Allocating scarce resources in disasters: emergency department principles

Area of Science:

• Disaster medicine
• Public health preparedness
• Emergency management

Background:

• Disaster medical resource triage necessitates a structured, planned approach.
• Emergency physicians often lack preparedness for modifying decision-making during disasters.
• Effective triage requires understanding ethical principles and operational concepts.

Purpose of the Study:

• To provide emergency physicians with a framework for disaster medical triage.
• To outline ethical and operational principles for adjusting medical interventions based on demand and resources.
• To review strategies for managing resource shortfalls during incidents.

Main Methods:

• Review of key concepts from disaster literature.
• Definition of response levels: conventional, contingency, and crisis.
• Consideration of resource and staff requirements for specific incident types (e.g., trauma, burns).

Main Results:

• A framework for ethical and operational principles in disaster triage is presented.
• The continuum of care (conventional, contingency, crisis) is defined to guide response scope.
• Strategies for resource shortfall management and preparedness tactics are discussed.

Conclusions:

• Preparation and understanding of triage objectives, strategies, and tactics improve decision-making during disasters.
• Adherence to a structured response framework promotes resource stewardship.
• Thoughtful triage leads to improved patient outcomes during mass casualty incidents.