Planning Exercises and Drills for Sudden Mass Casualty Incidents

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.