Disaster Preparedness and Mass Casualty Response

A mass-casualty incident occurs when the number or acuity of patients exceeds the resources normally available. The clinical goal therefore changes. Instead of using every available resource to optimize the first patient encountered, the team prioritizes interventions that produce the greatest achievable benefit across the affected population. This is not permission to provide careless care. It is a temporary change in how limited treatment spaces, staff, equipment, medications, and transport are allocated. A patient who would normally receive immediate one-to-one attention may need to wait while another patient with a more reversible, life-threatening problem is treated. An experienced nurse notices the mismatch early: patients are arriving faster than they can be assessed, routine beds are being converted to treatment spaces, staff are being pulled into unfamiliar roles, or a hazard is threatening the facility itself. Those observations should trigger the emergency operations plan rather than independent improvisation. Triage is dynamic. A patient’s category can change when breathing worsens, perfusion falls, mental status changes, treatment becomes available, or the incident pattern changes. The priority is never a permanent label.