Mass casualty incidents (MCIs) are diverse, unpredictable, and increasing in frequency, but preparation is possible and necessary. The nature of MCIs requires a trauma response but also requires effective and tested disaster preparedness planning. From an international perspective, the aims of this narrative review are to describe the key components necessary for optimisation of trauma system preparedness for MCIs, whether trauma systems and centres meet these components and areas for improvement of trauma system response. Many of the principles necessary for response to MCIs are embedded in trauma system design and trauma centre function. These include robust communication networks, established triage systems, and capacity to secure centres from threats to safety and quality of care. However, evidence from the current literature indicates the need to strengthen trauma system preparedness for MCIs through greater trauma leader representation at all levels of disaster preparedness planning, enhanced training of staff and simulated disaster training, expanded surge capacity planning, improved staff management and support during the MCI and in the post-disaster recovery phase, clear provision for the treatment of paediatric patients in disaster plans, and diversified and pre-agreed systems for essential supplies and services continuity. Mass casualty preparedness is a complex, iterative process that requires an integrated, multidisciplinary, and tiered approach. Through effective preparedness planning, trauma systems should be well-placed to deliver an optimal response when faced with MCIs.

大规模伤亡事件 (MCI) 是多种多样的、不可预测的并且频率越来越高，但准备工作是可能的和必要的。MCI 的性质要求对创伤做出反应，但也需要有效且经过测试的备灾计划。从国际角度来看，这篇叙述性综述的目的是描述优化 MCI 创伤系统准备所必需的关键组成部分，创伤系统和中心是否满足这些组成部分和改善创伤系统反应的领域。应对 MCI 所必需的许多原则都包含在创伤系统设计和创伤中心功能中。其中包括强大的通信网络、已建立的分诊系统以及保护中心免受安全和护理质量威胁的能力。然而，当前文献中的证据表明，需要通过在灾害准备规划的各个层面增加创伤领导者的代表、加强员工培训和模拟灾难培训、扩大应急能力规划、改进员工管理和 MCI 期间的支持，来加强 MCI 的创伤系统准备。在灾后恢复阶段，在灾难计划中明确规定儿科患者的治疗，以及多样化和预先商定的基本供应和服务连续性系统。大规模伤亡准备是一个复杂的、反复的过程，需要综合、多学科和分层的方法。通过有效的准备计划，创伤系统应该处于有利位置，以便在面对 MCI 时提供最佳响应。