King County MCI Tasks & Tactics

1. King County MCI Tasks & Tactics

2. Goals of the Revised Plan • County wide plan that was not a lesson plan • Reduce choke points and unnecessary actions • Streamline efforts and utilize procedures that are used every day • A plan that is scalable and flexible • A plan that is utilized and followed by all zones in King County

3. Noticeable Changes • Elimination of formal funnel points • Elimination of treatment tags • Changes to how patients are tracked • Elimination of patient numbering • County wide MCI designators • Hospital Control is now Disaster Medical Control Center (DMCC)

4. Changes

5. Changes

6. What defines an MCI • A mass casualty incident (MCI) is any incident in which emergency medical services personnel and equipment at the scene are overwhelmed by the number and severity of casualties at that incident

7. What you need to know to wear a vest • Don the vest • Understand the Incident Objective • Know the vest that you are adjacent to • Provide progress reports • Manage and request resources

8. First Arriving Officer • Unit signature • The location, or corrected location • Initial basic impression • Cause, if known

9. Scene Size Up • Brief scene impression including known hazards • Level of PPE • Estimated total number of patients • Establish the command designator and command post location • Initial company assignments • Designate the transportation corridor • Base and staging locations • Decide complex or not

10. Transportation Corridor • One of the most important initial tasks determined by the first in officer • Must be clearly communicated early to next in companies • If the first in officer cannot establish the transportation corridor then the next in unit should take that responsibility • Turn the corridor over to law enforcement when applicable

11. Incident Commander • Is responsible for directing and/or controlling resources by virtue of explicit legal, agency, or delegated authority • The IC is responsible for all aspects of the response, including developing incident objectives and managing all incident operations

12. Incident Commander

13. Recon • Will be incident driven • Advanced scene size up • Will perform a 360 of the event • Should identify: • Equipment needs • Estimated number of patients • Hazards • Cause of the incident • Any physical barriers that may divide the incident, or prevent ingress or egress

14. Recon

15. Medical Group • Should be assumed by a senior ALS member • Responsible for: • Transport • Treatment • Triage • Activation of the DMCC • Green Patient Management

16. Medical Group

17. Triage • Will report to Medical in smaller incidents and Rescue if the situation dictates • Will triage patients based on King Counties “Sick/Not Sick” guideline • Triage can be accomplished by a Triage Team, Extraction Team, or after safely leaving the area • It is understood that triage is fluid and dynamic and can change frequently

18. Types of Triage • ABC (per King County EMT protocol) • RPM • Sacco • START • Red / Not Red

19. Triage • County model of Sick vs. Not Sick • Allows rescuers to use the same triage mechanism that they use every day • Sick = Red • Not Sick = Yellow

20. Treatment • Identifies appropriate treatment areas • Populates the treatment area appropriately • Supervising treatment of all pt’s • Responsible for re-triaging pt’s as necessary • Coordinating with Transport • Prioritizing pt’s for transport • Apply the tracking band if time allows

21. Treatment for Larger Incidents • Assign a Red Treatment Leader • Assign a Yellow Treatment Leader • Request resources from Medical • Monitor and request medical supplies

22. Treatment

23. Transportation • Reports directly to Medical Group • Communicates directly with the DMCC • Ultimately responsible for patient tracking • Works with law enforcement liaison to keep the transportation corridor clear • Responsible for Ambulance Staging • Works directly with Treatment to coordinate patient transport

24. Transportation for Larger Incidents • Assign an Ambulance Staging Manager • Assign an Ambulance Loading Manager • Assign a DMCC coordinator • Assign a patient tracking aide • Request resources from Medical

25. Ambulance Staging Manager • Best staffed by an Ambulance Supervisor • Should be given a radio • Needs to remain in contact with Ambulance Loading or Transport Supervisor

26. Ambulance Loading Manager • Coordinates the loading of transport vehicles • Should be close to the treatment area to minimize the distance of patient movement

27. DMCC Coordinator • Only injury pattern that needs to be communicated is burns, OB trauma, and if applicable, pediatric patients • Do not give individual patient status, let them know what is loaded in the back of the transporting unit

28. Tracking • Ensures that all patients have a tracking band • All transport capable vehicles in King County will have two packs of 25.

29. Tracking • Will place a tracking sticker on a tracking board • All MSO’s and Medic units will have tracking sheets

30. Tracking • Instruct all transporting personnel to place a tracking sticker on the portion of the MIRF that will stay with the hospital

31. Transport

32. Green Patient Area Manager • Incident driven, 1 green pt or multiple green pts • Needs to be away from the working incident • Needs to have someone with medical authority to re-evaluate pt’s as needed • Coordinate to get pts to the hospital as needed • Liaison with law enforcement • Ensure patient tracking

33. Medical Org Chart

34. Rescue • Reports directly to operations • Should secure their own radio channel • Is responsible for overseeing extraction, extrication, and triage in larger incidents • Responsible for requesting and releasing resources as needed

35. Rescue

36. Extraction • Mobilization of pt’s to the treatment area • Extraction teams may also be assigned to triage • Extraction teams should manage pt care during movement

37. Extraction

38. Extrication • Responsible for the physical disentanglement of patients • Utilizes physical rescue tools

39. Extrication

40. Growing Incident