1. Principles of Major Incident Response
2/17/2019
Principles of Major Incident Response
Temple College EMS Professions
Temple College EMS Professions

2. Temple College EMS Professions
Major Incident
Cannot be managed with local resources
Multiple patients
Special hazards
Chemical
Radiological
Biological
Difficult rescue
Temple College EMS Professions

3. Major Incident Do the most good for the most people
LIMITED RESOURCE SITUATION
Do the most good for the most people
Control response
Control treatment
Control transport
Temple College EMS Professions

4. Temple College EMS Professions
Success depends on:
Knowing what is needed
Knowing what is available
Matching needs/resources
Temple College EMS Professions

5. Temple College EMS Professions
Command
A PLAN
Control
Communications
Temple College EMS Professions

6. Temple College EMS Professions
A good plan. . .
Is simple, concise, realistic
Is designed by the people who will use it
Defines responsibilities, areas of authority
Provides for unified command
Defines initial actions thoroughly, precisely
Temple College EMS Professions

7. Temple College EMS Professions
A good plan. . .
Keeps people doing what they do best
Provides for smooth interaction
Provides common terminology and a communications interface
Provides for training, practice, evaluation, revision
Temple College EMS Professions

8. Temple College EMS Professions
A good plan. . .
Describes what needs to be done, but…
Leaves how to do it up to the people using the plan
Temple College EMS Professions

9. Incident Command System
Effective C3 begins with first unit
Establish command
Do NOT treat patients
Temple College EMS Professions

10. Temple College EMS Professions
EMS Command
Perform size-up
Declare major incident
Request appropriate assistance
Designate staging area
Designate treatment area(s)
Coordinate with other agencies
Command until relieved
Temple College EMS Professions

11. Temple College EMS Professions
Triage Officer
Coordinate patient removal from danger
Provide Command with updates
Identify/correct life-threats without slowing triage
Assess, categorize, tag
Coordinate “hazard zone” activities
Continuously retriage
Temple College EMS Professions

12. Temple College EMS Professions
Staging Officer
Assure access routes
Assure orderly parking, traffic flow
Categorize units, capabilities
Assign units as requested
Inform Command of status
Temple College EMS Professions

13. Temple College EMS Professions
Treatment Officer
Locate treatment areas, advise Command and Triage
Evaluate resources needed for treatment
Assign, coordinate treatment personnel
Inform Command of status
Inform Command of available manpower
Temple College EMS Professions

14. Temple College EMS Professions
Transport Officer
Establish transport area(s)
Request ambulances from staging
Coordinate transport of patients with dispatch or command hospital
Direct transport to appropriate facilities
Inform Command of status
Maintain records of patient destinations
Temple College EMS Professions

15. Temple College EMS Professions
Support Officer
Determine equipment, supply needs
Coordinate procurement
Maintain inventory
Allocate equipment, supplies
Inform command of status
Temple College EMS Professions

16. Incident Command System
Temple College EMS Professions

17. Incident Command System
Positions are functions, not persons
One person can fill more than one position
Until delegated, Command performs all functions
Address communications to functions, not persons
Temple College EMS Professions

18. Incident Command System
Temple College EMS Professions

19. Incident Command System
Dispatch
EMS
Command
Staging
Officer
Hospitals
Triage
Officer
Treatment
Officer
Transport
Officer
Temple College EMS Professions

20. Temple College EMS Professions
Triage
“To sort”
Prioritizing patients based on severity
Temple College EMS Professions

21. START Able to walk? Simple Triage & Rapid Treatment Yes = Delayed
No = Assess Ventilation
Temple College EMS Professions

22. Temple College EMS Professions
START
Ventilation present?
Yes = Greater than 30 per minute?
Yes = Immediate
No = Assess perfusion
No = Position airway. Breathing present?
No = Dead
Temple College EMS Professions

23. Temple College EMS Professions
START
Perfusion adequate? (radial pulse)
Yes = Assess mental status
No = Immediate
Temple College EMS Professions

24. Temple College EMS Professions
START
Mental status adequate (follows commands)
Yes = Delayed
No = Immediate
Temple College EMS Professions

25. Temple College EMS Professions
Four Category System
Red:
Immediate life threat
Yellow:
Significant morbidity
Delayed life threat
Green:
Minimal life threat
Black:
Dead or will die
Temple College EMS Professions

26. Temple College EMS Professions
Rules of Triage
Greatest good for greatest number
Save lives, then limbs
One Chief, many Indians
Squeaky wheels don’t need grease
You can’t save everyone! So don’t try!
Temple College EMS Professions