During a Mass Casualty Incident, such as a natural disaster, terrorist event, or biosecurity incident, the main focus of emergency response teams is the casualties at the site and the surrounding treatment areas. Major incident triage systems aim to triage casualties on-site and transport them to hospitals as appropriate.   However, ambulance services can quickly become overwhelmed with large numbers of casualties, and your hospital could quickly find itself with a large number of survivors arriving independently and in need of triage and treatment.

It's also important to consider that if symptoms of injury, such as a concussion, only appear after the event, survivors may make their own way to the hospital.  An American Study of 29 Major Incidents covering 75 hospitals found that around 59% of initial casualties arrived by ambulance or helicopter, 16% by police car, and another 35% arrived independently by private means—by car, bus, taxi, or foot. While these figures refer to the first patients to arrive, overall, most patients in these disasters were transported by non-ambulance vehicles.

Is your major incident cupboard ready?

Hospitals have a designated storage area used to contain essential equipment and supplies to be deployed during a major incident – often called the ‘major incident cupboard’. A well-stocked major incident cupboard gives your hospital enhanced preparedness to adapt to various emergency scenarios, as well as shorter response times. This can be critical during multiple casualty events for saving lives and managing volatile situations effectively.

The NHS Major Incident Triage Tool (MITT) and the NHS Ten Second Triage (TST) system both have guidelines regarding the items and equipment that should be stocked in the major incident cupboard. These include items specifically designed for major incident responses, such as triage cards and a ‘major incident commander’s bag’ – containing crucial items needed by the individual responsible for leading and coordinating the response to a critical incident at your hospital.

TST is a triage method that assesses patients according to whether or not they are walking, talking, breathing, or not breathing, while MITT is a more detailed triage framework that recommends triage routes based on the characteristics of the incident, with different care scenarios for adult and paediatric patients.

Other essential major incident cupboard supplies include:

• Personal Protective Equipment (PPE) – e.g. gloves, masks, and gowns to protect healthcare workers from exposure to infectious materials and bodily fluids.
• Medical supplies – this can include a wide range of tools and devices used in emergency patient care, such as oxygen treatment and medical supplies for critical wound care.
• Communication devices – reliable communication is essential during a major incident, so many major incident cupboards include two-way radios, spare phone handsets, a laptop, and other devices to allow effective coordination among your response time.

Maintaining your emergency response

Fortunately, major incidents don’t happen often, but the downside of this is that in many hospitals the major incident cupboard is often poorly stocked and maintained. To avoid being unprepared should a major crisis occur, the contents of your major incident cupboard should be checked regularly and updated to make sure they align with the latest NHS guidelines and best practices.

For example, you should replace expired or damaged items and update comms equipment whenever new technologies and procedures become available. Maintenance is especially important for communication devices. Routine maintenance should include checking the battery of each device, as battery life can decline if devices are not used for extended periods of time.

Hospital staff should also be trained and knowledgeable about the contents of your major incident cupboard and how to use them to facilitate MITT and TST triage practices. This helps ensure that, if a major incident occurs, your response team can quickly and effectively use their equipment to provide the best possible care for your patients.

Next steps

Transform your hospital’s triage incident management with TSG’s solutions. Our specialists are ready to provide you with comprehensive information and personalised support tailored to your needs. Contact us today to start enhancing your hospital’s efficiency and patient care.

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