This article reviews the implications of mass-casualty, terrorist bombings for emergency department (ED) and hospital emergency responses. Several practical issues are considered, including the performance of a preliminary needs assessment, the mobilization of human and material resources, the use of personal protective equipment, the organization and performance of triage, the management of ex...

The relative accessibility to various chemical agents, including chemical warfare agents and toxic industrial compounds, places a toxicological mass casualty event, including chemical terrorism, among the major threats to homeland security. TMCE represents a medical and logistic challenge with potential hazardous exposure of first-response teams. In addition, TMCE poses substantial psychologica...

This paper describes an approach to training emergency responders for mass casualty incidents. The approach is derived from a methodology and supporting software system called Summit. The Summit approach uses an integration of scenarios, hierarchical task analysis, interaction modeling, and expected utility theory to represent how actors engage in complex tasks; here we model mass casualty inci...

Mass casualty and pandemic events pose a substantial challenge to the resources available in our current health care system. The ability to provide adequate oxygen therapy is one of the systems that could be out-stripped in certain conditions. Natural disasters can disrupt manufacturing or delivery, and pandemic events can increase consumption beyond the available supply. Patients may require m...

Efficient management of mass casualty incidents is complex, since regular emergency medical services structures have to be switched to a temporary “disaster mode” involving additional operational and tactical structures. Most of the relevant decisions have to be taken on-site in a provisional and chaotic environment. Data gathering about affected persons is one side of the coin; the other side ...

In a recent special issue of RESPIRATORY CARE, Daniel Talmor presented a very nice review of airway management during a mass-casualty event.1 He rightly pointed out that only experienced clinicians should perform intubation in these circumstances, and that training clinicians for the sole purpose of providing intubation during a mass-casualty event is unwise. He also listed anesthesiologists, c...

Mass casualty respiratory failure will lead to many challenges, not the least of which is safe and secure management of the victims' airways. These patients will be sicker than those typically managed in the operating room and will require more emergency management of their airways. Mass casualty incidents involving biological or chemical agents will pose the additional risk of exposure to path...

Preparing for a mass casualty event starts long before the event. Being able to provide care during an event requires collecting information about processes, equipment, supplies, and personnel to anticipate different situations. Planning should include an impact analysis to identify and prioritize critical services that need to be maintained. Impact analysis is carried out in concert with the e...

In the preceding chapter, Carl Jensen reviewed the final reports issued by commissions investigating Pearl Harbor, the 9/11 attacks, and Hurricanes Katrina and Rita. These inquiries paint a grave picture of the ability of government to consistently recognize and understand looming threats and to respond to large-scale critical incidents. We must, of course, recognize that all three documents he...

This paper illustrates the future role of mobile computing for the response in emergencies and mass casualty incidents (MCIs). Furthermore it describes the different components and functionalities which will be needed – in the form of a vision. This vision shows that a mobile system is capable to assist emergency teams and incident commanders in MCI operations. This mobile system has to contain...