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Zone One MCI Training

This document presents the revised Mass Casualty Incident (MCI) training protocols and updates to the MCI plan from June to July 2012. Key objectives include reducing choke points, improving division of labor, and enhancing patient tracking using NIMS terminology. The training focuses on initial scene size-up, the MCI process, eliminating unnecessary actions, and developing effective rescue and treatment groups. Updates also address the management of resources, transport coordination, and documentation practices to ensure a streamlined and efficient response during MCI situations.

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Zone One MCI Training

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  1. Zone One MCI Training June, 2012 July, 2012

  2. 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

  3. 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

  4. 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)

  5. WMD Incidents

  6. 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

  7. Maintain the Transportation Corridor!

  8. More Size-up Phase 2 • Estimate number of non-ambulatory patients • Consider extrication/relocation issues • Scene status: Static or Dynamic? • Decide: Complex…not complex

  9. Requesting Resources • Basic MCI Activities • Rescue/Extrication • Treatment/Transport • Ambulance staging • Complex Activities • Fire • Hazard Material • CBRNE • Collapse

  10. No SLUDGE No Fire, stable scene Southbound lanes open Overpass intact Patients walking around 6-10 Reds Simple extrication Static scene

  11. Commanding the radio • Provide size-up • Initiate command • Initial assignments • Safety & hoseline • Triage • Treatment • Request “base” resources • Request “transport” resources

  12. 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

  13. Changes

  14. Changes

  15. The Previous MCI Plan

  16. Typical MCI Org Chart 2012

  17. Are you doing the job…or leading it?

  18. Unit Leader/Group Supervisor • Don the vest • Understand Action Plan • Determine supervisors role • Develop organization • Develop relationships • Maintain accountability • Provide progress reports

  19. So, who does Triage? • Rapid Field Triage -BLS • Minimal Treatment • Who Supervises Triage: • Medical Group (small) • Rescue Group (Large) • Secondary Triage – ALS

  20. Treatment Unit • Locate suitable area • Secure supplies • Develop treatment teams • Determine transport priorities

  21. 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

  22. Expanding the Treatment Unit

  23. 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

  24. Transport Unit • Assure DMCC activation • Establish Ambulance Staging • Confirm transporting resources are inbound • Coordinate patient loading • Track Destinations

  25. Transportation Unit • Apply tracking bands • Communicate with DMCC • Receive patient destination • Manage documentation • Benchmarks: • All reds transported • All patients transported

  26. 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

  27. 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

  28. 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

  29. Expanding the Transport Unit

  30. Rescue Group/Unit • Disentanglement • Moves all patients to Treatment area • Personnel Intensive • May report to Medical or Operations • May provide field triage

  31. Expanding the Rescue Group

  32. 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

  33. Questions?

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