Mass Casualty Incidents<br />First Due / First Five<br />
Las Vegas Conv. Ctr 8/2011<br />
Las Vegas Conv. Ctr8/2011<br />
WARNING<br />
Indiana State Fair – 8/2011<br />
Indiana State Fair – 8/2011<br />What did they do right?<br />JOC.<br />Immediate Triage.<br />Quick treatment.<br />Rapid...
Objectives<br />Case Studies<br />Identifying the MCI<br />MCI Management<br />Command<br />Triage<br />Treatment<br />Tra...
Hurricane Andrew – 8/1992<br />Brand new EMT.<br />Let’s go.<br />Widespread damage.<br />Rules are rules.<br />
New Fairfield, CT School Buses -1996<br />Three School Buses > 200 patients<br />Paramedic and Volunteer Fire Officer<br /...
WTC – September 11th, 2001<br />
WTC Building 7 Collapses<br />
Liberty Plaza<br />
Broken CoC<br />Freelancing<br />Self-Dispatching<br />No Credentialing<br />Improper PPE<br />Resource Leeching<br />Taxe...
 WTC Tower #2<br />Rehab<br />Food<br />Primary <br />Care<br />Critical<br />Care<br />Triage / Transport<br />Supplies<...
Identifying the MCI<br />Definition<br />Needs outstrip resources<br />Threshold<br />More than initial response can treat...
Identifying the MCI<br />MCI Mode vs Standard Response<br />At an M.C.I.priority becomes Incident Management rather than p...
Identifying the MCI<br />Why?<br />Low Impact MCI<br />Increased Efficiency<br />Coordination<br />Communication<br />Cult...
MCI Management<br />Why Not Declare an MCI?<br />Bystanders – Expectations<br />Peers - Can’t handle it?<br />Hospitals – ...
MCI Management<br />How?<br />I must break you…<br />Of the habit of treating, not triaging.<br />“Providers will do only ...
MCI Management<br />Types of MCI<br />Mass Transit Crash<br />Personal MVA<br />Structural Collapse<br />Fire / Explosion<...
MCI Management<br />When do we pull the trigger on this?<br />You want to know…<br />Where to go?<br />Who to talk to?<br ...
Initial Hazards<br />Examples<br />Physical Hazards<br />Haz Mat<br />WMD<br />Crowds<br />Active Shooter<br />Weather<br ...
Initial Hazards<br />What can you SAFELY MAKE SAFE?<br />Call 4 Race Horses<br />Protect Yourself, Your Crew, Your Public<...
The First Five<br />
Command<br />What to do BEFORE the MCI<br />Hazard Assessment<br />Pre-Plan<br />Pre-Stock<br />Mutual Aid<br />Dispatch P...
Command<br />ICS / NIMS<br />Must have 100, 700<br />Should have 200, 800<br />May have 300, 400<br />I have NIMS 1,000,00...
Command<br />ICS / NIMS Features<br />Standard Structure<br />Expandable<br />Contractable<br />Modular<br />Chain of comm...
Command<br />
Command<br />Incident<br />Commander<br />Public Information<br />Officer<br />Command Staff<br />Liaison<br />Officer<br ...
Congratulations, You’re Hired!<br />Take the job<br />Job description<br />Dress for Success<br />Gather your tools<br />S...
Congratulations, You’re Hired!<br />
First Due!<br />Through the windshield<br />Size UP!<br />Location<br />Rough Number of patients<br />MCI Area<br />Comman...
First Due!<br />Size Up<br />
First In Unit / EMS Officer <br />
EMS Officer<br />Take the job<br />Initiate MCI<br />Take / Coordinate Command<br />Get Briefing<br />Grab Help<br />Dress...
EMS Officer<br />Watching out for personnel and other citizens<br />Watching traffic and its approach to the scene<br />As...
EMS Officer<br />One patient pinned under dash<br />Difficulty with lower extremities<br />Stable vital signs<br />Plannin...
Triage<br />Take the job<br />Get Briefing<br />Grab Help<br />Dress for Success<br />Vest<br />Radio<br />Triage Kits<br ...
 START TRIAGE<br />
Triage<br />Victim #1<br />66 y/o Male<br />CC: <br />Facial Lacerations<br />R:<br />22<br />P:<br />< 2 sec.<br />M:<br ...
Triage<br />Victim #2<br />22 y/o Female<br />CC: <br />L Ankle Pain<br />R:<br />28<br />P:<br />< 2 sec.<br />M:<br />Fo...
Triage<br />Victim #3<br />18 y/o Male<br />CC: <br />None Verbalized<br />R:<br />32<br />P:<br />> 2 sec.<br />M:<br />U...
Treatment<br />Take the job<br />Get Briefing<br />Grab Help<br />Dress for Success<br />Vest<br />Radio<br />Supplies<br ...
Treatment<br />
Transport<br />Take the job<br />Get Briefing<br />Grab Help<br />Dress for Success<br />Vest<br />Radios, Many Radios<br ...
Staging<br />Take the job<br />Get Briefing<br />Grab Help<br />Dress for Success<br />Vest<br />Radio<br />Set Up Your Wo...
Danbury, CT Anthrax – 9/2007<br />
The Next Step<br />Conferences<br />EMS World Expo<br />MCI Management Systems<br />Tabletop Exercises<br />Local Training...
SUMMARY<br />Objectives<br />Case Studies<br />Identifying the MCI<br />MCI Management<br />Command<br />Triage<br />Treat...
Upcoming SlideShare
Loading in...5
×

