A mass casualty incident (MCI) is any event in which medical resources become overwhelmed by the number and severity of casualties. Large-scale disasters such as earthquakes, hurricanes and terrorist acts are obvious examples of MCIs. Smaller incidents, however, can been equally crippling for a medical facility. A multi-car accident on a remote highway or a local infectious disease outbreak can bring normal hospital operations to a standstill. There is consensus that all hospitals should be ready to manage MCIs from a variety of causes, and ample evidence that many are still not prepared. As illustrated in the recent ASA Monitor article “Be Prepared”, the medical response to the “Ride the Ducks” MCI at a level 1 trauma center (Harborview Medical Center in Seattle) went smoothly because of planning, practice and staff familiarity with triage and trauma manage-ment....

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