Paediatric mass casualty response through the lens of Functional Resonance Analytical Methodology- lessons learned.

IF 3 2区医学 Q1 EMERGENCY MEDICINE Scandinavian Journal of Trauma Resuscitation & Emergency Medicine Pub Date : 2024-09-20 DOI:10.1186/s13049-024-01264-4

R J MacKinnon, D Slater, R Jenner, T Stenfors, C Kennedy, K P Härenstam

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Abstract

Background: Mass Casualty Incidents are rare but can significantly stress healthcare systems. Functional Resonance Analytical Methodology (FRAM) is a systematic approach to model and explore how complex systems adapt to variations and to understand resilient properties in the face of perturbations. The aim of this study was to use FRAM to create a model of a paediatric trauma system during the initial response to the Manchester Arena Attack to provide resilience-based insights for the management of future Mass Casualty Incidents (MCI).

Methods: Qualitative interviews in the immediate aftermath of a terrorist bombing, were followed up with further in-depth probing of subject matter experts to create a validated and verified FRAM model. This model was compared with real incident data, then simplified for future studies.

Results: A Work As Imagined (WAI) model of how a paediatric emergency department provided resilient healthcare for MCI patients from reception and resuscitation to definitive care is presented. A focused model exploring the pathway for the most severely injured patients that will facilitate the simulation of a myriad of potential emergency preparedness resilience response scenarios is also presented.

Conclusions: The systematic approach undertaken in this study has produced a model of a paediatric trauma system during the initial response to the Manchester Arena Attack, providing key insights on how a resilient performance was sustained. This modelling may provide an important step forward in the preparedness and planning for future MCIs.

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从功能共振分析方法的角度看儿科大规模伤亡应对--经验教训。

背景：大规模伤亡事件十分罕见，但会对医疗保健系统造成巨大压力。功能共振分析方法（FRAM）是一种系统性方法，用于模拟和探索复杂系统如何适应变化，以及了解系统在面对扰动时的弹性特性。本研究的目的是使用共振分析方法创建一个儿科创伤系统模型，用于对曼彻斯特竞技场袭击事件做出初步反应，为未来大规模伤亡事件（MCI）的管理提供基于恢复力的见解：方法：在恐怖爆炸事件发生后立即进行定性访谈，并进一步对相关专家进行深入探究，以创建一个经过验证和核实的 FRAM 模型。该模型与真实事件数据进行了比较，然后进行了简化，供今后研究使用：结果：本文介绍了一个 "想象中的工作"（WAI）模型，即儿科急诊部门如何为 MCI 患者提供从接待、复苏到最终护理的弹性医疗服务。此外，还介绍了一个重点模型，该模型探讨了伤势最严重的患者的治疗路径，有助于模拟各种潜在的应急准备复原响应情景：本研究中采用的系统方法建立了曼彻斯特竞技场袭击事件初期儿科创伤系统的模型，提供了有关如何保持弹性表现的重要见解。该模型可为未来重症监护病房的准备和规划迈出重要一步。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Scandinavian Journal of Trauma Resuscitation & Emergency Medicine EMERGENCY MEDICINE-

CiteScore

6.10

自引率

6.10%

发文量

审稿时长

6-12 weeks

期刊介绍： The primary topics of interest in Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine (SJTREM) are the pre-hospital and early in-hospital diagnostic and therapeutic aspects of emergency medicine, trauma, and resuscitation. Contributions focusing on dispatch, major incidents, etiology, pathophysiology, rehabilitation, epidemiology, prevention, education, training, implementation, work environment, as well as ethical and socio-economic aspects may also be assessed for publication.