Mass Casualty Anticipation – An essential, instinctual skill of EM physicians
Emergency medicine is full of surprises, twists, and turns. We don’t know what type of patient we will encounter prior to a shift, but we are ready for any and all. That being said, preparation is essential prior to the arrival of critical patients. This is why the airway cart is checked before starting a shift or the position of the bedside ultrasound machine is always mentally tracked in order to quickly grab if needed.
Unfortunately, individual preparation is not sufficient for large scale disasters. This level of preparation must happen on a hospital and interdepartmental level such as coordination between trauma surgery, orthopedics, and emergency medicine with agreed upon policies.
It is well known that primary percutaneous coronary intervention (PPCI) is the gold standard in STEMI treatment and that decreased door-to-balloon time has better patient outcomes. Guidelines recommend that the interval between arrival at the hospital and intracoronary balloon inflation (door-to-balloon time) should be 90 minutes or less.
In this series of videos, Dr. Rahul Patwari reviews the approach to the crashing neonate. Because these cases are often stressful, it is paramount to keep in mind a broad list of potential causes, such as “THE MISFITS” mnemonic:
