How we managed a CODE BLACK (Disaster) in our ED

At  2 AM  at night  08/3/14 no one in the Emergency Department (ED) had the slightest hint of what is on store for the next three hours .    It was just another relatively  relaxed night with occasional chest pain and diarrhea  patients after the day's battle in a crowded ED.But after fifteen minutes  the scene completely changed . The ED became a battle ground : There was a CODE BLACK- the NABH code for "Disaster".Time had come to put text book knowledge into real life  practice.
On 2:15 AM 8/3/15 the quietness of night was  replaced with sirens from ambulances and desperate cry for help  when Kolkata Police started bringing patients after patients in the ED. It was later confirmed that a mass casualty event has occurred as a bus carrying a marriage party met an accident and got overturned near Ajay Nagar Crossing , Kolkata .

A total of 37 patients were brought at the same time , two of them were declared brought dead and triaged as "black"

The Emergency Trauma team  led by Dr Indraneel Das Gupta and Dr Saptarshi Saha stated its Traiging :Nine of them  were found seriously wounded - they were categorized as Yellow. Five required CT Scan of Head and Neck and subsequent neurology opinion . Other six  had multiple fractures.
But the whole disaster was managed in just two hours  with close coordination with the Orthopedics and Neurology Department . Early intervention with oxygen ,splints ,blood ,fluids and ventilator  in this " golden hour " of trauma saved the lives of all the patients -many of whom would have faced significant mortality and morbidity if the treatment was delayed .

The  Emergency Physicians on duty gave evidence of their professionalism and dedication . The Department has been training its professionals  for years for such  disasters which are encountered more often in textbooks and newspapers than in real life. .

Our regards to the Emergency Trauma team for their expertise and professionalism. The ED Trauma Team consisted of :
Dr Indraneel Das Gupta , Dr Saptarshi Saha ,
Dr Pranab Barua ,Dr Sajid Nomani , Dr Vivek Goel , Dr Palash Mannna, Dr Abhijit Mondal , Dr Jayanta Mahato
it was later joined by Dr K Sridhar , Dr Sujoy Das Thakur and Dr Abhishek Mukherjee.

NB :
"Golden Hour" (Adapted)

Golden Hour Principle

In emergency medicine, the golden hour (also known as golden time) refers to a time period lasting for one hour following traumatic injury being sustained by a casualty or medical emergency, during which there is the highest likelihood that prompt medical treatment will prevent death. It is well established that the patient's chances of survival are greatest if they receive care within a short period of time after a severe injury;Some have come to use the term to refer to the core principle of rapid intervention in trauma cases, rather than the narrow meaning of a critical one-hour time period.

Principle: Cases of severe trauma, especially internal bleeding, require surgical intervention. Complications such as shock may occur if the patient is not managed appropriately and expeditiously. It therefore becomes a priority to transport patients suffering from severe trauma as fast as possible to specialists, most often found at a hospital trauma center, for definitive treatment. Because some injuries can cause a trauma patient to deteriorate extremely rapidly, the lag time between injury and treatment should ideally be kept to a bare minimum; this has come to be specified as no more than 60 minutes, after which time the survival rate for traumatic patients is alleged to fall off dramatically.

The late Dr. R Adams Cowley is credited with promoting this concept, first in his capacity as a military surgeon and later as head of the University of Maryland Shock Trauma Center. The concept of the "Golden Hour" may have been derived from French military World War I data.The R Adams Cowley Shock Trauma Center section of the University of Maryland Medical Center's website quotes Cowley as saying, "There is a golden hour between life and death. If you are critically injured you have less than 60 minutes to survive. You might not die right then; it may be three days or two weeks later — but something has happened in your body that is irreparable."