Managing Incidents with Multiple Casualties

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Managing Incidents with Multiple Casualties
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AIM TO SAVE THE LARGEST NUMBER OF SURVIVORS FROM
A MULTIPLE CASUALTY INCIDENT
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MANAGING INCIDENTS WITH MULTIPLE CASUALTIES

• Understanding the multiple casualty scene
• Triage
• Practicals (outdoor and indoor)
• Management

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The MCI Scene

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THE INITIAL PROBLEM.
Casualties
Resources
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THE OBJECTIVE.
Casualties
Resources
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THE OBJECTIVE.
Casualties
Resources
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THE OBJECTIVE.
Casualties
Resources
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THE OBJECTIVE.
Casualties
Resources
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THE OBJECTIVE.
Casualties
Resources
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THE OBJECTIVE.
Casualties
Resources
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THE OBJECTIVE.
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TIME IS IMPORTANT

• THE GOLDEN HOUR
• The critical trauma patient has only 60
• minutes from the time of injury to reach
• definitive surgical care, or the odds of
• a successful recovery diminish
• dramatically.
• Pre-Hospital Trauma Life Support, Second Edition,
• Patient Assessment and Management, page 42. 1990.

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Maximum survivors.
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YOUR SCENE MANAGEMENT

• Command
• Safety
• Assessment
• Communication
• Triage
• Treatment
• Transport

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ANY QUESTIONS ?
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TRIAGE

• Large scale triage is the hardest job anyone in
  pre-hospital care will ever do.
• A.J Heightman, Mass Casualty Incident Management.
  
• A practical approach to solving complex
  operational dilemmas.

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TRIAGE
WHY ?

• To get the right patient in the right place at
  the right time.

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TRIAGE
WHEN ?

• Casualties exceed the number of skilled rescuers.

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TRIAGE
HOW ?

• By a system which is

• Dynamic
• Quick
• Safe
• Reproducible.

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TRIAGE CODING

• Priority Treatment Color
• Immediate 1 Red
• Urgent 2 Yellow
• Delayed 3 Green
• Dead Black

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PATIENT ACCOUNTABILITY
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Nuclear, biological, chemical incident
organization
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PRIMARY TRIAGE
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PRIMARY TRIAGE
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PRIMARY TRIAGE
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PRIMARY TRIAGE
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PRIMARY TRIAGE
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PRIMARY TRIAGE
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PEDIATRIC TRIAGE
Children are involved in multiple casualty
incidents. The over prioritizing of children
will take valuable resources away from more
seriously injured adults. Triage systems based
on adult physiology will not provide accurate
triage.
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THE SMART TAPE
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PRACTICAL EXERCISE
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SECONDARY TRIAGE
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SECONDARY TRIAGE
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ANY QUESTIONS ?
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YOUR SCENE MANAGEMENT

• Command
• Safety
• Assessment
• Communication
• Triage
• Treatment
• Transport

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SMART COMMANDER
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SMART MCI BAG
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ANY QUESTIONS ?
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TRAINING MATERIALS
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SUMMARY
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THANK YOU