A descriptive analysis of triage, surge, and medical resource use in a university affiliated hospital after 8·12 explosion and burn at Tianjin Port

Objective To analyze the massive explosions and burn at Tianjin Port in 2015 resulted in a mass casualty event, and the entire course of response of a hospital to deal with such major sudden accident in order to find a rational strategy for optimal use of medical resources and reduce the critical mortality. Methods This study was done by a retrospective analysis of data from one trauma center at an academic hospital. Data including outcome, triage, severity and pattern of injuries, patient flow, and medical resources used were obtained by the review of hospital records. Results This disaster caused 165 deaths, 8 missing contact, and 797 non-fatal casualties. The Pingjin Hospital admitted 298 casualties, and 29 of them were seriously injured referred to by Tianjin Emergency Medical Center. Excessive triage rate made after transfer to another hospital was 62.07% with 11 of the 29 severely injured patients. Maximum (also the first) surge had 147 injured patients arrived around one hour after incident, the second surge had 31 seriously injured patients occurred around 4 hours after incident. Of them, 17 patients needed surgery and 17 patients were admitted to the intensive care unit. Conclusions These data showed that the number of casualties in the first surge was substantially larger than predicted and those casualties had less severe trauma, whereas the number of the injured in the second surge was less but the trauma was more severe. In order to maintain the hospital surge capacity, an effective re-triage and a hospital-wide damage control principle can be used to deal with. Key words: Mass casualty incident; Triage; Re-triage; Over-triage; Damage control protocol; Emergency medical services; Trauma