Planning Exercises and Drills for Sudden Mass Casualty Incidents

Abstract

Key components for planning exercises and drills for sudden mass casualty incidents (SMCIs):

• A plan for response to a SMCI needs to be written before the drill.

• Provide lectures to explain the plan to all individuals who may be involved in the response:

  • For pre-hospital: all first responders

  • For hospital: all medical, support personnel and administrators

• Organize tabletop exercises: Designed to bring together, into one room, all “players” that will respond to a SMCI (police, fire, EMS, hospitals, incident command, regional emergency operations center (REOC)). A large-scale incident is presented to them, and they have to resolve all challenges and pitfalls that it presents.

• Conduct sectorial pre-hospital exercises (Fig. 19.1): Constructed to train portions of the pre-hospital response separately. Examples:

  • Scene deployment to a SMCI and triage of patients: could be performed at the ambulance station parking lot, using inflatable dummies or cards with description of injuries.

  • Interaction between various ambulances and incident control: could be performed at an empty stadium parking lot, using inflatable dummies, where a few ambulances are deployed simultaneously. All paramedics perform triage, and the scene commander decides on transport priorities.

• Conduct sectorial hospital exercises: Constructed to train portions of the hospital response separately. Examples:

  • Deployment of triage, patient arrival and photography

  • Routes for emptying the emergency department

  • Routes for influx of patients

  • Deployment of alternate care sites

• Deploy a full exercise, preferably with pre-hospital and hospital training together (Fig. 19.2).

  There is no substitute for a well-organized, full-scale exercise testing all components of the response simultaneously.