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Disaster Preparedness, Triage, and Surge Capacity for Hospital Definitive Care Areas: Optimizing Outcomes when Demands Exceed Resources
Date: 2007
Author: J. David Roccaforte, MD, and James G. Cushman, MD
Institution: Elsevier Inc.
Bibliographic Entry: Roccaforte, J. David, and James G. Cushman. “Disaster Preparedness, Triage, and Surge Capacity for Hospital Definitive Care Areas: Optimizing Outcomes when Demands Exceed Resources.” Anesthesiology Clinics 25 (2007): 161-177.
Electronic Link: http://linkinghub.elsevier.com/retrieve/pii/S1932227507000031
Article is copyrighted; access article via a library portal or journal subscription.
Key Words: disaster planning, multiple casualty incidents (MCIs), mass casualty events
(MCEs), definitive care areas (DCAs), operating rooms (ORs), intensive care units (ICUs), severe acute respiratory syndrome (SARS), surgical intensive care unit (SICU)
Summary of Key Points, Issues, Conclusions:
Resources for disaster planning must be organized before an event allowing them to be optimally used for treating as many victims as possible while avoiding an overabundance of resources.
An analysis was completed on all casualties reported from the three main Lower Manhattan receiving hospitals on the morning of September 11, 2001. The data demonstrated that no hospital was overwhelmed by critically injured patients. Further analysis of casualty data comparing New York University–Downtown Hospital (NYU-DH) with Bellevue Hospital (BH) confirmed a linear association between critical mortality and overtriage, consistent with the findings of Frykberg. Subsequent discussion analyzed the concept of surge capacity and reviewed relevant characteristics of disaster events, victims of such events, and hospital resources. Problems experienced when triaging definitive care areas (DCAs) such as operating rooms (ORs) and intensive care units (ICUs) is also presented, along with the relevant victim characteristics. Using tabletop exercises, discussion addresses what can be done prior to the event to prepare a DCA for a multiple or mass casualty event.
Name of Researcher: Alison Stevens
Institution: Integrative Center for Homeland Security, Texas A&M University
Date Posted: May 15, 2008