Regional Mass Casualty Support Units

1. Regional Mass Casualty Support Units

2. Overview The purpose of this program is to provide general information regarding the Regional Mass Casualty Support Units (RMCSU) available to provide mobile MCI supplies to support EMS during a large scale incident.

3. Introduction How were the RMCSU established? Joint venture between the MA Department of Public Health and the five regional EMS Councils Purchased by MDPH with HRSA funds Registered to regional EMS council Hosted by individual ambulance services MDPH was awarded cooperative agreement funds by the U.S. Department of Health Resources and Services Administration (HRSA) under the National Bioterrorism Hospital Preparedness Program. Through contract the RMCSUs were registered by each individual EMS council who is responsible for the upkeep, maintenance, restocking, and annual inventories. Each trailer is hosted by an ambulance service located within each region. Each region was responsible for locating two suitable providers to staff the RMCSUs 24/7.MDPH was awarded cooperative agreement funds by the U.S. Department of Health Resources and Services Administration (HRSA) under the National Bioterrorism Hospital Preparedness Program. Through contract the RMCSUs were registered by each individual EMS council who is responsible for the upkeep, maintenance, restocking, and annual inventories. Each trailer is hosted by an ambulance service located within each region. Each region was responsible for locating two suitable providers to staff the RMCSUs 24/7.

4. Purpose of RMCSU Why were the RMCSUs developed? Who staffs and deploys the RMCSU? When can the RMCSU be used? Where can the RMCSU be used? The RMCSUs were developed as part of Health Resources Services Administration�s (HRSA) initiative dealing with emergency preparedness and EMS. Ten EMS supplies trailers (two per region) to aid EMS during an MCI. The RMCSUs are staffed by host services that were selected by each regional EMS council based on geographic location, access to major roadways, 24/7 staffing ability without depleting their own resources, ability to tow the RMCSU as well as willingness to work with the regions and DPH on this project. The RMCSU is deployed upon request of a scene Incident Commander, EMS Branch Director, Regional EMS Council Staff or DPH through each respective region�s CMED. The RMCSUs can be used for mass casualty incidents, disaster drills, pre-staging for large-scale events, or display purposes for EMS promotion events. The RMCSUs can be deployed within their base region, surrounding regions as backup, and other states as needed. The RMCSUs were developed as part of Health Resources Services Administration�s (HRSA) initiative dealing with emergency preparedness and EMS. Ten EMS supplies trailers (two per region) to aid EMS during an MCI. The RMCSUs are staffed by host services that were selected by each regional EMS council based on geographic location, access to major roadways, 24/7 staffing ability without depleting their own resources, ability to tow the RMCSU as well as willingness to work with the regions and DPH on this project. The RMCSU is deployed upon request of a scene Incident Commander, EMS Branch Director, Regional EMS Council Staff or DPH through each respective region�s CMED. The RMCSUs can be used for mass casualty incidents, disaster drills, pre-staging for large-scale events, or display purposes for EMS promotion events. The RMCSUs can be deployed within their base region, surrounding regions as backup, and other states as needed.

5. RMCSU Supplies The supplies within the RMCSU were designed to help support the EMS functions of an MCI. Categories of Supplies Treatment 50 adult backboards, 25 peadiatric backboards, soft supplies, O2 tanks and equipment, cervical collars, etc.. Incident Management Generator, MCI kit, tent, tools, trailer, CMED radio A full list of supplies is available at www.cmemsc.org (under the CMED heading) at: http://www.cmemsc.org/cmed/trailer.shtmlA full list of supplies is available at www.cmemsc.org (under the CMED heading) at: http://www.cmemsc.org/cmed/trailer.shtml

6. Communications What about communications equipment? How would the radio be used? Should these communications be used outside the ICS system? All of the RMCSUs in the Commonwealth are equipped with an APCO compliant CMED radio. Each radio is programmed with all of the current Med channels and is capable of being re-programmed to narrow band frequencies The CMED radio in the RMCSU can be used by the EMS Branch to coordinate patient transport, evaluate hospital bed status, request additional RMCSUs through the CMED system, request regional staff support. This would be done on the med channel that CMED assigns for the MCI. All communications should be done in conjunction with/through the Incident Command System, not by individual EMTs on scene.All of the RMCSUs in the Commonwealth are equipped with an APCO compliant CMED radio. Each radio is programmed with all of the current Med channels and is capable of being re-programmed to narrow band frequencies The CMED radio in the RMCSU can be used by the EMS Branch to coordinate patient transport, evaluate hospital bed status, request additional RMCSUs through the CMED system, request regional staff support. This would be done on the med channel that CMED assigns for the MCI. All communications should be done in conjunction with/through the Incident Command System, not by individual EMTs on scene.

7. Deployment Is there a recommended number of patients? Providers should utilize CMED for active MCI incidents for patient and hospital coordination as well as requesting regional resources. EMTs should request regional resources early if there is the possibility of a large numbers of patients. The request for a RMCSU is placed to the CMED center located within the provider service�s EMS region. CMED notifies the closest appropriate RMCSU to the staging area of the incident. If all RMCSUs within a specific region have already been deployed, the CMED center will contact an adjacent CMED center requesting additional RMCSUs. Each RMCSU is designed to assist in treating approximately 50 adult patients and 25 peadiatric patients. The units are designed to assist in treating patients in a large scale incident for an extended period of time, bringing additional treatment supplies as well as a small command area for the EMS Branch staff. It is recommended that the RMCSU be as close as possible to the treatment area where the supplies will be needed.Providers should utilize CMED for active MCI incidents for patient and hospital coordination as well as requesting regional resources. EMTs should request regional resources early if there is the possibility of a large numbers of patients. The request for a RMCSU is placed to the CMED center located within the provider service�s EMS region. CMED notifies the closest appropriate RMCSU to the staging area of the incident. If all RMCSUs within a specific region have already been deployed, the CMED center will contact an adjacent CMED center requesting additional RMCSUs. Each RMCSU is designed to assist in treating approximately 50 adult patients and 25 peadiatric patients. The units are designed to assist in treating patients in a large scale incident for an extended period of time, bringing additional treatment supplies as well as a small command area for the EMS Branch staff. It is recommended that the RMCSU be as close as possible to the treatment area where the supplies will be needed.