MCI First Due First Five

992

Published on

Using the instructor’s personal experiences from Hurricane Andrew and 9/11 along with lessons from MCI management around the world to make core skills of MCI management both concrete and tangible, students will learn “first due” command and control for large and small-scale mass casualty incidents and apply these principles through role-play and scenarios. This dynamic program covers fundamental aspects of Command, Triage, Treatment and Transportation.

Teaching Formats:
-Lecture
-Demonstration
-Interactive Role Play
-Question and Answer

Learning Objectives: Students will learn:
-The importance of the role of each first responder at any multi casualty incident.
-The differences and similarities between large and small impact MCIs.
-The roles and responsibilities of the four key MCI management positions.
-The importance of maintaining the functions of Incident Command and MCI management in the face of chaos and freelancing.

As seen at EMS World Expo 2011

Published in: Health & Medicine, Business
0 Comments
3 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
992
On Slideshare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
0
Comments
0
Likes
3
Embeds 0
No embeds

No notes for slide
  • Graphic descriptions of emotionally intense events.
  • MCI First Due First Five

    1. 1. Mass Casualty Incidents<br />First Due / First Five<br />
    2. 2. Las Vegas Conv. Ctr 8/2011<br />
    3. 3. Las Vegas Conv. Ctr8/2011<br />
    4. 4. WARNING<br />
    5. 5. Indiana State Fair – 8/2011<br />
    6. 6. Indiana State Fair – 8/2011<br />What did they do right?<br />JOC.<br />Immediate Triage.<br />Quick treatment.<br />Rapid movement from the patient generator.<br />Ready Resources.<br />What did they do right?<br />COMMAND.<br />TRIAGE<br />TREATMENT<br />TRANSPORT<br />STAGING<br />First Due<br />First Five<br />
    7. 7. Objectives<br />Case Studies<br />Identifying the MCI<br />MCI Management<br />Command<br />Triage<br />Treatment<br />Transport<br />Staging<br />
    8. 8. Hurricane Andrew – 8/1992<br />Brand new EMT.<br />Let’s go.<br />Widespread damage.<br />Rules are rules.<br />
    9. 9. New Fairfield, CT School Buses -1996<br />Three School Buses > 200 patients<br />Paramedic and Volunteer Fire Officer<br />Treatment Officer<br />Establishment of Command and Coordination<br />No Freelancing!<br />Scene Controls.<br />
    10. 10. WTC – September 11th, 2001<br />
    11. 11.
    12. 12.
    13. 13.
    14. 14. WTC Building 7 Collapses<br />
    15. 15. Liberty Plaza<br />
    16. 16.
    17. 17. Broken CoC<br />Freelancing<br />Self-Dispatching<br />No Credentialing<br />Improper PPE<br />Resource Leeching<br />Taxed Rescuers<br />
    18. 18.  WTC Tower #2<br />Rehab<br />Food<br />Primary <br />Care<br />Critical<br />Care<br />Triage / Transport<br />Supplies<br />Ambulance Staging<br />
    19. 19.
    20. 20.
    21. 21. Identifying the MCI<br />Definition<br />Needs outstrip resources<br />Threshold<br />More than initial response can treat / transport<br />Varies<br />
    22. 22. Identifying the MCI<br />MCI Mode vs Standard Response<br />At an M.C.I.priority becomes Incident Management rather than patient care<br />When needs outstrip resources, YOU CANNOT PROVIDE EFFECTIVE PATIENT CARE UNTIL YOU FIRST MANAGE THE INCIDENT. <br />
    23. 23. Identifying the MCI<br />Why?<br />Low Impact MCI<br />Increased Efficiency<br />Coordination<br />Communication<br />Culture<br />High Impact MCI<br />Increased Manageability<br />Increased Survivability<br />
    24. 24. MCI Management<br />Why Not Declare an MCI?<br />Bystanders – Expectations<br />Peers - Can’t handle it?<br />Hospitals – Treatment / Golden Hour<br />Supervisors – Cost<br />Self – Unfamiliarity<br />
