Christel Hendrickx, RN, CCRN – Disaster Coordinator
Els Jenar, MBS – Forensic Medicine
Wim Develter, MD – Forensic Medicine
Wim Van de Voorde, MD, PhD – Forensic Medicine
Marc Sabbe, MD, PhD – Emergency and Disaster Medicine
Emergency drill Vesalius SN 500
Deceased disaster victims: response and modeling
Background information University Hospitals Leuven
Staff: 8892
Physicians 1406
Nurses 2965
Others 4521
Authorised beds: 1995
Activities per year
Admissions 63.885
Hospitalisation days 460.732
Day care 99.711
Outpatient appointments 672.663
ED visits per year: 53.428
Objectives of the study
Improve processes & information management
Processes for:
Deceased victims
Hospitalised victims
By collaboration between hospital internal & external service
Focus: SWS/PCS – DC – FOR – C&C cell – PSIS (BRC) – DVI
Goals:
Forensic medicine: proposal national protocol
Belgium: standardised exchange disaster victim identification system
Methods
Modified Delphi: expert panel
Questionnaires interviews aid workers
Questionnaires observers
Time measurements
Visual material (film crew – pictures)
Observer reports
Questionnaires day 3 (cfr De Soir, Zech & Rimé)
External and internal observers / simulants about aid workers
Interviews aid workers: qualitative research (NVivo in progress)
Approval of ethical committee
Results: time measurements (32 h film – pictures)
Important findings:
Field exercise
Prompt start
Long time interval before starting forensic activities
Hospital exercise
Forensic processes
Long but adequate
Psychosocial intervention
Long but chaotic
Coordination & Command Cell exercise
Insufficient use of alerting procedures
Results: observer reports (n = 26)
Important findings:
Field exercise
No major, only limited operational remarks
Hospital exercise
Forensic processes
Good organisation individual dependent
Psychosocial intervention
Independent processes of internal and external services
Coordination & Command Cell exercise
Presence of experts resulted in teaching moments
Limited knowledge about crisis management
Disaster coordinator
Not officially informed by key players, nor hospital services (exercise coordinator)
Results: interviews aid workers (n= 28)
Important findings:
Field exercise
Conflict between exercise and “reality”
Hospital exercise
Forensic processes
Need of better operational guidelines and efficient communication
Fatigue due to long lasting processes risk for human errors
Psychosocial intervention
Lack of integration: communication – coordination – collaboration
Discussion: limitations - biases - confounders
Limitations
Artificial split of exercise over several days
Biases
“Reality” of the exercise
No real victims / family
Confounders
Daily activities of the hospital
Limited interest in crisis management
Conclusions
A specific but only rarely tested exercise
Registration of existing responses
Management
Information & communication flows
Observations of potential improvements
Modeling to a national protocol
Forensic medicine: national protocol
Belgium: standardised exchange disaster victim identification system
Importance of a hospital disaster coordinator
High satisfaction of direct collaborators
Questions – Remarks ?
A special word of thanks to:
DVI: chief inspector Dirk Maes
PSIS (BRC): Koen Van Praet
Police force Lubbeek: superintendent Herman Vercoutter
Fire brigade Zaventem: captain Pascal Elskens
Correspondence:
Christel Hendrickx, RN, CCRN Marc Sabbe, MD, PhD Wim Van de Voorde, MD, PhD
Emergency Department Emergency Department Forensic Medicine
University Hospitals Leuven University Hospitals Leuven University Hospitals Leuven
Herestraat 49 Herestraat 49 Herestraat 49
3000 Leuven 3000 Leuven 3000 Leuven
Belgium Belgium Belgium
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