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Hospital Surge Model Version 1.3: User Manual

Public Health Emergency Preparedness

This resource was part of AHRQ's Public Health Emergency Preparedness (PHEP) program, which was discontinued on June 30, 2011, in a realignment of Federal efforts.

This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://info.ahrq.gov. Let us know the nature of the problem, the Web address of what you want, and your contact information.

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Step 2: Specify Number and/or Type of Casualties

After you select a scenario on the Scenario Selection Screen, you must specify the number and/or type of casualties that you want to assume your hospital(s) will have to treat.

This screen has three buttons or links:

  • Click Previous to return to the Scenario Selection Screen.
  • Click Run Model to have the Hospital Surge Model estimate the resources required to treat the casualties you have specified.
  • Click Help to display the User Manual (note: you may need to disable your pop-up blocker to view the User Manual).

For example, if you select the sarin scenario, the following screen is displayed:

Scenario Selection Screen (Sarin Scenario)

Screen shot of the options for selecting a specific scenario. For this example (Sarin Scenario) the user can enter the expected number of casualties or the distribution of mild, moderate, and severe casualties.

For each of the scenarios, you have two options for specifying casualties:

  • Specify the number and type of casualties. For example, you could specify that your hospital(s) receives 100 mild, 20 moderate, and 10 severe cases of sarin exposure.
  • Specify the number of casualties. For example, you could simply specify that your hospital(s) receives 130 cases of sarin exposure. In this case, the casualties you receive are randomly selected from among all casualties from the attack.

The table below lists the type of casualties you can specify for each scenario:

Scenario Types of Casualties
Anthrax
  1. Mild: When victims become ill they are more than 3 days away from death, assuming no treatment.
  2. Severe: When victims become ill they are 3 or fewer days away from death, assuming no treatment.
Smallpox
  1. Onset: mild, generalized symptoms.
Pandemic Flu
  1. Moderate: Patients with moderate flu symptoms go directly to the floor for treatment.
  2. Severe: Patients with severe flu symptoms go directly to the ICU for treatment.
Plague
  1. Moderate:Patient requires hospitalization, but not in the ICU.
  2. Severe: Patient requires hospitalization in the ICU.
Chlorine
  1. Irritated: Burning in eyes or respiratory system, exposed to a detectable odor.
  2. Incapacitated: Intolerable irritation of respiratory system and lungs.
Mustard
  1. Irritated: Hoarseness or burning in throat and lungs, irritation in eyes.
  2. Severe: Temporary blindness, permanent eye damage, bronchopneumonia and skin damage.
Sarin
  1. Mild: Miosis, ocular pain, tearing, rhinorrhea, bronchospasm, slight dyspnea, respiratory secretions, salivation, diaphoresis.
  2. Moderate: Moderate dyspnea, nausea, vomiting, diarrhea.
  3. Severe: Loss of consciousness, convulsions, paralysis, copious secretions, apnea.
Nuclear Device
  1. Burns/moderate: Second-degree burns on hands and face.
  2. Burns/severe: Third-degree burns on hands and face (and 1st degree over the rest of the body).
  3. Trauma: Ppeople in collapsed skyscrapers.
  4. Trauma: People in collapsed houses and other light buildings.
  5. Trauma: People who receive multiple lacerations from flying glass.
  6. Trauma: People outside who receive blunt trauma.
  7. Radiation/mild: Nausea, vomiting, anorexia, fever, infections.
  8. Radiation/moderate: Mild symptoms as above, plus bleeding, fatigue and weakness.
  9. Radiation/severe: Moderate symptoms as above, plus headache, prostration, dizziness and disorientation .
  10. Fallout/mild: 1Gy equivalent dose for blood effects, no other equivalent dose (some bleeding and infection issues).
  11. Fallout/severe: 4Gy for blood effects (problems with bleeding and infection) and about 0.75 Gy for lethality and GI effects (some small fraction of people will die, and others get nausea, vomiting, etc.).
Radiological Dispersion Device (RDD)
  1. Mild: 1Gy equivalent dose for blood effects, no other equivalent dose (some bleeding and infection issues).
  2. Severe: 4Gy for blood effects (problems with bleeding and infection) and about 0.75 Gy for lethality and GI effects (some small fraction of people will die, and others get nausea, vomiting, etc.).
Radiological Point Source
  1. Mild: Nausea, vomiting, anorexia, fever, infections.
  2. Moderate: Mild symptoms as above, plus bleeding, fatigue and weakness.
  3. Severe: Moderate symptoms as above, plus headache, prostration, dizziness and disorientation.
Foodborne
  1. Adult Moderate: Adults show symptoms, but are able to be treated outside of the ICU.
  2. Child Moderate: Children show symptoms, but are able to be treated outside of the ICU.
  3. Adult Severe: Adults present at the hospital with severe symptoms requiring a ventilator.
  4. Child Severe: Children present at the hospital with severe symptoms requiring a ventilator.
Conventional (Improvised Explosive Device)
  1. Affected: Victims suffer from one type of blast injury, including lacerations, fractures, burns, and pulmonary blast.
  2. Moderate: Victims suffer from two types of blast injuries, including lacerations, fractures, burns, and pulmonary blast.
  3. Severe: Victims suffer from three or more types of blast injuries, including lacerations, fractures, burns, and pulmonary blast.

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