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A web-based model to support patient-to-hospital allocation in mass casualty incidents

Amram, Ofer MSc; Schuurman, Nadine PhD; Hedley, Nick BSc, MSc, PhD; Hameed, S. Morad MD, MPH

Journal of Trauma and Acute Care Surgery: May 2012 - Volume 72 - Issue 5 - p 1323–1328
doi: 10.1097/TA.0b013e318246e879
Original Articles

BACKGROUND: In a mass casualty situation, evacuation of severely injured patients to the appropriate health care facility is of critical importance. The prehospital stage of a mass casualty incident (MCI) is typically chaotic, characterized by dynamic changes and severe time constraints. As a result, those involved in the prehospital evacuation process must be able to make crucial decisions in real time. This article presents a model intended to assist in the management of MCIs. The Mass Casualty Patient Allocation Model has been designed to facilitate effective evacuation by providing key information about nearby hospitals, including driving times and real-time bed capacity. These data will enable paramedics to make informed decisions in support of timely and appropriate patient allocation during MCIs. The model also enables simulation exercises for disaster preparedness and first response training.

METHODS: Road network and hospital location data were used to precalculate road travel times from all locations in Metro Vancouver to all Level I to III trauma hospitals. Hospital capacity data were obtained from hospitals and were updated by tracking patient evacuation from the MCI locations. In combination, these data were used to construct a sophisticated web-based simulation model for use by emergency response personnel.

RESULTS: The model provides information critical to the decision-making process within a matter of seconds. This includes driving times to the nearest hospitals, the trauma service level of each hospital, the location of hospitals in relation to the incident, and up-to-date hospital capacity.

CONCLUSION: The dynamic and evolving nature of MCIs requires that decisions regarding prehospital management be made under extreme time pressure. This model provides tools for these decisions to be made in an informed fashion with continuously updated hospital capacity information. In addition, it permits complex MCI simulation for response and preparedness training.

British Columbia, Canada

From the Geography Department (O.A., N.S., N.H.), Simon Fraser University, British Columbia, Canada; and Department of Medicine (S.M.H.), University of British Columbia, Vancouver, Canada.

Submitted: May 12, 2011, Revised: September 23, 2011, Accepted: December 15, 2011.

Supported by a Michael Smith Foundation for Health Research (MSFHR) emerging team grant (to S.M.H.) and by career awards from MSFHR and the Canadian Institutes for Health Research (to N.S.).

Address for reprints: Nadine Schuurman, PhD, Simon Fraser Univeristy, 8888 University Drive, Burnaby, British Columbia, Canada V5A 1S6; email:

© 2012 Lippincott Williams & Wilkins, Inc.