The doctors and nurses who treated the River Valley fire victims

Key Concepts:

• VHF Standby Message: High-frequency radio transmission from SCDF ops center to alert medical teams to prepare for incoming casualties.
• Resuscitation Area: Area focused on addressing immediate life-threatening issues (ABC - Airway, Breathing, Circulation).
• Smoke Inhalation Injury: Damage to the respiratory system caused by inhaling smoke, leading to potential airway swelling.
• Burns Assessment: Evaluation of burn wounds to determine the percentage of body surface area affected and the depth of the burns.
• Clinical Stabilization: Initial medical interventions to stabilize a patient's vital signs and condition.
• Debriefing Session: Post-incident meeting for staff to discuss their experiences and emotions.

1. Initial Notification and Preparation:

• The SCDF team notified the hospital at approximately 10:00 AM about a fire outbreak on River Valley Road.
• The hospital received a VHF standby message regarding a child with smoke inhalation, followed by another for a second child casualty.
• Based on past experiences, the medical team anticipated a potential mini mass casualty situation.
• The VHF standby message included details about the patients, such as gender, race, and age.
• Pre-planned spaces within the critical care area were quickly converted to accommodate the expected casualties.
• The team was initially unaware of the exact number of casualties or the severity of their injuries.

2. Patient Management and Resuscitation:

• The resuscitation area focused on addressing ABC (Airway, Breathing, Circulation) issues.
• Most casualties suffered from smoke inhalation injuries, in addition to burns.
• A primary concern was the potential for airway swelling due to smoke inhalation.
• The anesthesia team was involved early to secure airways and ensure proper breathing for the children.
• Plastic surgeons assessed each patient to determine the percentage of burns and the necessary treatment.

3. Team Coordination and Assessment:

• A senior physician and a senior nurse were assigned to manage each case to ensure quality care.
• Upon arrival at the ICU, the plastic surgeon noted the organized activity and the nurses' ability to provide patient history.
• The plastic surgeon systematically assessed the burn wounds, removing temporary dressings and documenting the injuries.

4. Transfer to KK Hospital:

• Critically ill pediatric casualties were transferred to KK Hospital for continued management after initial clinical stabilization.
• The decision to transfer was based on the hospital being primarily an adult facility and the differences in treating adults and children (logistics and equipment).
• Close communication and coordination with KK Children's ICU and Emergency Department ensured safe and timely transfers.

5. Post-Incident Reflections and Support:

• The incident highlighted the importance of fire safety, especially concerning children in homes.
• The surge of critically ill pediatric patients was mentally challenging for the staff, many of whom are parents.
• A debriefing session was held to allow staff to unpack emotionally as a group.
• The speaker expressed relief that the team did their best for every casualty, sadness for those affected, and gratitude to the public and migrant workers who responded quickly.

6. Notable Quotes:

• "From past experiences, I knew that a mini mass casualty situation was a possibility."
• "We're not aware like how many number of casualties we will be receiving and the extent of injuries, so we have to quickly manage each patient, send out to the ward, and then we get ready for the next team to receive the next casualty."
• "I felt relieved that we managed to do the best that we could for every casualty. I felt very deep sadness for all those who are affected by the incident."

7. Synthesis/Conclusion:

The response to the River Valley Road fire involved rapid mobilization, efficient triage, and coordinated care to manage pediatric casualties with smoke inhalation and burns. The medical team prioritized airway management, burns assessment, and clinical stabilization before transferring patients to a specialized pediatric facility. Post-incident debriefing sessions were crucial for addressing the emotional impact on staff. The event underscored the importance of fire safety awareness and the value of community response in mitigating casualties.