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Published in: International Journal of Emergency Medicine 1/2011

Open Access 01-12-2011 | Original Research

Epidemiology of major incidents: an EMS study from Pakistan

Authors: Hunniya Waseem, Luca Carenzo, Junaid Razzak, Rizwan Naseer

Published in: International Journal of Emergency Medicine | Issue 1/2011

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Abstract

Background

A major incident is defined as an event that owing to the number of casualties has the potential to overwhelm the available resources. This paper attempts to describe the incidence and epidemiology of major incidents dealt with by a government-run emergency medical service (EMS) in the Punjab province of Pakistan, a developing country in South Asia. A major incident in this EMS is defined as any incident that produces three or more patients, or any incident in which extraordinary resources are needed.

Methods

All the calls received by an EMS Rescue 1122 were studied over a 6-month period. Calls that were defined as major incidents were identified, and further details were sought from the districts regarding these incidents. Questions specifically asked were the type of incident, time of the incident, response time for the incident, the resources needed, and the number of dead and injured casualties. Retrospective data were collected from the submitted written reports.

Results

Road traffic crashes (RTCs) emerged as the leading cause of a major incident in the province of Punjab and also led to the greatest number of casualties, followed by fire incidents. The total number of casualties was 3,380, out of which 73.7% were RTC victims. There was a high rate of death on the scene (10.4%). Certain other causes of major incidents also emerged, including violence, gas explosions and drowning.

