Resuscitation in a Multiple Casualty Event Roman Dudaryk, MD a,b , Ernesto A. Pretto Jr, MD, MPH c, * No commercial interests to report. a Division of Trauma Anesthesia, Department of Anesthesiology, Perioperative Medicine and Pain Management, Ryder Trauma Center, Jackson Memorial Hospital, University of Miami Miller School of Medicine, 1800 North West 10th Avenue T237, Miami, FL 33136, USA; b Division of Critical Care Medicine, Department of Anesthesiology, Perioperative Medicine and Pain Management, Ryder Trauma Center, Jackson Memorial Hospital, University of Miami Miller School of Medicine, 1800 North West 10th Avenue T237, Miami, FL 33136, USA; c Division of Transplant and Vascular Anesthesia, Department of Anesthesiology, Perioperative Medicine and Pain Management, Jackson Memorial Hospital, University of Miami Miller School of Medicine, 1800 North West 10th Avenue T237, Miami, FL 33136, USA * Corresponding author. E-mail address: eapretto@med.miami.edu KEYWORDS  Disaster  Multiple casualty event  Mass casualty event  Resuscitation  Disaster medicine  Life-supporting first aid  Bystander response  Advanced life support KEY POINTS  Increasingly, man-made disasters, such as wars, terrorism, and technologic disasters, are the cause of multiple casualty events.  Resuscitation in a multiple casualty event consists of the life support chain spanning basic life support, in the form of bystander-administered life-supporting first aid, and advanced life support by professional rescuers in the field, to prolonged life support and definitive care by medical and surgical teams in hospitals.  Bystander first aid continues to be the weakest link in the life support chain in everyday emergencies and multiple casualty events because of a lack of education and training programs for the public.  Advances in triage methodology have improved the allocation of limited resources in these events.  Common mechanisms of cardiac arrest among victims of a multiple casualty event are hypovolemia, traumatic brain injury, and airway obstruction.  Portable ultrasound has revolutionized diagnostic traumatology. Anesthesiology Clin 31 (2013) 85–106 http://dx.doi.org/10.1016/j.anclin.2012.11.002 anesthesiology.theclinics.com 1932-2275/13/$ – see front matter Ó 2013 Elsevier Inc. All rights reserved.