Mass Casualty Incidents: Planning Implications for Trauma

“If you know neither the enemy nor yourself, you will succumb in every battle.” – Sun Tzu, axiom 18 (490 BC) Failure to prepare is preparing to fail. While it may seem a daunting, even hopeless task, planning for disasters or mass casualty events is essential. It may be true that disasters defy planning and that the best for which one might hope is controlled chaos, but the success of a well-crafted and exercised disaster plan is measured by its ability to facilitate the restoration of order from the chaos. Although disasters are unpredictable and sudden, they are not necessarily random, and they can be an-ticipated (1). In certain geographic areas, the form of disaster (e.g. tornado, wildfire, earthquake, nuclear power plant events etc.) can be expected. Disasters, even from terrorism, follow patterns from which we can learn strategies to mitigate the damage. What is certain, however, is that disasters will be recurrent in one form or another. Factors that pre-dispose to increasing the risk of disaster include an increase in population density, including an increas-ingly aging population in industrial countries, in-creased settlement in high risk areas, an increase in hazardous materials and technological hazards, en-vironmental degradation, emergence of new infec-tious diseases, and the increased threat of terrorism (2)