Considerations for the vertical evacuation of hospitalized patients under emergency conditions.

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.