Dr. Ahmed Azab drazap69@yahoo.com

3. What is a MAJOR INCIDENT?

6. Major Incident Definition
• An incident where the
– NUMBER, SEVERITY, or TYPE of LIVE casualties, or
by its LOCATION, requires EXTRAORDINARY
resources.

7. Major Incident Definition
• An incident that presents a serious threat to
the health of the community
• An incident that disrupts the health service

8. Major Incident Classification
Compensated Uncompensated

9. Major Incident Classification
• Uncompensated
Major Incident
= DISASTER

10. PHASES OF DISASTER
• Pre-impact phase
• Impact phase
• Post-impact phase

11. What is Disaster Management

12. PHASES OF DISASTER MANAGEMENT
• Disaster Preparedness
• Disaster impact
• Disaster Response
• Rehabilitation - Recovery
• Disaster Mitigation

13. CSCATTT
• Command and Control
• Safety
• Communication
• Assessment
• Triage
• Treatment
• Transport

14. • Command
And
control

15. Command and control.
• Every group should have their Command.
• Every response area should have their
command.
• All of that – all the disaster response systems
should have higher command.

17. Tiers of Command
Bronze
• Bronze area is the area of immediate hazard and casualty rescue.
• Its boundary is the Inner Cordon.
• There may be more than one BRONZE area within an incident.
Silver
• Silver area is the entire scene.
• Its boundary is the outer cordon.
• There is only one silver area within an incident.
Gold
• Gold area is remote from the scene.
• It may be identified by a local authority, regional, or national
boundary.
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18. 18

19. Safety On The Scene
• Safety Priorities
The following safety priorities should be observed:
Self
Scene
Survivors (Injured & uninjured)
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20. Safety On The Scene
1- Personal Safety
Protective equipment:
High visibility jacket Protective boots
Hard hat Goggles or visors
Ear defenders Gloves
• Do Not approach the incident when hazards
are known to exist without permission of the
Bronze Fire Commander.

21. Safety On The Scene
2- Scene Safety
• Safety inside the Bronze area is the responsibility of
the Bronze Fire Commander especially in fire or
toxic chemicals.
• Safety inside the Silver area is the responsibility of
the Police who will evacuate any population at risk.
• If first on the scene, the Ambulance Commander
will take Control until additional resources arrive.
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22. Safety On The Scene
3- Survivor Safety
 Occasionally it will be necessary to move casualties
if there is an immediate threat to life as fire or toxic
chemicals. This will be done without the usual
precautions (e.g. spinal immobilization).
 Measures must be taken to avoid additional
casualties by preventing hypothermia, heat illness,
exhaustion and dehydration.
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23. Communications
Communication is always the most problematic part
of the plan.
Communication with:
• The staff
• The other responders
• The other health facilities
• The authorities
• The media
• The families
• The non-injured survivors
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24. Communications
• Communications are mainly performed using the radio.
• The radio must be monitored at all times.
Alternative Methods for communications:
Face-to-face, runner (written message),
megaphone, whistle, hand signals, pager,
and mobile phones.
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25. METHANE Report
M: My name.
Major incident STANDBY or DECLARED.
E: Exact location.
T: Type of incident.
H: Hazards, present and potential.
A: Access to scene, helicopter landing location.
N: Number and severity of casualties.
E: Emergency services, present and required.

26. Dealing with The Media
• All major incidents will attract a media response.
• The Silver Police Commander is responsible for
managing the media.
• Prepare a statement in advance if possible.
• Do Not be drawn into suppositions regarding the
cause and responsibility for the incident.
• In television interview:
Check your appearance: do you look professional?
Always assume that you are on the air.
Look straight at the interviewer, not the camera.
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27. Triage

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29. 29

30. Treatment
Treatment Priorities in Casualty Clearing Station (CCS):
• Airway, and cervical spine control.
• Breathing, and oxygen.
• Circulation, and control of bleeding.
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31. Major incident treatment limitations:
 Full spinal immobilization is impractical for all victims in a
rail crash for example, even though they are exposed to the
same injury.
 Oxygen is a limited source, so more than one patient can be
given oxygen from the same cylinder.
 Defibrillation is appropriate only for a witnessed cardiac
arrest, those with no vital signs should be pronounced
dead.
 Intubation has a limited role at the scene.
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32. Transport
Casualty Evacuation Principles: (‫)إخالء‬
The Silver Ambulance Commander and the Ambulance
Loading Officer are responsible for the efficient use of
available transport for patient evacuation.
Immediate Priority 1
These casualties should be evacuated
by emergency ambulance, if appropriate
use ambulance helicopter.
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33. Transport
Urgent Priority 2
These casualties might need to be moved by
emergency ambulance, but after Priority 1.

34. Transport
Delayed Priority 3
These casualties often do not need to be
moved by emergency ambulance, unless there
are adequate resources for all patients.

35. Medical Personnel on the scene
1. Silver ambulance commander
2. Bronze ambulance commander
3. Casualty clearing station (CCS) officer
4. Communications officer
5. Equipment officer
6. Loading officer
7. Parking officer
8. Primary triage officer
9. Safety officer
10. Secondary triage officer
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