Manage mass casualties with SAGGY PRIDE: when situation overwhelms available medical capabilities, certain key steps should be followed.(Clinical Rounds)

SAN FRANCISCO -- Every physician should consider how he or she would manage as the only medical professional in a mass-casualty situation, Lt. Cormac J. O'Connor, MC, USN, said at the annual meeting of the American Academy of Family Physicians.

Dr. O'Connor, a second-year resident in family medicine at Naval Hospital Camp Pendleton (Calif.), offered a mnemonic--SAGGY PRIDE--to help physicians remember the critical steps in managing mass casualties. (He emphasized that his suggestions are his own and do not represent official positions of the U.S. Navy or the Department of Defense.)

SAGGY PRIDE stands for Situational Awareness, Gather a Group and Yell, Plan Rapidly, Issue Directives, and Execute.

A "mass casualty" is any situation in which the number of casualties overwhelms the medical capabilities available. This can range from a single, critically ill person in a remote location to thousands of people in an urban area who are victims of a natural disaster or a terrorist attack.

"As a whole, civilian physicians are not trained to deal with mass casualty events," said Dr. O'Connor, who has served in combat with the U.S. Marine Corps in Iraq. "[Nevertheless] as a physician, you're expected to know what to do when many people are hurt, regardless of whether that falls within the nature of your practice."

Situational Awareness

In less than 1 minute, if possible, you need to get a grasp of what has happened. What is the nature of the calamity? How many people are involved? What is the location's condition and physical layout? What resources are likely to be available?