Introduction: Pre-positioning and maintaining additional critical equipment to manage sudden surges during mass casualty incidents (MCI) is crucial. While specialized equipment carts tailored for critical patients in logistically challenging situations have been shown to improve patient care, such carts have yet to be customized for MCI. This study aims to develop a customized MCI equipment cart (MCI-EC) for use in the emergency department (ED). Methods: The development of the MCI-EC followed a systematic approach. We focused on road traffic accidents (RTA) with ten casualties based on a study conducted in a similar urban setting, which identified this to be the most common MCI type. The anticipated injury profile was derived from a study on RTA-type MCI, followed by consensus between study members, which specified four airway or facial injuries, four head or cervical spine injuries, three chest injuries, two abdominal injuries, seven extremity injuries, and two thoracolumbar spine injuries. The equipment list was generated regarding published checklists and two rounds of voting by the study members. Finally, the dimensions and arrangement of the MCI-EC were prototyped to prioritize mobility, compactness, and ergonomics within the study ED to ensure practicality in the intended setting. Results: The MCI-EC was stainless steel and measured 180cm (H) x 47cm (D) x 95cm(W) on 6-inch diameter wheels. Equipment was arranged by treatment tasks comprising monitoring, airway and breathing interventions like intubation, and circulatory interventions like hemostatic dressings, intravenous volume delivery, and chest decompression. A photograph of the MCI-EC and the equipment list are provided as supplementary material. Conclusion: The MCI-EC was customized for treatment of MCI patients. This study is the first template for MCI-EC in similar settings, and a novel example for further customization in other settings.
Tan et al. (Sun,) studied this question.