Mass Causality Incident: We Have How many patients

1
Mass Causality Incident We Have How many patients

• Presented by
• Bill Milan NREMT-P, CCEMT-P

2
What is a Mass Causality Incident?

• Any Event that places excessive demands on
  personnel on hand or equipment on hand

3
Types of common MCIs

• Highway accidents
• Air Crashes
• Major Fires
• Train Derailments
• Building Collapses

• Hazardous Materials Releases
• Earthquakes
• Tornadoes
• Hurricanes
• Floods

4
Preparing for the Incident

• Preplanning
• Scene Management
• Post disaster follow up

5
Preplanning (phase 1)

• Preplanning includes frequent drills with
  multiple agencies to work together to better
  handle these incidents
• Should have a written plan for all responding
  agencies duties and all other needs for the
  incident management

6
Scene Management(phase 2)

• Scene Management begins with setting up a
  Incident Command System(ICS)

7
What is ICS?

• A Standardized Management System to be utilized
  in handling ALL types of emergencies to enhance
  emergency worker safety and effectiveness

8
Components of ICS

• Common Terminology
• Modular Organization
• Integrated Communications
• Command System
• Consolidated Action Plan

• Manageable Span of Control
• Designated Incident Facilities
• Comprehensive Resource Management

9
Communication

• Use common terminology when giving commands to
  reduce confusion(not using 10 codes or any other
  codes)
• Do most communications face to face
• Have a unified communication system
• Have a common command frequency

10
Modular Organization

• The ability to expand or contract the command
  system being used to fit the incident

11
Modular Organization cont
12
EMS ICS STRUCTURE
13
Manageable Span of Control

• Deals with the number of personnel under any
  individuals direct control
• Should range from 3 to 7
• IDEAL NUMBER IS 5

14
Designated Facilities

• Easy access
• Communications capability
• Equipment on-hand
• Computer capability
• Reference materials available

15
So Who Is In Charge Here??????

• This should be part of the preplanning document
  to eliminate confusion when a Incident occurs

16
Incident Commander

• Is a single individual or a group of individuals
  who oversee the Incident
• NOT ALWAYS THE FIRST ON SCENE OR THE SENIOR
  PERSON
• Should be the person who can organize the
  personnel and equipment most efficiently

17
You want me to go where????

• There should be several sectors established to
  manage the situation
• Each sector should have a officer to oversee the
  operations and report to the IC
• The sector officers must be strong supervisors
  and able to not get involved in the incident

18
Staging Sector

• This is a safe haven for personnel and equipment
• Should be within 3 minutes of the scene
• Very important to the success of the incident

19
Treatment Sector

• This is the area where the triaged patients are
  brought
• Patients are given tags to show treatment
  priorities and taken to proper area

20
Who Goes Where???

• Most places use START field guide to triage
  patients and place METTAG cards on patients
• START(Simple Triage And Rapid Transport)

21
START Triage

• Simple Triage and Rapid Transport
• Based on
• Ability to walk
• Respiratory effort
• Pulses/ perfusions
• Neurological status

22
START Triage
23
METTAG Cards(What are all the colors for?)

• Black(Dead or patients that have mortal wounds)
• Red(Most Critically Injured patients)
• Yellow(Less Critically Injured patients)
• Green(non-life or limb treatment)

24
METTAG
25
Why use the METTAG system

• Alerts care providers to patient priority
• Prevents re-triage of the same patient
• Serves as a tracking system

26
Where do all the patients go now??

• The Transportation sectors works with the
  treatment area and local hospitals to coordinate
  transport of patients
• Also sets up landing zones for Air Medical
  services to transport patients
• Makes sure there are means of transportation
  available at all times

27
Helispots and Heliports

• Helispot Temporary landing zones for
  helicopters
• Heliports Complex landing areas for
  helicopters, often with fueling and maintenance
  capabilities.

28
All patients are gone now what?

• Return all departments and equipment to service.
• Make a written report from all responding
  services of how the incident went
• Have a CISD(Critical Incident Stress Debriefing)
  for all responders
• Make available the written report to all services

29
Then ready yourself for the next MCI!