Managing a Medical Surge

  • Randy D. KearnsEmail author
Part of the Hot Topics in Acute Care Surgery and Trauma book series (HTACST)


This chapter briefly discusses the background of surge capacity and explores where the science is today. There are three key principles that are the focus of this chapter; rapidly triage and moving patients to where they can best be managed for their specific injuries, moving equipment and personnel to where a large group (or groups) of patients are located, and allocating resources to include leveraging existing personnel, space, and equipment for maximum utilization.

Do not confuse capacity and capability. The ability to manage one patient with a critical injury is not, by extension, an indication that the same team of personnel can also manage large numbers of patients with similar critical injuries. Space, equipment, or personnel may suggest that more significant numbers of patients can be managed but without adequate expertise, and by extension capacity, the capability to effectively manage a surge of patients may be problematic.

There are two categories of surge events that any jurisdiction or facility may confront. They include the “no notice” (also referred to as “time-zero”) mass casualty incident (MCI) and the more gradual surge associated with scenarios such as a pandemic event. A “no notice” MCI event includes examples such as a traffic collision involving a bus, train derailment, or a residential building collapse. Although more gradual in onset than the “no notice” event, surge capacity is also needed during disasters that extend over time and include infectious disease outbreaks. The sudden and immediate demand for medical services by a group of patients is not a new phenomenon. Nevertheless, management of these events has evolved through modeling and real-world events driving process improvement.


Conventional surge capacity Contingency surge capacity Crisis surge capacity Force multiplier  Immediate bed availability Just-in-time training Mass casualty incident Surge equilibrium 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.University of New Orleans, College of Business AdministrationNew OrleansUSA
  2. 2.University of North Carolina, School of MedicineChapel HillUSA

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