As a result, management in MCI could be handled within the resources of the emergency team based on emergency physicians cooperating with other specialists, as well as nursing staffs. Finally, it was found that three victims were predicted to die due to high TRISS but one victim unexpectedly survived despite having a high TRISS due to effective resuscitation and good

cooperation from multidisciplinary health care services. Limitation By nature, research on disaster medicine is largely descriptive as MCI is virtually impossible to study via prospective randomized controlled trials and the study could not be double Inhibitors,research,lifescience,medical blinded or concealed. Regarding hospital preparedness in specific circumstances as military MCI, health care providers cannot normally access in the operation zone where WMDs were used and could not Inhibitors,research,lifescience,medical normally evacuate or transport casualties because of entrapment by the crowds resulting in delayed prehospital time from minutes to hours or even days. Implementation and suggestion Knowledge in mechanism of injury, distribution of injured

body regions together with the proven factors influencing ISS used to predict mortality, are all important keys for proper medical management and preventive measures. Implications concerning hospital organizational aspects include improving management with limited health care resources and enhancing hospital surge capacity for Inhibitors,research,lifescience,medical MCI. Implications concerning the Ministry of Defence aspects include improving effectiveness of Inhibitors,research,lifescience,medical protective equipment in SB939 clinical trial future military MCI. Implications concerning the national aspects include establishing harmonized military-civilian collaboration in MCI response network. This study is based on cases in a military hospital, and recommendations may require non- military studies in public health hospitals

to compare results. MCIs are heterogeneous Inhibitors,research,lifescience,medical by nature and their unexpectedness favors an “all-hazard” approach including radiation & nuclear wastes, bioterrorism, chemical weapons or explosion. MCI preparedness must be prompt every time. Conclusions Blast injury was the most common mechanism of injury among Thai military personnel injured in the MCI April 10, 2010. Age and injured body regions such as head & neck, chest and abdomen Roxadustat clinical trial were proven factors influencing ISS. These factors should be considered for effective medical treatment and preparing protective equipment to prevent such injuries in the future. Competing interests The authors have no relevant financial interests, financial relationships, or competing interests (financial or nonfinancial) to report. Authors’ contributions NB reviewed literature, conceived & designed the study, requested & revised proposal submission throughout ethical process, managed the collected data, performed the data analysis & result interpretation, drafted & revised the manuscript. SI conceived the study, participated to the study design.