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Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Consensus on items and quantities of clinical equipment required to deal with a mass casualties big bang incident: a national Delphi study
Authors: Duncan, Edward
Colver, Keith
Dougall, Nadine
Swingler, Kevin
Stephenson, John
Abhyankar, Purva
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Keywords: Mass casualties
Major incident
Delphi method
Big bang
Clinical equipment
Issue Date: Feb-2014
Publisher: BioMed Central
Citation: Duncan E, Colver K, Dougall N, Swingler K, Stephenson J & Abhyankar P (2014) Consensus on items and quantities of clinical equipment required to deal with a mass casualties big bang incident: a national Delphi study, BMC Emergency Medicine, 14, Art. No.: 5.
Abstract: Background: Major short-notice or sudden impact incidents, which result in a large number of casualties, are rare events. However health services must be prepared to respond to such events appropriately. In the United Kingdom (UK), a mass casualties incident is when the normal response of several National Health Service organizations to a major incident, has to be supported with extraordinary measures. Having the right type and quantity of clinical equipment is essential, but planning for such emergencies is challenging. To date, the equipment stored for such events has been selected on the basis of local clinical judgment and has evolved without an explicit evidence-base. This has resulted in considerable variations in the types and quantities of clinical equipment being stored in different locations. This study aimed to develop an expert consensus opinion of the essential items and minimum quantities of clinical equipment that is required to treat 100 people at the scene of a big bang mass casualties event. Methods: A three round modified Delphi study was conducted with 32 experts using a specifically developed web-based platform. Individuals were invited to participate if they had personal clinical experience of providing a pre-hospital emergency medical response to a mass casualties incident, or had responsibility in health emergency planning for mass casualties incidents and were in a position of authority within the sphere of emergency health planning. Each item's importance was measured on a 5-point Likert scale. The quantity of items required was measured numerically. Data were analyzed using nonparametric statistics. Results: Experts achieved consensus on a total of 134 items (54%) on completion of the study. Experts did not reach consensus on 114 (46%) items. Median quantities and interquartile ranges of the items, and their recommended quantities were identified and are presented. Conclusions: This study is the first to produce an expert consensus on the items and quantities of clinical equipment that are required to treat 100 people at the scene of a big bang mass casualties event. The findings can be used, both in the UK and internationally, to support decision makers in the planning of equipment for such incidents.
Type: Journal Article
DOI Link:
Rights: © 2014 Duncan et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
Affiliation: NMAHP Research
Scottish Ambulance Service
NMAHP Research
Computing Science - CSM Dept
National Ambulance Resilience Trust
NMAHP Research

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