Your browser doesn't support JavaScript. Please upgrade to a modern browser or enable JavaScript in your existing browser.
Skip Navigation U.S. Department of Health and Human Services
Agency for Healthcare Research Quality

Public Health Emergency Preparedness: Providing Mass Medical Care with Scarce Resources

Slide Presentation by Marianne Matzo, Ph.D., APRN, BC, FAAN

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 It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work.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: Let us know the nature of the problem, the Web address of what you want, and your contact information.

Please go to for current information.

Broadcast on November 29, 2006, the Web conference Providing Mass Medical Care With Scarce Resources: Strategies and Tools for Community Planners gave an overview of the community planning guide and provided planners at the institutional, State, and Federal levels with valuable insights and information that will help them plan for and respond to a Mass Casualty Event (MCE).

Marianne Matzo, Ph.D., APRN, BC, FAAN, and Professor of Palliative Care Nursing; University of Oklahoma College of Nursing, delivered a presentation during the conference entitled Application of Concepts to a Pandemic Case Study. This is the text version of Dr. Matzo's slide presentation. Select to access the PowerPoint® Slides (475 KB).

Palliative Care Issues

Slide 1

Palliative Care Issues

Marianne Matzo, Ph.D., APRN, BC, FAAN
Professor, Palliative Care Nursing
University of Oklahoma College of Nursing

Slide 2

  • Palliative care is care provided by an interdisciplinary team.
  • Focused on the relief of suffering.
  • Support for the best possible quality of life.

A doctored photo shows a New York City skyline with two parallel searchlights, possibly standing in for the Twin Towers, and a pair of huge crutches leaning against a building.

Slide 3

Catastrophic Mass Casualty Palliative Care

Palliative Care is:

  • Evidence-based medical treatment.
  • Vigorous care of pain and symptoms throughout illness.
  • Care that patients want.

Palliative Care is not:

  • Abandonment.
  • The same as hospice.
  • Euthanasia.
  • Hastening death.

A photo shows an American flag seen through a broken or dirty window.

Slide 4

  • Good palliative care occurs wherever the patient is.
  • The community should be prepared about the principles of palliative care in a disaster situation.

A photo shows firefighters trudging through smoking ruins.

Slide 5

  • The minimum goal: die pain and symptom free.
  • Effective pain and symptom management is a basic minimum of service.

A photo shows a crowd of uniformed health care personnel talking amongst themselves.

Slide 6

  • Adequate and aggressive palliative care services should be available to everyone.
  • Palliative care under circumstances of a mass casualty event is aggressive symptom management.

A photo shows a construction crew working at ruins.

Slide 7

At the upper left of the slide are the words Catastrophic MCE. An arrow points down from there to an oval labeled Triage Plus First Response. Arrows point down from that oval to three ovals labeled The Too Well, The Optimal for Treatment, and The Too Sick to Survive.

At the upper right of the slide are the words Prevailing Circumstances. Arrows point down from there to two boxes labeled Receiving Disease Modifying Treatment and Existing Hospice and PC Patients. Arrows point down from the former box to the three bottom ovals. A single arrow points down from the latter box to the oval labeled The Too Sick to Survive.

Slide 8

Catastrophic MCE and Large Volume

At the upper left of the slide is an oval labeled The Too Sick to Survive, with an asterisk. The asterisk is defined at the bottom as: 1, those exposed who will die over the course of weeks; 2, already existing palliative care population; and 3, vulnerable population who become palliative care due to scarcity.

Next to the oval are the words Initially Left in Place. Below is the word Then, with a colon. An arrow labeled Transport points rightward from there to the words Other than Active Treatment Site.

Slide 9

Clinical Services after Triage


  • Personnel.
  • Coordination.
  • Supplies.

A photo shows the New York Harbor with smoke filling the sky.

Slide 10

Clinical Process Issues

  • Symptom management, including sedation near death.
  • Spirituality/meaningfulness.
  • Family and provider support: mental health.
  • Family and provider grief and bereavement.
  • Event-driven protocols and clinical pathways.

Slide 11

Preparation for the Future

"Many of us discussed the need to evaluate what happened and learn how to be better prepared for the future.
"You're expected to know how to do mass casualty. You must train for the worst and hope for the best."

A photo shows medical and security personnel.

Current as of November 2006

Internet Citation:

Palliative Care Issues. Public Health Emergency Preparedness: Providing Mass Medical Care with Scarce Resources. Web Conference, broadcast on November 29, 2006. Agency for Healthcare Research and Quality, Rockville, MD.


The information on this page is archived and provided for reference purposes only.


AHRQ Advancing Excellence in Health Care