The article by Kaplowitz et al in this special issue of Disaster Medicine and Public Health Preparedness describes the trauma system response to the wanton suicide shooting at Virginia Tech in April 2007.1 The authors are to be congratulated for sharing their experience so quickly, within just 3 months of the event (as of this writing), and in a manner that is consistent with the science of mas...

O 7, 2011, marked the end of the 10th year of US combat operations in Iraq and Afghanistan. As in previous conflicts, these wars have led to major advances in treating combat casualties, and the advances are also being translated into injury management paradigms in civilian trauma centers. Coincident with these advances was an increase in combat casualty research directed toward identifying new...

In the twentieth century, rarely have mass casualty events yielded hundreds or thousands of critically ill patients requiring definitive critical care. However, future catastrophic natural disasters, epidemics or pandemics, nuclear device detonations, or large chemical exposures may change usual disaster epidemiology and require a large critical care response. This article reviews the existing ...

Catastrophic mass casualty events (MCEs), such as pandemic influenza outbreaks, earthquakes, or large-scale terrorism-related events, quickly and suddenly yield thousands of victims whose needs overwhelm local and regional health care systems, personnel, and resources. Such conditions require deploying scarce resources in a manner that is different from the more common multiple casualty event. ...

The equipment lists provided in this article are not intended to be proscriptive or definitive. They are simply an illustration of the logical application of equipment selection and packing principles according to the likely needs of the casualty. Although trained personnel with relatively little equipment can perform simple interventions, optimal care requires some advanced techniques and good...

Optimizing trauma care delivery is paramount to saving lives on the battlefield. During the past decade of conflict, trauma care performance improvement at combat support hospitals and forward surgical teams in Afghanistan and Iraq has increased through Joint Trauma System and DoD Trauma Registry data collection, analysis, and rapid evidence-based adjustments to clinical practice guidelines. Al...

Damage control orthopaedics is well described for civilian trauma. However, significant differences exist for combat-related extremity trauma. Military combat casualty care is defined by levels of care. Each level of care has a specific role in the care of the wounded patient. Because of lack of equipment, austere environments, and significant soft tissue wounds, most combat fractures are stabi...