Westminster Attack - how Nurses prepare for major incidents

How do NHS Emergency departments prepare and plan for major incidents like the one experienced by St Thomas' during Wednesday's Westminster Attack?

On the afternoon of Wednesday the 22nd of March 2017, the unfolding terror attack in Westminster drew media headlines and worldwide attention as the members of the emergency services attended the scene to help the injured civilians.

Amongst the attending services were the nurses and doctors from the nearby hospital, St Thomas’s. A major incident was declared by the London Ambulance Service.

A major incident is thankfully a rare event but is defined as ‘…any occurrence that presents serious threat to the health of the community or causes such numbers or types of casualties, as to require special arrangements to be implemented.’

(Ref: England.NHS.uk)

How NHS emergency departments prepare for major incidents

For those who work in the emergency services sector and the NHS environment, the words ‘Major Incident’ are to be regarded with both apprehension and nervous anticipation.

It is the highest level of alert that the services can be placed on and something that all emergency department nurses and doctors, are trained to be ready for.

Each hospital and service has a plan in place to manage a major incident, regardless of what the origin or nature of it is, and the hospital team immediately begins to prepare to be a receiving centre for the incoming casualties.

On the 22nd of March, there were estimated to be over 50 casualties including several with life threatening injuries. This level of casualties would be overwhelming for a single Emergency Department to assess and therefore the injured were spread across different trusts who all acted as receiving centres.

St Thomas’s itself is not a major trauma centre but the staff descended on Westminster Bridge to provide support to the emergency services already in attendance.

In my time as an emergency department nurse; now nearly a decade ago, I was fortunate enough to only have to be on alert for a major incident twice.

The first being the Camden Tube crash in October 2003, and the second; we were stood down as a receiving centre before any patients arrived.

I can remember that feeling of nervous anxiety as we cleared the waiting room of all non-urgent patients and redirected them to other services, in the knowledge that we were going to be receiving people with multiple injuries of a traumatic nature.

Trauma calls are always intense, even when there is one casualty, never mind the prospect of several at once.

I cannot begin to appreciate the level of fear that the medics and nurses experienced whilst they were running towards Westminster Bridge last Wednesday.

I take my hat off to them all.