Mass Casualty Management

In this episode of Frontline Surgery: Mastering Military Trauma Care, Col (ret) Jeremy Cannon, MD joins hosts Drs. Joshua Dilday and Rachel Russo to break down the realities of managing a mass casualty (MASCAL) event. The discussion focuses on battlefield triage systems, including the 10-second triage tool, priority categorization (P1, P2, P3, expectant), and rapid decision-making under extreme resource constraints, limited blood supply, and uncertain evacuation timelines. Key topics include damage control surgery, hemorrhage control, tourniquet application, TCCC principles, walking blood bank activation, junctional and torso trauma prioritization, resuscitative thoracotomy decision thresholds, prolonged field care considerations, and blood product logistics. Dr. Cannon emphasizes the importance of a designated triage officer, patient accountability systems (PAD tracking), communication roles, and maintaining situational awareness during combat casualty surges. The episode also explores military–civilian trauma system integration, disaster preparedness exercises, leadership under pressure, expectant category decision-making, and the emotional and ethical challenges of battlefield surgery. Preparation, rehearsal, shared mental models, and disciplined surgical leadership are highlighted as essential to optimizing survival in high-acuity combat trauma and mass casualty scenariosKeywords:mass casualty, trauma surgery, military medicine, triage, leadership, combat casualty care, surgical skills, resource managementLiterature Mentioned:Front Line Surgery: A Practical ApproachTen Second Triage ToolDisaster Management and Emergency Preparedness CourseSTOP THE BLEED Program