Análisis de las técnicas de distribución de torniquetes empleadas por transeúntes en incidentes con víctimas en masa usando simulación de eventos discretos.

Abstract

[ES] Stop the Bleed es una campaña estadounidense que busca entrenar y empoderar a los transeúntes a actuar rápidamente contra el sangrado severo, antes de que llegue la ayuda profesional, para mejorar la tasa de supervivencia de las víctimas de en incidentes con víctimas en masa. Esta campaña ha llevado a la colocación de kits que contienen torniquetes en espacios públicos, los cuales pueden ser utilizados por voluntarios o personal de primeros auxilios. Asumiendo que la localización de los torniquetes en una calle ha sido previamente estudiada, una pregunta sin responder es cómo el público debe distribuir los torniquetes, tras retirarlos de dichas localizaciones, en su camino para ayudar a las víctimas. En el presente trabajo de fin de máster, un modelo de simulación ha sido desarrollado para estudiar diferentes técnicas de distribución de torniquetes con el objetivo de minimizar el número de muertes. Para responder a esta pregunta, tres escenarios distintos que tienen lugar en una calle peatonal han sido modelados: una bomba, un tiroteo y un atropello masivo. El método utilizado es la simulación de eventos discretos y las actividades principales que han sido llevadas a cabo son la recolección de datos, desarrollo del modelo conceptual, desarrollo del modelo de simulación usando el programa Arena Simulation, validación y verificación del modelo, análisis de sensibilidad y experimentación con el modelo.

[EN] Due to an increase in the number and severity of intentional mass casualty events, in 2015 the USA launched Stop the Bleed, a national awareness campaign which has the purpose of educating the public in bleeding control techniques, and empower bystanders to provide help before the arrival of professional help. This campaign has placed bleeding control kits, which contain tourniquets, in public spaces. The scenario that has been studied is a suicide bomb in a pedestrian street, which does not represent any particular street, but it has been modelled specifically for this simulation study. Tourniquets have been placed in several locations along the street, and the aim of this study is to provide recommendations for how to distribute the tourniquets among the victims in a mass casualty incident. To deal with the huge variability of these type of events and with the impossibility of reproducing an event like this in the real world, discrete-event simulation has been used as the method to carry out the study. Particularly, Arena is the software where the simulation model has been developed. The results from the study show that performing triage of victims, i.e. sorting the victims depending on the severity of their injuries, leads to a higher survival rate than if priorization of victims is not performed. Therefore, it is not recommended to distribute the tourniquets on the basis of the proximity from the person who is carrying the tourniquets, since the number of victims who would die in the event has been proved to be higher. Moreover, to maximize the number of victims that receive a tourniquet, it has been found that the task of picking up the tourniquets should be carried out by a few people; however, distributing the tourniquets should be a shared task. This means that, as long as all the victims are already being assisted, people who are willing to help should stay in the explosion zone and wait for other volunteers that come with tourniquets and help them with the task of distributing the tourniquets.