Table 3.
Statements that reached expert consensus
| Area | Mean | SD | Round |
|---|---|---|---|
|
Initial medical response management at the regional (strategic) level |
|
|
No |
| Time point of notification of the first appropriate staff person, Duty Officer (DO) to take on the role of medical management coordinator |
4.93 |
0.25 |
1 |
| Location of incident |
4.90 |
0.30 |
1 |
| Time point when major incident was declared by duty officer (DO) |
4.75 |
0.64 |
1 |
| Time point when regional medical command centre establishes contact with management at the scene of the incident |
4.75 |
0.51 |
1 |
| Content of regional medical command centre issues guidelines for course of action |
4.66 |
0.80 |
1 |
| Time point for decision on additional recourses to be sent to the scene |
4.65 |
0.61 |
1 |
| Time point when regional medical command centre issues guidelines for course of action |
4.63 |
0.66 |
1 |
| Time point for and changes in operational level of regional medical command centre |
4.62 |
0.67 |
3 |
| Who reported incident |
4.62 |
0.62 |
1 |
| Time point and if other person than DO assumes the role as initial medical management coordinator |
4.55 |
0.82 |
3 |
| Operational level of regional medical command centre |
4.44 |
1.05 |
1 |
| Time point at which the regional medical command centre deactivates its DMMP |
4.42 |
1.10 |
2 |
|
Type of incident (incident characteristics) |
|
|
No |
| Incident type |
4.88 |
0.42 |
2 |
|
Initial medical response management at the local level (scene of the incident) |
|
|
No |
| Time for first report from scene “Window report” |
4.89 |
0.40 |
1 |
| Content of the first management at the incident site, decisions about the course of action/issues guidelines for the medical response |
4.85 |
0.35 |
2 |
| First EMS ambulance at the incident site and time of arrival |
4.82 |
0.66 |
1 |
| Number of mobile medical teams and time point when alarming each one |
4.79 |
0.67 |
1 |
| Time points at which medical responders at scene are activated and demobilised |
4.78 |
0.49 |
3 |
| Content of second report from scene |
4.77 |
0.69 |
2 |
| The number of T1 category patients transported from the scene to receiving healthcare facilities |
4.77 |
0.80 |
1 |
| Content, according to METHANE, of first report from scene according to the MIMMS concept * |
4.75 |
0.58 |
2 |
| Content of the first management at the incident site, decisions about the course of action/issues guidelines for response |
4.74 |
0.52 |
3 |
| Number of ambulances and time point for alarming each ambulance |
4.73 |
0.90 |
1 |
| Number of first responder vehicles and time point for alarming each |
4.46 |
1.10 |
1 |
| Number of ambulance helicopters alarmed and time point for alarming each |
4.76 |
0.67 |
1 |
| Time point when on scene medical management establishes contact with regional medical command centre |
4.68 |
0.60 |
1 |
| Time point when on scene medical control and coordination is operational |
4.67 |
0.72 |
1 |
| The number of T2 category patients transported from the scene to receiving healthcare facilities |
4.65 |
0.84 |
1 |
| Time point when first EMS ambulance arrives on scene |
4.57 |
0.79 |
2 |
| Time point when on scene medical control and coordination is demobilised |
4.57 |
0.74 |
3 |
| The number of T3 category patients transported from the scene to receiving healthcare facilities |
4.55 |
0.93 |
1 |
| Time for second report from scene “confirming report” |
4.53 |
0.96 |
1 |
| Time point when management at the incident site makes decisions about the course of action/ issues, guidelines for the medical response |
4.53 |
0.99 |
3 |
| Time when management at the incident site issues the first course of action, general guidelines for response |
4.51 |
1.01 |
1 |
| The number of T4 category patients transported from the scene to receiving healthcare facilities |
4.44 |
0.78 |
3 |
| Units sending prehospital teams |
4.41 |
0.73 |
3 |
| Time point at which the first patient has been triaged at the scene of the MI |
4.37 |
0.86 |
3 |
| Triage system used |
4.35 |
0.91 |
3 |
