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

2. 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

3. 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

4. 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.

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

6. 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

7. 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

8. 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.

9. 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

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

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

12. Simple Incident Scene Layout

13. Contaminated Patient Scene Layout

14. Non-Contaminated Patient Scene Layout

15. 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

16. 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

17. Roles and Responsibilities (example – Triage Unit Leader)

18. 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

19. Communications Flowchart

20. 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

21. Appendix A - Definitions

22. Appendix B – NCR MCSUs

23. Appendix C – Inventory Lists

24. Appendix D – MCSU FOG

25. Appendix E – MAB FOG

26. Appendix F – Command Boards & Worksheets

27. Appendix F – Command Boards & Worksheets

28. Appendix F – Command Boards & Worksheets

29. Appendix F – Command Boards & Worksheets

30. Appendix F – Command Boards & Worksheets

31. Appendix F – Command Boards & Worksheets

32. Appendix F – Command Boards & Worksheets

33. Appendix F – Command Boards & Worksheets

34. Appendix G – S.T.A.R.T. Triage

35. Appendix H – Triage Tag