    25. 25. MCI Management<br />How?<br />I must break you…<br />Of the habit of treating, not triaging.<br />“Providers will do only what they have been trained to do, or not do, if not trained ”<br />Disaster Management Pitfalls, (Ramzy & Warren, JEMS 1983)<br />“Now is the time to inventory lessons learned from previous disasters and use them to plan together.”<br />Preparing for terrorism, an emergency services guide, (Buck, G. 2002)<br />
    26. 26. MCI Management<br />Types of MCI<br />Mass Transit Crash<br />Personal MVA<br />Structural Collapse<br />Fire / Explosion<br />Crime Scenes<br />Terrorist Events / Haz Mat<br />Mass Gatherings / Events<br />Others<br />Train for what you get.<br />
    27. 27. MCI Management<br />When do we pull the trigger on this?<br />You want to know…<br />Where to go?<br />Who to talk to?<br />What is wrong with MY patient?<br />The Vests and Triage Tags answer these questions from a distance and without radio traffic<br />He may look funny in those tights but everybody know he’s in charge<br />
    28. 28. Initial Hazards<br />Examples<br />Physical Hazards<br />Haz Mat<br />WMD<br />Crowds<br />Active Shooter<br />Weather<br />Area Access<br />Traffic<br />Angry Bees<br />Other?<br />
    29. 29. Initial Hazards<br />What can you SAFELY MAKE SAFE?<br />Call 4 Race Horses<br />Protect Yourself, Your Crew, Your Public<br />Time<br />Distance<br />Shielding<br />Secondary Events<br />Accidental<br />Targeted<br />
    30. 30. The First Five<br />
    31. 31. Command<br />What to do BEFORE the MCI<br />Hazard Assessment<br />Pre-Plan<br />Pre-Stock<br />Mutual Aid<br />Dispatch Protocols<br />Education<br />Training<br />Culture Change<br />
    32. 32. Command<br />ICS / NIMS<br />Must have 100, 700<br />Should have 200, 800<br />May have 300, 400<br />I have NIMS 1,000,001<br />
    33. 33. Command<br />ICS / NIMS Features<br />Standard Structure<br />Expandable<br />Contractable<br />Modular<br />Chain of command<br />Unity of command<br />Span of control<br />Communication<br />Accountability<br />
    34. 34. Command<br />
    35. 35. Command<br />Incident<br />Commander<br />Public Information<br />Officer<br />Command Staff<br />Liaison<br />Officer<br />Safety<br />Officer<br />General Staff<br />Operations<br />Section Chief<br />Planning<br />Section Chief<br />Logistics<br />Section Chief<br />Finance/Admin<br />Section Chief<br />Branch / Division / Sector<br />EMS Branch<br />Director<br />Rescue Branch Director<br />Haz Mat Branch Director<br />BLS Unit<br />ALS Unit<br />Unit / Strike Team / Task Force<br />
    36. 36. Congratulations, You’re Hired!<br />Take the job<br />Job description<br />Dress for Success<br />Gather your tools<br />Set Up Your Workspace<br />Clear your desk<br />Go To Work<br />Empty your In-Box<br />Communicate<br />Upstream and Downstream<br />
    37. 37. Congratulations, You’re Hired!<br />
    38. 38. First Due!<br />Through the windshield<br />Size UP!<br />Location<br />Rough Number of patients<br />MCI Area<br />Command location<br />Hazards<br />Access<br />Immediate <br />Additional Resources<br />
    39. 39. First Due!<br />Size Up<br />
    40. 40. First In Unit / EMS Officer <br />
    41. 41. EMS Officer<br />Take the job<br />Initiate MCI<br />Take / Coordinate Command<br />Get Briefing<br />Grab Help<br />Dress for Success<br />Vest<br />Radio<br />Command Board<br />Set Up Your Workspace<br />Incident Area<br />Command Post<br />Ingress<br />Egress<br />T, T, T, S Areas<br />Go To Work<br />Assign T, T, T, S<br />Call 4 Racehorses<br />Structure<br />Staff<br />Stuff<br />Communicate<br />Upstream <br />IC<br />Downstream<br />Triage<br />Treatment<br />Transport<br />Staging<br />
    42. 42. EMS Officer<br />Watching out for personnel and other citizens<br />Watching traffic and its approach to the scene<br />Assigned to a single resource or to a company<br />Lookouts<br />Protect tactical channels from chatter.<br />Establish traffic control on a separate channel.<br />Communications<br />Established early on in the incident <br />Communicated to all personnel <br />Escape routes<br />Established early in the incident<br />Second area of refuge established as a back-up <br />Safety zones<br />
