Mahoney Eric J, Biffl Walter L, Cioffi William G
Division of Trauma and Surgical Critical Care, Department of Surgery, Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, Rhode Island 02903, USA.
J Intensive Care Med. 2008 Jul-Aug;23(4):219-35. doi: 10.1177/0885066608315677. Epub 2008 May 25.
Despite the ever-present risk of mass-casualty incidents (MCIs) in all geographical regions, there is a limited body of literature detailing specifically how an intensive care unit (ICU) prepares for such an event. When responding to an overwhelming volume of severely injured victims, the intensivist must make a paradigm shift away from providing complete care to all patients to one of preferentially administering care to those with the greatest likelihood of survival. To do this effectively, ICU directors must possess a detailed understanding of the entire disaster response, including organization, triage, staffing, and treatment. This article provides a comprehensive review of each of these topics, as well as a framework on specific elements of critical care and treatment based on published literature and expert opinion to assist the clinician in directing care to where it is most appropriate.
尽管在所有地理区域大规模伤亡事件（MCI）的风险始终存在，但专门详细阐述重症监护病房（ICU）如何为此类事件做准备的文献却很有限。在应对大量重伤患者时，重症监护医生必须进行范式转变，从为所有患者提供全面护理转向优先为最有可能存活的患者提供护理。要有效做到这一点，ICU主任必须对整个灾难应对有详细的了解，包括组织、分诊、人员配备和治疗。本文全面回顾了这些主题中的每一个，以及基于已发表文献和专家意见的重症监护和治疗具体要素框架，以帮助临床医生将护理引导至最适当的地方。
