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Published January 23, 2023 | Version v1.0.0
Study Design Open

Disaster and Mass Casualty Incident Responses by Intensive Care Units: A Scoping Review Protocol


An a priori scoping review protocol submission to the Northwestern DigitalHub (an institutional repository for the research and scholarly output of Northwestern Medicine) following Preferred Reporting Items for Systematic Review and Meta-analysis Protocols.


Critical care has displayed an interest in the field of disaster and mass casualty incident response (2). A disaster refers to a man-made or natural event requiring resources from outside a local community to return to pre-event status (3). An incident occurs secondary to similar hazards, requiring an emergency response to protect life, however, may not require resources from outside a local community (4). A mass casualty incident focuses on healthcare system capacity, where casualties rapidly exceed capabilities (5). Here we focus on the timeframe of acute response by intensive care units (ICUs) themselves: a relief phase - where lifesaving and mitigation efforts dominate - and a subsequent recovery phase - where efforts return systems to pre-event status. Significant infrastructure, personnel and equipment resources are required to operate ICUs (6). Disasters and mass casualty incidents are known to result in an influx of critically ill patients (2). Thus, ICU populations must be thought of as especially at risk.Yet, there remains a paucity of well-compiled data from the front-lines of ICU response initiatives, hampering evidence-based guideline production (2). Disaster research theory, though, is well-established (3). Categorical, continuous, or even narrative data reported by responders in the midst of response initiatives represent evidence (7). It is possible that through initial publication and valuating of such reports, we may illuminate intervention effects, variation in experience and practice, and identify gaps and inconsistencies in the literature.The purpose of this scoping review will be to compile and analyze ICU disaster and mass casualty incident response experiences. We intend to characterize ICU experiences - reported by ICUs themselves - to organize quantitative and qualitative data. Quantitative data, in the form of categorical and continuous items reported, will be assessed. Qualitative analyses will be undertaken through narrative inquiry of anecdotes. Outcomes of interest include identification of trends, analyses of existing reports for consistency, typical experience strengths or weaknesses, lessons learned, and best practices. This scoping review represents the first published data compilation and analysis of ICU disaster and mass casualty incident response initiatives.


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March 31, 2023
April 5, 2024