Decision Support for Casualty Triage in Emergency Response

Abstract

Mass-casualty incidents (MCI) cause a sudden increase in demand of medical resources in a region. The most important and challenging task in addressing an MCI is managing overwhelmed resources with the goal of increasing total number of survivors. Currently, most of the decisions following an MCI are made in an ad-hoc manner or by following static guidelines that do not account for amount of available resources and number of the casualties. The purpose of this dissertation is to introduce and analyze sophisticated service prioritization and resource allocation tools. These tools can be used to produce service order strategies that increase the overall number of survivors. There are several models proposed that account for number and mix of the casualties, and amount and type of the resources available. Large number of the elements involved in this problem makes the model very complex, and thus, in order to gain some insights into the structure of the optimal solutions, some of the proposed models are developed under simplifying assumptions. These assumptions include limitations on the number of casualty types, handling of deaths, servers, and types of resources. Under these assumptions several characteristics of the optimal policies are identified, and optimal algorithms for various scenarios are developed. We also develop an integrated model that addresses service order, transportation, and hospital selection. A comprehensive set of computational results and comparison with the related works in the literature are provided in order to demonstrate the efficacy of the proposed methodologies.