8. Incidents I requested the RMCSU. What do I get? Who do the RMCSU staff report to? What about After-Action Reports (AAR)? Once an Incident Commander or EMS Branch Director have contacted CMED requesting a RMCSU to their scene (declared MCI or pre-staged event) they will receive: 1. One RMCSU 2. Two staff members from the hosting service reporting to the Staging area to manage RMCSU in accordance with the RMCSU Policies & Procedures for Deployment 3. A regional staff member (if needed by EMS Branch or host service) The EMS Branch Director and Incident Commander must communicate throughout the incident about resources that are being requested by the EMS Branch so that the resources are accounted for, allocated and deployed. The RMCSU staff will report to the Incident Commander, EMS Branch Director or their designee during the incident. The EMS Branch Director or IC and the RMCSU staff should provide a copy of an After Action Report to the regional EMS Executive Director to improve response and coordination for the RMCSU.Once an Incident Commander or EMS Branch Director have contacted CMED requesting a RMCSU to their scene (declared MCI or pre-staged event) they will receive: 1. One RMCSU 2. Two staff members from the hosting service reporting to the Staging area to manage RMCSU in accordance with the RMCSU Policies & Procedures for Deployment 3. A regional staff member (if needed by EMS Branch or host service) The EMS Branch Director and Incident Commander must communicate throughout the incident about resources that are being requested by the EMS Branch so that the resources are accounted for, allocated and deployed. The RMCSU staff will report to the Incident Commander, EMS Branch Director or their designee during the incident. The EMS Branch Director or IC and the RMCSU staff should provide a copy of an After Action Report to the regional EMS Executive Director to improve response and coordination for the RMCSU.

9. Demobilization What happens to the RMCSU after the incident? Once the RMCSU has been released by either the Incident Commander or EMS Branch Director, the RMCSU staff will return the unit to its host location and complete an inventory and an After Action Report. A copy of both documents should be sent to the regional EMS Executive Director for replenishment of supplies and quality improvement.Once the RMCSU has been released by either the Incident Commander or EMS Branch Director, the RMCSU staff will return the unit to its host location and complete an inventory and an After Action Report. A copy of both documents should be sent to the regional EMS Executive Director for replenishment of supplies and quality improvement.

10. Restocking How are the RMCSUs restocked after an incident? After an incident the host service will work with their respective EMS regions to appropriately restock the trailer. A complete inventory will be taken with the region staff to determine what supplies to re-order and to address any other issues regarding the RMCSU. Once the host service completes the inventory, the regional office will work directly with the host service to restock the RMCSUs. A log will be kept of all supplies used at active incidents and events as well as supplies ordered for restocking. These logs will be kept with the RMCSU for review by the region for reporting purposes.After an incident the host service will work with their respective EMS regions to appropriately restock the trailer. A complete inventory will be taken with the region staff to determine what supplies to re-order and to address any other issues regarding the RMCSU. Once the host service completes the inventory, the regional office will work directly with the host service to restock the RMCSUs. A log will be kept of all supplies used at active incidents and events as well as supplies ordered for restocking. These logs will be kept with the RMCSU for review by the region for reporting purposes.

11. Pre-staged Events & Drills Can the RMCSU be pre-staged for large-scale non-emergent events? Can the RMCSU be deployed for MCI training exercises or drills? What about After-Action Reports (AAR)? The RMCSUs can be deployed for pre-staging of large events, depending on funding and host service staff availability. The RMCSUs can be deployed for local MCI training. Contact the Executive Director of the regional EMS office to coordinate activation of the RMCSU for MCI/Drill exercises. At the completion of each drill, both the host agency for the drill and the RMCSU host service staff will complete an After Action Review and forward a copy to the Regional EMS Executive Director for review and improvements.The RMCSUs can be deployed for pre-staging of large events, depending on funding and host service staff availability. The RMCSUs can be deployed for local MCI training. Contact the Executive Director of the regional EMS office to coordinate activation of the RMCSU for MCI/Drill exercises. At the completion of each drill, both the host agency for the drill and the RMCSU host service staff will complete an After Action Review and forward a copy to the Regional EMS Executive Director for review and improvements.

12. Conclusion Summary Questions Regional Contacts (next slide)

13. Regional EMS Councils Western Massachusetts EMS Council (EMS Region I) 168 Industrial Park Drive Northampton, MA 01060 (413) 586-6065 Central Massachusetts EMS Council (EMS Region II) 361 Holden Street Holden, MA 01520 (508) 854-0111 NorthEast EMS Council (EMS Region III) 16 Delcarmine Street Wakefield, MA 01880 (781) 224-3344 Metropolitan Boston EMS Council (EMS Region IV) 25 B Street, Suite A Burlington, MA 01803 (781) 505-4367 Southeastern Massachusetts EMS Council (EMS Region V) 10 Center Street Middleborough, MA 02346 (508) 946-3960