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Mass Casualties Table Top Exercise

Scenario based at West Ham United Football Club

Exercise date: 5 March 200913.00 – 17.00 hrs

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Aim of the exerciseTo exercise London’s

collaborative response to a mass casualty incident in London and to scope the effectiveness of existing

plans.

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Objectives1.To scope the need for further

Mass Casualty Plans;

2.To ensure that all organisations develop an understanding of:

the role of their own organisation in a coordinated response to mass casualty incidents;

the resilience required to maintain / refresh a response over a unspecified protracted period.

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West Ham football stadium is situated on Green Street, a high street that runs north-south between the A118 Romford Road and the A124 Barking Road.

It is on the boundary of the former County Boroughs of East Ham and West Ham, in the Borough of Newham.

Nearest underground station is Upton Park.

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The stadium is based at the Boleyn Ground, commonly known as Upton Park, in Newham, East London.

The capacity of the Boleyn Ground is 35,303.

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The match begins at 19.45 hrs on a Wednesday in March 2009

Incident reporting

20.20 hrs – first news of the incident reported on SKY news. A serious incident has occurred at West Ham Football stadium. The match has had to be abandoned and the crowded football stadium is being evacuated due to the number of casualties.

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Shortly after kick offThe steel gantry above the fans in one of the stands had suddenly collapsed due to an apparent structural failure.

Panic sets in as the fans in the upper stand attempt to escape from the falling masonry and steel girders.

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Injured fans surged forward and attempted to climb over the seating and jump into the lower stand and to escape onto the pitch. Many have been crushed before they reach assistance.

Many more have been injured in the panic to try and get to safety.

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At 20.30 hrs the London Ambulance Service presence at the match notifies Ambulance control of the incident.

Vehicle access is difficult via Green Street due to thevolume of peopleexiting the stadium.

Initial alert to blue light services

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Casualty estimatesAn unknown number of supporters have been crushed to death by the collapsed masonry and steel.

Approximately 2,000 more are thought to have been injured.

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MAP SHOWING ACUTE TRUSTS IN LONDON

HARD COPY WILL BE PROVIDED FOR EACH TABLE

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Group session 1In your syndicate groups, please discuss

for each organisation represented:

1. How will your organisation be alerted?

2. What initial actions will you take?

3. Who will be coordinating the incident management?

4. What are the challenges you will face?

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At 21.30 hrs casualties are estimated as:

Category Patient condition Nos

P1 Casualties needing immediate life-saving resuscitation and/or surgery

500

P2 Stabilised casualties needing early treatment but delay is acceptable.

500

P3 Casualties requiring treatment but a longer delay is acceptable

1,000

Note: The critical trauma patients only have 60 minutes from the time of injury to reach definitive surgical care, or the odds of successful recovery will diminish dramatically.

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Local hospital capacity for injured

Nominated Trust Category 1 Category 2 Category 3

Newham University NHS Trust 4 30 56

Whipps Cross University NHS Trust 6 10 60

Homerton University NHS Foundation Trust 10 30 200

King George’s University NHS Trust 3 10 30

TOTAL LOCAL BED CAPACITY 23 80 346

London Ambulance Service alert receiving hospitals of the potential casualties and local trusts confirm the following bed capacity.

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Group session 2In view of the bed capacity gap locally,

please discuss:

1. What will your organisation do?

2. How will the response be coordinated locally?

3. How will the response be coordinated regionally?

4. How will organisations be communicating with each other?

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Resources are stretched as more casualties arrive

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By 22.30 hrs local hospital capacity is exceeded

There are at least:

Category 1 Category 2 Category 3 500 500 1,000

who need to be accommodated at alternative Trusts.

Category Category 1 Category 2 Category 3

Capacity available elsewhere in London

87 700 1194

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Group session 3In light of this information, please discuss

for each organisation represented:

1. What actions will be taken?

2. What are the problems?

3. What are the problems associated with the distance of other available hospitals?

4. What solutions can be delivered locally?

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Group session 4It is now 09.00 hrs the following day and all casualties requiring hospitalisation are in definitive care. All those that could be treated and discharged have been processed.

In light of this information, please discuss for each organisation represented:

1. What are the organisational issues now?

2. What are the problems?

3. How will we offer immediate psychological support to 2,000 people who may have psycho-social problems in the aftermath of the incident?

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Group session 5It is now one week after the incident.

1. What ongoing recovery issues will your organisation be facing, if any?

2. How will we offer medium and long-term psychological support to 2,000 people who may have psycho-social problems in the aftermath of the incident?

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Next steps

Please identify the next 5 steps for mass casualties planning for your own organisation.