Features  |   April 2017
Roles of the Anesthesiologist During Mass Casualty Events
Author Affiliations
  • Catherine Kuza, M.D.
    Committee on Trauma and Emergency Preparedness
  • Joseph (Jay) McIsaac, M.D., M.S.
    Committee on Trauma and Emergency Preparedness
Article Information
Airway Management / Critical Care / Respiratory System / Trauma / Burn Care / Features
Features   |   April 2017
Roles of the Anesthesiologist During Mass Casualty Events
ASA Monitor 04 2017, Vol.81, 14-17.
ASA Monitor 04 2017, Vol.81, 14-17.
The medical community has exhibited an increased interest in mass casualties over the past few years with the occurrence of many natural disasters (hurricanes, earthquakes, etc.), disease epidemics (SARS, Ebola, etc.), transportation accidents (motor vehicle, train, etc.), biochemical and radioactive disasters, and the frighteningly rising number of terrorist acts. The mechanisms of injury include blunt and penetrating trauma, burns, and chemical and radiation injuries.1  A mass casualty event (MCE) occurs when the number of victims surpasses the treatment ability and resources provided by a medical center. An MCE is a dynamic situation that requires the coordination and organization of many personnel through various phases of care in an attempt to decrease the strain put on health care personnel and systems due to the overwhelming demand for medical attention in the setting of seemingly less available resources, equipment and providers.2  Even at level I trauma centers with an activated disaster plan, it is difficult to provide care to more than seven casualties per hour.3,4  With the advent of the perioperative surgical home and the increasing presence of anesthesiologists outside the O.R., there is undoubtedly a great need for anesthesiologists’ skills and services during an MCE. In the U.S., Hospital Incident Command Systems (HICS) coordinate care between hospitals and responding organizations, assign responsibilities to personnel, plan and coordinate support requirements, and obtain necessary equipment or supplies from outside sources. They provide job action sheets that define the responders’ roles and list the tasks needed to be performed.5 -8  Anesthesiologists may be assigned to provide care in the pre-hospital disaster site, emergency department (ED), decontamination area, O.R., recovery area or intensive care unit (ICU).
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