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MULTI-CASUALTY INCIDENTS. A Review and Update for EMS Command. MCI Overview. General Purpose : To review/refresh Multi-Casualty Incidents and how they work in the Incident Command sequence Appropriate identification of an MCI Initiation of the Incident Command System - PowerPoint PPT Presentation
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MULTI-CASUALTYINCIDENTS
A Review and Update for
EMS Command
MCI Overview
• General Purpose:– To review/refresh Multi-Casualty Incidents
and how they work in the Incident Command sequence
• Appropriate identification of an MCI• Initiation of the Incident Command System• Build-out of the Incident Command System for:
– Small scale incidents– Large scale incidents
MCI Overview
• Performance Objectives– At the end of this presentation, the
participants shall be able to:• Implement the Incident Command System for
an MCI• Correctly identify an MCI• Successfully navigate their assigned role in a
mock MCI
?Has this happened to you
OR
Maybe you did this……..
Patients are in units and no one knows anything about them.
The Medic left scene with the first patient he/she saw.
You arrive. No information available but….”See my cool Jimmie Jacks”.
Trauma patient count confused by communications issues.
Packaged patients waited 10 minutes for transport units that were requested one by one.
There has to be a better way!!!!!!!
You can do this!!!!
Initiate the Incident Command Sequence
• 1st arriving unit officer should:• Assume command• Declare the incident an MCI• Request additional resources• Perform triage
Initiate the Incident Command Sequence
• The following functions must occur:– Triage– Treatment area, if appropriate (small v.
large scale)– Transport/Communications
Command Designation Options
• IC retains EMS functions (triage, treatment, etc.)
• IC designates an EMS Group Supervisor – Build out based on incident scope/span of
control
TRIAGE/TREATMENT
• Small scale incident– Apply Triage identifier (ribbon, tag)
– Report patient count to EMS Group Supervisor or IC
• Regardless of Triage color
– Initiate treatment of patients in place– No formal treatment area
• Large scale incident– Apply Triage identifier– Patients moved to designated Treatment
areas (Triage Officer)– Patient information gathered in Treatment
area (Treatment Officer)
TRIAGE/TREATMENT
Treatment Areas
• Large scale event• Assign group supervisor
– Sub-divide into appropriate colors• Location Considerations
– Safety– # of patients – Removal of pts from scene
• Refine patient count– Re-assess/re-triage– #/color
• Update resource needs
Transportation/Communications
– HospitalCommunications• Sm v Lg scale• “Call Down” plan• High priority pts to appropriate hosp.• Dispatch center likely overwhelmed• Role of Communications Group Sup v
individual transport units
