TY  - JOUR
PY  - 2021//
TI  - Mass casualty management after a boiling liquid expanding vapor explosion in an urban area
JO  - Journal of emergency medicine
A1  - Gamberini, Lorenzo
A1  - Picoco, Cosimo
A1  - Imbriaco, Guglielmo
A1  - Monesi, Alessandro
A1  - Flauto, Alfonso
A1  - Cordenons, Fiorella
A1  - Dell'Arciprete, Oscar
A1  - Mora, Fabio
A1  - Costa, Daniela Maria Roberta
A1  - Lupi, Cristian
A1  - Mazzoli, Carlo Alberto
A1  - Gordini, Giovanni
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: The catastrophic fail of a container holding a pressure-liquified gas can generate a boiling liquid expanding vapor explosion (BLEVE) with a subsequent blast wave, flying fragments, and fire or toxic gas release.     CASE REPORT: This report describes the management of a mass casualty disaster related to a BLEVE in an urban area due to a highway accident involving a tanker carrying liquified petroleum gas and a truck transporting chemical solvents. The event resulted in 158 casualties that were triaged, stabilized, and transported into the "hub" and "spoke" hospitals of the regional trauma network within 3 h and 22 min from the event by the Emergency Medical Services. The logistic complications related to the partial collapse of the highway bridge on an underlying urban road and the relative solutions adopted, as well as the application and advantages of the use of the Simple Triage and Rapid Treatment (START) algorithm in the field and the criteria adopted for the distribution of patients within the trauma network, are discussed, along with the potential pitfalls observed.     WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: BLEVE events are rare but can be complex in both logistical management and clinical presentation of the lesions related to the event. The START algorithm is a valuable tool for rapid triage in mass casualty incidents.<p />  <p>Language: en</p>
LA  - en
SN  - 0736-4679
UR  - http://dx.doi.org/10.1016/j.jemermed.2020.11.029
ID  - ref1
ER  -