Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments

Surgeons Advised To Give Up On Worst Injured In Case Of Nuclear Detonation

Researchers concluded that surgical triage following a nuclear detonation should treat moderately injured patients first, then severely and mildly injured people, because of the limited medical personnel and material resources that would be available.

The model of time and resource-based triage (MORTT) tests different hospital-based triage approaches in the first 48 hours after a nuclear detonation of an improvised nuclear device. It’s not a tool in and of itself, but it examines the effect of various prioritizations and focuses primarily on the surgical needs of trauma victims.

The report appears in Disaster Medicine and Public Health Preparedness. The entire issue, devoted to nuclear preparedness, is open access.

According to the study, the focus of triage in a mass casualty incident changes from the needs of an individual victim to the goal of saving the most lives possible.

MORTT found that in poorly resourced settings, prioritizing victims with moderate life-threatening injuries over victims with severe life-threatening injuries saves more lives and reduces demand for intensive care, which is likely to outstrip local and national capacity, the authors found. More lives would be saved if victims with combined injury (trauma plus radiation more than 2 Gy) are prioritized after nonirradiated victims with similar trauma.

Also, the authors wrote, as the victim loading increases up to 10 times the available personnel or resources, triage by moderate-severe-mild saves three times as many people than other systems. This could translate into thousands of lives saved.

“The results differ significantly from conventional triage schemes, in which the salvageable victim most likely to die next is prioritized, but these results are logical in the aftermath of a nuclear detonation for multiple reasons,” the authors wrote. “First, severely injured people have a lower probability of survival even if treated. Second, severely injured people require more resources. Finally, medical resources may be unavailable to stabilize moderately injured victims while severely injured people are treated, and therefore people with moderate injuries will progress to a more severe category.”

ACP Hospitalist has previously covered emergency response issues, surge response and how hospitalists responded after the Haitian earthquake.

*This blog post was originally published at ACP Hospitalist*

You may also like these posts

    None Found

Read comments »

Comments are closed.

Return to article »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »