Estimating Surge Capacity for Mass-Casualty Incidents

Abstract

ISSUE: As emergency departments (EDs) address the need to generate surge capacity for a sudden influx of patients in a mass-casualty incident (MCI), guidelines are needed to determine minimum staffing levels and the types and numbers of equipment and supplies needed. The equipment and supplies list may include gurney's or personal protective equipment. PROJECT: This project was to develop minimum guidelines for our ED to manage a large influx of patients effectively in the first several hours after a MCI. Descriptive information was obtained from observations and records associated with this project. The following sources of information were analyzed in the development of the minimum guidelines: (1) American College of Surgeons recommendations regarding the ED care of major trauma (blunt and penetrating injuries, burns); (2) United States' Center for Disease Control information on the most common injuries in mass trauma; (3) standard triage categories of red, yellow, and green; and (4) a survey of 250 rural and urban hospitals that found that an influx of twice the ED bed volume would be considered an MCI at each facility. RESULTS: An Excel spreadsheet was developed to calculate immediate minimum staffing, equiment and supply needs for an influx of twice the number of ED beds. This spreadsheet has been trialed successfully by the ED. This surge capacity estimation tool addresses only the needs of the MCI and not the needs of normal patient volume. LESSONS LEARNED: The surge capacity estimation tool is a useful resource when preparing for an MCI. It can be adapted to address the needs of an influx of patients due to infectious disease.