Spontaneous hospitalization in the immediate aftermath of the manchester arena bombing.

The distribution of the patients among available hospitals is pivotal to effectively manage a terrorist attack. Unfortunately, by the time of the arrival of the first relief unit, victims self‐present to the hospital outside any distribution plan (spontaneous hospitalization). This paper presents an evidence‐based investigation of victims' spontaneous hospitalization and distribution of patients in the immediate aftermath of the Manchester Arena Bombing with a focus on patients who self‐presented at the local hospitals by nonambulance vehicles. Despite the quick arrival of the relief units, 85 patients (61%) made their own way to the hospitals, self‐presenting at an emergency department outside the dispersal framework. Results of this paper show that, differently from the literature, survivors not always decided to go to the closest hospital but, for people living close to the event (less than 15 miles) the decision is to go toward the most familiar hospital close to their home rather than the event. This paper can be used to improve response plans after terrorist attacks that consider victims' behavior and the phenomena of "reverse triage" and "wave of casualties"; without such consideration, in fact, a planned distribution and the consequently management plan effectiveness and efficacy are lower. [ABSTRACT FROM AUTHOR]