Nation’s emergency plans ‘inadequate’
Bron: Sunday Herald
Burns expert warns hospitals would not cope in terror attack
Nation’s emergency plans ‘inadequate’
SCOTTISH hospitals are seriously underprepared to deal with a major fire disaster or terror attack, a leading medical expert has claimed. John McGregor, a consultant plastic and burns surgeon at St John’s Hospital, West Lothian, has warned that existing contingency plans for emergencies are inadequate . He believes that without an urgent rethink of the current strategy, Scotland is vulnerable to a crisis in its ability to properly treat burns victims. Despite a range of potential Scottish terrorist targets – most notably the Faslane and Coulport naval bases and the new parliament building in Edinburgh – McGregor warned the country would struggle to cope with a major disaster .
He suggested lessons had not been learned from the 1988 Piper Alpha oil platform explosion, which killed 167 offshore workers and left many survivors terribly burned. “There are no guidelines at the moment other than the standard major disaster incident plans for each hospital. These are not specifically designed to cope with a large-scale incident in which the majority of cases are burns,” McGregor said. “There is the Grangemouth oil refinery and Mossmorran [an ethylene plant] in Fife. We haven’t had major incidents there recently but what happens if there is one? We ought to be looking at this now. We have a situation now that if we had a major disaster we may struggle. “The purpose of this is not to terrify people but to make them aware that we ought to be thinking more about this. With the Scottish parliament now in Edinburgh and other potential targets for terrorists, it is important we have some idea of how to plan for this.”
Across the UK, police and emergency services are on a high state of alert over the Christmas period, which because of its significance to Christians, government officials fear could prove the trigger for an attack. They also fear that bombing Britain at this time could be a way to destabilise the elections in Iraq on January 30. McGregor called on ministers to look to the model adopted in the Netherlands in 1990 to cope specifically with large-scale burns emergencies.
The plan, developed by Scottish anaesthetist Dr David Mackie, who has worked in the Netherlands for almost 30 years, was used successfully in 2001 after a fire in Volendam in which 13 people died and 180 were injured when Christmas decorations caught fire in a nightclub packed with teenagers celebrating New Year. Within minutes the temperature had reached 1000˚C as revellers frantically tried to escape. But Mackie’s plan was credited with keeping casualties to a minimum. Under the scheme, burns victims are not automatically sent to the accident and emergency department at the local hospital or nearest burns unit. Instead, a burns assessment team (BAT) – a consultant, a nurse and an anaesthetist – are sent to the site to assess patients and direct each to the most appropriate hospital, not necessarily the unit nearest the disaster scene.
McGregor said: “In the event of a disaster the number of casualties is potentially huge. If they all went to the accident and emergency department in the locality, it would be overwhelmed. They wouldn’t have the number of staff who are trained in treating burns. “ Patients who do not need major burns care could go to outlying hospitals. Somewhere on the site, the assessment team would identify who really has major burns and needs to be admitted to the nearest burns unit. By doing that you ensure patients get the best treatment and hospitals are not overwhelmed. “The assessment team would then go out two or three days after the incident to hospitals to look again at whether patients needed more appropriate care. Some may need to be sent to more peripheral hospitals, while other might need to be sent to the specialist burns units.”
In the spring, McGregor will lead a delegation of plastic surgeons who will meet with Dr Mac Armstrong, Scotland’s chief medical officer, to discuss how a national plan can be adopted. It comes at a time when there is concern that burns units in Scotland may fall victim to NHS reorganisation. McGregor said: “It hasn’t really been discussed or thought out at a higher level. At next year’s meeting I will be speaking to Mac Armstrong and his team about how we can move forward .”
Dr Mackie, who is based at the Red Cross Hospital in Beverwijk, in the Netherlands, gave his backing to McGregor’s call for a national plan for Scotland. He said: “I do believe a plan like this is the most efficient way of distributing a large number of patients who need very specific care.” A Scottish Executive spokesman said: “We are currently looking at burns services in Scotland to make sure they best meet people’s needs. That includes making sure burns services can cope with emergency situations. “We have already had some discussion with Mr McGregor about the Dutch plan, and we would be happy to have further discussions with him.”
