British journal of anaesthesia
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Efficiency is an essential part of sustainable healthcare, especially in emergency and acute care (including surgical) settings. Waste minimisation, streamlined processes, and lean principles are all important for responsible stewardship of finite health resources. However, the promotion of efficiency above all else has effectively subordinated preparedness as a form of waste. ⋯ The ongoing COVID-19 pandemic has exposed the gap between efficient processes and resilient systems in many health settings. In anticipation of future pandemics, natural disasters, and mass casualty incidents, health systems, and individual healthcare workers, must prioritise preparedness to be ready for the unexpected or for crises. This requires a reframing of priorities to view preparedness as crucial insurance against system failure during disasters, by taking advantage of lessons learnt preparing for war and mass casualty incidents.
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Exercising for mass casualty incidents is mandated by governing organisations with the aim of maintaining readiness within the healthcare sector for the many challenges these incidents bring. This readiness is delivered through a combination of discussion-based and operation-based exercises that are targeted to the needs of both the individuals delivering care and the needs of the overall system of patient flow and treatment. Although exercising for disaster preparedness is resource intensive, it is the repetitive, iterative nature that allows for wide staff capture and exposure along with continual improvement of plans. ⋯ A cycle of design, challenge, and redesign should target areas of greatest need and greatest benefit. The conventional advice, when introducing exercising, is to start small and build up over time with repeated exercises that demonstrate increasing response capability. However, some organisations would benefit from an exercise that lays bare shortcomings and acts to galvanise change.
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Preparedness for mass casualty events is essential at local, national, and global levels. Much more needs to be done by all stakeholders to avoid unnecessary morbidity and mortality despite the challenges that COVID-19 continues to present. In this editorial, we highlight the challenges and solutions for mass casualty incident preparations.
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With healthcare systems rapidly becoming overwhelmed and occupied by patients during a pandemic, effective and safe care for patients is easily compromised. During the course of the current pandemic, numerous treatment guidelines have been developed and published that have improved care for patients with COVID-19. Certain lessons have only been learned during the course of the outbreak, from which we can learn for future pandemics. This editorial aims to raise awareness about the importance of timely stockpiling of sufficient amounts of personal protection equipment and medications, adequate oxygen supplies, uninterrupted electricity, and fair locally adapted triage strategies.
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We outline the history, implementation and clinical impact of the formation of an Airway Lead Network. Although recommendations to improve patient safety in airway management are published and revised regularly, uniform implementation of such guidelines are applied sporadically throughout the hospital and prehospital settings. ⋯ Locally, the Airway Lead may chair a multi-disciplinary airway committee within their organisation; an Airway Lead Network enables Airway Leads to share common problems and solutions to promote optimal airway management on a national level. Support from governing bodies is an essential part of this structure.