In emergency/mass casualty situations resulting from chemical release incidents, local health care providers will need to adjust their existing protocols for medical prioritization. For example, medical triage may be needed to prioritize moderately injured survivors over those that are unlikely to recover even with extensive treatment. Hospitals should plan for a surge of exposed patients and should consider establishing agreements with regional medical facilities to expedite the sharing of resources and transport of survivors to facilities with treatment capacity. Potential shortages in critical medical personnel, supplies, and equipment may cause a need for prioritization of medical care beyond normal triage procedures. Any adjustments made to protocols and procedures, and the decision-making factors and personnel behind them, must be made transparent via careful public messaging to ensure continued public confidence during a resource-restricted response.
In addition to equipment and staff requirements, communities should also characterize emergency medical services (EMS) and hospital capabilities and capacities, as well as veterinary services, when planning for large-scale release and potential mass casualty incidents. To address potential shortfalls, planners may consider development of a robust all-hazards medical and veterinary surge plan, including the pre-incident identification of coordinating points that will be able to provide rapid reachback access to resources even when not on-scene, such as poison control and academic centers.