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Mass CasualtyIncident
Preparation for EMS
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Mass Casualty Incident (MCI)
• Definition– An incident which produces
multiple casualties such that emergency services, medical personnel and referral systems within the normal catchment area cannot provide adequate and timely response and care without unacceptable mortality and/or morbidity.
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Chronology of a Disaster • Incident with multiple casualties reported to CCE
Central Dispatch– Police/Fire/EMS are dispatched by CCE.– Incident Command is established on scene– Size up identifies mass casualty event.– Incident Commander notifies Central Dispatch to activate the
Mass Casualty Plan– Incident Commander establishes staging area and requests
additional resources.
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Flow Chart
911Call
911Call Fire
Fire
LawLaw
EMSEMS
IncidentCommand
IncidentCommand
Size-upSize-up
ActivateMassCasualtyPlan
ActivateMassCasualtyPlan
CentralDispatch
CentralDispatch
EstablishCommandPost
EstablishCommandPost
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Chronology (continued)
• Central Dispatch Activates Mass Casualty Plan – Central Dispatch notifies
area hospitals of plan activation
– Central Dispatch obtains available EMS units from adjacent locations and directs them to staging
– Central Dispatch notifies County Coordinator of plan activation
– Central Dispatch requests channel priority
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EstablishCommandPost
EstablishCommandPost
NotifyEMC
NotifyEMC
EMS Ground
StagingStaging
AmbulanceAmbulance
HelicopterHelicopter
EMS Ground155.295 VHF
CentralDispatch
CentralDispatch
AlternateAlternateTransport
Transport
KK
EMSCommand
EMSCommand
VictimCollectionArea
VictimCollectionArea
On-sceneTreatment
On-sceneTreatment
TriageTriage
MedicalControl
MedicalControl
NotifyArea Hospitals
NotifyArea Hospitals
DetermineCapacity
DetermineCapacity
ActivateHospitalEmergencyPlan
ActivateHospitalEmergencyPlan
ActivateHospitalEmergencyPlan
ActivateHospitalEmergencyPlan
AlertNearest Hospital
AlertNearest Hospital
TX or 800Mghz
155.340 VHF HERN
ActivateEOC
ActivateEOC Tracking
Tracking
AdditionalResources
EmergencyDeclaration
EmergencyDeclaration
StateEOC
StateEOC
PIOPIO
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EMS RESPONSE• First arriving unit:
Senior EMS responder assumes Command role– Put on EMS Command EMS Command vest– Assist IC in locating staging– Establish victim collection area– Deploy Mass Casualty Kit– Strip rig for use at triage
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EMS RESPONSE
• First arriving Unit:
Second EMS responder assigned role of Triage Officer
- Put on Triage OfficerTriage Officer Vest
- Triage and tag victims
- Use MFR or medically trained volunteers
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EMS RESPONSE
• Second Arriving Unit:Third EMS person assigned role of
transportation officer- Put on Transportation OfficerTransportation Officer
vest- Establish communications with
Medical Control Hospital via HERN on 155.340
- Establish communications with staging on EMS Ground 155.295
- Strip rig of gear for use at victim collection point
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EMS Response
• Second arriving Unit:Fourth EMS responder
assigned role of Treatment Officer
- Put on Treatment OfficerTreatment Officer vest- Supervise establishment of
victim collection area- Supervise treatment of
victims in collection area
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Victim Collection Point
• Select secure area with protection from further injury
• Accessibility for transporting ambulances
• Use ground sheets from mass casualty kit
• Identify each Priority area with colored flag
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EstablishCommandPost
EstablishCommandPost
NotifyEMC
NotifyEMC
EMS Ground
StagingStaging
AmbulanceAmbulance
HelicopterHelicopter
EMS Ground155.295 VHF
CentralDispatch
CentralDispatch
AlternateAlternateTransport
Transport
KK
EMSCommand
EMSCommand
VictimCollectionArea
VictimCollectionArea
On-sceneTreatment
On-sceneTreatment
TriageTriage
MedicalControl
MedicalControl
NotifyArea Hospitals
NotifyArea Hospitals
DetermineCapacity
DetermineCapacity
ActivateHospitalEmergencyPlan
ActivateHospitalEmergencyPlan
ActivateHospitalEmergencyPlan
ActivateHospitalEmergencyPlan
AlertNearest Hospital
AlertNearest Hospital
TX or 800Mghz
155.340 VHF HERN
ActivateEOC
ActivateEOC Tracking
Tracking
AdditionalResources
EmergencyDeclaration
EmergencyDeclaration
StateEOC
StateEOC
PIOPIO
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Coordination
• Treatment Officer advises Transportation Officer when victim ready for transport.
