A REVIEW OF THE MANAGEMENT OF A MAJOR INCIDENT INVOLVING PREDOMINANTLY PEDIATRIC CASUALTIES

On 27 September 1993 a double-decker bus full of secondary school chil dren was involved in a collision with a lorry. A total of 58 people we re injured, including two fatalities. All except two of the casualties were children. Forty-two casualties, including all of the seriously i njured, were taken to the Accident & Emergency Department at York Dist rict Hospital. Fifteen casualties were admitted, the majority with clo sed head injuries. Most of the injuries were of a minor nature, predom inantly soft-tissue damage and superficial lacerations. This paper rev iews these injuries and the implementation of the hospital major accid ent (MAJAX) plan. It identifies specific problems encountered with thi s incident. It also describes the measures taken retrospectively to up grade the MAJAX plan. It highlights the difficulties encountered by me dical staff called to the incident who were unfamiliar with managing i njuries and describes retrospective attempts to improve the awareness of trauma management skills.