Mass-casualty incidents: how does an ICU prepare?

Area of Science:

• Critical Care Medicine
• Disaster Preparedness
• Public Health Emergencies

Background:

• Mass-casualty incidents (MCIs) pose a significant risk globally.
• Existing literature on intensive care unit (ICU) preparation for MCIs is limited.
• Effective MCI response necessitates a shift in critical care delivery paradigms.

Purpose of the Study:

• To review ICU preparation strategies for mass-casualty incidents (MCIs).
• To provide a framework for critical care management during overwhelming MCI scenarios.
• To guide intensivist decision-making towards prioritizing patients with the highest survival likelihood.

Main Methods:

• Comprehensive literature review on disaster response relevant to ICUs.
• Synthesis of expert opinion on critical care during mass-casualty events.
• Development of a framework for ICU disaster preparedness and response.

Main Results:

• ICU directors require a thorough understanding of disaster response organization, triage, staffing, and treatment.
• A paradigm shift from complete care to survival-focused triage is essential.
• The article outlines specific critical care elements and treatment strategies for MCIs.

Conclusions:

• ICUs must develop robust preparedness plans for mass-casualty incidents.
• Effective MCI management hinges on strategic triage and resource allocation.
• This review offers a framework to optimize critical care delivery during mass-casualty events.