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King County MCI Tasks & Tactics
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Goals of the Revised Plan
County wide plan that was not a lesson plan Reduce choke points and unnecessary actions Streamline efforts and utilize procedures that are used every day A plan that is scalable and flexible A plan that is utilized and followed by all zones in King County
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Noticeable Changes Elimination of formal funnel points
Elimination of treatment tags Changes to how patients are tracked Elimination of patient numbering County wide MCI designators Hospital Control is now Disaster Medical Control Center (DMCC)
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Changes
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Changes
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What defines an MCI A mass casualty incident (MCI) is any incident in which emergency medical services personnel and equipment at the scene are overwhelmed by the number and severity of casualties at that incident
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What you need to know to wear a vest
Don the vest Understand the Incident Objective Know the vest that you are adjacent to Provide progress reports Manage and request resources
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First Arriving Officer
Unit signature The location, or corrected location Initial basic impression Cause, if known This is the window survey
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Scene Size Up Brief scene impression including known hazards
Level of PPE Estimated total number of patients Establish the command designator and command post location Initial company assignments Designate the transportation corridor Base and staging locations Decide complex or not This is after your boots have hit the ground
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Transportation Corridor
One of the most important initial tasks determined by the first in officer Must be clearly communicated early to next in companies If the first in officer cannot establish the transportation corridor then the next in unit should take that responsibility Turn the corridor over to law enforcement when applicable
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Incident Commander Is responsible for directing and/or controlling resources by virtue of explicit legal, agency, or delegated authority The IC is responsible for all aspects of the response, including developing incident objectives and managing all incident operations
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Incident Commander Incident Commander
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Recon Will be incident driven Advanced scene size up
Will perform a 360 of the event Should identify: Equipment needs Estimated number of patients Hazards Cause of the incident Any physical barriers that may divide the incident, or prevent ingress or egress This is for a bigger incident where this information could not be obtained by the first in officer
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Recon Incident Commander Operations Recon
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Medical Group Should be assumed by a senior ALS member
Responsible for: Transport Treatment Triage Activation of the DMCC Green Patient Management It needs to be noted that the MGS may or may not fill the roll of some or all of these rolls depending on the event
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Medical Group Incident Commander Operations Recon Medical Group
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Triage Will report to Medical in smaller incidents and Rescue if the situation dictates Will triage patients based on King Counties “Sick/Not Sick” guideline Triage can be accomplished by a Triage Team, Extraction Team, or after safely leaving the area It is understood that triage is fluid and dynamic and can change frequently Emphasize that triage may not be a formal
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Types of Triage ABC (per King County EMT protocol) RPM Sacco START
Red / Not Red
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Triage County model of Sick vs. Not Sick
Allows rescuers to use the same triage mechanism that they use every day Sick = Red Not Sick = Yellow
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Treatment Identifies appropriate treatment areas
Populates the treatment area appropriately Supervising treatment of all pt’s Responsible for re-triaging pt’s as necessary Coordinating with Transport Prioritizing pt’s for transport Apply the tracking band if time allows Assigning a paramedic to retriage once the pt makes it into the tx area
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Treatment for Larger Incidents
Assign a Red Treatment Leader Assign a Yellow Treatment Leader Request resources from Medical Monitor and request medical supplies
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Treatment Incident Commander Recon Operations Medical Group Treatment
Red Unit Leader Yellow Unit Leader
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Transportation Reports directly to Medical Group
Communicates directly with the DMCC Ultimately responsible for patient tracking Works with law enforcement liaison to keep the transportation corridor clear Responsible for Ambulance Staging Works directly with Treatment to coordinate patient transport
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Transportation for Larger Incidents
Assign an Ambulance Staging Manager Assign an Ambulance Loading Manager Assign a DMCC coordinator Assign a patient tracking aide Request resources from Medical
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Ambulance Staging Manager
Best staffed by an Ambulance Supervisor Should be given a radio Needs to remain in contact with Ambulance Loading or Transport Supervisor
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Ambulance Loading Manager
Coordinates the loading of transport vehicles Should be close to the treatment area to minimize the distance of patient movement
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DMCC Coordinator Only injury pattern that needs to be communicated is burns, OB trauma, and if applicable, pediatric patients Do not give individual patient status, let them know what is loaded in the back of the transporting unit
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Tracking Ensures that all patients have a tracking band
All transport capable vehicles in King County will have two packs of 25.
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Tracking Will place a tracking sticker on a tracking board
All MSO’s and Medic units will have tracking sheets
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Tracking Instruct all transporting personnel to place a tracking sticker on the portion of the MIRF that will stay with the hospital
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Transport Incident Commander Recon Operations Medical Group
Treatment Transport Ambulance Staging Ambulance Loading DMCC Coordinator Tracking Aide
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Green Patient Area Manager
Incident driven, 1 green pt or multiple green pts Needs to be away from the working incident Needs to have someone with medical authority to re-evaluate pt’s as needed Coordinate to get pts to the hospital as needed Liaison with law enforcement Ensure patient tracking Who should this person be in contact with to ask for transportation to the hospital if needed?
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Medical Org Chart Incident Commander Operations Recon Medical Group
Treatment Transport
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Rescue Reports directly to operations
Should secure their own radio channel Is responsible for overseeing extraction, extrication, and triage in larger incidents Responsible for requesting and releasing resources as needed
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Rescue Incident Commander Operations Recon Medical Group Rescue
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Extraction Mobilization of pt’s to the treatment area
Extraction teams may also be assigned to triage Extraction teams should manage pt care during movement
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Extraction Incident Commander Recon Operations Rescue Medical Group
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Extrication Responsible for the physical disentanglement of patients
Utilizes physical rescue tools
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Extrication Incident Commander Operations Recon Medical Group Rescue
Extraction Extrication
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Growing Incident Incident Command Finance Planning Logistics
Operations Medical Treatment Yellow Unit Red Unit Transport Ambulance Staging Ambulance Loading DMCC Coordinator Tracking Aide Rescue Extraction Extrication Triage Hazard Mitigation Decon Haz Mat Fire Recon
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