Mass Casualty Incidents

Mass Casualty events may occur as a result of natural or human-caused disasters or after an act of terrorism. The planning and response to disasters and catastrophes needs to take into consideration the distinction between progressive and sudden events. Insidious or slowly progressive disasters produce a large number of victims but over a prolonged time period, with different peaks in the severity of patients presenting to the hospital. For example, radiation events will produce a large number of victims who will present days, weeks, months, or years after exposure, depending on the dose of radiation received. The spread of a biological agent or a pandemic will produce an extremely high number of victims who will present to hospitals during days to weeks after the initial event, depending on the agent and progression of symptoms. On the other hand, in a sudden disaster, there is an abrupt surge of victims resulting from an event such as an explosion or a chemical release. After the sarin gas attack in a Tokyo subway in 1995, a total of 5500 victims were injured and required medical attention at local hospitals immediately after the attack. The car bomb that exploded near the American Embassy in Nairobi, Kenya, killed 213 people and simultaneously produced 4044 injured patients, many requiring medical care at local hospitals. The Madrid train bombing in March 2004 produced more than 2000 injured victims in minutes, overwhelming the city’s healthcare facilities. More than 500 injured patients were treated at local hospital after the mass shooting in Las Vegas. Finally, earthquakes may produce a large number of victims in areas in which the medical facilities are partially or completely destroyed. Sudden events bring an immediate operational challenge to community healthcare systems, many of which are already operating at or above capacity. The pre-hospital as well as hospital planning and response to sudden mass casualty incidents (SMCI’s) is extremely challenging and requires a standard and protocol driven approach. Many textbooks have been published on Disaster Medicine; although they may serve as an excellent reference, they do not provide a rapid, practical approach for management of SMCI’s. The first edition of “Mass Casualty Incidents: The Nuts and Bolts of Preparedness and Response for Acute Disasters” dealt exclusively with sudden mass casualty incidents. The second edition will expand its focus and include planning and response for insidious and protracted disasters as well. This new book is designed to provide a practical and operational approach to planning, response and medical management of sudden as well as slow progressive events. The target audience of the second edition will be health care professionals and institutions, as well as allied organizations, which respond to disasters and mass casualty incidents. Parts I and II are essentially the first edition of the book and consist of planning of personnel, logistic support, transport of patients and equipment and response algorithms. These 2 parts will be revised and updated and include lessons learned from major mass shootings that occurred recently in the United States and other parts of the world Part III will describe the planning process for progressive disasters and include response algorithms and checklists. Part IV will handle humanitarian and mental health problems commonly encountered in disaster areas. Part V will deal with team work and communication both critical topics when handling catastrophes and mass casualty incidents. This new book will be a comprehensive tool for healthcare professionals and managers and should perform demonstrably better in sales and downloads. It will be of value at the pre-hospital as well as the hospital level, to plan and respond to the majority of catastrophes and mass casualty incidents.

This manual, written by world opinion leaders in the field, is designed to provide readily accessible, step-by-step guidance on all aspects of the management of mass casualty incidents. Readers will find a wealth of helpful practical suggestions as well as information on the latest relevant scientific advances and their implications. Globally, mass casualty incidents are becoming more frequent even in unexpected places. There is a need for a dependable manual suitable for use by all who must be prepared to face mass casualty incidents, including practicing physicians, surgeons, anesthesiologists, nurses, and administrators. This book meets that need. It is the first practical manual to be devoted to the topic, and its portable format will allow it to be kept in the pocket at all times, ready for immediate consultation. The innovative nature of much of the content and the inclusion of up-to-date literature reviews ensure that the manual will remain relevant for years to come.

Problems contacting emergency services and delayed assistance are not unusual when incidents occur in rural areas, and the consequences can be devastating, particularly with mass casualty incidents. The IOM's Forum on Medical and Public Health Preparedness for Catastrophic Events held a workshop to examine the current capabilities of emergency response systems and the future opportunities to improve mass casualty response in rural communities.

