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Core Goal #9: Mass Casualty/Hospital Surge

Mass Casualty/Hospital Surge

Every region in Maryland should have the equipment, supplies, and training to respond to a mass casualty event either directly or via close at hand mutual aid, including events requiring mass decontamination. Maryland should have pre-identified surge plans from areas hospitals, public health, and EMS that identify likely gaps in resources, a statewide information sharing systems between hospitals, public health, and EMS (both electronic, and MOU-type agreements), supply stockpiles, and emergency plans for alternate treatment, such as temporary field hospitals.

Why is Mass Casualty / Hospital Surge important?
A mass casualty event is any incident in which emergency medical services personnel and equipment at the scene are overwhelmed by the number and severity of casualties, and could include a train accident or an incident in a location such as a stadium where hundreds or thousands could require medical treatment.  Hospital and health system surge is an increase in the overall stress on the entire health system, from paramedics and individual doctor’s offices to emergency rooms and critical care units.  A surge could result from a mass casualty incident or also during pandemic influenza or other disease outbreaks as an increased number of sick or injured patients require medical attention.   Increasing the capacity to deal with mass casualty incidents or health system surges is accomplished by robust local hospital surge plans, tracking and sharing resources on-hand in hospitals, stockpiling and distributing resources from supply caches, and tracking hospital emergency department stress and bed availability.

Strategic Plan for Mass Casualty/Hospital Surge:

9A –Maryland hospitals, public health, and EMS should have the technological infrastructure and information systems in place to share information on medical resources needed every day as well as during mass-casualty/hospital surge events.

• Support the development of Maryland’s medical technology infrastructure that will provide for information sharing, resource tracking, and patient tracking.
• Develop sufficient backup and portable alternate communications for Maryland’s hospitals.

9B – Every region in Maryland should have pre-identified surge plans from area hospitals, public health, and EMS which are reviewed regularly to identify likely gaps in resources.

• Develop a pre-identified healthcare system [hospitals, public health, and EMS] surge plan that meets a baseline standard and is coordinated across jurisdictions.
• Pre-place the physical and technical elements necessary for surge plan implementation so that they are available when needed.
• Facilitate training so that personnel are capable and trained to implement a surge plan.

9C – Every region’s public health agencies, EMS jurisdictions, and hospitals should have MOU-type agreements to share resources in cases of mass casualty incidents.

• Facilitate the development of mechanisms, whether through MOUs or other such agreements, that enable the sharing of public health and medical resources in a time of need.

9D – Every region’s public health agencies, EMS jurisdictions, and hospitals should have the equipment, training and supplies to respond to a mass casualty incident, including emergency plans for altering standards of care and for temporary field hospitals.

• Develop EMS provider access to the human, technical, medical, and transportation resources necessary to respond to a mass casualty incident and facilitate regular exercises and training.
• Facilitate training for hospital, EMS, and public health personnel in mass decontamination procedures and develop plans to provide those services.