– Movement of Patients• Based on hospital availability?• Coordinate w/ Staging• Record keeping
Communication Options
• Communications Officer may:– make all communications with hospital(s)– designate ALS consults only. All others
via Communications Officer.
Suppression Group
ICS for the MCI
Incident Commander
Triage Supervisor
Treatment Supervisor
Transport/ Communications
EMS Group Rescue Group
Incident Commander
Communi-cations
Treatment
Triage
Transport
EMS Group
1st arriving unit officer
In place or designated areas
Consider ALS provider, EMS supervisor
(Can later be used in Transp/Comm)
Command Resources
• Position documents– Medical Group Supervisor– Transportation Group Supervisor
• Patient tracking documents– Transport Stubs– Treatment Supervisor– Treatment Disposition
Version 11/27/07
MED GROUP SUPERVISOR TRANSPORTATIONSUPERVISOR
MED SUPPLY COORDINATOR
TRIAGE UNIT LEADER TREATMENT UNIT LEADER
MINOR MANAGER
DELAYED MANAGER
IMMEDIATE MANAGER
TREATMENT DISPATCHMANAGER
PORTER UNIT(S)
TRIAGE UNIT(S)
MORGUE MANAGER
INCIDENT COMMANDER
EMS BRANCH DIRECTOR
OPS SECTION DIRECTOR
STAGING MANAGER
MED COM COORDINATOR
SITUATION STATUSINCIDENT LOCATION
TASK OR OBJECTIVETIME
COMPLETEDTASK OR OBJECTIVE
TIMECOMPLETED
APPOINT TREATMENT LEADERPROVIDE VEST & WORKBOARD
ESTABLISH PERIMETER/ZONES
DETERMINE THE CASUALTY COLLECTION POINT
ESTABLISH / IDENTIFY TRIAGE UNITS
ASSIGN PORTER UNITS
ACCOUNTABILITY & PAR CHECKS
IDENTIFY TREATMENT AREAS BOTHVISUALLY AND VERBALLY
APPOINT TREATMENT MANAGERSPROVIDE VESTS, WORKSHEETS
SET UP MEDICAL SUPPLY
DETERMINE TRANSPORTATION NEEDS OF PATIENTS
START TRIAGE COMPLETED
MONITOR PERSONNEL, REHAB
REASSIGN PERSONNEL AFTER TASK COMPLETION
CONTACT TRANSPORTATION GROUP
TRANSPORT IN ORDER OF SEVERITY
ASSIGN LOADER UNITS
DETERMINE IF EXTRICATION AND HAZMAT GROUPS ARE REQUIRED
MONITOR PERSONNEL, REHAB
PATIENT COUNT
TOTAL
IMMEDIATE
DELAYED
MINOR
DECEASED
MONTGOMERY COUNTY INCIDENT COMMAND SYSTEM WORKBOARD ©
MEDICAL GROUP SUPERVISOR3STAGING LOCATION RESOURCE STATUS
NOTES
TREATMENT UNITTRIAGE UNIT
ALPHA
BR
AV
O
CHARLIE
DE
LTA
TACTICALCHANNEL
COMMANDCHANNEL
MEDICALGROUP
MEDCOMMCHANNEL
TRANSPORTATION SUPERVISOR
INCIDENT COMMANDER
EMS BRANCH DIRECTOR
OPERATIONS SECTION CHIEF
STAGING MANAGER
MEDICAL COMMUNICATIONS COORDINATOR
GROUND AMBULANCE COORDINATOR
AIR AMBULANCE COORDINATOR
TASK OR OBJECTIVETIME
COMPLETED
APPOINT COORDINATORSPROVIDE VESTS, WORKSHEETS
ESTABLISH AMBULANCE STAGING
ESTABLISH LANDING ZONE
ACTIVATE MEDCOMM
REQUEST MORE TRANSPORTATION UNITS AS NEEDED
TRANSPORT IMMEDIATE PATIENTS
TRANSPORT DELAYED PATIENTS
TRANSPORT MINOR PATIENTS
MAINTAIN DOCUMENTATION
DEACTIVATE MEDCOMM
DETERMINE TOTAL PATIENT COUNT AND SPECIAL TRANSPORT NEEDS
DETERMINE HOSPITAL CAPABILITIES
DECLARE INGRESS/EGRESS FOR GROUND TRANSPORT UNITS
ASSIGN LOADERS
NOTES CHARLIE
ALPHA
BR
AV
O
DE
LTA
MONTGOMERY COUNTY INCIDENT COMMAND SYSTEM WORKBOARD ©
TRANSPORTATION SUPERVISOR4
MEDICAL GROUP