• Staging sends ambulance and load patient
• Treatment Officer advises Medical Control of patient’s Priority Chief complaint Gender and age
• Medical Control assigns hospital destination
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Coordination (continued)
• Transportation Officer verbally advises ambulance of destination
• Ambulance transports patient observing radio silence unless en-route emergency
• Ambulance monitors HERN on 155.340
• Once patient delivered, ambulance returns to Staging for re-assignment
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NMHNMH
CAHCAH
CMHCMH
OtsegoOtsego
MunsonMunson
StraitsStraits
TreatmentTreatment
ReleaseRelease
TransferTo OtherFacility
TransferTo OtherFacility
MorgueMorgue
Flow Chart continued
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Staff & Equipment
• Mass Casualty Kit
- Request from nearest EMS agency
• Fire and first responders– Move patients to established
Collection Points
• Arriving EMS units– Report to staging– Move up when directed by
Transportation Officer
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Staging
• Staging area established by IC with advice from Medical Command
• CCE notified of Staging Location
• Staging and Transportation communicate on freg.155.295
• Assets and Resources are dispersed
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General Considerations • Agency Responses
– Police– Fire – EMS
• Command Responsibility– Initial Agency on Scene
• Multiple Disciplines– Unified Command
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Communication
• Obstacles– Terrain– Different Frequencies– Overloaded channels
• Hospital– Medical Control– Patient Routing– Transportation Officer– Staging Officer
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Things to Remember…• Maintain strict radio procedures• Enroute communications must
be limited to urgent matters only• Transport patients in adequate
vehicles• Transport patients with
adequate escort staff• Maintain a log of all Patients
(PCR)
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IN REVIEWIN REVIEW
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Flow Chart
911Call
911Call Fire
Fire
LawLaw
EMSEMS
IncidentCommand
IncidentCommand
Size-upSize-up
ActivateMassCasualtyPlan
ActivateMassCasualtyPlan
CentralDispatch
CentralDispatch
EstablishCommandPost
EstablishCommandPost
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EstablishCommandPost
EstablishCommandPost
NotifyEMC
NotifyEMC
EMS Ground
StagingStaging
AmbulanceAmbulance
HelicopterHelicopter
EMS Ground155.295 VHF
CentralDispatch
CentralDispatch
AlternateAlternateTransport
Transport
KK
EMSCommand
EMSCommand
VictimCollectionArea
VictimCollectionArea
On-sceneTreatment
On-sceneTreatment
TriageTriage
MedicalControl
MedicalControl
NotifyArea Hospitals
NotifyArea Hospitals
DetermineCapacity
DetermineCapacity
ActivateHospitalEmergencyPlan
ActivateHospitalEmergencyPlan
ActivateHospitalEmergencyPlan
ActivateHospitalEmergencyPlan
AlertNearest Hospital
AlertNearest Hospital
TX or 800Mghz
155.340 VHF HERN
ActivateEOC
ActivateEOC Tracking
Tracking
AdditionalResources
EmergencyDeclaration
EmergencyDeclaration
StateEOC
StateEOC
PIOPIO
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NMHNMH
CAHCAH
CMHCMH
OtsegoOtsego
MunsonMunson
StraitsStraits
TreatmentTreatment
ReleaseRelease
TransferTo OtherFacility
TransferTo OtherFacility
MorgueMorgue
Flow Chart continued
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QUESTIONS?QUESTIONS?