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New expert panel report examines standards of care during mass casualty events

Guidelines for officials on how to plan for delivering health and medical care in a mass casualty event are outlined in a new report from an expert panel convened by the Agency for Healthcare Research and Quality and the HHS Office of Public Health Emergency Preparedness. The report presents the recommendations of a 39-member panel of experts in bioethics, emergency medicine, emergency management, health administration, health law and policy, and public health that was convened in August 2004 to examine this challenge.

The report, Altered Standards of Care in Mass Casualty Events: Bioterrorism and Other Public Health Emergencies, offers a framework for how to provide optimal care during a potential bioterrorism or other public health emergency involving thousands, or even tens of thousands, of victims. For example, planners at the Federal, State, regional, community, and health systems levels should develop or revise triage guidelines for specific types of events and allocation guidelines for the use of scarce resources such as ventilators, burn beds, or surgical suites, according to the report.

In addition to examining the reallocation of health and medical resources among hospitals and other health facilities, the report considers a number of important nonmedical issues, including:

  • What circumstances would trigger a call for altered standards of care, and who is authorized to make that call?
  • What existing laws and mechanisms allow for legal, regulatory, or accreditation adjustments in provider liability, licensing, facility standards, and patient privacy?
  • What sources of relief are available to address concerns about financial resources and reimbursement of medical care costs?
  • What public communication strategies are needed before, during, and after a mass casualty event?
  • What supports are available for populations with special needs, such as children, individuals who have physical or cognitive disabilities, and non-English speakers?

The report suggests that public- and private-sector entities take a collaborative approach when developing next steps in responding to public health emergencies.

Go to to access Altered Standards of Care in Mass Casualty Events: Bioterrorism and Other Public Health Emergencies online. Print copies (AHRQ Publication No. 05-0043) are available from the AHRQ Publications Clearinghouse.

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