Emergency Mass Critical Care

  • E. J. Jimenez


At any moment regular television programming could be interrupted with news of the emergence of a new strain of infective agent, a major industrial accident, or a terrorist event. Many devastating events are widespread and naturally occurring, like hurricanes, in which we have ample warning time to enact preparation plans; while others, like earthquakes, volcanoes, or tsunamis may kill or injure thousands before the news reports hit the airwaves. Industrial accidents and terrorist events are usually sudden and occur without any warning. Any of these events may have a local or regional effect; some may even have a global impact [1]. Regardless of the cause, after such an event, large amounts of the populace will be seeking medical care, whether from their primary care providers, public health departments, or local hospitals.


Critical Care Severe Acute Respiratory Syndrome Sequential Organ Failure Assessment Score Joint Commission Personal Protective Equipment 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    EM-DAT: The International Disaster Database. Available at: Accessed May 11, 2009Google Scholar
  2. 2.
    Devereaux A, Christian M, Dichter J et al (2008): Definitive care for the critically ill during a disaster: Summary of suggestions from the task force for mass critical care summit 133:1SGoogle Scholar
  3. 3.
    Rubinson L, Hick J, Hanfling D et al (2008) Definitive care for the critically ill during a disaster: a framework for optimizing critical care surge capacity. Chest 133: 18SCrossRefPubMedGoogle Scholar
  4. 4.
    Grissom T, Farmer J (2005) The provision of sophisticated critical care beyond the hospital: lessons from physiology and, military experiences that apply to civil disaster medical response. Crit Care Med 33(1 Suppl):S13CrossRefGoogle Scholar
  5. 5.
    Dara S, Ashton R, Farmer J (2005) Engendering enthusiasm for sustainable disaster critical care response: why this is of consequence to critical care professionals? Crit Care 9:125–127CrossRefPubMedGoogle Scholar
  6. 6.
    Daugherty E, Branson R, Rubinson L (2007) Mass casualty respiratory failure. Curr Opin Crit Care 13:51–56CrossRefPubMedGoogle Scholar
  7. 7.
    Aylwin C, Konig T, Brennan N et al (2007) Reduction incritical mortality in urban mass casualty incidents: analysis of triage, surge, and resource use after the London bombings on JULY 7 368:2219–2225Google Scholar
  8. 8.
    Cushman J, Pachter H, Beaton H (2003) Two New York Cityhospitals’ surgical response to the September 11, 2001, terrorist attack in New York City. J Trauma 2003 54:147–154Google Scholar
  9. 9.
    de Ceballos J, Turegano-Fuentes F, Perez-Diaz D et al (2005) 11 March 2004: the terrorist bomb explosions in Madrid, Spain an analysis of the logistics, injuries sustained and clinicalmanagement of casualties treated at the closest hospital. Crit Care 9:104–111CrossRefPubMedGoogle Scholar
  10. 10.
    Manthous C, Jackson W Jr. (2007) The 9–11 Commission’sinvitation to imagine: a pathophysiology-based approach to critical care of nuclear explosion victims. Crit Care Med 35:716–723CrossRefPubMedGoogle Scholar
  11. 11.
    Baker D (2005) Critical care requirements after mass toxic agentrelease. Crit Care Med 2005 33(1 Suppl):S66–S74CrossRefGoogle Scholar
  12. 12.
    Barbera J, Macintyre A (2004) Medical surge capacity andcapability: a management system for integrating medical and health resources during large-scale emergencies. CNA Corporation, Alexandria, VAGoogle Scholar
  13. 13.
    Morens D, Fauci AS (2007) The 1918 influenza pandemic: insights for the 21st century. J Infect Dis 195:1018–1028CrossRefPubMedGoogle Scholar
  14. 14.
    Shirley P (2006) Critical care delivery: the experience of a civilian terrorist attack. J R Army Med Corps 152:17–21PubMedGoogle Scholar
  15. 15.
    Centers for Disease Control and Prevention. Flu Surge 2.0, 2006. Available at: Accessed May 11, 2009Google Scholar
  16. 16.
    California Emergency Medical Services Authority (EMSA). Hospital Incident Command System Guidebook — August 2006. Available at: Accessed May 11, 2009Google Scholar
  17. 17.
    Kaiser Permanente Hazard-Vulnerability Analysis (HVA) tool. Available at: PM.pdf. Accessed: May 11, 2009Google Scholar
  18. 18.
    Joint Commission on Accreditation of Hospital Organizations: Hazard Vulnerability Analysis. Available at: Accessed May 11, 2009Google Scholar
  19. 19.
    Joint Commission on Accreditation of Healthcare Organizations (2006) Comprehensive Accreditation Manual for Hospitals: The Official Handbook. Joint Commission Resources Oakbrook Terrace, IL, p EC-4.10Google Scholar
  20. 20.
    Fundamentals of Disaster Management course book. 3rd ed. Chicago, Society of Critical Care Medicine 2009. Available at: Accessed May 11, 2009Google Scholar
  21. 21.
    Fundamental Critical Care Support course book. 4th ed. Chicago, Society of Critical Care Medicine 2007. Available at: Accessed May 11, 2009Google Scholar
  22. 22.
    Christian M, Hawryluck L, Wax R et al (2006) Development of a triage protocol for critical care during an influenza pandemic. CMAJ 175(11) 1377PubMedGoogle Scholar
  23. 23.
    Hick J, Rubinson L, O’Laughlin D et al (2007) Clinical review: allocating ventilators during large-scale disasters-problems, planning, and process. Crit Care 11:217–226CrossRefPubMedGoogle Scholar
  24. 24.
    Jimenez E, Poalillo E (2009) Bioterrorism (Chapter 176). In Civetta, Taylor, & Kirby’s Critical Care. 4th ed. Gabrielli A, Layon J, Yu M (ed) Lippincott-Williams-Wilkins, Philadelphia.Google Scholar
  25. 25.
    Jimenez E, Poalillo E (2008) Personal Protective Equipment. In: Fundamentals of Disaster Management. 3rd ed. Chicago, Society of Critical Care MedicineGoogle Scholar
  26. 26.
    Zamora J, Murdoch J, Simchison B (2006) Contamination: a comparison of 2 personal protective systems. CMAJ 175(3):249–254PubMedGoogle Scholar
  27. 27.
    Daugherty E, Perl T, Needham D (2009) The use of personal protective equipment for control of influenza among critical care clinicians: a survey study. Crit Care Med 37:1210–1216CrossRefPubMedGoogle Scholar
  28. 28.
    Casanova L, Alfano-Sobsey E, Rutala W et al (2008) Virus transfer from personal protective equipment to healthcare employees’ skin and clothing. Emerg Infect Dis 14:1291–1293.CrossRefPubMedGoogle Scholar
  29. 29.
    Upshur R, Singer P (2005) Stand on guard for thee: ethical considerations in preparedness planning for pandemic influenza: a report of the University of Toronto Joint Centre for Bioethics Pandemic Influenza Working Group. University of Toronto Joint Centre for Bioethics. Toronto, Ontario, Canada, pp 1–29Google Scholar

Copyright information

© Springer-Verlag Italia 2009

Authors and Affiliations

  • E. J. Jimenez
    • 1
    • 2
  1. 1.Central Florida and Florida State UniversityUniversities of FloridaOrlandoUSA
  2. 2.Critical Care and Intermediate Critical CareOrlando Regional Medical CenterOrlandoUSA

Personalised recommendations