Planning Exercises and Drills for Sudden Mass Casualty Incidents

  • Mauricio LynnEmail author


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.


Exercise Drill Plan Pre-hospital Hospital Surprise 

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.University of Miami Miller School of Medicine, Jackson Memorial Hospital, Department of SurgeryMiamiUSA

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