Normal hospital response to severe trauma begins with trauma team activation following advance notification. This is the ideal in isolated trauma scenarios but is even more imperative in mass casualty

scenarios. Communication has been identified as a key component of disaster preparedness and response. An analysis of the response to three sequential aircraft crashes in Texas, found communication to be one of the major problems encountered in the implementation of the community and hospital disaster Ibrutinib cell line plan [5]. Its total absence meant that we were completely unprepared to receive the first surge of casualties and each subsequent surge was without advance warning. Communication was also needed for mobilizing personnel and other resources from within and outside the hospital, and for information and media management as well as the coordination of response efforts between medical personnel and other agencies of government involved in the disaster response such as the police, military, Red Cross, and other voluntary organizations. The lack of this communication made the overall response efforts disjointed and uncoordinated.

The crisis took place before the introduction of mobile telephony in our city and we do not have pagers or two way radios. The existing hospital intercom system and the fixed lines proved grossly inadequate for the internal and external communication needs respectively. Field triage was crude and did not follow any organized SCH772984 systems. Injured patients were merely conveyed to the hospital if they were fortunate

enough to chance upon a military patrol, aid workers and volunteers, or other good Samaritans who were willing and able to help. The aim of triage is to identify that minority of critically injured patients, out of the large pool of patients with less severe injuries so that trauma care assets can be prioritized in favor of the former. Effective triage is necessary to screen out the majority of non critically FER injured survivors, and results are best when performed by a trained physician in the field [6]. A change in philosophy occurs in the approach to the management of mass casualty: the goal is to do the ‘greatest good for the greatest number’ and not the greatest good for the individual [2, 7]. Most effective triage systems accept an overtriage rate of up to 50%, i.e. patients who have been triaged as having critical injuries when in fact they had less severe injuries. This high rate is necessary to reduce the undertriage rate to below 0.5%, i.e. the proportion of patients who were triaged as having non critical injuries when in fact they had critical injuries [7]. In the absence of systematic field triage, a high proportion of patients brought to our facility had non critical injuries as every injured patient was evacuated to the hospital.