Modified critical care and treatment space considerations for mass casualty critical illness and injury.

Mass critical care events are increasingly likely, yet the resource challenges to augment everyday, unrestricted critical care for a surge of disaster victims are insurmountable for nearly all communities. In light of these limitations, an expert panel defined a circumscribed set of key critical care interventions that they believed could be offered to many additional people and yet would also continue to offer substantial life-sustaining benefits for nonmoribund critically ill and injured people. They proposed Emergency Mass Critical Care, which is based on the set of key interventions and includes recommendations for necessary surge medical equipment, treatment space characteristics, and staffing competencies for mass critical care response. To date, Emergency Mass Critical Care is untested, and the real benefits of implementation remain uncertain. Nonetheless, Emergency Mass Critical Care currently remains the only comprehensive construct for mass critical care preparedness and response. This paper reviews current concepts to provide life-sustaining care for hundreds or thousands of people outside of traditional critical care sites.

[1]  K. Koenig.  Homeland Security and Public Health: Role of the Department of Veterans Affairs, the US Department of Homeland Security, and Implications for the Public Health Community , 2003, Prehospital and Disaster Medicine.

[2]  P. Singer,et al.  Conventional terrorism and critical care , 2005, Critical care medicine.

[3]  C. Gomersall,et al.  Avian influenza (H5N1): implications for intensive care , 2006, Intensive Care Medicine.

[4]  Jeffrey L Arnold,et al.  Disaster Medicine in the 21st Century: Future Hazards, Vulnerabilities, and Risk , 2002, Prehospital and Disaster Medicine.

[5]  E. Frykberg,et al.  Medical management of disasters and mass casualties from terrorist bombings: how can we cope? , 2002, The Journal of trauma.

[6]  C. Sprung,et al.  Multiple Casualty Terror Events: The Anesthesiologist's Perspective , 2004, Anesthesia and analgesia.

[7]  Kobi Peleg,et al.  The special injury pattern in terrorist bombings. , 2004, Journal of the American College of Surgeons.

[8]  T. Shimazu,et al.  Overview of evacuation and transport of patients following the 1995 Hanshin-Awaji earthquake. , 1998, The Journal of emergency medicine.

[9]  R. Voelker.  Mobile hospital raises questions about hospital surge capacity. , 2006, JAMA.

[10]  V. Kvetan.  Critical care medicine, terrorism and disasters: are we ready? , 1999, Critical care medicine.

[11]  J. Farmer,et al.  Providing critical care during a disaster: The interface between disaster response agencies and hospitals , 2006, Critical care medicine.

[12]  Laura Hawryluck,et al.  Clinical review: SARS – lessons in disaster management , 2005, Critical care.

[13]  Lewis Rubinson,et al.  Positive-pressure ventilation equipment for mass casualty respiratory failure. , 2006, Biosecurity and bioterrorism : biodefense strategy, practice, and science.

[14]  T. O'Toole,et al.  Critical care during epidemics , 2005, Critical care.

[15]  M. Cushman,et al.  Management of multiple burn casualties in a high volume ED without a verified burn unit. , 2001, The American journal of emergency medicine.

[16]  Erik Auf der Heide,et al.  Disaster Response: Principles of Preparation and Coordination , 1989 .

[17]  M. Haupt,et al.  Guidelines on critical care services and personnel: Recommendations based on a system of categorization of three levels of care* , 2003, Critical care medicine.

[18]  S. Einav,et al.  In-Hospital Resource Utilization During Multiple Casualty Incidents , 2006, Annals of surgery.

[19]  D. Tai,et al.  Expanding ICU facilities in an epidemic: recommendations based on experience from the SARS epidemic in Hong Kong and Singapore , 2006, Intensive Care Medicine.

[20]  H. Smithline,et al.  Mass casualty terrorist bombings: a comparison of outcomes by bombing type. , 2004, Annals of Emergency Medicine.

[21]  Jack Sariego,et al.  CCATT: a military model for civilian disaster management. , 2006, Disaster management & response : DMR : an official publication of the Emergency Nurses Association.

[22]  M. Llewellyn.  Perspectives from MTF USNS Mercy. , 2006, Military medicine.

[23]  J. Roccaforte,et al.  Disaster preparation and management for the intensive care unit. , 2002, Current opinion in critical care.

[24]  Joseph A. Barbera,et al.  Medical Surge Capacity and Capability: A Management System for Integrating Medical and Health Resources During Large-Scale Emergencies; Second Edition , 2007 .

[25]  F. Turégano-Fuentes,et al.  11 March 2004: The terrorist bomb explosions in Madrid, Spain – an analysis of the logistics, injuries sustained and clinical management of casualties treated at the closest hospital , 2004, Critical care.

[26]  K. Kizer,et al.  The Department of Veterans Affairs' role in Federal Emergency Management. , 2000, Annals of emergency medicine.

[27]  Bennett P deBoisblanc,et al.  Black Hawk, please come down: reflections on a hospital's struggle to survive in the wake of Hurricane Katrina. , 2005, American journal of respiratory and critical care medicine.

[28]  E Auf der Heide,et al.  Disaster planning, Part II. Disaster problems, issues, and challenges identified in the research literature. , 1996, Emergency medicine clinics of North America.

[29]  Marvin L. Birnbaum,et al.  Health Disaster Management Guidelines for Evaluation and Research in the Utstein Style , 1999, Prehospital and Disaster Medicine.

[30]  Kristi L Koenig,et al.  Understanding surge capacity: essential elements. , 2006, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[31]  Walter L Biffl,et al.  Lessons learned from a nightclub fire: institutional disaster preparedness. , 2005, The Journal of trauma.

[32]  T. Stewart,et al.  Severe acute respiratory syndrome and critical care medicine: The Toronto experience , 2005, Critical care medicine.

[33]  H. Chandler.  Data Base , 1985, Journal of learning disabilities.

[34]  H. Belzberg,et al.  Suicide Bombing Attacks: Update and Modifications to the Protocol , 2004, Annals of surgery.

[35]  T. Cook,et al.  Development of a triage protocol for critical care during an influenza pandemic , 2006, Canadian Medical Association Journal.

[36]  D. Talmor,et al.  Augmentation of hospital critical care capacity after bioterrorist attacks or epidemics: Recommendations of the Working Group on Emergency Mass Critical Care‡ , 2005, Critical care medicine.