Paediatric mass casualty response through the lens of Functional Resonance Analytical Methodology- lessons learned

MacKinnon, R. J., Slater, D., Jenner, R., Stenfors, T., Kennedy, C. and Härenstam, K. P. 2024. Paediatric mass casualty response through the lens of Functional Resonance Analytical Methodology- lessons learned. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 32 (1) , 93. 10.1186/s13049-024-01264-4

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Abstract

Background Mass Casualty Incidents are rare but can significantly stress healthcare systems. Functional Resonance Analytical Methodology (FRAM) is a systematic approach to model and explore how complex systems adapt to variations and to understand resilient properties in the face of perturbations. The aim of this study was to use FRAM to create a model of a paediatric trauma system during the initial response to the Manchester Arena Attack to provide resilience-based insights for the management of future Mass Casualty Incidents (MCI). Methods Qualitative interviews in the immediate aftermath of a terrorist bombing, were followed up with further in-depth probing of subject matter experts to create a validated and verified FRAM model. This model was compared with real incident data, then simplified for future studies. Results A Work As Imagined (WAI) model of how a paediatric emergency department provided resilient healthcare for MCI patients from reception and resuscitation to definitive care is presented. A focused model exploring the pathway for the most severely injured patients that will facilitate the simulation of a myriad of potential emergency preparedness resilience response scenarios is also presented. Conclusions The systematic approach undertaken in this study has produced a model of a paediatric trauma system during the initial response to the Manchester Arena Attack, providing key insights on how a resilient performance was sustained. This modelling may provide an important step forward in the preparedness and planning for future MCIs.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Engineering
Publisher:	BioMed Central
ISSN:	1757-7241
Date of First Compliant Deposit:	10 December 2024
Date of Acceptance:	9 September 2024
Last Modified:	10 Dec 2024 12:30
URI:	https://orca.cardiff.ac.uk/id/eprint/174606

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