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Assessment of hospital surge capacity using the MACSIM simulation system: a pilot study

Artikel i vetenskaplig tidskrift
Författare Kristina Lennquist Montán
L. Riddez
S. Lennquist
A. C. Olsberg
H. Lindberg
D. Gryth
Per Örtenwall
Publicerad i European Journal of Trauma and Emergency Surgery
Volym 43
Nummer/häfte 4
Sidor 525-539
ISSN 1863-9933
Publiceringsår 2017
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för kirurgi
Sidor 525-539
Språk en
Länkar dx.doi.org/10.1007/s00068-016-0686-...
Ämnesord Surge capacity, Major incident, Simulation system, Hospital preparedness, MACSIM system, mass-casualty incidents, nonoperative management, computer-simulation, disaster, bombings, Emergency Medicine
Ämneskategorier Klinisk medicin

Sammanfattning

Aim The aim of this study was to use a simulation model developed for the scientific evaluation of methodology in disaster medicine to test surge capacity (SC) in a major hospital responding to a simulated major incident with a scenario copied from a real incident. Methods The tested hospital was illustrated on a system of magnetic boards, where available resources, staff, and patients treated in the hospital at the time of the test were illustrated. Casualties were illustrated with simulation cards supplying all data required to determine procedures for diagnosis and treatment, which all were connected to real consumption of time and resources. Results The first capacity-limiting factor was the number of resuscitation teams that could work parallel in the emergency department (ED). This made it necessary to refer severely injured to other hospitals. At this time, surgery (OR) and intensive care (ICU) had considerable remaining capacity. Thus, the reception of casualties could be restarted when the ED had been cleared. The next limiting factor was lack of ventilators in the ICU, which permanently set the limit for SC. At this time, there was still residual OR capacity. With access to more ventilators, the full surgical capacity of the hospital could have been utilized. Conclusions The tested model was evaluated as an accurate tool to determine SC. The results illustrate that SC cannot be determined by testing one single function in the hospital, since all functions interact with each other and different functions can be identified as limiting factors at different times during the response.

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