Transcript Summit County Mass Casualty Plan

Summit County
Mass Casualty
Incident Plan
Summary of Changes
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Terminology is NIMS compliant.
Term hospital has been expanded to
include free standing emergency
facilities.
LVI language has been removed.
Directions to facilities removed.
“Police” is now law enforcement.
Summary of changes
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Law enforcement duties have been
expanded.
CISM for patients, families, as well as
responders will be coordinated by the ADM
and American Red Cross.
Allied health personnel removed.
“Akron Safety Communications” is replaced
with SC Sheriff’s Communications.
Summary of changes
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“Red Cross” replaced with American Red
Cross of Summit and Portage Counties.
ARC will provide patient tracking.
Number of triage tags reduced from 100 to
25 per med unit; triage tape added.
No decon tape as the triage tags will
indicate.
Summary of changes
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Triage tags attached to wrist or ankles and
not on clothing.
Communications to emergency care units
routed through the EMS Transport Unit
Leader.
Law enforcement will now assign a liaison to
the FBI and coordinate “in custody” patients
with EMS if applicable.
Summary of changes
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Section now included for explanations of
acronyms.
Sample ICS organization chart now
included.
Summit County Mass Casualty Trailer
Activation Policy now included.
Glossary of terms now included.
Section of ready to use ICS forms now
included.
Mass Casualty Incident
(MCI)
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Incident where the number of victims
exceeds the number of rescuers and
resources that can be immediately
triaged, treated and transported.
or
25 or more victims.
Command Structure
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Incident Commander (MCI)
– Ranking fire or rescue officer at the scene
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EMS Branch Director or Group Supervisor
– In charge of all EMS related actives
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EMS Triage Group Supervisor/Unit Leader
– In charge of all triage, tagging, & movement into
the EMS Treatment Area.
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Reports to EMS Branch Director or Group Supervisor
EMS Treatment Group Supervisor/Unit Leader
– In charge of all activities including treatment &
retriage within the EMS Treatment Area.
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Reports to EMS Branch Director or Group Supervisor
Command Structure
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EMS Transport Group Supervisor/Unit Leader
– In charge of all patient movement from the EMS
Transportation Unit to the receiving emergency care
facilities. Communications with the coordinating
hospital.
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Reports to EMS Branch Director or Group Supervisor
Is advised by the Coordinating Hospital where victims are to
be transported
EMS Transport
needed)
Group
Supervisor
Aid
(if
– Assists the EMS Transport Group Supervisor in
duties as assigned.
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Reports to EMS Transport Group Supervisor
Command Structure
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Safety Officer
– Recommends and develops measures for assuring
personnel safety; to assess or anticipate hazards
and unsafe situations.
Command Structure
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Ambulance Staging Manager (if needed)
– Maintains inventory control over
staging.
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ambulance
Reports to EMS Transport Group Supervisor
Mass Decontamination Unit Leader
– In charge of all mass decontamination operations
onsite.
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Staging Area Manager
– In charge of all off-site equipment & manpower.
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Maintains inventory control over staging area and
available resources.
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Reports to Incident Commander
Joint Information Center
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This is a fixed facility for dissemination
of public information.
All agencies involved in the MCI are
represented in the JIC.
Emergency Operations
Center
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A fixed facility, away from the scene
where involved agencies’
representatives, elected officials and
support agencies make command
decisions. This will usually be activated
when multiple agencies are involved.
There is never more than one EOC.
Direction & Control Areas
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Command Post
– Fixed, clearly marked, on-scene location where Incident Commander
makes command decisions and coordinates all scene operations.
– A command post shall be used for each incident scene.
 Identified by green flashing light
Cold Zone
– Perimeter separating bystanders & traffic from the incident.
Warm Zone
– Separates the Incident Area from the Support Area.
 Accessible to only active working personnel.
 For safety, media not permitted without an escort.
Hot Zone
– Restricted area, usually meaning some type of protective measure is
needed for entry. Not always activated during an MCI.
– In a Hazardous Materials incident, decontamination may be required for
all persons and equipment leaving the hot zone.
Direction & Control Areas
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EMS Transport Unit
– Located within the inner perimeter where patients
are moved for retriage, treatment & prioritization of
transport.
 Divided in to rows with colored flags or markers.
 Red, Yellow & Green
 Retagging can take place
Special Situations
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Burns
– Four or less victims (adult/children) transported to
Akron Children's Hospital Burn Unit.
– With five or more victims, the four most critical will
be transported to Burn Unit, the remainder rotated
to each receiving hospital.
– Coordinating hospital notifies Burn Unit of total
number of burn victims & locations of victims.
– Medical Director of the Burn Unit will decide on
any patients to be transshipped or further care
instructions.
Special Situations
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Children
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Twenty-five or more victims are rotated to all hospitals.
The more seriously injured will be transported to
Children’s.
DOA’s
All DOA’s are left in place until released by
the Medical Examiner.
Special Situations
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Physician requested at the scene
– EMS Medical Advisor for the community may
choose to respond.
– If an additional physician is needed, the EMS
Branch Director or Group Supervisor should request
the EMS Transport Group Supervisor to notify the
coordinating
hospital
of
the
specific
indications/situation which requires a physician on
the scene.
