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Prehospital Mass Casualty Incident Response to a Fire in a Nursing Home in Milan, Italy: Actions Taken and Shortcomings

Published online by Cambridge University Press:  14 December 2023

Alba Ripoll-Gallardo*
Affiliation:
SSD AAT Milano, Agenzia Regionale Emergenza Urgenza (AREU), Dipartimento di Emergenza e Accettazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
Annapaola D’Ambrosio
Affiliation:
Agenzia Regionale Emergenza Urgenza (AREU), Milan, Italy
Paola Manzoni
Affiliation:
SSD AAT Milano, Agenzia Regionale Emergenza Urgenza (AREU), Dipartimento di Emergenza e Accettazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
Vincenzo Grifone
Affiliation:
SSD AAT Milano, Agenzia Regionale Emergenza Urgenza (AREU), Dipartimento di Emergenza e Accettazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
Catia Pedrazzi
Affiliation:
Agenzia Regionale Emergenza Urgenza (AREU), Milan, Italy
Giovanni De Luca
Affiliation:
SSD AAT Milano, Agenzia Regionale Emergenza Urgenza (AREU), Dipartimento di Emergenza e Accettazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
Davide Arghetti
Affiliation:
Agenzia Regionale Emergenza Urgenza (AREU), Milan, Italy
Armando Stellini
Affiliation:
Agenzia Regionale Emergenza Urgenza (AREU), Milan, Italy
Alessandro Zambelan
Affiliation:
Agenzia Regionale Emergenza Urgenza (AREU), Milan, Italy
Ilaria Ruggiero
Affiliation:
SSD AAT Milano, Agenzia Regionale Emergenza Urgenza (AREU), Dipartimento di Emergenza e Accettazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
Riccardo Cusmà-Piccione
Affiliation:
SSD AAT Milano, Agenzia Regionale Emergenza Urgenza (AREU), Dipartimento di Emergenza e Accettazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
Gianluca Bacullo
Affiliation:
Agenzia Regionale Emergenza Urgenza (AREU), Milan, Italy
Franco Lorito
Affiliation:
SSD AAT Milano, Agenzia Regionale Emergenza Urgenza (AREU), Dipartimento di Emergenza e Accettazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
Paolo Perbellini
Affiliation:
Agenzia Regionale Emergenza Urgenza (AREU), Milan, Italy
Matteo Giacovelli
Affiliation:
SSD AAT Milano, Agenzia Regionale Emergenza Urgenza (AREU), Dipartimento di Emergenza e Accettazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
Massimo De Donno
Affiliation:
Agenzia Regionale Emergenza Urgenza (AREU), Milan, Italy
Simone Pelà
Affiliation:
SSD AAT Milano, Agenzia Regionale Emergenza Urgenza (AREU), Dipartimento di Emergenza e Accettazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
Giacomo Colzani
Affiliation:
Agenzia Regionale Emergenza Urgenza (AREU), Milan, Italy
Elena Brioschi
Affiliation:
Agenzia Regionale Emergenza Urgenza (AREU), Milan, Italy
Gianliuca Chiodini
Affiliation:
Agenzia Regionale Emergenza Urgenza (AREU), Milan, Italy
Giuseppe Sechi
Affiliation:
Agenzia Regionale Emergenza Urgenza (AREU), Milan, Italy
Alberto Zoli
Affiliation:
Agenzia Regionale Emergenza Urgenza (AREU), Milan, Italy
Roberto Fumagalli
Affiliation:
SC Anestesia e Rianimazione 1, Dipartimento di Emergenza e Accettazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy Department of Medicine and Surgery, University Milan Bicocca, Milan, Italy
Riccardo Stucchi
Affiliation:
SSD AAT Milano, Agenzia Regionale Emergenza Urgenza (AREU), Dipartimento di Emergenza e Accettazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
*
Corresponding author: Alba Ripoll Gallardo; Email: alba.ripoll@med.uniupo.it.

Abstract

On July 7, 2023, at 1:21 am, a fire was declared in a retirement home in Milan, Italy. The number of casualties (n = 87) according to the Simple Triage and Rapid Treatment (START) triage system was categorized as 65 green, 14 yellow, 2 red, and 6 black; 75% were women, and the mean age was 85.1 years (± 9). Most patients were unable to walk. A total of 30 basic life support (BLS) ambulances, 3 advanced cardiac life support (ACLS) teams on fast cars, 2 buses, and 1 coordination team were deployed. A scoop and run approach was adopted with patients being transported to 15 health care facilities. The event was terminated at 5:43 am. Though the local mass casualty incident (MCI) response plan was correctly applied, the evacuation of the building was difficult due to the age and comorbidities of the patients. START failed to correctly identify patients categorized as minor. Communication problems arose on site that led to the late evacuation of critical patients.

Type
Report from the Field
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc

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References

Kirby, P. Italian retirement home fire in Milan leaves six dead and dozens hurt. Published July 7, 2023. Accessed July 26, 2023. https://www.bbc.com/news/world-europe-66130854 Google Scholar
Gryth, D, Rådestad, M, Nilsson, H, et al. Evaluation of medical command and control using performance indicators in a full-scale, major aircraft accident exercise. Prehosp Disaster Med. 2010;25:118-123.CrossRefGoogle Scholar
Nilsson, H, Vikström, T, Jonson, CO. Performance indicators for initial regional medical response to major incidents: a possible quality control tool. Scand J Trauma Resusc Emerg Med. 2012;17(20):81.Google Scholar
Rådestad, M, Nilsson, H, Castrén, M, et al. Combining performance and outcome indicators can be used in a standardized way: a pilot study of two multidisciplinary, full-scale major aircraft exercises. Scand J Trauma Resusc Emerg Med. 2012;28(20):58.Google Scholar
Clarkson, L, Williams, M. EMS Mass Casualty Triage. StatPearls Publishing. Updated August 8, 2022. Accessed July 26, 2023. https://www.ncbi.nlm.nih.gov/books/NBK459369/ Google Scholar
McKee, CH, Heffernan, RW, Willenbring, BD, et al. Comparing the accuracy of mass casualty triage systems when used in an adult population. Prehosp Emerg Care. 2020;24:515-524.Google Scholar
Neeki, M, Du Montier, S, Toy, J, et al. Prehospital trauma care in disasters and other mass casualty incidents—a proposal for hospital-based special medical response teams. Cureus. 2021;13:e13657.Google Scholar