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Mass casualty incidents—are you ready? A major incident planning template for diagnostic radiology


Mass casualty incidents (MCIs) create a large number of casualties in a short period of time. Diagnostic radiology plays an important role in major incident responses but is often underrepresented during major incident planning (MIP) and simulation. Surveys suggest radiologists are unfamiliar with their role during an MCI. We aimed to identify key topics for radiology MIP, familiarize radiologists with their role during an MCI and identify areas for future research. The terms “radiology” and “mass casualty incident” were entered into the advanced search builder on PubMed. Abstracts from this primary search were reviewed and papers selected for inclusion. Additional studies of interest were identified upon review of reference sections of relevant articles and from the related article tab on PubMed. MCI and trauma guidelines were reviewed. Key factors that caused issues during prior MCIs were identified including staff alert mechanisms, patient identification strategies, patient tracking, scan ordering and result communication. Limitations of local imaging resources and capacity should be identified and inform plans for the utilization of diagnostic radiology in the MCI setting. Simulation can help identify areas for improvement and familiarize staff with their roles. Further development of reliable MCI alert technology and patient identification strategies are needed as well as prospective validation of trauma CT selection criteria to identify patients who will benefit most from CT. Radiology should take part in MIP to address key issues encountered during prior MCIs and in MCI simulation to optimize major incident response.

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Computed tomography


Critical Incident Stress Debriefing


Emergency department


Focused Assessment with Sonography for Trauma


Information technology


Instant messaging mobile phone application


Mass casualty incident


Minimal accepted care


Multiplanar reconstruction


The National Institute for Health and Care Excellence


Patient Barcode Registration Systems


Picture archiving and communication system


Royal College of Radiologists


Short Message System

Surge capacity:

The ability of the radiology department or imaging modality to expand beyond the normal capacity to meet the increased demand for clinical care




United States of America


United Kingdom


Whole body computed tomography


World Health Organization


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Author information

Ryan JW: Performed literature review, primary author of the article

Murphy A: Critically revised the work

MacMahon PJ: Critically revised the work

Bolster F: Formulated the concept of article, critically revised the work

Correspondence to James W. Ryan.

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This was a review article of published literature; therefore, no informed consent was sought or obtained.

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Ryan, J.W., Murphy, A., MacMahon, P.J. et al. Mass casualty incidents—are you ready? A major incident planning template for diagnostic radiology. Emerg Radiol (2020).

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  • Mass casualty incidents
  • Disaster planning
  • Major incident planning
  • Radiology