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• How will your Junior Doctors react?
  Joseph M Hobson
  Published on: 16 September 2009
• 9/11 = MM/DD but 7/7 = DD/MM or MM/DD
  Christopher B Everett
  Published on: 19 October 2006
• Major Incident Policy Awareness
  Esmond RM Carr
  Published on: 4 September 2006

• Published on: 16 September 2009

  How will your Junior Doctors react?

  • Joseph M Hobson, Doctor (FY1)

  Four years on from 7/7 I believe the issue of major incident awareness has still not been properly addressed. Wong in 2006 highlighted the inadequacy of Registrar awareness with their major incident contingency plan and their role. This year I set out to establish Junior Doctor’s (FY1 + FY2) awareness at Wrexham Maelor Hospital using a similar questionnaire.

  Greater than 90% of Junior Doctors did not know wh...

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  Four years on from 7/7 I believe the issue of major incident awareness has still not been properly addressed. Wong in 2006 highlighted the inadequacy of Registrar awareness with their major incident contingency plan and their role. This year I set out to establish Junior Doctor’s (FY1 + FY2) awareness at Wrexham Maelor Hospital using a similar questionnaire.

  Greater than 90% of Junior Doctors did not know what would be expected of them during a major incident.

  No Junior Doctor knew what to do if bleeped about a major incident. No medical or surgical Junior Doctor would attend to their ward first, 13% of FY1’s and 38% of FY2’s would report to A+E. Switchboard would receive calls from 17% of FY1’s and 6% of FY2’s, and A+E 13%, 19% respectfully.

  12.5% of FY1’s believed their role would be triage. 17%, 25% of ward FY1’s, FY2’s believed they would be working in A+E.

  Of all the Junior Doctors, only 12% of surgical FY1’s and 25% of medical FY2’s would attend to existing patients, only 25% of the surgical FY2’s would shortlist patients for discharge.

  These findings, 2 years on from Wong’s report still show a dangerous lack of awareness by doctors on major incidents. Not only did our Junior Doctors not know what to do, their choices on the day would be highly detrimental. However, after organised teaching, all Junior Doctors knew who to ring, where to go and what to do during a major incident.

  It could seem ‘it’ll never happen to us’ is the line that keeps major incident training off the induction programme. Can we afford this innocence? Staff unaware of their roles and responsibilities will turn a major incident into a major disaster.

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  Conflict of Interest:
  None declared.

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• Published on: 19 October 2006

  9/11 = MM/DD but 7/7 = DD/MM or MM/DD

  • Christopher B Everett, Retired GP

  Dear Editor

  If there should be another major terrorist attack, we must think hard about any popular abbreviation that might be applied to it.

  If the 7th July attack in London had occurred on the following day would it have been called 8/7 or 7/8 which would have confused either our trans-atlantic neighbours or us.

  The potential confusion exists because the North Americans use the MM/DD/YYYY sy...

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  Dear Editor

  If there should be another major terrorist attack, we must think hard about any popular abbreviation that might be applied to it.

  If the 7th July attack in London had occurred on the following day would it have been called 8/7 or 7/8 which would have confused either our trans-atlantic neighbours or us.

  The potential confusion exists because the North Americans use the MM/DD/YYYY system rather than the more logical and widespread DD/MM/YYYY method. Was it the Americans who first called the London attack 7/7, otherwise the Twin Towers would have been called 11/9 by us!

  This ambiguity is an impediment in many fields and is likely to remain confusing in future. Does anyone have a solution or should this strange type of abbreviation be carefully avoided in any future major disaster unless it should happen to occur on 1/1, 2/2 3/3 (and so) which seems unlikely?

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  Conflict of Interest:
  None declared.

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• Published on: 4 September 2006

  Major Incident Policy Awareness

  • Esmond RM Carr, ENT Surgery Specialist Registrar
  • Other Contributors:
    • Paul Chatrath, Prem Palan

  Dear Editor,

  We agree with Turner et al (1) that more needs to be done to prepare doctors on how to respond to major incidents. We have published data from a study carried out before the July 7th bombings (2) on the knowledge of doctors on major incident policies. One of the main problems we identified which is not discussed in Turner et al’s paper is that major incident policies are large documents (approximately 100...

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  Dear Editor,

  We agree with Turner et al (1) that more needs to be done to prepare doctors on how to respond to major incidents. We have published data from a study carried out before the July 7th bombings (2) on the knowledge of doctors on major incident policies. One of the main problems we identified which is not discussed in Turner et al’s paper is that major incident policies are large documents (approximately 100 sides of A4 paper in the hospital where the study was carried out), the majority of which is not relevant to any one particular doctor. In our study based at a central London teaching hospital that was directly involved in the July 7th bombings we assessed doctors’ knowledge of the major incident policy by asking where doctors should report to in the event of a major incident. We managed to increase the knowledge of doctors on the major incident policy from 4% to 78% by condensing the important information for doctors onto a 1 sided A4 information sheet. We would disagree with the authors’ feelings that the main London hospitals were in a good state of readiness before the London bombings. As part of our study we spoke to doctors in all 38 hospitals within the M25 with Accident & Emergency departments and only doctors in 2 hospitals said they had read or received training on their hospital major incident policy. On the day of the bombings it would appear that hospitals coped well with the major incident but this should not make us complacent into thinking that the system would have coped well had there been more casualties. We would have hoped that in the aftermath of the July 7th bombings and our study that the situation would have improved but Turner et al.’s paper would unfortunately suggest that this is not the case.

  Yours sincerely

  Esmond Carr

  Paul Chatrath

  Prem Palan

  References

  1. Wong K, Turner PS, Boppana A et al. Preparation for the next major incident: are we ready? Emerg Med J 2006; 23; 709-712.

  2. Carr ERM, Chatrath P, Palan P. Audit of doctors’ knowledge of major incident policies. Ann R Coll Surg Engl 2006; 88: 313–315.

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  Conflict of Interest:
  None declared.

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