Conclusion

Road traffic crashes are the most common cause of a major incident in developing countries such as Pakistan. Injury prevention initiatives need to focus on RTCs.
Literature
1.
go back to reference NHSME: Emergency Planning in the NHS: Health services arrangements for dealing with major incidents. Volume 25. London: HC; 1990. NHSME: Emergency Planning in the NHS: Health services arrangements for dealing with major incidents. Volume 25. London: HC; 1990.
2.
go back to reference Carley S, Mackway-Jones K, Donnan S: Major incidents in Britain over the past 28 years. J Epidemiol Community Health 1998, 52: 392–398. 10.1136/jech.52.6.392PubMedCentralCrossRefPubMed Carley S, Mackway-Jones K, Donnan S: Major incidents in Britain over the past 28 years. J Epidemiol Community Health 1998, 52: 392–398. 10.1136/jech.52.6.392PubMedCentralCrossRefPubMed
3.
go back to reference Advanced Life Support group: Major incident medical management and support. London: BMJ Publishing; 2002. Advanced Life Support group: Major incident medical management and support. London: BMJ Publishing; 2002.
4.
go back to reference Razzak JA, Kellermann AL: Emergency medical care in developing countries: is it worthwhile? Bull World Health Organ 2002, 80: 900–905.PubMedCentralPubMed Razzak JA, Kellermann AL: Emergency medical care in developing countries: is it worthwhile? Bull World Health Organ 2002, 80: 900–905.PubMedCentralPubMed
5.
go back to reference Channa R, Jaffrani HA, Khan AJ, Hassan T, Razzak J: Transport time to trauma facilities in Karachi: an exploratory study. Int J Emerg Med 2008, 1: 201–4. 10.1007/s12245-008-0051-1PubMedCentralCrossRefPubMed Channa R, Jaffrani HA, Khan AJ, Hassan T, Razzak J: Transport time to trauma facilities in Karachi: an exploratory study. Int J Emerg Med 2008, 1: 201–4. 10.1007/s12245-008-0051-1PubMedCentralCrossRefPubMed
7.
go back to reference Raftery KA: Emergency medicine in southern Pakistan. Ann Emerg Med 1996, 27: 79–83. 10.1016/S0196-0644(96)70300-1CrossRefPubMed Raftery KA: Emergency medicine in southern Pakistan. Ann Emerg Med 1996, 27: 79–83. 10.1016/S0196-0644(96)70300-1CrossRefPubMed
8.
go back to reference Mehdi IJ: Emergency medicine in Pakistan. Ann Emerg Med 1996, 27: 84–88. 10.1016/S0196-0644(96)70301-3CrossRefPubMed Mehdi IJ: Emergency medicine in Pakistan. Ann Emerg Med 1996, 27: 84–88. 10.1016/S0196-0644(96)70301-3CrossRefPubMed
9.
go back to reference Naseer R: Study of the Emergency Response Services. In Report for the UNDP. Pakistan Office and the Ministry of Interior, Government of Pakistan; 2002. Naseer R: Study of the Emergency Response Services. In Report for the UNDP. Pakistan Office and the Ministry of Interior, Government of Pakistan; 2002.
10.
go back to reference Khan A, Zafar H, Naeem SN, Raza SA: Transfer delay and in-hospital mortality of trauma patients in Pakistan. Int J Surg 2010, 8(2):155–8. Epub 2009 Dec 21 10.1016/j.ijsu.2009.10.012CrossRefPubMed Khan A, Zafar H, Naeem SN, Raza SA: Transfer delay and in-hospital mortality of trauma patients in Pakistan. Int J Surg 2010, 8(2):155–8. Epub 2009 Dec 21 10.1016/j.ijsu.2009.10.012CrossRefPubMed
11.
go back to reference Naqvi H, Kazim SF, Huma S: Terrorism and health: the responsibility of intellectuals. J Pak Med Assoc 2010, 60(5):403–5.PubMed Naqvi H, Kazim SF, Huma S: Terrorism and health: the responsibility of intellectuals. J Pak Med Assoc 2010, 60(5):403–5.PubMed
12.
go back to reference Rescue 1122 Control Room. Headquarters Directly accessed on 15/07/2010 Rescue 1122 Control Room. Headquarters Directly accessed on 15/07/2010
13.
go back to reference Sasser S, Varghese M, Kellermann A, Lormand JD: Prehospital trauma care systems. Geneva, World Health Organization; 2005. Sasser S, Varghese M, Kellermann A, Lormand JD: Prehospital trauma care systems. Geneva, World Health Organization; 2005.
14.
go back to reference Waseem H, Naseer R, Razzak JA: Establishing a successful pre-hospital emergency service in a developing country: experience from Rescue 1122 service in Pakistan. Emerg Med J 2011, 28(6):513–5. 10.1136/emj.2010.096271CrossRefPubMed Waseem H, Naseer R, Razzak JA: Establishing a successful pre-hospital emergency service in a developing country: experience from Rescue 1122 service in Pakistan. Emerg Med J 2011, 28(6):513–5. 10.1136/emj.2010.096271CrossRefPubMed
15.
go back to reference Umer M, Sepah YJ, Shahpurwala MM, Zafar H: Suicide bombings: process of care of mass casualties in the developing world. Disasters 2009, 33: 809–21. 10.1111/j.1467-7717.2009.01110.xCrossRefPubMed Umer M, Sepah YJ, Shahpurwala MM, Zafar H: Suicide bombings: process of care of mass casualties in the developing world. Disasters 2009, 33: 809–21. 10.1111/j.1467-7717.2009.01110.xCrossRefPubMed
16.
go back to reference Hofman K, Primack A, Keusch G, Hrynkow S: Global health concerns: addressing the growing burden of trauma and injury in low and middle-income countries. Am J Public Health 2005, 95: 13–7. 10.2105/AJPH.2004.039354PubMedCentralCrossRefPubMed Hofman K, Primack A, Keusch G, Hrynkow S: Global health concerns: addressing the growing burden of trauma and injury in low and middle-income countries. Am J Public Health 2005, 95: 13–7. 10.2105/AJPH.2004.039354PubMedCentralCrossRefPubMed
17.
go back to reference Peden M, Scurfield R, Sleet D, Mohan D, Hyder AA, Jarawan E, Mathers C: World Report on Road Traffic Injury Prevention. Geneva, World Health Organization; 2004. Peden M, Scurfield R, Sleet D, Mohan D, Hyder AA, Jarawan E, Mathers C: World Report on Road Traffic Injury Prevention. Geneva, World Health Organization; 2004.
18.
go back to reference Hang HM, Ekman R, Bach TT, Byass P, Svanström L: Community-based assessment of unintentional injuries: a pilot study in rural Vietnam. Scand J Public Health 2003, (Suppl 62):38–44. Hang HM, Ekman R, Bach TT, Byass P, Svanström L: Community-based assessment of unintentional injuries: a pilot study in rural Vietnam. Scand J Public Health 2003, (Suppl 62):38–44.
19.
go back to reference Razzak JA, Luby SP: Estimating deaths and injuries due to road traffic accidents in Karachi, Pakistan, through the capture-recapture method. Int J Epidemiol 1998, 27: 866–70. 10.1093/ije/27.5.866CrossRefPubMed Razzak JA, Luby SP: Estimating deaths and injuries due to road traffic accidents in Karachi, Pakistan, through the capture-recapture method. Int J Epidemiol 1998, 27: 866–70. 10.1093/ije/27.5.866CrossRefPubMed
20.
go back to reference Fatmi Z, Hadden WC, Razzak JA, Qureshi HI, Hyder AA, Pappas G: Incidence, pattern and severity of reported unintentional injuries in Pakistan for persons five years and older: results of the National Health Survey of Pakistan 1990–94. BMC Public Health 2007, 7: 152. 10.1186/1471-2458-7-152PubMedCentralCrossRefPubMed Fatmi Z, Hadden WC, Razzak JA, Qureshi HI, Hyder AA, Pappas G: Incidence, pattern and severity of reported unintentional injuries in Pakistan for persons five years and older: results of the National Health Survey of Pakistan 1990–94. BMC Public Health 2007, 7: 152. 10.1186/1471-2458-7-152PubMedCentralCrossRefPubMed
22.
go back to reference Nishtar S, Mohamud KB, Razzak J, Ghaffar A, Ahmed A, Khan SA, Mirza YA: Injury prevention and control: National Action Plan for NCD Prevention, Control and Health Promotion in Pakistan. J Pak Med Assoc 2004, 54(12 Suppl 3):S57–68.PubMed Nishtar S, Mohamud KB, Razzak J, Ghaffar A, Ahmed A, Khan SA, Mirza YA: Injury prevention and control: National Action Plan for NCD Prevention, Control and Health Promotion in Pakistan. J Pak Med Assoc 2004, 54(12 Suppl 3):S57–68.PubMed
Metadata
Title
Epidemiology of major incidents: an EMS study from Pakistan
Authors
Hunniya Waseem
Luca Carenzo
Junaid Razzak
Rizwan Naseer
Publication date
01-12-2011
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Emergency Medicine / Issue 1/2011
Print ISSN: 1865-1372
Electronic ISSN: 1865-1380
DOI
https://doi.org/10.1186/1865-1380-4-48

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