SCOTTISH hospitals are seriously underprepared to deal with a major fire disaster or terror attack, a leading medical expert has claimed. John McGregor, a consultant plastic and burns surgeon at St John’s Hospital, West Lothian, has warned that existing contingency plans for emergencies are inadequate . He believes that without an urgent rethink of the current strategy, Scotland is vulnerable to a crisis in its ability to properly treat burns victims. Despite a range of potential Scottish terrorist targets – most notably the Faslane and Coulport naval bases and the new parliament building in Edinburgh – McGregor warned the country would struggle to cope with a major disaster .
He suggested lessons had not been learned from the 1988 Piper Alpha oil platform explosion, which killed 167 offshore workers and left many survivors terribly burned. “There are no guidelines at the moment other than the standard major disaster incident plans for each hospital. These are not specifically designed to cope with a large-scale incident in which the majority of cases are burns,” McGregor said. “There is the Grangemouth oil refinery and Mossmorran [an ethylene plant] in Fife. We haven’t had major incidents there recently but what happens if there is one? We ought to be looking at this now. We have a situation now that if we had a major disaster we may struggle. “The purpose of this is not to terrify people but to make them aware that we ought to be thinking more about this. With the Scottish parliament now in Edinburgh and other potential targets for terrorists, it is important we have some idea of how to plan for this.”
Across the UK, police and emergency services are on a high state of alert over the Christmas period, which because of its significance to Christians, government officials fear could prove the trigger for an attack. They also fear that bombing Britain at this time could be a way to destabilise the elections in Iraq on January 30. McGregor called on ministers to look to the model adopted in the Netherlands in 1990 to cope specifically with large-scale burns emergencies.
The plan, developed by Scottish anaesthetist Dr David Mackie, who has worked in the Netherlands for almost 30 years, was used successfully in 2001 after a fire in Volendam in which 13 people died and 180 were injured when Christmas decorations caught fire in a nightclub packed with teenagers celebrating New Year. Within minutes the temperature had reached 1000˚C as revellers frantically tried to escape. But Mackie’s plan was credited with keeping casualties to a minimum. Under the scheme, burns victims are not automatically sent to the accident and emergency department at the local hospital or nearest burns unit. Instead, a burns assessment team (BAT) – a consultant, a nurse and an anaesthetist – are sent to the site to assess patients and direct each to the most appropriate hospital, not necessarily the unit nearest the disaster scene.
McGregor said: “In the event of a disaster the number of casualties is potentially huge. If they all went to the accident and emergency department in the locality, it would be overwhelmed. They wouldn’t have the number of staff who are trained in treating burns. “ Patients who do not need major burns care could go to outlying hospitals. Somewhere on the site, the assessment team would identify who really has major burns and needs to be admitted to the nearest burns unit. By doing that you ensure patients get the best treatment and hospitals are not overwhelmed. “The assessment team would then go out two or three days after the incident to hospitals to look again at whether patients needed more appropriate care. Some may need to be sent to more peripheral hospitals, while other might need to be sent to the specialist burns units.”
In the spring, McGregor will lead a delegation of plastic surgeons who will meet with Dr Mac Armstrong, Scotland’s chief medical officer, to discuss how a national plan can be adopted. It comes at a time when there is concern that burns units in Scotland may fall victim to NHS reorganisation. McGregor said: “It hasn’t really been discussed or thought out at a higher level. At next year’s meeting I will be speaking to Mac Armstrong and his team about how we can move forward .”
Dr Mackie, who is based at the Red Cross Hospital in Beverwijk, in the Netherlands, gave his backing to McGregor’s call for a national plan for Scotland. He said: “I do believe a plan like this is the most efficient way of distributing a large number of patients who need very specific care.” A Scottish Executive spokesman said: “We are currently looking at burns services in Scotland to make sure they best meet people’s needs. That includes making sure burns services can cope with emergency situations. “We have already had some discussion with Mr McGregor about the Dutch plan, and we would be happy to have further discussions with him.”