Transcript Mass Casualty Incidents

Mass Casualty Incidents
What constitutes an MCI?
• More than one patient and system resources
are taxed at the time
• Anytime there are more Patients than
Rescuers
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The Goal of all Responders
Should be to
“Save as Many Lives
as Possible”
The Basics
• Your first 5 minutes will determine how the
incident will go: Emotions are Contagious
• Think Incident Command
• Think Triage
• Pre-plan and train or you will fail
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Incident Command
• First person on scene sends an Initial On
Scene Report
– See as much as the scene as you can
in 30 seconds
– Process what you see and hear
– THINK - Don’t Panic
– Paint an accurate picture of the scene
with your brief report
– Declare yourself the IC, Where the IC Post will
be and where responding units should report to 7
Triage - “To sort by priority”
• Hard to do for the inexperienced, but it is
really very easy
• All responders must know
what the goal is……..
• Sometimes most severely injured patient
does not get treated and dies
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How to Triage using the Tags
• Conduct an Initial Walkthrough
• Tag Patients as
Red, Yellow, Green or Blue
• Remember - Triage is constantly conducted
so don’t panic with your first tag
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RED - IMMEDIATE
• Severely injured but able
to be saved with relatively
quick treatment and
transport
– Examples:
° Severe bleeding,
° Severe Shock,
° Open Chest or
Abdominal Wounds,
° Unconscious but has
pulse and is breathing,
° Several Major Fractures
• Emotionally Out Of
Control (Emotions are Contagious)
• Injured Rescuers - For
Morale of other Rescuers
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Yellow - Delayed
• Injured but unable to walk on their own
• These people will be treated!
– Don’t over tag people because of
bystanders or age (children)
• Examples:
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severe burns but no respiratory distress,
spinal injuries
moderate blood loss
conscious with head injuries
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Green - Walking Wounded or
Mortal Wounds
• Minor injures that need to be assessed or treated
but not right away.
• Ex: Minor fractures, minor bleeding
• Some systems use the green tag for obviously
mortal wounds where death appears reasonably
certain
– (these patients can be retriaged later if
personnel and/or resources become available)
• Have a Refusal Log handy and use it
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Blue/Black - Obviously Dead
• Some systems include Dead or Obviously
Dying
• Depends on local protocols
• Examples:
– cardiac arrest
– respiratory arrest but has pulse
– etc.
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Treatment
• Once Triage is done, move patients to the
proper treatment area
• Use tarps, cones, flags, to mark areas
• Control access to areas
• Constantly re-triage
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Transportation
• Ambulances report to staging area
• Transportation Officer assigns patients to
ambulances
• Broadcast the “All Immediates
Transported”
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Management of the Deceased
• If it is a crime scene, leave the bodies
where they are
• Cover the victim with a white sheet if
possible
• If the bodies can be seen by the surviving
patients, consider moving them
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Designate a Temporary
Morgue Area
• Should be out of site from bystanders and
victims
• Maintain Access Control
– loved ones
– media
– thieves
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Handling the Dead
• Show respect and dignity
• Reduce the pain that witnesses may feel
(they will watch)
• Package them as if they were still alive
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Body Bags
• Always choose white instead of black if
possible
– white is pure and is associated with patients
– black resembles a trash bag
• Inner plastic lining that can stay intact for
viewing
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Carrying the Dead
• It is virtually impossible to carry the bag
without support
• Always use a backboard or better yet,
a scoop stretcher
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Emotional Distancing Techniques
• Double Glove and
Tape Wrists of
Personnel
• Use shovels and not
hands to pick up body
parts
• Cover the body or at
least the head before
picking it up
• Use Vicks VapoRub
under a mask when
necessary
• Scoop Stretchers when
possible
• Secure the body to the
backboard well so that
it does not move
• Volunteers only !
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Summary - Top Ten
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First On Scene Report
Escalated Response
Think Incident Command
Triage
Treat by Priority
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Summary - Top Ten
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Separate victims by priority
Transport by priority
Re-Triage Constantly
Only move the dead when it is effecting
patient care
10. Train, Train, Train and Practice
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