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Addressing Surge Capacity in a Mass Casualty Event Nathaniel Hupert, M.D., M.P.H. Assistant Professor of Public Health and Medicine Weill Medical College.

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Presentation on theme: "Addressing Surge Capacity in a Mass Casualty Event Nathaniel Hupert, M.D., M.P.H. Assistant Professor of Public Health and Medicine Weill Medical College."— Presentation transcript:

1 Addressing Surge Capacity in a Mass Casualty Event Nathaniel Hupert, M.D., M.P.H. Assistant Professor of Public Health and Medicine Weill Medical College Cornell University New York City

2 Why Model Surge? We already know the U.S. health care system has very little surge capacity. What is the benefit of creating computer models of it? Two possible answers: 1. Reassess common assumptions about the determinants of capacity 2. Quantitative casualty estimates for varied planning efforts (e.g, ranging from different service lines in a single hospital to emergency planning functions in a region)

3 Determinants of Surge Capacity Surge arrivals Hospital or network capacity Medical supplies Out-of- region facility SNFHome Staff Event Beds Pre-hospital management Surge Discharge* Treated Died *Note: I am indebted to Sam Benson, EMT-P, New York City Office of Emergency Management for the notion of “surge discharge”

4 Delay in Reaction None (Hours) Long (Days) Shorter (1-2 Days)Longer 4+ Days Time needed to protect community Protection Less More Modeling Pre-hospital Capacity SAFE

5 Modeled Outcomes of Pre-hospital Anthrax Prophylaxis Percentage of exposed individuals don’t get sick because they receive antibiotics in time Increasing Hospital Surge

6 If 100,000 people were exposed to anthrax and your prophylaxis campaign… Could cover all in 2 days after a 1 day delay  ~1,000 sick

7 Could cover all in 2 days after a 2 day delay  ~4,000 sick If 100,000 people were exposed to anthrax and your prophylaxis campaign…

8 Modeling Improves Community-wide Surge Capacity Planning by Linking Pre-hospital and Hospital-based Care Planning One exposure scenario… …can lead to different total and daily casualty loads depending on pre-hospital preparedness and response…...with different implications for hospital surge arrivals… …yielding different patient outcomes.  

9 “Community-Based Mass Prophylaxis: A Planning Guide for Public Health Preparedness”


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