Use What You’ve Got: Resource Utilization in a Mass Casualty in Afghanistan

Abstract

Multiple casualty incidents occur somewhat frequently at deployed hospitals in combat environments. Mass casualty events are less common than multiple casualty incidents. A mass casualty event (MASCAL) is when the patient volume or acuity overwhelms the health care facility and/or system. The US Army uses Forward Surgical Teams (FST) to provide life saving surgery close to point of injury on the battlefield. An FST is a 20-person team, which is the first level of care on the battlefield with surgical capability. Given the size and the limited resources of an FST, mass casualty events can potentially occur somewhat regularly. Optimal outcomes for mass casualty events in limited resource environments require robust planning, good communication, flexibility, and creativity. The following is an account of how a “split-operations” Forward Surgical Team successfully managed a mass casualty involving 34 patients, 33 of which were children.