On August 1, 2016, the Fire Department of the City of New York (FDNY) began using a four-level categorization system for Mass Casualty Incidents (MCIs). Use of the MCI levels informs emergency medical service patient transportation decisions and provides hospitals with additional situational awareness.

The levels are:

  • Minimal to Moderate – Level A
  • Significant – Level B
  • Major – Level C
  • Catastrophic – Level D

Each level is associated with a fixed allotment of critical and non-critical patients which hospitals should be prepared to receive during the MCI.

FDNY staff conducted analyses of MCIs that occurred during the first year of implementation for these new protocols. This overview summarizes these analyses, describes MCI coding adjustments, and provides interpretation for hospital Emergency Departments that are part of the NYC 911-system.