This manual is aimed to provide health care professionals, at the scene and at hospitals, as well as allied organizations, a practical and operational approach for planning the response to mass casualty incidents (MCI’s), with emphasis to the types of events that are sudden in nature, resulting in a number of injured or contaminated patients that overwhelm the local health care system. From activation of the MCI plan to the specific medical care of multiple simultaneous patients, the manual offers checklists and algorithms of “what to do” during the first minutes after a MCI occurred. The manual is designed to be adapted and modified for specific institutions according to their size and capabilities. Written by a world expert in the field of MCI management, Mass Casualty Incidents: The Nuts and Bolts of Preparedness and Response for Acute Disasters is a valuable resource for all health care professionals and institutions that deal with mass casualty incidents.

Mass Fatality and Casualty Incidents: A Field Guide presents in checklist form the recommended responses to events that result in mass fatalities, such as the Oklahoma City bombing, the crash of a jet airliner, or the attack on the World Trade Center. All cities in the United States will have to have a mass fatality disaster plan in effect by the end of 1999. Mr. Jensen is a leading authority in this area and provides training for police, fire and hospital personnel (including EMTs and social workers), local, state, federal and international emergency planners and responders. This book details actions that are part of a mass fatality incident response. Specifically, they are the actions that begin once life and property preservation ceases and continues through to the release of the deceased. Thus, primary focus is on search, recovery, medicolegal investigation, personal effects operations, family assistance operations, and media operations. Ancillary steps include logistics support, security, responder protection, attitudes and coping with mass death.

Proceedings of the NATO Advanced Study Institute on Applying Lessons Learned and Sharing Best Practices in Addressing Pandemics and Catastrophic Health Eventa, Slavonski Brod, Croatia, 27 November - 8 December 2011--T.p. verso.

Hospital Emergency Response Teams aims to provide authoritative training for hospital personnel in the emergency department, as well community-level medical service personnel, assisting them in times of disaster and emergency. Comprised of six chapters, the book covers various aspects of emergency response. Some of the aspects are the National Incident Management System (NIMS) implementation activities for hospitals and health care systems and the Hospital Incident Command System (HICS) IV missions. The book also explains the implementation issues, requirements, and timelines in establishing an internal HICS IV program. It presents the assessment of likely mass casualty events and potential hospital impact. The book also features appendices for emergency response team checklists, PPE donning and doffing guide, ambulatory and non-ambulatory decontamination setup, ETA exercises, and ETA drills.The book is intended to provide understanding of emergency response to first emergency medicine professionals, first responders, security staff, community-level disaster planners, and public health and disaster management researchers. Common sense approach shows what really works, not what is theoretically achievable Forms, checklists, and guidelines can be used to develop concrete response plans, validate existing operations, or simply expand knowledge base The latest from OSHA, Joint Commission and NIMS (National Incident Management System) Cross-disciplinary author team ensures material is appropriate for all member of this important collaboration

During natural disasters, disease pandemics, terrorist attacks, and other public health emergencies, the health system must be prepared to accommodate a surge in the number of individuals seeking medical help. For the health community, a primary concern is how to provide care to individuals during such high demand, when the health system's resources are exhausted and there are more patients than the system can accommodate. The IOM's Forum on Medical and Public Health Preparedness for Catastrophic Events held a workshop June 10-11, 2009, to assess the capability of and tools available to federal, state, and local governments to respond to a medical surge. In addition, participants discussed strategies for the public and private sectors to improve preparedness for such a surge. The workshop brought together leaders in the medical and public health preparedness fields, including policy makers from federal agencies and state and local public health departments; providers from the health care community; and health care and hospital administrators. This document summarizes the workshop.

Problems contacting emergency services and delayed assistance are not unusual when incidents occur in rural areas, and the consequences can be devastating, particularly with mass casualty incidents. The IOM's Forum on Medical and Public Health Preparedness for Catastrophic Events held a workshop to examine the current capabilities of emergency response systems and the future opportunities to improve mass casualty response in rural communities.