Abstract

Introduction: Maharashtra ‘Bandh’ call from the members of a community in the state of Maharashtra. The Maharashtra government has appealed to protesters to maintain calm and not break the law. A gathering of over 500 protestors in the city of Navi Mumbai got violent, especially on the major highway junction close to the hospital wherein the local law enforcement agencies had to use various methods including ‘lathi-charge’ and shotgun fire to control the escalating situation. Communication within hospital and even outside the hospital was getting difficult, internet was jammed and absolutely no means of transportation for staff inside hospital to go out and vise versa. Hospital had a limited resource to manage the victims of ‘Bhand’ (Short gun injury). To triage accordingly and manage the mob was challenge to take over.

Methodology: As a result of the above violence and response and resources available a total of 26 patients (including both civilians and police personnel) in which 3 were pediatric age group presented to this teaching tertiary care hospital in a span 12 hours. This study is a descriptive analysis of the same with emphasis on triage, resource allocation and outcomes.

Results

1. Disaster-management systems-of-care were activated and executed. All 26 patients were triaged initially, including 2 categorized red.
2. Total of 14 were discharged after initial care and 12 admitted for definitive care.
3. Out of the 12 admitted, 10 had sustained ballistic injuries. 3 of them were operated: 1 required major surgery and 2 minor surgeries. The remaining 7 were managed conservatively using combination of various criteria. 2 of the 12 patients required ICU admission and rest were managed in ED-Wards.
4. All patients were discharged home with no disability.

Conclusions

1. Effective triaging and systematic disaster-management protocol activation is the most important first step in dealing with such a situation.
2. Outcome was good because of a multi-disciplinary team approach.