Considerations for the vertical evacuation of hospitalized patients under emergency conditions


  • Paul P. Rega, MD, FACEP
  • Gregory Locher, EMT-P
  • Heidi Shank, RN, BSN
  • Kendra Contreras, RN, BSN
  • Christopher E. Bork, PhD, EMT-B, FASAHP



hospital, evacuation, HICS, disaster, healthcare facilities


Hospitals and other healthcare institutions in the twenty-first century face myriad challenges to their survival against a number of threats from many sources. A number of those threats, eg, internal, external, accidental, or intentional, may require the prompt evacuation of both patients and staff. Although rare, this possibility is becoming more frequent in the United States. Unfortunately, despite accrediting agencies’ mandates, there is a profound paucity of strategic and tactical guidelines in the medical literature. The purpose of this article is to present a strategic methodology for evacuation, particularly emergent evacuation, within the National Incident Command System/Hospital Incident Command System framework and to explore the tactics that should be considered when relocating multiple patients in various degrees of medical compromise.

Author Biographies

Paul P. Rega, MD, FACEP

Assistant Professor, Department of Public Health and Preventive Medicine, University of Toledo, Toledo, Ohio; Department of Emergency Medicine, College of Medicine, University of Toledo, Toledo, Ohio.

Gregory Locher, EMT-P

NWO Healthcare System Planning/Exercise/ Training Coordinator, Hospital Council of Northwest Ohio, Toledo, Ohio.

Heidi Shank, RN, BSN

Director of ICU and Step-Down Unit, Bay Park Community Hospital, Oregon, Ohio.

Kendra Contreras, RN, BSN

Director of Emergency Center and Short Stay Unit, Bay Park Community Hospital, Oregon, Ohio.

Christopher E. Bork, PhD, EMT-B, FASAHP

Professor and Director of Homeland Security, Department of Public Health and Preventive Medicine, College of Medicine, University of Toledo, Toledo, Ohio; Professor, College of Nursing, University of Toledo, Toledo, Ohio.


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How to Cite

Rega, MD, FACEP, P. P., G. Locher, EMT-P, H. Shank, RN, BSN, K. Contreras, RN, BSN, and C. E. Bork, PhD, EMT-B, FASAHP. “Considerations for the Vertical Evacuation of Hospitalized Patients under Emergency Conditions”. American Journal of Disaster Medicine, vol. 5, no. 4, July 2010, pp. 237-46, doi:10.5055/ajdm.2010.0029.