    43. 43. EMS Officer<br />One patient pinned under dash<br />Difficulty with lower extremities<br />Stable vital signs<br />Planning to roll up dash<br />Removing glass from windshield<br />Establishing I.V. on patient<br />Manpower<br />Send FD to assist<br />Dispatch helicopter<br />Conditions<br />Actions<br />Needs<br />
    44. 44. Triage<br />Take the job<br />Get Briefing<br />Grab Help<br />Dress for Success<br />Vest<br />Radio<br />Triage Kits<br />Set Up Your Workspace<br />Patient Generator<br />Ingress<br />Egress<br />Go To Work<br />Primary Triage<br />Non-Injured HERE - W<br />Injured HERE - G<br />Raise You’re Hand – Y<br />Breathing – R<br />Not Breathing - B<br />Secondary Triage<br />Tag<br />Treat<br />Portage<br />Communicate<br />Upstream <br />IC<br />Downstream<br />Treatment<br />
    45. 45. START TRIAGE<br />
    46. 46. Triage<br />Victim #1<br />66 y/o Male<br />CC: <br />Facial Lacerations<br />R:<br />22<br />P:<br />< 2 sec.<br />M:<br />Follows Commands<br />
    47. 47. Triage<br />Victim #2<br />22 y/o Female<br />CC: <br />L Ankle Pain<br />R:<br />28<br />P:<br />< 2 sec.<br />M:<br />Follows Commands<br />
    48. 48. Triage<br />Victim #3<br />18 y/o Male<br />CC: <br />None Verbalized<br />R:<br />32<br />P:<br />> 2 sec.<br />M:<br />Unresponsive<br />
    49. 49. Treatment<br />Take the job<br />Get Briefing<br />Grab Help<br />Dress for Success<br />Vest<br />Radio<br />Supplies<br />Staff<br />Structure<br />Stuff<br />Set Up Your Workspace<br />Think BIG<br />Have a backup<br />Ingress<br />Egress<br />Tape<br />Checkpoints<br />Tarps / Flags / Designators<br />Go To Work<br />Treatment<br />Assist? – W<br />First In, Last Out- G<br />Delayed– Y<br />Immediate – R<br />Dependent / Morgue – B<br />Re-Triage<br />Communicate<br />Upstream <br />Triage<br />Downstream<br />Transport<br />
    50. 50. Treatment<br />
    51. 51. Transport<br />Take the job<br />Get Briefing<br />Grab Help<br />Dress for Success<br />Vest<br />Radios, Many Radios<br />Patient Tracking Sheets<br />Set Up Your Workspace<br />Ingress<br />Egress<br />Go To Work<br />Notify Comms<br />Notify Hospitals<br />Track Patients<br />ID<br />Ambulance<br />Destination<br />Coordinate Specialties<br />Communicate<br />Upstream <br />Treatment<br />Downstream<br />Hospitals<br />Staging<br />
    52. 52. Staging<br />Take the job<br />Get Briefing<br />Grab Help<br />Dress for Success<br />Vest<br />Radio<br />Set Up Your Workspace<br />Ingress<br />Egress<br />Go To Work<br />Track Resources<br />Drivers Stay<br />Crew Goes<br />Take Equipment<br />Communicate<br />Upstream <br />IC<br />Transport<br />Downstream<br />Ambulances<br />
    53. 53. Danbury, CT Anthrax – 9/2007<br />
    54. 54. The Next Step<br />Conferences<br />EMS World Expo<br />MCI Management Systems<br />Tabletop Exercises<br />Local Training<br />Triage Tuesdays<br />Regional Exercises<br />Full Scale Drills<br />National Fire Academy<br />Ongoing and Pilot Programs<br />
    55. 55. SUMMARY<br />Objectives<br />Case Studies<br />Identifying the MCI<br />MCI Management<br />Command<br />Triage<br />Treatment<br />Transport<br />Staging<br />
    56. 56. SUMMARY<br />Take the job<br />Job description<br />Dress for Success<br />Gather your tools<br />Set Up Your Workspace<br />Clear your desk<br />Go To Work<br />Empty your In-Box<br />Communicate<br />Upstream and Downstream<br />
    57. 57. <ul><li>What this was not…
    58. 58. What this was…
    59. 59. Who I am…
    60. 60. Who you are…
    61. 61. Because we’re EMS,</li></ul> and we’re here to help.<br />
    62. 62. For More Information<br />For questions, comments, feedback<br />and to find additional resources on this and other lecture topics find me at…<br />Twitter: @romduck<br />Linked In: romduck<br />email: romduck@snet.net<br />www.romduckworth.com<br />

    ×