Emergency management plan for mass casualty incidents: from the 2009 L’Aquila earthquake to the evolution of hospital emergency preparedness in the Marche Region, central Italy.

Assuming that Emergency Management Plan For Mass Casualty Incidents (PEIMAF) only if prepared to meet the requirements of the law and not calibrated, tested and updated to the changing needs of hospitals and the local context, they are useless and doomed to fail", it is set to a study to research the issues and problems related to the response of a real mass casualty incident like the L'Aquila earthquake of 2009, whether they were present in the plans of hospitals in the province of Ancona and thus improve the PEIMAF the Marche Region in an optical uniformity and integration. Research methods. First case study: were administered questionnaires to open and closed questions, and / or interviews with staff in the hospital San Salvatore, coordinators of MEDEVAC, leaders of four Operations Centres of 118 'Abruzzo, responsible for the emergency departments of hospitals in the Abruzzo region; Second case study: were administered questionnaires to closed questions and open to the staff of hospitals in the province of Ancona, performed data processing and a briefing with representatives hospital to highlight the issues, made ​​a command post exercise followed by a debriefing, accomplished scale exercise at the emergency departments of Ancona; Results. In the first case study the problems were mainly related to the lack of planning and / or disclosure thereof. In the second case study has highlighted the lack of training of the staff even if you noticed a problem with raising the awareness of the importance of planning. The major problems have occurred on early warning, communication, coordination, press release. Conclusion Given the path taken in the Marche region is important to continue to work while maintaining a continuous feedback between the components of the emergency response delegated to such Civil Protection, Disaster Medical Assistance Team (ARES -ITALIA-), hospital coordination groups; make annual exercises, stimulate ongoing development of contingency plans.