Crisis management in mass casualty incidents in hospital settings

Abstract

The term 'disaster' denotes a low-probability but high-impact event that causes a large number of individuals to become ill or injured. Hospitals are required to have an Emergency Operations Plan (EOP) which describes how a facility will respond to and recover from all hazards. It is inclusive of the six critical elements: communications, resources and assets, safety and security, staff responsibilities, utilities, clinical support activities. The 'all hazards' approach allows ability to respond to a range of emergencies varying in scale, duration, and cause. The EOP addresses response procedures, capabilities and procedures when the hospital cannot be supported by the community, recovery strategies, initiating and terminating response and recovery phases, activating authority and identifies alternate sites for care, treatment and services. The initial response to an emergency begins with recognition that an incident may, or has occurred. In cases where the incident is likely to impact or disrupt routine operations, and may require coordination of efforts and response involvement among hospitals, health care coalition partners, EMS, public health, and environmental health. Key management issues involving situational status, incident characteristics and resource capabilities must be quickly determined and communicated amongst response partners in order to establish a common operating picture. The hospital plays maybe a small but crucial role in this larger picture. It is the epicenter of medical care delivered to those who are injured. Each type of threat presents different challenges to hospitals, which must able to respond to each in some capacity. Given finite resources, however, hospitals must attempt to focus their resources on the most likely and potentially serious scenarios.

Keywords

• disaster
• emergency operation plan
• hospital
• communication
• responsibility
• recovery