Multi-Casualty Incidents Tactical Standard Henderson Fire Department 4 th Edition

Objectives Define MCI Describe the difference between level 1, 2, 3, 4, or 5 MCI Understand the 6 stages of MCI management Explain Unified Command Describe the basic ICS structure of MCI Identify the primary responsibility of each group or unit of a normal MCI Explain the requirements of the morgue

Objectives cont. Describe the role of the medical supply group Explain the evolution of a MCI event Define “Extreme MCI” Explain the organization of an Extreme MCI Understand the operations of an extreme MCI Identify the locations of Casualty Collection Points for Extreme MCI

Overview Definition of MCI Definition of MCI –Level 1, 2, 3,4, or 5 Variety Variety Frequency Frequency Evolution of the MCI Evolution of the MCI Multi-jurisdictional Multi-jurisdictional

Six Stages of MCI Management 1. Preplanning & Training 2. Initial Response 3. Operations 4. Stabilization 5. Demobilization 6. Termination

Unified Command Two Primary Situations Two Primary Situations 1.Single Jurisdiction 2.Multi-jurisdiction

Basic MCI Operations Dispatch Dispatch Arrival Arrival Additional Resources Additional Resources ICS Assignments ICS Assignments –Traffic/Crowd Control –Rescue/Extrication Group –Medical Group  Triage Unit  Treatment Unit –Transportation Group –Possibly LZ Group

Rescue/Extrication Assigned Early Assigned Early Hazard Zone Hazard Zone Prioritize Patients Prioritize Patients Responsibilities Responsibilities IC Rescue/Extrication

Medical Group Responsibilities Responsibilities Triage Unit Triage Unit Treatment Unit Treatment Unit IC Rescue/ExtricationMedical Group Triage UnitTreatment Unit

Transportation Group Responsibilities Responsibilities IC Rescue/ExtricationMedical Group Triage UnitTreatment Unit Transportation Group

Additional Unit, Group or Branches Morgue Morgue Safety Safety Staging Staging Medical Supply Medical Supply

Basic MCI Response En-route En-route Arrival Arrival Apparatus Positioning Apparatus Positioning Secure Hazards Secure Hazards Initial Triage Initial Triage Additional Resources Additional Resources Patient Stabilization Patient Stabilization Traffic/Crowd Control Traffic/Crowd Control Rescue/Extrication Rescue/Extrication Medical Group Medical Group Possible LZ Group Possible LZ Group Possible Transportation Group Possible Transportation Group

Advanced Plan (MCI-A) Extreme Mass Casualty An Extreme MCI is an event in which the number of patients exceeds 300 or greater. The Mass Casualty Incident Advanced Plan (MCI-A) is included in the Clark County Multi-Jurisdictional Mass Casualty Plan. It provides guidance and procedures for the response to any incident involving 300 or greater casualties herinto referred to as an Extreme Mass Casualty. It was designed specifically to deal with local disasters including Weapons of Mass Destruction, Chemical, Biological, Radiological, Nuclear, and high-yield explosives or CBRNE.

Organization Initial Arriving Company - IC & “Sifting” Rescue/Extrication Group Holding Area Group 2nd Opinion Group Medical Group Transportation Group Casualty Collection Points

Hot Zone - Deceased Warm Zone non-ambulatory Holding Area Initial Arriving Company Establish Command BIR Request Resources Begin “Sifting” ambulatory to Holding Area. Cold Zone Sifting

Hot Zone - Deceased Warm Zone non-ambulatory Decon Rescue/Ext Cold Zone TriageTXTransport Ambulance Staging Loading To Hospital 2nd opinionHolding Area CP To Casualty Collection Point Hazmat Medical

Sets & Reps Receive Dispatch Receive Dispatch Verbalize Pre-incident Information Verbalize Pre-incident Information Complete En route Research Complete En route Research Verbalize En route concerns Verbalize En route concerns Complete Brief Initial Report Complete Brief Initial Report Conduct Survey of Incident & Identify Hazards Conduct Survey of Incident & Identify Hazards Verbalize Securing of Scene Verbalize Securing of Scene Complete Initial Triage Complete Initial Triage Request Appropriate Resources Request Appropriate Resources Assign & Track Units Assign & Track Units Complete IC Worksheet Complete IC Worksheet

Brief Initial Report? Triage Report: 1.Silver Car – 1 delayed, 1 minor, no extrication 2.Black Car – 1 immediate, 1 delayed, extrication needed 3.Green Car – 1 immediate, 2 delayed, 1 minor, extrication needed Resources Needed?

Brief Initial Report? Triage Report: 1.Green Car – 2 immediate, 2 delayed, extrication needed 2.Silver Car – 1 delayed, 2 minor, no extrication Resources Needed?

Brief Initial Report? Triage Report: 1.Black Truck – 1 dead, 2 immediate, extrication needed 2.School Bus – 2 immediate, 10 delayed, 12 minor, no extrication Resources Needed?

Brief Initial Report? Triage report: 1.White Truck – 2 immediate, no extrication 2.White Car – 1 dead, 1 immediate, 2 delayed, extrication needed Resources Needed?