Mass Casualty Management After a Boiling Liquid Expanding Vapor Explosion in an Urban Area.
The Journal of emergency medicine · 2021-01-07 · Case report
Abstract
BACKGROUND: The catastrophic fail of a container holding a pressure-liquified gas can generate a boiling liquid expanding vapor explosion (BLEVE) with a subsequent blast wave, flying fragments, and fire or toxic gas release. CASE REPORT: This report describes the management of a mass casualty disaster related to a BLEVE in an urban area due to a highway accident involving a tanker carrying liquified petroleum gas and a truck transporting chemical solvents. The event resulted in 158 casualties that were triaged, stabilized, and transported into the "hub" and "spoke" hospitals of the regional trauma network within 3 h and 22 min from the event by the Emergency Medical Services. The logistic complications related to the partial collapse of the highway bridge on an underlying urban road and the relative solutions adopted, as well as the application and advantages of the use of the Simple Triage and Rapid Treatment (START) algorithm in the field and the criteria adopted for the distribution of patients within the trauma network, are discussed, along with the potential pitfalls observed. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: BLEVE events are rare but can be complex in both logistical management and clinical presentation of the lesions related to the event. The START algorithm is a valuable tool for rapid triage in mass casualty incidents.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Interagency collaboration · Mass casualty triage · Triage instruments · Urban
Related articles
- Field triage and patient maldistribution in a mass-casualty incident. (Prehosp Disaster Med, 2007)
- Optimizing Mass Casualty Triage: Using Discrete Event Simulation to Minimize Time to Resuscitation. (J Am Coll Surg, 2024)
- Mass casualty management of a large-scale bioterrorist event: an epidemiological approach that shapes triage decisions. (Emerg Med Clin North Am, 2002)
- Management of Mass Casualties Using Doctor Helicopters and Doctor Cars. (Air Med J, 2017)
- Mass casualty incident training in a resource-limited environment. (Br J Surg, 2012)
- Mass Casualty Incident Preparedness for Airport Emergencies: Report From an Aeroplane Crash Simulation at Guglielmo Marconi Airport, Bologna (Italy). (Disaster Med Public Health Prep, 2024)