Modified Delphi study to determine the components of a Medical Cache required for local or international medical deployment after a major incident or disaster

Includes bibliographical references.Background: Disasters occur without warning; they have the potential to cause chaos and destruction in unsuspecting communities and on the environment. The personnel of the Western Cape Emergency Medical and Rescue Services are suitably trained to respond to major incidents or disasters, but lack the support of a standardised medical cache. This in turn compromises the preparedness of such a team to deploy to major incidents and or disasters inside and outside the provincial boundaries. Aim: This study was to obtain consensus regarding what such a medical cache should be comprised of, specifically regarding medical equipment and pharmacological agents. Methodology: A three iteration modified Delphi study was conducted over ten months. During this time selected experts who are currently working in the field of disaster response and emergency medicine, were asked to voluntarily and anonymously complete three iterations of questionnaires. After each iteration the primary researcher collected and analysed the responses for consensus. Consensus was set at 85% so as to formulate the questionnaires for the subsequent iterations. Results: Consensus was achieved with items like the laryngoscope; rugged electrocardiogram with extra-long leads; scoop stretcher; stokes basket and a KEO. Other items such as the Arterial Blood Gas (ABG) machine and the Ultrasound machine did not achieve consensus. Disposable equipment like endotracheal tubes; bandages; intravenous administration sets and dial-a-flow devices were amongst the items to be included in the medical cache, these were based on existing research regarding disposable equipment. The majority of pharmacological agents, such as broad spectrum Antibiotics, Suxamethonium and Fentanyl achieved consensus early on; while other pharmacological agents like Ondansetron and Thrombolytic agents did unsurprisingly not achieve consensus across any of the iterations. Conclusion: This study assisted in identifying the necessary medical equipment and pharmacological agents to be included in a medical cache, which would enable medical rescue teams to be prepared prior and during deployment, whether in or outside the borders of the Western Cape, South Africa or internationally