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Altered Standards of Care in Mass Casualty Events

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.

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Bioterrorism and Other Public Health Emergencies

A mass casualty event could compromise the ability of health systems to deliver services meeting established standards of care. It is critical to plan for adjusting current heath and medical care standards to ensure that the care provided in a mass casualty event result in saving as many lives as possible.

To address the issue, an expert panel was convened by the Agency for Healthcare Research and Quality (AHRQ) and the Office of the Assistant Secretary for Public Health Emergency Preparedness, U.S. Department of Health and Human Services (HHS).

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1. Introduction
2. Health and Medical Care Delivery in a Mass Casualty Event
   Health and Medical Care Standards
   Hypothetical Scenarios Illustrating Changes in Delivery of Care
   Changes in Care Delivery Common to Two Scenarios
3. Framework and Guiding Principles When Planning for Health and Medical Care in a Mass Casualty Event
   Guiding Principles for Developing Altered Standards of Care
4. The Larger Context: Important Related Issues
   Authority to Activate Use of Altered Standards of Health and Medical Care
   Legal and Regulatory Issues
   Financial Issues
   Communicating with the Public
   Ensuring an Adequate Supply of Health Care Providers
   Provider Training and Education Programs
   Protection of Health Care Providers and Facilities
   Caring for Populations with Special Needs
   Transportation of Patients
5. Recommended Action Steps

1. Two Mass Casualty Scenarios Used to Identify Anticipated Changes to Care Delivery
2. Changes Specific to Care Delivery in a Multiple Explosion (Scenario 1)
3. Changes Specific to Care Delivery in a Biological Event (Scenario 2)
4. How Health and Medical Care Standards May Have to Be Modified in a Mass Casualty Event by Stage of Disease in the Population
5. Draft Checklist for State and Local Government Attorneys to Prepare for Possible Disasters
6. Model State Emergency Health Powers Act
7. Colorado's Approach to Planning for Disaster Emergencies—Executive Orders
B1. Operation of the Modular Emergency Medical System (MEMS)

Appendix A. Expert Meeting on Mass Casualty Medical Care Participant List
Appendix B. Preliminary Review of Selected Emergency Response Protocols and Models

Prepared for AHRQ by Health Systems Research Inc., under Contract No. 290-04-0010.

The authors of this report are responsible for its content. No statement in the report should be construed as an official position of AHRQ or the U.S. Department of Health and Human Services.

This document is in the public domain and may be used and reprinted without permission except those copyrighted materials noted, for which further reproduction is prohibited without the specific permission of the copyright holders.

AHRQ Publication No. 05-0043
Current as of April 2005


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


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