ABSTRACT
BACKGROUND: On June 20, 1994, a discharged serviceman with a psychiatric history opened fire with a MAC-90 assault rifle at Fairchild Air Force Base in Spokane, Washington. The attack killed 5 people and wounded 22. This report reviews the communication, triage, transport, injuries, and the community medical response to this mass casualty. METHODS: Data for the review were obtained from city-wide debriefing sessions, medical records, and evaluation forms from prehospital agencies. RESULTS: A total of 19 patients were triaged to four community hospitals, while 3 victims with comparatively minor injuries stayed at the Base hospital. All fatalities except a child in utero died at the scene. All victims surviving to hospital were discharged recovered from their injuries. Two patients were undertriaged, 1 of whom sustained a pelvic and buttock wound. CONCLUSIONS: Rapid triage was possible due to: (1) initial treatment by military medical personnel; (2) an established and practiced disaster plan; (3) the use of disaster packs and triage tags; (4) the immediate initiation of triage and transport; and (5) coordinated ground and air transport.
Subject(s)
Disaster Planning , Emergency Medical Services , Homicide , Violence , Adolescent , Adult , Aged , Child , Child, Preschool , Disaster Planning/organization & administration , Female , Humans , Injury Severity Score , Male , Middle Aged , Military Personnel , Retrospective Studies , Transportation of Patients , Triage , Washington , Wounds, Gunshot/therapyABSTRACT
We detail the unique and comprehensive approach to evaluation taken by the state of Washington before development and legislation of a statewide trauma system plan. The various types of data collected and the rationale for collecting them are discussed. In addition, the advantages, disadvantages, and limitations of individual study methods are elucidated. These data-gathering approaches may serve as a guide for other states or regions contemplating comprehensive trauma system development.
Subject(s)
Quality Assurance, Health Care , Trauma Centers/standards , Data Collection , Emergencies , Evaluation Studies as Topic , Humans , Prospective Studies , State Health Plans/legislation & jurisprudence , Trauma Centers/legislation & jurisprudence , United States , WashingtonABSTRACT
On May 18, 1980, Mount St Helens, Washington State's most active volcano, erupted violently. Volcanic eruptions in recent geologic history have demonstrated tremendous environmental impact and caused significant loss of human life. Volcanic ash expelled during the eruption was deposited on much of eastern Washington and had a profound effect on local air quality. Although ash is relatively inert, analysis revealed a small but significant amount of free crystalline silica, the causative agent of silicosis. The fine particles of ash were of respirable size, and there was a remarkable increase in the volume of respiratory cases seen in emergency departments during the period of high airborne particulate levels. Numerous cases of injury indirectly related to the fall of ash were also seen. The long-term effect of exposure to this volcanic ash is unknown. A prompt, coordinated community medical response is necessary to protect the general population from the potential hazard of exposure to volcanic ash.
