Patient prioritization and resource allocation in mass casualty incidents

Mass-casualty incidents, such as multi-car traffic accidents, plane crashes, and terrorist bombings, create a sudden spike in demand for emergency resources in an area. Providers of emergency medical services must act quickly to make decisions that will affect the lives of injured patients. Particularly important is triage, the process of classifying patients and prioritizing them for transportation from the scene of the incident. The most widely used standard for mass-casualty triage, START, prescribes a fixed priority ordering among the different classes of patients, without explicitly accounting for resource limitations. We develop policies to improve the resource allocation phase of START by explicitly incorporating resource limitations. Next, we develop policies for assigning resources when two or more incidents occur at the same time and demand the same set of resources. Current standards, such as START, do not prescribe how to handle such situations---these decisions are most often made in an ad hoc manner. Finally, we examine the problem of efficiently routing a large number of patients affected by a major disaster, such as a biological, chemical, or nuclear incident, to facilities where they can be treated. We provide insight on how resources can be used effectively to treat patients as quickly as possible. Throughout this work, we focus on policies that are analytically justified, intuitive, broadly applicable, and easy to implement. Using numerical results and simulation, we demonstrate that implementing policies based on quantitative analysis can make a meaningful impact by increasing the expected number of survivors in a mass-casualty incidentDoctor of Philosoph