BOX 1-1

Most Common MCIs Experienced by Rural Hospitals

From most to least frequent:

  • Vehicular crash

  • Severe weather

  • Bus crash

  • Hazardous materials (Hazmat)

  • Power failure

  • Tornado or hurricane

  • Multiple gunshot wounds

  • Fire

  • Heat

  • Flood

  • Explosions

  • Airplane crash

  • Other natural cause

  • Lightning

  • Train crash

SOURCE: Manley et al. (2006).

list demonstrates for state and federal policymakers the type of commonly occurring events that can overload a rural EMS system. Many rural health systems exceed their surge capacity and trigger an MCI event with an influx of only a handful, less than 10, patients. Contrast this, Bass said, to a major city such as Washington, DC, where having 10 patients at a single time is a daily event, and the capacity to surge and respond is much more robust.

Drew Dawson, director of the Office of Emergency Medical Services of NHTSA said that, although the impetus for the NTSB recommendation to FICEMS was the Mexican Hat incident, the workshop discussion of solutions and approaches should be from an all-hazards perspective.

Dawson charged speakers and participants to identify practical, creative, and actionable solutions to incrementally improve rural EMS mass casualty response, both in the short and long term. This includes identifying barriers and developing practical strategies, with as much specificity as possible, to work around those barriers.

Common Challenges

Rural and frontier areas face significant and unique challenges in responding to an MCI, which will be discussed in much greater detail



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