Because the risk of terrorist attacks and other mass casualty events remains high, hospitals must be prepared to optimally respond to a surge in patients with life- and limb-threatening injuries. On 9/11, as well as during explosive events in London, Madrid, Mumbai, and Israel, the closest hospitals were disproportionately affected, resulting in a surge of critically injured patients. This was not the case in Boston, where there was a highly unusual degree of preparedness and pre-deployment resources available as a result of standing ready for the Boston Marathon.

The Greater New York Hospital Association (GNYHA), in collaboration with the New York City Department of Health and Mental Hygiene (DOHMH) and GNYHA hospital members, have developed the following template plans to prepare hospitals in the New York region to respond to such events. GNYHA also worked collaboratively with its Critical Care–Emergency Preparedness Advisory Workgroup, including Robert Bristow, MD, Medical Director of Emergency Management at NewYork–Presbyterian Hospital, who was instrumental in contextualizing hospital- and departmental-specific roles and responsibilities to prepare for and respond to an explosive or mass casualty event.

To ensure this level of preparedness, hospitals may consider developing or improving their departmental-specific preparedness plans and emergency operations plans (EOPs) so that a fully integrated response model of critical care delivery is quickly realized after a mass casualty event. These templates are not intended to be implemented as is, but rather as tools to help hospitals create customized integrated explosive event or mass casualty event clinical response plans that will synchronize and coordinate the activities of the Emergency Department, Radiology Department, Perioperative Services, Department of Surgery, and Critical Care Services (Department of Medicine and ICUs). A fully integrated clinical response will allow affected hospitals to quickly mobilize all available resources at the time of an incident to provide the highest standard of care to critically injured patients.