CHANNEL
LOCATION
TOTAL
MEDICAL GROUP
CHANNEL
LOCATION
TOTAL
MEDICAL GROUP
CHANNEL
LOCATION
TOTAL
MEDICAL GROUP
CHANNEL
LOCATION
TOTAL
SITUATION STATUS
SITUATION STATUS
SITUATION STATUS
SITUATION STATUS
SITUATION STATUSINCIDENT LOCATION STAGING LOCATION RESOURCE STATUS
TACTICALCHANNEL
COMMANDCHANNEL
TRANSPORTGROUP
MEDCOMMCHANNEL
TOTAL NUMBER OF PATIENTS TRANSPORTED
Version 11/27/07
1 2 3
4 5 6
7 8
MONTGOMERY COUNTY INCIDENT MANAGEMENT SYSTEM ©
TRANSPORT RECORDER PAGE OF
TRANSPORT STUBSMCFRS MCIWorksheet # 4Version 11/27/07
MEDICAL GROUP
RECEVING MEDICAL FACILITY
TREATMENT AREA
REQUEST & ASSIGN PERSONNEL TO PATIENT TREATMENT AREAS
ENSURE SECONDARY TRIAGE IS COMPLETED
COORDINATE TRANSPORTATION EFFORTS WITH THE TREATMENT DISPATCH MANAGER
ENSURE PROPER DOCUMENTATION IS COMPLETED
TARP, FLAG, TENT, AND/OR CONES ADMINISTRATION BOX PATIENT ASSESSMENT BOX AIRWAY BOX IV BOX AND IV FLUIDS TRAUMA / BULK BANDAGE BOX LITTERS AND BACKBOARDS OXYGEN MULTILATOR SYSTEM INDIVIDUAL PATIENT CARE KITS
RESOURCESTASKS OR OBJECTIVES
1
BAR CODESTIME
INTIME OUT
NOTES
2
3
4
5
6
7
8
9
10
MONTGOMERY COUNTY INCIDENT MANAGEMENT SYSTEM ©
TREATMENT AREA MANAGER PAGE OF
MCFRS MCIWorksheet # 1Version 11/27/07
AGE/ SEX
M F
M F
M F
M F
M F
M F
M F
M F
M F
M F
BAR CODESTIME
INTIME OUT
NOTESAGE/ SEX
IMMEDIATEMANAGER
DELAYEDMANAGER
MINORMANAGER
TREATMENT AREA
REQUEST & ASSIGN PERSONNEL TO PATIENT TREATMENT AREAS
ENSURE SECONDARY TRIAGE IS COMPLETED
COORDINATE TRANSPORTATION EFFORTS WITH THE TREATMENT DISPATCH MANAGER
ENSURE PROPER DOCUMENTATION IS COMPLETED
TARP, FLAG, TENT, AND/OR CONES ADMINISTRATION BOX PATIENT ASSESSMENT BOX AIRWAY BOX IV BOX AND IV FLUIDS TRAUMA / BULK BANDAGE BOX LITTERS AND BACKBOARDS OXYGEN MULTILATOR SYSTEM INDIVIDUAL PATIENT CARE KITS
RESOURCESTASKS OR OBJECTIVES
1
BAR CODESTIME
INTIME OUT
NOTES
2
3
4
5
6
7
8
9
10
MONTGOMERY COUNTY INCIDENT MANAGEMENT SYSTEM ©
TREATMENT AREA MANAGER PAGE OF
MCFRS MCIWorksheet # 1Version 11/27/07
AGE/ SEX
M F
M F
M F
M F
M F
M F
M F
M F
M F
M F
BAR CODESTIME
INTIME OUT
NOTESAGE/ SEX
IMMEDIATEMANAGER
DELAYEDMANAGER
MINORMANAGER
MCFRS MCI Worksheet #2 Version 11/27/07
2
1
BAR CODESTAG
COLORTIME OUT
AGE/ SEX
M F
M F
HOSPITAL/DESTINATION
TRANSPORTUNIT
MONTGOMERY COUNTY INCIDENT MANAGEMENT SYSTEM ©
TREATMENT DISPOSITION PAGE OF
4
3M F
M F
6
5M F
M F
8
7M F
M F
9M F
NOTES
10M F
11M F
12M F
PATIENTCOUNT
PATIENTCOUNT
PATIENTCOUNT
MCFRS MCI Worksheet #2 Version 11/27/07
2
1
BAR CODESTAG
COLORTIME OUT
AGE/ SEX
M F
M F
HOSPITAL/DESTINATION
TRANSPORTUNIT
MONTGOMERY COUNTY INCIDENT MANAGEMENT SYSTEM ©
TREATMENT DISPOSITION PAGE OF
4
3M F
M F
6
5M F
M F
8
7M F
M F
9M F
NOTES
10M F
11M F
12M F
PATIENTCOUNT
PATIENTCOUNT
PATIENTCOUNT
•A/C Mike McAdams
•A/C “Rusty” Rothenhoeffer
•B/C Mark Davis
•Capt. LeRoy Gross
•Capt. Vicki Fowler
•Capt. Beth Sanford
•Lt. Jon Fiedler
To the following persons who contributed to the success of this program: