Retrospective analysis of 197 mass casualty incidents and exploration of hospital management procedures

Objective To understand the characteristics and hospital management procedures of mass casualty incidents in Jinshan District and to provide clinical suggestions for standardizing the management of mass casualty incidents.

Methods A retrospective analysis of mass casualty incidents handled by the Affiliated Jinshan Hospital of Fudan University from January 1, 2010 to December 31, 2021 was conducted, and the characteristics and hospital treatment procedures of mass casualty incidents were analyzed.

Results The hospital handled 197 mass casualty incidents in 12 years, with a total of 1430 injured persons. The primary cause of injury was traffic accidents, accounting for 100 cases(50.9%), followed by chemical injuries, accounting for 25 cases(12.7%). The most common age distribution of the injured population was between 21 and 50 years old, with 995 people(69.5%); 964(67.4%) were male and 466(32.6%) were female; 23(1.6%) were dead on arrival; 73(5.1%) were admitted to the ICU, and 106(7.4%) were hospitalized. The frequency of mass casualty incidents was similar in March to May(spring) with 60 cases(30.5%), June to August(summer) with 52 cases(26.4%), and September to November(autumn) with 54 cases(27.4%), while the frequency decreased in December to next February(winter) with 31 cases(15.7%). The highest frequency of occurrence was from 8:00 to 16:00, with 186cases(94.4%), followed by 16:00 to 24:00, with 11 cases(5.6%), and no mass casualty incidents occurred from 0:00 to 8:00. After the new treatment procedure was implemented in 2016, the forewarning rate increased significantly(P < 0.05), the forewarning content increased(P < 0.01), and the allocation time of treatment materials was significantly shortened(P < 0.01); the accuracy rate of secondary injury assessment increased(P < 0.01), and the retention time was significantly reduced(P < 0.01).

Conclusions In Jinshan District of Shanghai, the primary cause of mass casualty incidents was traffic accidents, followed by chemical injuries. The age group with the most mass casualties was between 20 and 50 years old, with males significantly outnumbering females. The key points of mass casualty incident treatment include forewarning, timely initiation of treatment procedures, zone and hierarchical treatment, secondary damage control, timely diversion, experienced commanders, summary, and drills.