Mass Casualty Incident Preparation for EMS

1. Mass CasualtyIncident Preparation for EMS

2. 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.

3. 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.

4. Flow Chart Law Activate Mass Casualty Plan Establish Command Post Fire Incident Command Size-up 911 Call EMS Central Dispatch

5. 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

6. Ambulance Staging EMS Ground 155.295 VHF Helicopter Transport EMS Ground Alternate Establish Command Post EMS Command Triage Victim Collection Area On-scene Treatment Central Dispatch K 155.340 VHF HERN TX or 800Mghz Notify EMC Activate Hospital Emergency Plan Medical Control Alert Nearest Hospital Notify Area Hospitals Activate Hospital Emergency Plan Determine Capacity PIO Activate EOC Emergency Declaration Tracking Additional Resources State EOC

7. EMS RESPONSE • First arriving unit: Senior EMS responder assumes Commandrole • Put on EMS Command vest • Assist IC in locating staging • Establish victim collection area • Deploy Mass Casualty Kit • Strip rig for use at triage

8. EMS RESPONSE • First arriving Unit: Second EMS responder assigned role of Triage Officer - Put on Triage Officer Vest - Triage and tag victims - Use MFR or medically trained volunteers

9. EMS RESPONSE • Second Arriving Unit: Third EMS person assigned role of transportation officer - Put on Transportation 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

10. EMS Response • Second arriving Unit: Fourth EMS responder assigned role of Treatment Officer • Put on Treatment Officer vest • Supervise establishment of victim collection area • Supervise treatment of victims in collection area

11. 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

12. Ambulance Staging EMS Ground 155.295 VHF Helicopter Transport EMS Ground Alternate Establish Command Post EMS Command Triage Victim Collection Area On-scene Treatment Central Dispatch K 155.340 VHF HERN TX or 800Mghz Notify EMC Activate Hospital Emergency Plan Medical Control Alert Nearest Hospital Notify Area Hospitals Activate Hospital Emergency Plan Determine Capacity PIO Activate EOC Emergency Declaration Tracking Additional Resources State EOC

13. 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

14. 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

15. Release NMH Treatment Transfer To Other Facility CAH Morgue CMH Otsego Munson Straits Flow Chart continued

16. 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

17. 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

18. General Considerations • Agency Responses • Police • Fire • EMS • Command Responsibility • Initial Agency on Scene • Multiple Disciplines • Unified Command

19. Communication • Obstacles • Terrain • Different Frequencies • Overloaded channels • Hospital • Medical Control • Patient Routing • Transportation Officer • Staging Officer

20. 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)

21. IN REVIEW

22. Flow Chart Law Activate Mass Casualty Plan Establish Command Post Fire Incident Command Size-up 911 Call EMS Central Dispatch

23. Ambulance Staging EMS Ground 155.295 VHF Helicopter Transport EMS Ground Alternate Establish Command Post EMS Command Triage Victim Collection Area On-scene Treatment Central Dispatch K 155.340 VHF HERN TX or 800Mghz Notify EMC Activate Hospital Emergency Plan Medical Control Alert Nearest Hospital Notify Area Hospitals Activate Hospital Emergency Plan Determine Capacity PIO Activate EOC Emergency Declaration Tracking Additional Resources State EOC

24. Release NMH Treatment Transfer To Other Facility CAH Morgue CMH Otsego Munson Straits Flow Chart continued

25. QUESTIONS?