Junior doctors clueless about what to do during major incidents

June 30, 2011, British Medical Journal

Junior doctors have no idea what they should be doing when a major incident, such as a terrorist attack or transport disaster, occurs, reveals research published in the online journal BMJ Open.

This could be critical, says the author, especially as the UK's current terrorism threat level is classified as "severe," meaning that a is highly likely.

The Department of Health defines a major incident as "any event whose impact cannot be handled within routine service arrangements." It involves special procedures by one or more of the , the NHS, or a Local Authority.

As such, every UK hospital has a Major Incident Contingency Plan, to help it best manage the extraordinary demands likely to be imposed on it during this time. And every healthcare professional has a dedicated page in this plan, explaining their contacts, roles, and responsibilities, known as an "action card."

But a survey of 89 junior doctors in three NHS hospital trusts in Wales showed that nine out of 10 (91%) didn't know what would be expected of them in the event of a major incident.

Standard procedure in Wales is that once a major incident is confirmed, junior doctors should go to their ward, contact the senior nurse in charge, and compile a list of patients who could safely be discharged while managing the others who can't. Should they be needed elsewhere, they will be contacted by a senior doctor or the hospital control centre.

However, the survey responses indicated that almost half (47%) would initially go the department, while more than one in four (27%) had no idea where they should go.

Almost one in three (31%) didn't know whom they should contact, while 16% said they would contact the switchboard, which would be shut during a major incident.

The junior doctors were also unsure of their primary role, with 16% believing this would be triage of injured patients, and over half (53%) expecting to clerk in patients in emergency care or the medical/surgical assessment units.

Only 3% would first go their ward, and only around one in 10 (12%) believed their primary role would involve ward patients. Only 1% would list patients for discharge.

Most (90%) of the junior doctors recognised the gaps in their knowledge and asked for some teaching on the subject. As the author points out, this is not included in medical school curricula or induction programmes for junior doctors in Wales.

"NHS trusts in Wales are not alone within the UK in regard to poor awareness during a major incident," says the author. "Studies throughout the last 10 years have shown that despite continuing catastrophes within the UK, major incident awareness throughout hospitals is poor and vital teaching is absent from most staff timetables."

And he warns: "Staff [who are] unaware of their roles and responsibilities will turn a major incident into a major disaster."

Related Stories

Recommended for you

Sweet, bitter, fat: New study reveals impact of genetics on how kids snack

February 22, 2018
Whether your child asks for crackers, cookies or veggies to snack on could be linked to genetics, according to new findings from the Guelph Family Health Study at the University of Guelph.

The good and bad health news about your exercise posts on social media

February 22, 2018
We all have that Facebook friend—or 10—who regularly posts photos of his or her fitness pursuits: on the elliptical at the gym, hiking through the wilderness, crossing a 10K finish line.

Smartphones are bad for some teens, not all

February 21, 2018
Is the next generation better or worse off because of smartphones? The answer is complex and research shows it largely depends on their lives offline.

Tackling health problems in the young is crucial for their children's future

February 21, 2018
A child's growth and development is affected by the health and lifestyles of their parents before pregnancy - even going back to adolescence - according to a new study by researchers at the Murdoch Children's Research Institute, ...

Lead and other toxic metals found in e-cigarette 'vapors': study

February 21, 2018
Significant amounts of toxic metals, including lead, leak from some e-cigarette heating coils and are present in the aerosols inhaled by users, according to a study from scientists at Johns Hopkins Bloomberg School of Public ...

Why teens need up to 10 hours' sleep

February 21, 2018
Technology, other distractions and staying up late make is difficult, but researchers say teenagers need to make time for 8-10 hours of sleep a night to optimise their performance and maintain good health and wellbeing.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.