Archives for April 5, 2008

An MCI “just won’t happen to me”

How can we practice for a mass casualty incident (MCI) if we believe “it couldn’t happen to me”?

While in San Francisco I had the chance to speak with Dr. Jacob Or, the president of the Israeli Association of Emergency Medicine, on a couple of occasions. He also happens to be an emergency physician at the largest trauma center in the Middle East. During a presentation he gave on the state of emergency medicine in Israel, Dr. Or couldn’t help but comment on how excellently well-prepared his men and women were for a mass casualty incident. Their surge capacity, apparently, is the stuff of legend, and it’s all been tested and proven. There was an upspoken current that the U.S. had a lot to learn from this small nation in this regard. Undoubtedly.

But I had a question, so I met up with Dr. Or after the talk over a beer. What about the docs in Iowa? In Peoria? What about the docs who want to improve surge capacity and disaster preparedness, but for whom an MCI simply isn’t a daily reality? How can we make disaster preparedness a reality for the EPs in the States who don’t see an impending threat of any kind?

“That’s the million dollar question” another doc chimed in.

The response I heard from Dr. Or and others was this: Focus on legitimate regional threats. If your town is near an oil refinery, base your mass casualty drill on a disaster at the plant, not a bomb at the mall. If you practice in Florida, your MCI should involve a hurricane rather than a terrorist attack.

Makes sense and it’s good logic, but it only partially satisfied me, so I want to know what people think. Have you experienced a mass casualty drill that was either particularly effective or ineffective? In your experience, what efforts were taken to get participants mentally invested in the drill? How can we make mass casualty drills more meaningful, and more effective in the long term?

-Logan Plaster

Emergency Physicians Monthly