How and why do you declare a major incident?
BACKGROUND
The decision to declare a major incident (MI) is not one to be taken lightly, but a delay in doing so may have dire consequences. The aim of this study was to ascertain what factors make specialists from a variety of professional backgrounds in the United Kingdom determine from an initial visual assessment of a scene that a MI should be declared.


METHODS
Participants were presented with three different scenarios, which were presented pictorially. Their responses were noted.


RESULTS
One hundred seventy-eight professionals took part in this study. For Scenario 1 (a road traffic incident), 101 (57%) declared a MI. For a coach rollover in Scenario 2, a MI was declared by 82 (46%) people, and a MI was declared by 156 (87%) for a rail crash in Scenario 3. Forty-six participants had attended a MI previously. The results for declaring a MI in this group were: (1) Scenario 1, 25 (54%); (2) Scenario 2, 25 (54%); and (3) Scenario 3, 44 (96%). Of this group, 44 had previously had training before experiencing the MI. Those who had > or = 10 years of service in emergency services were more likely to declare a MI in Scenario 2 and 3.


CONCLUSIONS
The main problem with the existing system is the interpretation and subjective nature of the word "major". Specialists incorporate many individual factors into using the word. Future research should focus on the development of a system tied to more objective analysis.
Smart
Colin John
CJ
TSG Associates Ltd, Leeds, West Yorkshire, England. colin@smartmci.com
Maconochie
Ian
I
D000063:Accidents, Traffic; D003625:Data Collection; D003657:Decision Making; D003695:Delivery of Health Care; D004189:Disaster Planning / Q000191:economics / Q000592:standards*; D004190:Disasters; D004636:Emergency Service, Hospital; D006801:Humans; D054527:Mass Casualty Incidents; D011634:Public Health / Q000592:standards*; D040841:Resource Allocation / Q000191:economics / Q000592:standards*; D011795:Surveys and Questionnaires; D014218:Triage / Q000379:methods / Q000458:organization & administration*; D006113:United Kingdom