Hospital trauma care in multiple-casualty incidents: A critical view

During a multiple-casualty incident, a large casualty caseload adversely af fects the quality of trauma care given to individual patients. From a traum a care perspective, the goal of the hospital emergency plan is to provide s everely injured patients with a level of care that approximates the care gi ven to similar patients under normal conditions. Therefore, the realistic a dmitting capacity of the hospital is determined primarily by the number of trauma teams that the hospital can recruit. Effective triage of these casua lties is often not straightforward, with high over-triage rates. Simplified triage algorithms may be a practical alternative to more elaborate schemes . The concept of minimal acceptable care is the key to a staged management approach during a mass-casualty incident. Discrete-event computer simulatio n and war game tabletop exercises for key personnel are 2 new modalities th at are supplementing the traditional mock disaster drill as effective plann ing and training tools.