Clinical Challenges in Managing Mass Casualty Incidents: A Human-Centered and Evidence-Based Clinical Framework

Mass casualty incidents (MCIs) represent one of the most complex and ethically challenging scenarios in clinical medicine. The sudden surge of critically ill patients, combined with limited resources and incomplete information, places clinicians under extraordinary pressure. While trauma-related mortality is often immediate, a substantial proportion of preventable deaths during disasters arise from internal medical complications such as sepsis, shock, acute kidney injury (AKI), and respiratory failure. This article provides a comprehensive clinical analysis of the challenges associated with managing MCIs, with particular emphasis on bedside decision-making, dynamic triage, and the pivotal role of internal medicine physicians. Drawing on real-world disaster experiences and high-quality international literature, a human-centered clinical framework is proposed to integrate standardized protocols with adaptive clinical reasoning. Strengthening this approach may significantly improve outcomes in large-scale disasters.

کلیدواژه ها:

Mass casualty incidents ، Disaster medicine ، Clinical management ، Triage ، Internal medicine ، Crisis standards of care