A mass casualty event could compromise the ability of health systems to deliver services meeting established standards of care. It is critical to plan for adjusting current heath and medical care standards to ensure that the care provided in a mass casualty event result in saving as many lives as possible.
To address the issue, an expert panel was convened by the Agency for Healthcare Research and Quality (AHRQ) and the Office of the Assistant Secretary for Public Health Emergency Preparedness, U.S. Department of Health and Human Services (HHS).
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Summary
1. Introduction
Overview
2. Health and Medical Care Delivery in a Mass Casualty Event
Health and Medical Care Standards
Hypothetical Scenarios Illustrating Changes in Delivery of Care
Changes in Care Delivery Common to Two Scenarios
3. Framework and Guiding Principles When Planning for
Health and Medical Care in a Mass Casualty Event
Framework
Guiding Principles for Developing Altered Standards of Care
4. The Larger Context: Important Related Issues
Authority to Activate Use of Altered Standards of Health and Medical Care
Legal and Regulatory Issues
Financial Issues
Communicating with the Public
Ensuring an Adequate Supply of Health Care Providers
Provider Training and Education Programs
Protection of Health Care Providers and Facilities
Caring for Populations with Special Needs
Transportation of Patients
5. Recommended Action Steps
Exhibits
1. Two Mass Casualty Scenarios Used to Identify Anticipated Changes to Care Delivery
2. Changes Specific to Care Delivery in a Multiple Explosion (Scenario 1)
3. Changes Specific to Care Delivery in a Biological Event (Scenario 2)
4. How Health and Medical Care Standards May Have to Be Modified in a Mass Casualty Event by Stage of Disease in the Population
5. Draft Checklist for State and Local Government Attorneys to Prepare for Possible Disasters
6. Model State Emergency Health Powers Act
7. Colorado's Approach to Planning for Disaster Emergencies—Executive Orders
B1. Operation of the Modular Emergency Medical System (MEMS)
Appendixes
Appendix A. Expert Meeting on Mass Casualty Medical Care Participant List
Appendix B. Preliminary Review of Selected Emergency
Response Protocols and
Models
Prepared for AHRQ by Health Systems Research Inc., under Contract No. 290-04-0010.
The authors of this report are responsible for its content. No statement in the report should be construed as an official position of AHRQ or the U.S. Department of Health and Human Services.
This document is in the public domain and may be used and reprinted without permission except those copyrighted materials noted, for which further reproduction is prohibited without the specific permission of the copyright holders.
AHRQ Publication No. 05-0043
Current as of April 2005
Internet Citation:
Altered Standards of Care in Mass Casualty Events: Bioterrorism and Other Public Health Emergencies. AHRQ Publication No. 05-0043, April 2005. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/altstand/
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