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Zone One MCI Training. June, 2012. July, 2012. Revised 2011 MCI Plan: WHY?. Reduce choke (funnel) points Minimize unnecessary actions Improve division of labor Increase plan scalability for all events Simplify patient tracking Utilize NIMS terminology. Training Objectives.
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Zone One MCI Training June, 2012 July, 2012
Revised 2011 MCI Plan: WHY? • Reduce choke (funnel) points • Minimize unnecessary actions • Improve division of labor • Increase plan scalability for all events • Simplify patient tracking • Utilize NIMS terminology
Training Objectives • Discuss Updates and Changes of the Plan • Review of initial MCI scene size-up • Overview of general MCI concepts • Demonstrate each element of the MCI process on the drill ground • Review equipment on MCI-99
MCI Changes at a glance • Develop “Rescue Group” to package and move patients • Eliminate formal funnel point • Eliminate use of treatment tags • Eliminate patient numbering (felt pen) • Utilize NIMS Terms: Hospital Control is now Disaster Medical Control Center (DMCC)
Initial Size-up Phase 1 • Look for SLUDGE • Identify immediate hazards • Consider access/egress options to secure a transportation corridor. • Observe base/staging options • Estimate number of patients
More Size-up Phase 2 • Estimate number of non-ambulatory patients • Consider extrication/relocation issues • Scene status: Static or Dynamic? • Decide: Complex…not complex
Requesting Resources • Basic MCI Activities • Rescue/Extrication • Treatment/Transport • Ambulance staging • Complex Activities • Fire • Hazard Material • CBRNE • Collapse
No SLUDGE No Fire, stable scene Southbound lanes open Overpass intact Patients walking around 6-10 Reds Simple extrication Static scene
Commanding the radio • Provide size-up • Initiate command • Initial assignments • Safety & hoseline • Triage • Treatment • Request “base” resources • Request “transport” resources
Physical Actions of the First-in Crew • Engine/Ladder Company • Recon / Risk Assessment • Mitigate immediate high risks • Secure Transportation Corridor • Begin Triage • Direct movement of “Green” Walking wounded • Implement Rescue Group • Medic Units/MSO Decide: Patient or Scene mgmt • Medical Group • Treatment Unit • Transport Unit
Unit Leader/Group Supervisor • Don the vest • Understand Action Plan • Determine supervisors role • Develop organization • Develop relationships • Maintain accountability • Provide progress reports
So, who does Triage? • Rapid Field Triage -BLS • Minimal Treatment • Who Supervises Triage: • Medical Group (small) • Rescue Group (Large) • Secondary Triage – ALS
Treatment Unit • Locate suitable area • Secure supplies • Develop treatment teams • Determine transport priorities
Treatment Unit • Reasons for a Treatment Area • Visual indicator for injured • No transportation available • Immediate life-saving treatment • Move the reds, hold others • Assure appropriate treatment • Use Aid/Medic Units for supplies • Prioritize patients for transport • Use a “Treatment Dispatch Manager” • Benchmarks: • All reds transported • All patients transported
King County MCI Resource Vehicles • Units that are specifically designed to manage at least 35 MCI patients with medical equipment, backboards, and oxygen supplies. • There are regionally located: • MCI-99 North King County • MCI-9 Eastside • MCI-51 and 81 South King County • MCI-1 City of Seattle • MCI-777 Port of Seattle
Transport Unit • Assure DMCC activation • Establish Ambulance Staging • Confirm transporting resources are inbound • Coordinate patient loading • Track Destinations
Transportation Unit • Apply tracking bands • Communicate with DMCC • Receive patient destination • Manage documentation • Benchmarks: • All reds transported • All patients transported
Tracking • All transport capable vehicles in King County will have tracking bands • Typically applied at the ambulance loading or DMCC activity area. • Ensures that all patients have a tracking band
Tracking • Retain one peel-off sticker on a tracking board • All MSO’s and Medic Units will have tracking sheets • Tracking sheets allow for sticker or Barcode tracking
Tracking • Instruct all transporting personnel to place a tracking sticker on the Medical Incident Report: • Hospital form • Agency form • EPCR agencies need to enter number in laptop
Rescue Group/Unit • Disentanglement • Moves all patients to Treatment area • Personnel Intensive • May report to Medical or Operations • May provide field triage
Summary of Key Points for MCI • Secure the transport corridor !! • Keep transport units staged separately • Medics focus on Medical/Treatment/Transport • Early notification of DMCC • Suppression focus on Rescue/Extraction • Perform secondary triage before transport • Separate loading from DMCC activities