DMCH launches facility to manage mass casualties

Dhaka Medical College Hospital (DMCH) has set up a mass casualty management centre to handle influx of patients due to disastrous incidents like Rana Plaza or Nimtoli tragedies.

This first of its kind facility in Bangladesh, built in the basement of DMCH's emergency building, will be able to treat over 100 patients at a time.

Named CBRN and Mass Casualty Management Centre, the facility has two components -- one will treat people exposed to chemical, biological, radiation and nuclear (CBRN) hazards while the other will provide treatment to victims of any major accident.

"DMCH has been the 'go to' hospital for patients across the country, especially the impoverished. The daily inflow of patients at the hospital has been two times higher than its capacity," said DMCH Director Brig Gen AKM Nasir Uddin.

"But it becomes unmanageable for us when a huge number of patients turns up at the hospital after an incident like Nimtoli or Rana Plaza tragedies," he told The Daily Star recently.

The chemical-induced Nimtoli inferno  in June 2010 killed 124 people and injured over 100 while the Rana Plaza collapse in 2013 killed at least 1,132 people and injured over 2,500.

"That's why we have set up a Mass Casualty Management Centre," said the DMCH director.

He said they have also set up the CBRN Casualty Management Centre considering the rise in use of hazardous chemicals at factories and keeping in mind the global campaign on hospital disaster preparedness and response against it.

"Besides, the construction of a nuclear power plant is going on in the country," said Nasir Uddin.

Both the centres will be able to provide treatment facilities without interrupting normal activities at the emergency department, said the DMCH director, who initiated the move last year to build the facility at a place meant for car parking but later turned into a warehouse.

CBRN Casualty Management Centre has three zones -- red, yellow and green. It also has three ICU beds, a High Dependency Unit, central oxygen supply system, an operation theatre, separate rooms for male and female patients and a reception triage in the red zone. At least 56 patients could be decontaminated at a time in this facility, he said.

"It is possible to decontaminate 280 patients within an hour as we have the capacity of decontaminating a patient within five minutes," said Nasir Uddin, adding, "When a patient of the green zone will be stable, they will be shifted to the emergency, ICU or other wards of the hospital."

"Our Mass Casualty Management Centre will be able to treat 70 to 80 patients at a time," he said.

A modern air handling system has also been installed at the centre, which was prepared around two months back, said the director.

"There is no doctor, nurses and other officials in the centres but there is a standing order so that doctors, nurses and other relevant medical staffers who were trained in this regard will join there immediately after a major accident," he said.

The director said this facility can be used as a training centre and also for providing treatment to Covid-19 patients if the pandemic sees a sudden rise. 

Talking about DMCH's initiative, Dr MA Sabur, who teaches health system at Dhaka University's health economics institute, said it is a good endeavour, but at the same time, the facility should have necessary medicine and workforce in place.

"The authorities should organise drills with healthcare professionals from time to time, to keep them prepared to handle any situation when the time comes," he said.