Rethinking Prehospital Response to Mass Casualty Events: Move, Treat, and Transport
Stephen Rush, Michael Lauria, Erik S. DeSoucy, Eric J. Koch, Jonathan J Kamler, Michael A Remley, Nate Alway, Fredrick Brodie, Paul Barendregt, Keary Miller, Richard Hines, Matthew Champagne, Lorenzo Paladino, Stacy Shackelford, Ethan A. Miles, Warren C. Dorlac, Jennifer M. Gurney, Douglas Robb, Ricky Kue
Abstract
Herein, we present a simplified approach to prehospital mass casualty event (MASCAL) management called "Move, Treat, and Transport." Prior publications demonstrate a disconnect between MASCAL response training and actions taken during real-world incidents. Overly complex algorithms, infrequent training on their use, and chaotic events all contribute to the low utilization of formal triage systems in the real world. A review of published studies on prehospital MASCAL management and a recent series of military prehospital MASCAL responses highlight the need for an intuitive MASCAL management system that accounts for expected resource limitations and tactical constraints. "Move, Treat, and Transport" is a simple and pragmatic approach that emphasizes speed and efficiency of response; considers time, tactics, and scale of the event; and focuses on interventions and evacuation to definitive care if needed.