MANAGING MASS CASUALTIES IN LIMITED RESOURCE SETTING: A COMPARISON BETWEEN A PERIPHERAL HOSPITAL AND FORWARD TREATMENT CENTER

Abstract

Objective: To share our experience of handling mass casualties at remote locations with an aim to help formulate a policy regarding future training of doctors. Study Design: Case series. Place and Duration of Study: Combined Military Hospital Thal Pakistan, from Jan 2016 to Sep 2018, including three months in Forward Treatment Center in operational areas. Methodology: The injuries due to war trauma were included in our study. Resource management and changes made to accommodate the influx of mass trauma that required damage control surgery were described. Results: A total of 16 casualties from two mass casualty incidents at two medical centers were included in our study. There was no difference in triage class (p=0.96). Splinter injury limbs were most common injury. One patient required damage control surgery done at Combined Miliary Hospital with most requiring hemostasis prior to transport (8 at Combined Military Hospital versus 3 at Forward Treatment center), p=0.346. Conclusion: Most of mass casualties at our hospital were minor injuries requiring immediate first aid. In addition, the damage control resuscitation and surgery done at these remote locations may have helped prevent mortality and morbidity in the more severely injured.