Epidemiology of major incidents: an EMS study from Pakistan

All the calls received by an EMS Rescue 1122 were studied over a 6-month period. Calls that were defined as major incidents were identified, and further details were sought from the districts regarding these incidents. Questions specifically asked were the type of incident, time of the incident, response time for the incident, the resources needed, and the number of dead and injured casualties. Retrospective data were collected from the submitted written reports.Road traffic crashes (RTCs) emerged as the leading cause of a major incident in the province of Punjab and also led to the greatest number of casualties, followed by fire incidents. The total number of casualties was 3,380, out of which 73.7% were RTC victims. There was a high rate of death on the scene (10.4%). Certain other causes of major incidents also emerged, including violence, gas explosions and drowning.Road traffic crashes are the most common cause of a major incident in developing countries such as Pakistan. Injury prevention initiatives need to focus on RTCs.Major incidents overwhelm local emergency medical service. For planning purposes it is imperative to study the epidemiology and incidence of such incidents.Major incidents have not been studied in developing countries. We present findings of a study conducted by a trained pre-hospital service in a province of Pakistan. Road traffic crashes emerged as the most prevalent cause of a major incident in our study, and they cause the greatest number of casualties. The findings of this study will have implications for public health professionals who are dealing with injury prevention in the developing world.Major incidents have been defined as "events that owing to the number and severity of live casualties require special arrangements" [1]. This definition encompasses a wide array of incidents that may include mass gatherings, train crashes, large road traffic crashes [RTCs] or bombings. Any incident that is unpredictable in nature, sudden and resul