The Major Incident Hospital, located in the UMC Utrecht, is an internationally unique facility for providing immediate emergency care for casualties in exceptional circumstances. It is the result of co-operation between the Ministry' of Defense’s Central Military Hospital and the UMC Utrecht. The combination of a large academic medical institution, a military hospital, a trauma centre and the National Poison and Control Centre (NVIC), the Major Incident Hospital offers not only superb infrastructure, but also the expertise required to provide emergency care in case of disaster and calamity.
During the renovation of the Central Military Hospital (CMH), the Ministry of Defence established a disaster management hospital in the former AZU building, now the home of UMC. The military emergency hospital, now called Major Incident Hospital, was intended to provide the infrastructure for the care of large of numbers of military casualties. In recent years, a growing demand has also arisen to make the space available somehow for the Civil Major Incident Relief Organisation. During construction it had already been decided that the UMC's Intensive Care 1/Clinical Toxicology department and the RIVM's National Poison Information Centre should be established as operational units in the hospital.
Moving the Major Incident Hospital to operational status was accelerated with the outbreak of the Gulf War in 1990. The CMH as well as the UMC and the NVIC played an important part in both these and other developments in the Major Incident Hospital. Since then, the collaboration has made it possible to admit groups of people quickly and efficiently for observation and treatment in the Major Incident Hospital.
Aims and Briefing
"The Major Incident Hospital is a facility for providing guaranteed medical and other related short-term care facilities in the event of accident or emergency for groups of more than five military or civilian casualties, whose requirements exceed the standard care facilities of hospitals in a qualitative or quantitative respect. It is prepared to come to aid in the event of a number of different scenario's."
The Major Incident Hospital is available for the following five scenarios:
- situations of war or threat of war, crisis or conflict management, whereby large numbers of military casualties need to be cared for;
- situations concerning accidents abroad involving groups of residents of the Netherlands (military and/or civilian) who need to be repatriated;
- situations regarding specific catastrophes, attacks or large-scale accidents in the Netherlands, which exceed the capabilities of regular care facilities;
- situations in which the Dutch government offers help in the form of medical care for foreign victims of accidents abroad.
- admission of a reduced number of patients with a particular infectious disease.
The Major Incident Hospital is an organisation with its own governing board, which is selected by the chairman of the board of the UMC Utrecht and the commanding officer of the CMH. The daily running of the board is in the hands of the management team that includes representatives from both organisations.
The Major Incident Hospital (8000 m2) consists of an intensive care department (12 beds), a medium/low care department (50 beds), two low care departments (totalling 200 beds), three operation theatres with recovery, an X-ray unit and a triage and treatment room (35 beds).
Emergency Response Programme
The Emergency Response Programme describes the procedures for admitting 100 patients within 30 minutes. Under exceptional circumstances, this can be extended to 300 patients. The procedures for dealing with family and the media is also covered in the Emergency Response Programme.
An automated personnel alert system is used in order to ensure the rapid availability of staff. The personnel can be contacted via the national civilian mobile telephone network and the directors of the Major Incident Hospital have a permanent overview of the number of staff available at any one time via a modem connection. A patient barcode registration system has also been developed to admit patients efficiently.
The Major Incident Hospital organisation is traditionally designed for the care of casualties of different forms of physical violence. Care facilities for casualties of nucleair, chemical or biological catastrophe are virtually non-existent in the Netherlands. Specific expertise is required for these cases, which for a large part is available in the Major Incident Hospital through collaboration with the National Poison Information Centre and others.
The infrastructure of the Major Incident Hospital, which, for example, has its own air conditioning system with special filters, is suitable for the care of patients under quarantine conditions. As a result of this, it is possible to provide centralised care for groups of patients with particular indectious diseases such as smallpox and SARS.