Wadem cs38-07- conception exercice orsan amavi

April 25-28, 2017 Dr jan-Cedric Hansen 1

CS38-07: Design of an mass casualties type exercise (ORSAN

AMAVI) involving more than 30 hospitals on behalf of the Normandy

regional public health authorities (ARS)

Dr Jan-Cedric Hansen

Member of the Board for the French Society for Disaster Medicine

Member of the Board for StratAdviser Ltd

Registered BCNR/Cindynician European Expert-Auditor under EX2016D276660contact : [email protected]


The author(s) declare(s) that there is no

conflict of interest regarding the release of

this presentation

Presenting Author: Dr Jan-Cedric Hansen

CS38-07: Design of an mass casualties type exercise (ORSAN

AMAVI) involving more than 30 hospitals on behalf of the Normandy

regional public health authorities (ARS)

(Abstract 1031)

Location in a Mall

8/11/2017 Dr JC Hansen Exercice Santé Manche 2016 SFMC-ARS Normandie 3

Vicinity


100 m

Mall

Hospital

Initial Scenario• 08:30: Mall opens

• 10:00: 3 terrorists attack the crowd in the hall with machine guns

• 10:01: most clients seek refuge in improvised shelters– Shops’ backroom, technical spaces, ...

• 10h01 - 10h29: terrorists search hidden groups & individuals and slaughter whoever they find

• 10.30: a terrorist targeted by the police special forces rushes into an improvised shelter and light up his explosive belt

• 10h30 - 12h48: the two other terrorists continue their slaughter within the Mall playing “hide and seek” with police special forces until their neutralization


192 victims planned


Numérodeplastron SiteHoraire

blessureP0Destination

HorairePEC

PRV/SAU

Numérode

victimeSINUS

Étatcliniqueinitial

Point0-PRV

Typologie

atteinte

principale

Typedelésion

dominante

Classification

SFMCGenre Âge Noms Prénom

Horaire

départvers

PMA

Moyende

transportau

PMA

Horairearrivée

auPMATriPMA ZonePEC

Mode

transfert

HorairePEC

soinsPMADiagnosticPMA ScoreGlasgow

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0:00 0 0:00 0 0 0 0:00 0 0

1 Fusillade 10:00 PRV 10:20 1121

Conscience:non;

Respiration:oui;

Circulation:oui;

Hémorragie:oui;

Garrot:non

Thorax Hémorragie Rouge M 7 @JOUENNE @Wandrille 10:30Brancardnorme

EN186510:40 UA Soins Brancard 0:00 Polytraumatisé 7

2 Fusillade 10:00 PRV 10:20 1122

Conscience:oui;

Respiration:oui;

Circulation:oui;

Hémorragie:non;

Garrot:non

Thorax Plaie Jaune M 22 @LEBRUN @Polydor 10:31Brancardnorme

EN186510:41 UR Soins Brancard Polycriblé 10

3 Fusillade 10:00 SAUCHPC-C 10:20 1282

Conscience:oui;

Respiration:oui;

Circulation:oui;

Hémorragie:non;

Garrot:non

Thorax Plaie ? M 64 @BUNEL @Laud n/a n/a n/a n/a n/a n/a n/a Polycriblé 13

4 Fusillade 10:00 PRV 10:30 1126

Conscience:non;

Respiration:oui;

Circulation:oui;

Hémorragie:non;

Garrot:non

Têteetcou Plaie Rouge M 36 @NICOLLE @Ludovi 10:40Brancardnorme

EN178910:50 UA Soins Brancard Polycriblé 11

5 Fusillade 10:00 PRV 10:29 1125

Conscience:non;

Respiration:oui;

Circulation:oui;

Hémorragie:non;

Garrot:non

Têteetcou Fracture Rouge M 18 @X @X 10:39Brancardnorme


6 Fusillade 10:00 PRV 10:25 1123

Conscience:oui;

Respiration:oui;

Circulation:oui;

Hémorragie:oui;

Garrot:non

Têteetcou Hémorragie Jaune F 43 @HUE @Ernestène 10:35Brancardnorme

EN186510:45 UR Soins Brancard Plaiesmultiples 6

7 Fusillade 10:00 PRV 10:26 1124

Conscience:oui;

Respiration:oui;

Circulation:oui;

Hémorragie:non;

Garrot:non

Têteetcou Fracture Jaune M 35 @BECHET @Médéric 10:36Brancardnorme


8 Fusillade 10:03 PRV 10:32 1127

Conscience:non;

Respiration:oui;

Circulation:oui;

Hémorragie:non;

Garrot:non

Membres Fracture Rouge F 73 @X @X 10:42Brancardnorme


9 Fusillade 10:04 PRV 10:33 1128

Conscience:non;

