Comprehensive Outline of All-Cause Hazards Leading

to

Disaster-Level Mass Casualty Incidents for Hospitals

I. Natural Hazards

A. Meteorological Events

• Hurricanes/Tropical Storms: Wind damage, flooding, patient evacuation needs

• Tornadoes: Structural collapse, flying debris injuries

• Floods: Contaminated water, displacement of patients/staff

• Extreme Heat: Heatstroke, power grid overload

• Winter Storms: Hypothermia, transportation shutdowns, supply chain disruption

B. Geological Events

• Earthquakes: Building collapse, infrastructure failure

• Landslides: Road blockages, trauma injuries

• Tsunamis: Coastal hospital flooding, mass drownings

• Volcanic Eruptions: Ash inhalation, burns, infrastructure damage

C. Biological Events (Natural Outbreaks)

• Pandemic Influenza: Respiratory failure, ventilator shortages

• COVID-19-like Events: ICU surge, PPE shortages

• Ebola Virus: Hemorrhagic fever, isolation needs

• Zika Virus: Birth defects, vector control challenges

• West Nile Virus: Neurological complications

II. Technological Hazards

A. Infrastructure Failures

• Power Outage: Life-support system failure, generator dependency

• Water Supply Disruption: Hygiene issues, dialysis interruption

• HVAC Failure: Temperature regulation, infection control

• Medical Gas Failure: Oxygen supply interruption

B. Transportation Accidents

• Airplane Crash: Burn injuries, blunt trauma

• Train Derailment: Crush injuries, mass trauma

• Bus Collision: Pediatric or elderly casualties

• Maritime Accident: Drowning, hypothermia

C. Industrial Accidents

• Chemical Plant Explosion: Burns, blast injuries

• Toxic Gas Release: Chlorine gas: Respiratory distress; Ammonia: Eye and lung irritation; Hydrogen sulfide: Neurological effects

• Radiological Incidents: Nuclear power plant leak: Radiation sickness; Medical isotope spill: Contamination risk

D. Cybersecurity Incidents

• Ransomware Attack: EHR access blocked, delayed care

• Data Breach: Patient privacy compromised

• System Downtime: Medication errors, communication breakdown

III. Human-Caused Hazards

A. Acts of Violence

• Active Shooter: Gunshot wounds, lockdown procedures

• Bombing: Blast injuries, structural damage

• Chemical/Biological Terrorism: Sarin gas: Neurological failure; Ricin: Multi-organ failure; Anthrax: Respiratory or cutaneous infection

B. Hazardous Materials (HAZMAT) Incidents

• Chemical Spills: Gasoline: Burns, inhalation risk; Hydrofluoric acid: Severe tissue damage; Phenol: Systemic toxicity

• Biological Agent Release: Botulinum toxin: Paralysis; Smallpox: High contagion

• Radiological Dispersal Devices (Dirty Bombs): Radiation exposure, panic

C. Public Health Emergencies (Non-Natural)

• Foodborne Illness Outbreaks: E. coli, Salmonella

• Water Contamination: Cryptosporidium, lead poisoning

IV. Hospital-Specific Hazards

A. Fire / Explosion

• Operating Room Fire: Burns, evacuation

• Electrical Fire: Smoke inhalation, equipment loss

• Oxygen Tank Explosion: Blast injuries

B. Structural Collapse

• Building Failure: Entrapment, trauma

• Elevator Malfunction: Crush injuries, access delays

C. Internal Violence

• Patient-on-Staff Assault: Trauma, psychological impact

• Psychiatric Patient Incident: Hostage situations, injuries

D. Infection Control Breaches

• MRSA Outbreak: Isolation needs

• C. difficile Spread: GI complications

• Sterilization Failure: Surgical site infections

V. Cascading or Compound Events

• Earthquake → Fire → Power Outage

• Hurricane → Flooding → Disease Outbreak

• Cyberattack → EHR Downtime During Pandemic Surge

VI. Special Considerations

• Surge Capacity: ICU beds, triage protocols

• Supply Chain Disruption: Medications, PPE, food

• Staff Shortages: Burnout, illness, transportation issues

• Communication Failures: Radio, internet, paging systems

• Evacuation Challenges: Neonatal ICU, ventilated patients