– A returning EMS unit or law enforcement officer
may assist in the relay of the physician to the
scene.
Incident Operations
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First unit on the scene will give a survival scan,
estimate number of victims & types of injuries .
In an obvious MCI, the first unit will advise the
local dispatch who will call Summit County
Sheriff’s Communications Center. It should be
clearly stated this is a MASS CASUALTY
INCIDENT.
All operations will be in plain English. NO radio
codes will be used.
Consider activating mass casualty trailer and
whether chempaks should be brought to the
scene.
DOA’S
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All DOA’s are left at the scene until released
by the Medical Examiner. DOA’s should not
be moved unless:
– Access is needed to aid other victims
When a DOA is moved-try not to
Disturb any evidence, keep the victim as close to
their original place (position) as possible.
– On their MCI tag, make notations/diagrams.
ACTIVATING MCI
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Once your communications center has been
instructed by the senior officer to activate the
MCI the following will occur:
Notify Summit County Sheriff’s Communications
Center. Speak with a supervisor ONLY &
advise:
– Location/staging of the incident
– Estimate of amount of victims & type of injuries
All further communications will be to the dispatcher
on the dispatch frequency (MERC) and to the
coordinating hospital by cellular phone.
Summit County Sheriff’s
Communications Center
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Contacts
Summit
County
Emergency
Management Agency, American Red Cross,
Summit County Medical Examiner.
Response Duties & Responsibilities
Coordinating Hospital
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Is the medical control for the involved community.
Receives initial calls.
Maintains constant Communication with the EMS
Transportation Group Supervisor or Unit Leader
ONLY, at the scene via cellular telephone, MERC Fire
5 or landline telephone.
Advises the EMS Transport Group Supervisor which
hospital patients are to be transported to.
Notifies all county hospitals on HITS hotline of the
situation & updates them periodically.
Coordinates with other counties’ Coordinating Hospital
the distribution of the victims when out of county
hospitals are involved in the MCI Event.
Response Duties & Responsibilities
Receiving Hospitals
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Area hospitals will be notified by Coordinating
Hospital. The Receiving Hospital will discuss
any special concerns with the Coordinating
Hospital via the HITS phone.
Receiving Hospitals will work with American
Red Cross on victim processing and
notifications.
Activate their in house disaster plans
Mental health support for patients and families
may be provided by receiving facility staff.
Response Duties & Responsibilities
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Fire Departments
– All fire suppression and rescue activities.
– May also handle EMS depending on local procedure.
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Emergency Medical Services
– All EMS activities relating to triage, patient care &
transport.
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Law Enforcement
– All activities regarding scene security.
– Work with other emergency personnel to establish
cold, warm & hot zones, crowd control,
investigation, security for temporary morgue etc.
Response Duties & Responsibilities
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Medical Examiner
– Responsibility for the deceased individuals.
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American Red Cross
– Collection of patient names & destinations from
receiving hospitals/emergency care facilities.
– Receipt of health & welfare inquiries from public.
– Establishment of shelter & feeding facilities for
displaced families.
Response Duties & Responsibilities
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Summit
Agency
County
Emergency
Management
– Assistance to the Incident Commander by locating
special resources at the local, state & federal level.
– Coordination of special volunteer resources.
– Establish Emergency Operations Center when
requested by the Incident Commander.
– Notify Akron Regional Hospital Association.
Response Duties & Responsibilities
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Amateur Radio
– Summit County Amateur Radio personnel will be
used as the primary backup to normal two-way and
telephone communications systems.
– May be used as the primary link for relaying patient
info between hospitals & American Red Cross.
Medical Response/Patient
Care
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First EMS unit estimates number of casualties
and type of incident.
Incident Commander designates a Command
Post & an EMS Branch Director or Group
Supervisor.
EMS Group Supervisor designates the EMS
Triage Unit Leader, EMS Treatment Unit Leader
& EMS Transport Unit Leader.
Triage Tags & Equipment
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Each community EMS unit in Summit County
will be equipped with a package of 25 Summit
County Triage Tags.
Triage tape system will be located on each
EMS unit for rapid assessment.
Triage tags must be completed on all patients.
Additional equipment
– Vest for each unit leader.
– Colored flags or markers for patient areas.
Triage Tags & Equipment
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Red Tag
– Most urgent, 1st priority
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Patients with life-threatening injury that have a high
probability of survival if given immediate care and
rapidly transported.
Yellow Tag
– Urgent, 2nd priority
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Victims with injuries that may become life-threatening
if not treated.
Triage Tags & Equipment
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Green Tag
– Non-urgent, 3rd priority
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Patients with localized injuries that need treatment but do
not have an immediate systemic implication.
Black Tag
– DOA, 4th priority
Patients who are obviously dead or in cardio-pulmonary
arrest.
 Patients whose injuries are so grave that they have little
chance of survival regardless of care.
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Special Situations
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If the initial responding EMS unit is not
capable of transmitting on cellular
phone the safety services radios will
be used (MERC).
Amateur radio will be considered for
additional backup.
Should the HITS fail, backup would be
identical to above (MERC).
The ARC and the Barberton RC will be the
lead agencies to handle RC responsibilities.
Questions??