Mass Casualty Incidents: Planning Implications for Trauma Care

Failure to prepare is preparing to fail. While it may seem a daunting, even hopeless task, planning for disasters or mass casualty events is essential. It may be true that disasters defy planning and that the best for which one might hope is controlled chaos, but the success of a well-crafted and exercised disaster plan is measured by its ability to facilitate the restoration of order from the chaos. Although disasters are unpredictable and sudden, they are not necessarily random, and they can be anticipated (1). In certain geographic areas, the form of disaster (e.g. tornado, wildfire, earthquake, nuclear power plant events etc.) can be expected. Disasters, even from terrorism, follow patterns from which we can learn strategies to mitigate the damage. What is certain, however, is that disasters will be recurrent in one form or another. Factors that predispose to increasing the risk of disaster include an increase in population density, including an increasingly aging population in industrial countries, increased settlement in high risk areas, an increase in hazardous materials and technological hazards, environmental degradation, emergence of new infectious diseases, and the increased threat of terrorism (2).