incidents that have yet to be addressed, such as limited mass transport capability with an undue reliance on the Australian Defence Force and very limited civilian capability.”

He said future development of e-records and implementation of SMART tags might assist with medical communication.