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INVOLVEMENT OF R ADIOLOGISTS IN MAPPING OUT MEDICAL FACILITIES' MA SS CA SUALT Y INCIDENT ¥MCI¦ PL ANS IS KE Y TO HANDLING THOSE OCCURRENCES, A S DEMONSTR ATED BY A 2015 TR AGEDY IN SE AT TLE THAT LEF T 51 VICTIMS IN NEED OF EMERGENCY CARE. and [ has] radiolog y ... been involved in pla nning for it? ' I see ver y few ha nds go up." AVERTING BOTTLENECKS With MCIs, the number of patients in need of radiology exams increases signifi cantly and rapidly, Dr. Berger notes. This strains resources and requires optimization of throughput by cutting down on imaging time or triaging patients diŠ erently to avoid bottlenecks. During the Seattle incident, Dr. Linnau and his team narrowly avoided a log jam. "The infl ux of patients stopped when we were about to be backlogged with patients in CT," he says. "I think we were somewhat prepared and OK but got lucky that the infl ux of patients stopped when it did." The radiology team now sits on the HMC Disaster Committee a nd pa r ticipates every six months in mock MCI drills, which Dr. Berger agrees is essential to gauging the eŠ ectiveness of MCI protocols. ■ STUDY HIGHLIGHTS H A R B O R V I E W M E D I C A L C E N T E R …HMC†, the reg ion's dedicated Level 1 trauma and burn center, received 19 of the casua lties, 16 of those within one hour, a f ter a tourist vehicle col lided with a charter bus on a highway bridge. Ken F. Linnau, MD, MS, emergency radiologist at HMC and University of Wa sh i ng ton A ssociate Professor of Radiology, and his colleagues immedi- ately found that their MCI plan, which was based on previous data simulation from literature reviews, underestimated scanner time at fi ve minutes per scan per patient. " T hat wa s t he most impor ta nt point for us, realizing that simulation data presented in litera- ture was probably not easily achievable," says Dr. Linnau, one of the authors of a study published in Februar y 2017 in Emergency Radiology. The actua l time per patient per scan avera ged 15 to 17 minutes, including transfer of patients from the g urney to the CT scanner to the resuscitation bay. Six teen patients received CT imaging on the three ava ilable sca nners, with an average of four patients scanned per hour per machine. This a lso was at odds with another recent study, published in the British Journal of Radiology, in which a mock MCI put CT scan time at slightly under 10 minutes and total patients scanned per hour per machine at six. ON THE SIDELINE Dr. Linnau says hospital disaster commit- tees too often do not draw on the insight of radiologists responsible for triaging patients during MCIs. T h a t i s a l s o t h e v i e w o f Fe r c o Berger, MD, head of the Emergency and Trauma Radiology Division–Sunnybrook Hea lth Sciences Centre and Assistant Professor in the Department of Medical Imaging at the University of Toronto. "Radiology a lot of the time is left at the sideline when dealing with preparation for mass casualty incidents," Dr. Berger says. "I've g iven lectures on this a nd a lways sta r t with the question: ' W ho knows the MCI protocol in their hospital, Need for Radiology Preparedness during Mass Casualty Incidents BY K AITLIN GUNTER " Once disaster hits, it's too late to come up with a plan." • KEN F. LINNAU, MD, MS, EMERGENCY RADIOLOGIST, HARBORVIEW MEDICAL CENTER, AND UNIVERSITY OF WASHINGTON ASSOCIATE PROFESSOR OF RADIOLOGY STUDY HIGHLIGHTS STUDY HIGHLIGHTS STUDY HIGHLIGHTS STUDY HIGHLIGHTS STUDY HIGHLIGHTS STUDY HIGHLIGHTS STUDY HIGHLIGHTS STUDY HIGHLIGHTS STUDY HIGHLIGHTS STUDY HIGHLIGHTS STUDY HIGHLIGHTS STUDY HIGHLIGHTS STUDY HIGHLIGHTS STUDY HIGHLIGHTS STUDY HIGHLIGHTS 1 8