Surgical resource utilization in urban terrorist bombing: A computer simulation

Background: The objective of this study was to analyze the utilization of s urgical staff and facilities during an urban terrorist bombing incident, Methods: A discrete-event computer model of the emergency room and related hospital facilities was constructed and implemented, based on cumulated dat a from 12 urban terrorist bombing incidents in Israel. Results: The simulation predicts that the admitting capacity of the hospita l depends primarily on the number of available surgeons and defines an opti mal staff profile for surgeons, residents, and trauma nurses. The major bot tlenecks in the flow of critical casualties are the shock rooms and the com puted tomographic scanner but not the operating rooms. The simulation also defines the number of reinforcement staff needed to treat noncritical casua lties and shows that radiology is the major obstacle to the flow of these p atients.; Conclusion: Computer simulation is an important new tool for the optimizati on of surgical service elements for a multiple-casualty situation.