Abstract

BackgroundOne of the most critical practices in mass casualty incident management is vacating the victims from scene of the incident and transporting them to proper healthcare facilities. Decision on distribution of casualties needs to be taken on pre-developed policies and structured decision support mechanisms. While many studies tried to present models for the distribution of casualties, no systematic review has yet been conducted to evaluate the existing models on casualty distribution following mass casualty incidents. A systematic review is therefore needed to examine the existing models of patient distribution and to provide a summary of the models. This systematic review protocol is aimed to examine the existing models and extracting rules and principles of mass casualty distribution.MethodsThis study will comprehensively investigate existing papers with search phrases and terms including “mass casualty incident”, distribution, evacuation, and Mesh terms directly corresponding to search phrases. No limitations on the type of studies, date of publication, or language of the relevant documents will be imposed. PubMed, Web of Science, Scopus, and Google Scholar will be searched to access the relevant documents. Included papers will be critically appraised by two independent reviewers. The data including incidents type, scene characteristics, patient features, pre-hospital resources, and hospital resources will be categorized. Subgroup analysis will be conducted when possible.DiscussionTo the best of our knowledge, no study has yet addressed the effects and interaction of contributing factors on the decision-making processes for casualty’s distribution. This is the first study that comprehensively assesses and critically appraises the current models of casualty distribution. This study will provide evidences about models and criteria for casualty distribution following mass casualty incidents.Systematic review registrationPROSPERO Registration Number: CRD42016049115

Highlights

  • One of the most critical practices in mass casualty incident management is vacating the victims from scene of the incident and transporting them to proper healthcare facilities

  • Studies show that long waiting periods in emergency departments and high bed occupancy rates are often inevitable in these situations

  • Aims/objectives Primary objectives The primary objectives of this systematic review include: 1- Investigating the criteria for casualty distribution in trauma-related mass casualty incidents

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Summary

Methods

Aims/objectives Primary objectives The primary objectives of this systematic review include: 1- Investigating the criteria for casualty distribution in trauma-related mass casualty incidents. 2- Reviewing the existing models of casualty distribution in trauma-related mass casualty incidents. Secondary objectives The secondary objectives of this study include: 1- Determining the criteria for patient distribution in trauma-related mass casualty incidents based on scene characteristics, patient features, pre-hospital, and hospital resources. 2- Assessing the models and criteria for patient distribution in trauma-related mass casualty incidents by type of incident (air, railway, RTIs, etc.). The study variables to be extracted include the country which the study is originated, the department conducted the study, the type and method of the study, the principles and rules of patient distribution regarding to scene characteristics, patient features, pre-hospital resources, and hospital resources. Given the comprehensiveness of the methodology of the study and since it encompasses all the studies conducted on the subject of casualty distribution, it can be used in developing a practical model for the better management of mass casualty incidents.

Discussion
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