Minimizing mortality in a mass casualty event: Fluid networks in support of modeling and staffing

The demand for medical treatment of casualties in mass casualty events (MCEs) exceeds resource supply. A key requirement in the management of such tragic but frequent events is thus the efficient allocation of scarce resources. This article develops a mathematical fluid model that captures the operational performance of a hospital during an MCE. The problem is how to allocate the surgeons - the scarcest of resources - between two treatment stations in order to minimize mortality. A focus is placed on casualties in need of immediate care. To this end, optimization problems are developed that are solved by combining theory with numerical analysis. This approach yields structural results that create optimal or near-optimal resource allocation policies. The results give rise to two types of policies, one that prioritizes a single treatment station throughout the MCE and a second policy in which the allocation priority changes. The approach can be implemented when preparing for MCEs and also during their real-time management when future decisions are based on current available information. The results of experiments, based on the outline of real MCEs, demonstrate that the proposed approach provides decision support tools, which are both useful and implementable.