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Every country has some level of wealth and stage of development, existing health systems along with their human and material resources. These systems have arrangements and infrastructure for management of any casualty. This lays the foundation of mass casualty management system in situations of emergency. The mass casualty plan during times of emergency has some generic framework to follow. Let us see what and how the steps should a government take to curb the hazards of the incident. Establishing a baseline: in order to improve existing systems, a baseline is essential. In this baseline, the current system capacity is assessed so that planned changes can be eventually measured. The assessment requires the health ministry to analyze the health care resources and direct the lower levels of the government to take the responsibility. With this analysis, one can have the comprehensive review of the health care system which will provide components to handle the mass casualty incident. Hazard analysis and risk assessment: the second initiative in this regard would be to carry out hazard analysis and risk assessment of the previous incidents. It should be carried out at national as well as provincial/state levels also. The task must include the gathering of retrospective data on prior incidents. This analysis must include not only the large scale disasters but also smaller ones like industrial or traffic accidents, mudslides, floods, fires, or building collapses. It should also have a forward looking component to assess future risks. Developing a national mass casualty plan: Finally, the management, with the help of emergency management stakeholders, should create a national mass casualty management plan. This plan should be compatible with plans of local levels. It is necessary to review the plan regularly to consider issues like evolving hazards, improvements in resources and capacity, innovation in mass casualty procedures, techniques and lessons. Monitoring, surveillance and early warning: the above described collection and analysis is a vital part of the preparation of the mass casualty plan. Now it must be followed by following steps: Monitoring: a part of the ministry should be engaged in regular collection and maintenance of this information. The information should be prepared , processed and disseminated in such a way that policy and decision makers can use it instantly. Surveillance: mass casualty incidents also include hazard like pandemics, biological and chemical incidents. Therefore a surveillance committee should be there to take measures to identify any risk early and initiate some protective measures in it. Early warning: the surveillance function should be followed by the early warning of any identified incidents like floods or volcanic eruptions. This will help in triggering the measures for the safety and prevention. Financial and material resources: the ministry of health should make a detailed costing of the plan or an estimated cost to the probable incidents. If the ministry does not have enough resources, the request for special budget allocation must be made by the national government. Stockpiling: in the mass casualty plan, the ministry must keep the required resources close to the risk areas. With this, basic assistance in the form of cert kits, food, water, tools, fire extinguishers, triage flags, vests, etc. can be reached on time without relying on the few centralized facilities and transportation infrastructure.
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