Respiration:oui;

Circulation:oui;

Hémorragie:non;

Garrot:non

Membres Plaie Rouge F 85 @MALHERBE @Cllâodène 10:43Brancardnorme


10 Fusillade 10:05 PRV 10:34 1129

Conscience:oui;

Respiration:oui;

Circulation:oui;

Hémorragie:oui;

Garrot:oui

Membres Hémorragie Jaune M 48 @BAILLEUL @Charlot 10:44Brancardnorme

EN186510:54 UR Soins Brancard Polytraumatisé 9

11 Fusillade 10:06 PRV 10:35 1134

Conscience:oui;

Respiration:oui;

Circulation:oui;

Hémorragie:non;

Garrot:non

Membres Fracture Jaune M 46 @JULIEN @Prudent 10:46Brancardnorme


12 Fusillade 10:07 PRV 10:36 1135

Conscience:oui;

Respiration:oui;

Circulation:oui;

Hémorragie:oui;

Garrot:oui

Membres Hémorragie Jaune F 33 @ETIENNE @Aimée 10:46Brancardnorme


13 Fusillade 10:08 PRV 10:37 1136

Conscience:oui;

Respiration:oui;

Circulation:oui;

Hémorragie:non;

Garrot:non

Membres Fracture Jaune F 18 @MARTIN @Jade 10:46Brancardnorme

EN186510:56 UR Soins Brancard Polytraumatisé 3

14 Fusillade 10:09 PRV 10:38 1137

Conscience:oui;

Respiration:oui;

Circulation:oui;

Hémorragie:non;

Garrot:non

Membres Plaie Jaune F 55 @MESNAGE @Ursule 10:46Brancardnorme


Victims’ pathway


PO: Point Zero of slaughter - PRV: Victim Gathering Point - ESV: Spontaneous Evacuation of Victim - LMA: Advanced Medical Post - SAU CHPC-V: Emergency Department of the Public Hospital Center of Cotentin Valognes site - SAU PdC: Emergency Department of the CotentinPolyclinic - SAU CHPC-C: Emergency Department of the Public Hospital Center of Cotentin site of Cherbourg

Articulation of actors’ war rooms

Animation team

Generates the flow of victims, defines the typology of injuries, plays the role of the deployable Advanced Medical Triage post and informs the Emergency

Wards of the spontaneous evacuations concerning

them

Crisis War Roomof “ARS Zonal +/-

Centre 15”

Dispatches victims according to Assets

availability/available hospital beds/typology of casualties

HospitalsCrisis

War Room

Inform the Crisis War Room of “ARS Zonal +/- Centre 15” of their capacity of patient reception according to the

typology of the victims


Kinetic flow of victims


0

50

100

150

200

250Te

mp

s

10

:05

10

:11

10

:17

10

:23

10

:29

10

:35

10

:41

10

:47

10

:53

10

:59

11

:05

11

:11

11

:17

11

:23

11

:29

11

:35

11

:41

11

:47

11

:53

11

:59

12

:05

12

:11

12

:17

12

:23

12

:29

12

:35

12

:41

12

:47

12

:53

12

:59

13

:05

13

:11

13

:17

13

:23

13

:29

13

:35

Cumul victimes Cumul au PRV Cumul au PMA Cumul victimes evacuées PMA

Victims’ Load vs time log


0

5

10

15

20

25

30

35

Tem

ps

10

:05

10

:11

10

:17

10

:23

10

:29

10

:35

10

:41

10

:47

10

:53

10

:59

11

:05

11

:11

11

:17

11

:23

11

:29

11

:35

11

:41

11

:47

11

:53

11

:59

12

:05

12

:11

12

:17

12

:23

12

:29

12

:35

12

:41

12

:47

12

:53

12

:59

13

:05

13

:11

13

:17

13

:23

13

:29

13

:35

Nombre victimes présentes au PRV Nombre victimes présentes au PMA

Sample of the Hospitals involved


H

H

HH

H

H

H20 km

Interest of Advanced Medical Post

• Buffers victims flows

• Allows early haemodynamic stabilisation and

resuscitation in addition to damage control

• Prolongs and secures the “Golden Hour”

• Permits to dispatch victims according to

surgery rooms and surgeons actual

availability even in remote hospitals


Interest of Advanced Medical Post

• Buffers victims flows

• Allows early haemodynamic stabilisation and

resuscitation in addition to damage control

• Prolongs and secures the “Golden Hour”

• Permits to dispatch victims according to

surgery rooms and surgeons actual

availability


Crisis War Roomof “ARS Zonal + Centre 15”

comment:

Wadem cs38-07- conception exercice orsan amavi

Healthcare

Transcript of Wadem cs38-07- conception exercice orsan amavi