Transcript Multiple Casualty Training

Mass Casualty
Incident
Preparation for EMS
Mass Casualty Incident (MCI)
• Definition
– An incident which produces
multiple casualties such
that emergency services,
medical personnel and
referral systems within the
normal catchment area
cannot provide adequate
and timely response and
care without unacceptable
mortality and/or morbidity.
Chronology of a Disaster
• Incident with multiple casualties reported to CCE
Central Dispatch
–
–
–
–
Police/Fire/EMS are dispatched by CCE.
Incident Command is established on scene
Size up identifies mass casualty event.
Incident Commander notifies Central Dispatch to activate the
Mass Casualty Plan
– Incident Commander establishes staging area and requests
additional resources.
Flow Chart
Law
911
Call
Fire
Incident
Command
Size-up
Activate
Mass
Casualty
Plan
Establish
Command
Post
EMS
Central
Dispatch
Chronology (continued)
• Central Dispatch Activates
Mass Casualty Plan
– Central Dispatch notifies
area hospitals of plan
activation
– Central Dispatch obtains
available EMS units from
adjacent locations and
directs them to staging
– Central Dispatch notifies
County Coordinator of plan
activation
– Central Dispatch requests
channel priority
Ambulance
EMS Ground
155.295 VHF
Staging
Helicopter
Transport
EMS
Ground
Establish
Command
Post
Alternate
EMS
Command
Central
Dispatch
Victim
Collection
Area
Triage
Activate
Hospital
Emergency
Plan
Alert
Nearest
Hospital
On-scene
Treatment
K
Medical
Control
155.340 VHF
HERN
TX or 800Mghz
Notify
Area
Hospitals
Notify
EMC
Activate
Hospital
Emergency
Plan
Activate
EOC
Determine
Capacity
PIO
Emergency
Declaration
State
EOC
Tracking
Additional
Resources
EMS RESPONSE
• First arriving unit:
Senior EMS responder
assumes Command role
–
–
–
–
–
Put on EMS Command vest
Assist IC in locating staging
Establish victim collection area
Deploy Mass Casualty Kit
Strip rig for use at triage
EMS RESPONSE
• First arriving Unit:
Second EMS responder
assigned role of Triage
Officer
- Put on Triage Officer Vest
- Triage and tag victims
- Use MFR or medically trained
volunteers
EMS RESPONSE
• Second Arriving Unit:
Third EMS person assigned role of
transportation officer
- Put on Transportation Officer
vest
- Establish communications with
Medical Control Hospital via
HERN on 155.340
- Establish communications with
staging on EMS Ground 155.295
- Strip rig of gear for use at victim
collection point
EMS Response
• Second arriving Unit:
Fourth EMS responder
assigned role of Treatment
Officer
- Put on Treatment Officer vest
- Supervise establishment of
victim collection area
- Supervise treatment of
victims in collection area
Victim Collection Point
• Select secure area with
protection from further injury
• Accessibility for transporting
ambulances
• Use ground sheets from
mass casualty kit
• Identify each Priority area
with colored flag
Ambulance
EMS Ground
155.295 VHF
Staging
Helicopter
Transport
EMS
Ground
Establish
Command
Post
Alternate
EMS
Command
Central
Dispatch
Victim
Collection
Area
Triage
Activate
Hospital
Emergency
Plan
Alert
Nearest
Hospital
On-scene
Treatment
K
Medical
Control
155.340 VHF
HERN
TX or 800Mghz
Notify
Area
Hospitals
Notify
EMC
Activate
Hospital
Emergency
Plan
Activate
EOC
Determine
Capacity
PIO
Emergency
Declaration
State
EOC
Tracking
Additional
Resources
Coordination
• Treatment Officer advises
Transportation Officer when
victim ready for transport.
• Staging sends ambulance and
load patient
• Treatment Officer advises
Medical Control of patient’s
 Priority
 Chief complaint
 Gender and age
• Medical Control assigns
hospital destination
Coordination (continued)
• Transportation Officer
verbally advises ambulance
of destination
• Ambulance transports
patient observing radio
silence unless en-route
emergency
• Ambulance monitors HERN
on 155.340
• Once patient delivered,
ambulance returns to
Staging for re-assignment
Flow Chart continued
Release
NMH
Treatment
Transfer
To Other
Facility
CAH
Morgue
CMH
Otsego
Munson
Straits
Staff & Equipment
• Mass Casualty Kit
- Request from nearest EMS
agency
• Fire and first responders
– Move patients to established
Collection Points
• Arriving EMS units
– Report to staging
– Move up when directed by
Transportation Officer
Staging
• Staging area established by
IC with advice from Medical
Command
• CCE notified of Staging
Location
• Staging and Transportation
communicate on freg.155.295
• Assets and Resources are
dispersed
General Considerations
• Agency Responses
– Police
– Fire
– EMS
• Command Responsibility
– Initial Agency on Scene
• Multiple Disciplines
– Unified Command
Communication
• Obstacles
– Terrain
– Different Frequencies
– Overloaded channels
• Hospital
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–
–
–
Medical Control
Patient Routing
Transportation Officer
Staging Officer
Things to Remember…
• Maintain strict radio procedures
• Enroute communications must
be limited to urgent matters only
• Transport patients in adequate
vehicles
• Transport patients with
adequate escort staff
• Maintain a log of all Patients
(PCR)
IN REVIEW
Flow Chart
Law
911
Call
Fire
Incident
Command
Size-up
Activate
Mass
Casualty
Plan
Establish
Command
Post
EMS
Central
Dispatch
Ambulance
EMS Ground
155.295 VHF
Staging
Helicopter
Transport
EMS
Ground
Establish
Command
Post
Alternate
EMS
Command
Central
Dispatch
Victim
Collection
Area
Triage
Activate
Hospital
Emergency
Plan
Alert
Nearest
Hospital
On-scene
Treatment
K
Medical
Control
155.340 VHF
HERN
TX or 800Mghz
Notify
Area
Hospitals
Notify
EMC
Activate
Hospital
Emergency
Plan
Activate
EOC
Determine
Capacity
PIO
Emergency
Declaration
State
EOC
Tracking
Additional
Resources
Flow Chart continued
Release
NMH
Treatment
Transfer
To Other
Facility
CAH
Morgue
CMH
Otsego
Munson
Straits
QUESTIONS?