ABSTRACT
This chapter focuses on the evolving roles of technology in sustaining performance in mass casualty environments. It describes the triage process using the metaphor of the skin of an onion. The process involves continuous re-assessment and reallocation of resources to ensure optimal medical outcome at the individual and aggregate levels. The primary methodology of assessment of categories of triage in an unconventional threat environment is underpinned by threat agent assessment. When feasible, each phase of the assessment should include essential task management critical decision-making under stress, team management skills, and iterative situation assessment and dynamic readjustment of action plan, based upon incorporation of new or altered information. The primary assessment of mass casualty survivability and subsequent distribution of resources follows conventional management procedures followed by a series of unique considerations. The multi-factorial, stressful conditions encountered in Mass Casualty Incident are extraordinarily difficult to emulate, and most importantly, performance cannot be extrapolated with a high degree of certainty from training environments.
