Report Outlines Planning Guidelines for 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 HHS Agency for Healthcare Research and Quality and Office of Public Health Emergency Preparedness.


The report, Altered Standards of Care in Mass Casualty Events, 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.


Altered Standards of Care in Mass Casualty Events includes 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.


Providing optimal care in a mass casualty event requires that we identify, plan, and prepare for the circumstances of available providers, facilities, equipment, and transportation of casualties, said AHRQ director Carolyn M. Clancy, MD. Were grateful to the experts who helped provide a starting point for government agencies and private organizations grappling with these critical issues.


In addition to examining the reallocation of health and medical resources among hospitals and other health facilities, the report considers a number of important non-medical 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, persons with physical or cognitive disabilities, and non-English speakers?


The report suggests that a collaborative approach should be taken by government and private organizations when developing next steps in responding to public health emergencies.


Altered Standards of Care in Mass Casualty Events can be found online at Printed copies may be ordered by calling (800) 358-9295 or by sending an e-mail to


AHRQ has funded more than 50 emergency preparedness-related studies, workshops, conferences, and other activities to help hospitals and health care systems prepare for medical emergencies. Information about these projects can be found at


Source: Agency for Healthcare Research and Quality (AHRQ)