Major incident

Nurses General Nursing


Is any one aware of any study available for the management of Major incident at ward level. If so where, when and How much.

Don't mean to be dumb, but what is ward level?

I run the recieving ward for any major incident i.e. bombing etc.

For a large teaching hospital in London (UK.

We are the first stop after accident and emergency, when not running the infrequent Major incident it is the Male Trauma & Orthopeadic ward.

So in times of crisis it must metamoph into the major incident ward, and I would like to do it better.

Does anybody run a major incident recieving ward?


That is the ward identified to take all those patient injured in one incident, it make security, the press and debriefing easier, Hopefully it also means the nurses caring for them are the most appropriatley trained.

Originally posted by D. Rowe:

Don't mean to be dumb, but what is ward level?

In most US hospitals, patients are triaged out to the most appropriate units (or wards) after an incident. Most hospitals have disaster plans which include setting up of a control center and having the ER be the "facilitation" area. In our organization there is a global plan as well as individual plans for each area. If a big enough area was hit in a disaster, would one ward be enough to hold all victims and would it be appropriate to have all of them on one ward. Don't forget that while trauma would be the major indicator for admits, the hospital would also get increased pysch, pediatric, medical (cardiac,resp, diabetic) admits as well. What about those who may have no where to go if all other members of the family were killed, etc. Contigency planning has to thought of for all of these situations.

Many hospitals in the US are involved in the Domestic Preparedness Program. Though this programs focus is on reacting to WMD, some of it's principles may be applicable to your situation.

As I've just had a new hard drive put into my computer, it may take me awhile to find the link for DPP info. I'll send as soon as I find it.


Don't Worry About Things You Can Control...

Don't Worry About Things You Cannot Control...

Ward Level- that would be, not accident and emergency or Theatre.


Originally posted by Bones:

Ward Level- that would be, not accident and emergency or Theatre.

Maybe there is confusion about this ward word because the younger US nurses do not know what a ward is. We have not had wards in the US in 20 years, if there are any still around they are very rare. A ward(for the youngsters out there)was a very large unit where the patients were lined up around the walls and the nursing staff walking up and down at the foot of the beds. Think of a semi-private with 20 to 40 people people in it. My very first unit in 1967 was a ward with 5 large rooms each having 12 patients. I think the insurance in those days called anything with 4 or more patients in it a ward. I believe there are many wards in use in the UK, I see them on UK TV shows all the time, I just do not know if the things I see are being accurately portrayed. If I believed everything I see on TV I would think UK nurses wore white uniforms with black stockings and black shoes, I have been told this is not so.

The ward is not as Florence Nightingale once new it, but thet is as was previousley describe is a "nightingale ward" named after the lady with the lamp herself.

The "ward" is an identifying noun of a clinical area which has its own specific identity and is run indepedently of other areas by a nursing clinical leadr.

I am sure we all have experience of this despite the descibing noun. Does any one have any experience with the phrase major incident or are other terms used.

We do seem to be two contries seperated by a common language!


Hello Bones,

In the U.S. during the warning or rescue phase of a major event or incident, the hospital goes to the incident. If it cannot reach the incident then it gets as close as possible. The U.S. has mobile hospitals and has developed staffing resources through our National Disaster Medical System.

Here we have found that if you use the local hospitals during the first two phases you are at risk for creating secondary incidents. The secondary incidents occur when reoccurring events are not managed and then escalate.

Later as the incident evolves into the recovery phase, patients are integrated into local healthcare facilities. This is the most overlooked aspect of disaster planning. Depending on the type of incident, there maybe prolong elevated acute care/hospital census and extreme staff fatigue/illness.

I have a pet peeve about using abbreviations and acronyms on Web sites because I feel it can slow and limit the exchange between readers. Since I know it will always happen, for those readers who are not familiar with the specialty or are from outside the U.S., below is a link to the standard abbreviations used in the U.S. U.S standard acronyms and abbreviations from the Federal response plan.

If any readers have links to other countries list of acronyms or abbreviations they would be appreciated.


The National Hazards Center at the University of Colorado, Boulder has information available on line at:

When I did a search on hospital planning there were many hits. Here are two:

Hospitals and Community Emergency Response: What You Need to Know. Publication #PB98-130321INF. 1997. 32 pp. $12.00, microfiche; $25.50, paper. Copies can be obtained from the National Technical Information Service, 5285 Port Royal Road, Springfield, VA 22161; (800) 553-6847 or (703) 605-6000; fax: (703) 321-8547; e-mail: [email protected]; WWW:

Hospitals must be prepared to protect health care workers who respond to emergencies involving hazardous substances. Of special concern are situations where contaminated patients arrive for triage or treatment following a major disaster. In many localities, hospitals have not been firmly integrated into the community disaster response system and may not be prepared to safely treat multiple casualties that include victims who may be exposed to toxic substances. This document discusses emergency response planning principles that hospitals can adopt to help reduce the risk to health care workers.

Emergency Preparedness in Health Care Organizations. Linda Young Landesman, Editor. 1996. 194 pp. $35.00, plus $7.95 postage and handling. Available from the Joint Commission on Accreditation of Healthcare Organizations, P.O. Box 75751, Chicago, IL 60675-5751; (630) 792-5800; fax: (800) 676-3299. This book is designed to help hospitals and other health care organizations get ready to face major disasters and emergencies. It covers how to: develop a proactive emergency management plan; gain a clear understanding of key disaster planning issues, including command center operation, communications, community interaction, and emergency department operation; make critical decisions regarding implementation of the disaster plan; train staff; and comply with accreditation standards. Almost half of the book recounts various actual hospital emergency response situations.

[This message has been edited by Sharon (edited October 18, 2000).]

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