Mass-casualty triage: Distribution of victims to multiple hospitals using the SAVE model

During a mass casualty incident (MCI), to which one of several area hospitals should each victim be sent? These decisions depend on resource availability (both transport and care) and the survival probabilities of patients. This paper focuses on the critical time period immediately following the onset of an MCI and is concerned with how to effectively evacuate victims to the different area hospitals in order to provide the greatest good to the greatest number of patients while not overwhelming any single hospital. This resource-constrained triage problem is formulated as a mixed-integer program, which we call the Severity-Adjusted Victim Evacuation (SAVE) model. It is compared with a model in the extant literature and also against several current policies commonly used by the so-called incident commander. The experiments indicate that the SAVE model provides a marked improvement over the commonly used ad-hoc policies and an existing model. Two possible implementation strategies are discussed along with managerial conclusions. (C) 2014 Elsevier B.V. All rights reserved.