NOVA MANUAL TRAINING Multiple Casualty Incident August 2008 PRINCE WILLIAM COUNTY NOVA MANUAL TRAINING Multiple Casualty Incident August 2008

Preface Sources used in production of this manual Virginia Mass Casualty Incident Management Curriculum Model Procedure Guide for Emergency Medical Incidents NOVA Command Officer Operations Manual COG Chapter 16 National Incident Management System

Preface Goals of the Multiple Casualty Incident Manual: Establish a NIMS compliant multiple incident plan Establish multiple casualty incident response package Do the greatest good for the greatest number Effectively use personnel, equipment and resources Avoid relocating the incident

Overview The Multiple Casualty Incident Manual outlines the response policies and procedures utilized by NOVA jurisdictions in the event of a multiple casualty incident. It will establish consistency throughout the Northern Virginia region on many levels including resource deployment, organization, communications and patient flow.

Incident Descriptions EMS Task Force Multiple Casualty Incident (MCI) Alarm Low Impact Incident High Impact Incident Disaster / Terrorism Incident

Initial Company Operations First arriving unit shall recon the incident and establish Incident Command utilizing the five S’s Safety Size-Up Send Set Up START / Jump START Triage

Initial Company Operations Multiple Casualty Incident Command The Incident Commander fill follow the NOVA Command Officer Operations Manual Hazard Mitigation Haz Mat / WMD Collapse and Extrication Fire Incidents

Organization Development EMS Task Force and MCI Alarm were developed to quickly gain specific scalable resources for a MCI. Units are dispatched in a predetermined order to identify their assignment without distracting the IC but may be changed as needed. EMS Task Force and MCI Alarm have been established to give predetermined allotment of resources. Patient counts used to build response packages based on patients to be transported set up for 30% red, 30% yellow and 40% green.

Multiple Casualty Response Components EMS Task Force – up to 10 patients See page 9 MCI Alarm – up to 25 patients Teams ALS and BLS Strike Team Mobile Treatment Team

Patient Processing Flowchart See page 10 Quick reference used to facilitate patient care, movement, treatment and transport for a typical MCI.

Scene Layouts See pages 11 – 13 Layout ideas that may be used during set up of MCI mitigation.

Simple Incident Scene Layout

Contaminated Patient Scene Layout

Non-Contaminated Patient Scene Layout

EMS Branch Positions This section details the roles and responsibilities of the various EMS Branch positions: Triage Unit Leader Triage Units Porters Morgue Manager Treatment Unit Leader Immediate (Red) Treatment Manager Delayed (Yellow) Treatment Manager Minor (Green) Treatment Manager

EMS Branch Positions cont. Treatment Dispatch Manager Medical Supply Coordinator Medical Group Supervisor Transportation Group Supervisor Medical Communications Coordinator Patient Transport Recorder Air/Ground Ambulance Coordinator EMS Staging Manager/Coordinator EMS Branch Check-in Transport Loader Transport Units (Air/Ground) EMS Branch Director

Roles and Responsibilities (example – Triage Unit Leader)

Communications EMS Branch Radio Assignments Radio Grouping Flowchart EMS Task Force – one EMS tactical channel MCI Alarm – two EMS tactical channels Radio Grouping Flowchart See page 28 Northern Virginia Regional Hospital Coordinating Center (RHCC) / EMS Activation Protocol (MedComm) Procedure for using RHCC

Communications Flowchart

Appendices A – Definitions B – National Capital Region Medical Support Units (list) C – Medical Care Support Unit Inventory List D – Medical Care Support Unit Field Operating Guide E – Medical Ambulance Bus Field Operating Guide F – EMS Branch Command Boards and Worksheets G – S.T.A.R.T. Triage system Flow Chart H – Sample NOVA Triage Tag

Appendix A - Definitions

Appendix B – NCR MCSUs

Appendix C – Inventory Lists

Appendix D – MCSU FOG

Appendix E – MAB FOG

Appendix F – Command Boards & Worksheets

Appendix F – Command Boards & Worksheets

Appendix F – Command Boards & Worksheets

Appendix F – Command Boards & Worksheets

Appendix F – Command Boards & Worksheets

Appendix F – Command Boards & Worksheets

Appendix F – Command Boards & Worksheets

Appendix F – Command Boards & Worksheets

Appendix G – S.T.A.R.T. Triage

Appendix H – Triage Tag