Morris, NaomiAlRamadhan, Abdulilah Adnan J2025-12-152025https://hdl.handle.net/20.500.14154/77490Primary health care centres, or PHCs, can triage, stabilise, and offload hospitals during mass casualty incidents; MCIs, however, are not yet ready in Saudi Arabia. This study assessed PHC preparedness in the Al Ahsa Health Cluster, a high-risk area for road traffic events and mass gatherings. We used a convergent mixed-methods design and collected data in August and September 2025 through interviews with six PHC directors and four cluster leaders, a contextual staff survey of about 95 respondents, and a review of administrative records on volumes and facility layout. Thematic analysis guided qualitative findings, and descriptive statistics supported triangulation. Results showed a consistent gap between basic capability and surge performance. Written and rehearsed MCI protocols were missing. Training emphasised evacuation and BLS over triage, team roles, and handover. Crash carts and ambulance kits lacked standard content and routine audits. Communication relied on informal calls instead of role-based hotlines and structured reports to hospitals and the Saudi Red Crescent Authority. PHCs are underused assets because governance, protocols, and communication systems are weak. We recommend a short PHC MCI playbook, quarterly functional drills, a dedicated clinical hotline to the cluster command centre, and standardised crash carts with monthly checks to speed care and improve coordination.72enMass Casualty IncidentEmergency PreparednessPrimary Health CareSurge CapacityDisaster PlanningSaudi Arabia.Thesis