| Time when casualty-clearing station can start receiving patients |
4.34 |
0.72 |
3 |
|
Management/liaison (in general when nothing else is specified) |
|
|
No |
| Time point for the first referral of patients to the receiving health care facilities (referral key) |
4.65 |
0.72 |
1 |
| Time point when contact made with the authority at the national level |
4.65 |
0.61 |
3 |
| Time for decision if another county / region needs to be alerted and content of this decision |
4.63 |
0.80 |
1 |
| Time point for the first decision on the course of action at the regional level of management |
4.62 |
0.62 |
1 |
| The measures initiated to address operational /infrastructure disruption |
4.60 |
0.78 |
3 |
| What kind of expertise becomes engaged |
4.55 |
0.63 |
3 |
| Decision on information to “own staff” in the county health care units |
4.53 |
0.69 |
3 |
| Time point when liaison is established with other actors, emergency support function (ESP) |
4.48 |
0.73 |
3 |
| Time point for established liaison with agencies and organisations affected on matters of strategic management (rescue service, police) |
4.41 |
0.86 |
3 |
| All time points for the updated references of patients to the receiving healthcare facilities |
4.40 |
1.08 |
1 |
| Time point and type of media contacts (including press releases, press communiqué, press conference) |
4.32 |
0.77 |
2 |
| Decisions on sending liaison officer to county administrative board |
4.20 |
0.72 |
3 |
|
Patient transport/resources |
|
|
No |
| Time point at which the first priority 1 (T1) patient was transported to healthcare facilities |
4.68 |
0.76 |
1 |
| Time point at which the last priority 1 (T1) patient was transported to receiving healthcare facilities |
4.68 |
0.71 |
1 |
| The number of transport units (other than by ambulance) |
4.53 |
0.74 |
3 |
| Alternative transport units |
4.34 |
0.76 |
1 |
|
Initial medical response management at the local level (healthcare facilities) |
|
|
No |
| Total number of patients received by health care facilities |
4.96 |
0.19 |
2 |
| Time when the alarm receiver on receiving hospital is alerted |
4.85 |
0.36 |
1 |
| Arrival time the first ambulance to the healthcare facility |
4.79 |
0.49 |
1 |
| Arrival time for the first priority 1 (T1) patient from the incident site to the healthcare facility |
4.79 |
0.49 |
1 |
| Arrival time for the last priority 1 (T1) patient from the incident site to the healthcare facility |
4.72 |
0.52 |
1 |
| Time point of startup / shutdown when decontamination station is in operation |
4.70 |
0.60 |
1 |
| Name of receiving hospital |
4.68 |
0.60 |
1 |
| Time point of established medical management coordination at receiving hospital (ie, when management can be exercised) |
4.64 |
0.73 |
3 |
| Change and time point for changing the emergency level at the healthcare facilities including startup / shutdown |
4.59 |
0.93 |
2 |
| Time point at which the hospital activates its disaster medical management plan |
4.58 |
0.68 |
1 |
| Time point when medical management at each healthcare facility is deactivated |
4.53 |
0.74 |
3 |
| Arrival time of the first self-presenting patient to the healthcare facility |
4.41 |
0.77 |
1 |
|
Injury severity and mortality (patient characteristics) |
|
|
No |
| The total number of injured |
4.96 |
0.18 |
1 |
| Mortality on scene (number) |
4.90 |
0.30 |
1 |
| Mortality in the emergency department (number) |
4.89 |
0.31 |
2 |
| Mortality Pre-hospital and during transport (number) |
4.86 |
0.43 |
1 |
| Dominating type of injury |
4.72 |
0.52 |
1 |
| Injury severity (ISS) |
4.62 |
0.88 |
2 |
| The total number of self-presenting patients to the healthcare facility |
4.58 |
0.50 |
1 |
| Affected but uninjured (estimated number) |
4.37 |
0.97 |
2 |
|
Staff equipment |
|
|
No |
| Disturbance and type of disturbance of communication |
4.60 |
0.72 |
1 |
| Disturbance and type of disturbance of documentation systems | 4.50 | 0.82 | 1 |
* Acronym for the content, defined in the Major Incident and Medical Management Support Course (MIMMS) developed in Great Britain.