Development of a Tool to Assess Cities Mass Casualty Emergency Response and Action

BackgroundThe accelerating pace of urbanization worldwide has highlighted the improvement of disaster response in cities as a global priority. Yet, there remains a poor understanding of the emergency response to mass casualty incidents (MCI) in these environments. This study aimed to develop a conceptual framework for cities responses and potential policy levers. MethodsWe conducted a scoping review followed by in-depth interviews (IDIs), focus group discussions (FGDs), and a modified Delphi process to develop the framework for Cities Assessment of Mass Casualty Emergency Response and Action (CAMERA). ResultsCAMERA framework consists of six essential components of urban emergency response systems: 1) communication, 2) safety and security, 3) human resources, 4) policy and plans, 5) command control and coordination, and 6) care delivery. IDIs and FGDs also provided insight on assessment methodologies for evaluating response capacity. Using these components, we then developed a framework consisting of a diagnostic and management approach that city leadership can undertake in MCI management to ensure effective functioning at various levels of incident response. ConclusionThe CAMERA framework offers novel and simplified guidance to policymakers and other stakeholders in their attempt to improve MCI response systems across cities globally.