MCI First Due First Five
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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
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MCI First Due First Five
- 3. MCI: Forward Movement Where we are right now. Problem Goal Challenge
- 4. MCI: Forward Movement How are we going to get there? Case Studies Identify the MCI Forward Movement of Patients ① Command ② Triage ③ Treatment ④ Transport ⑤ Staging
- 5. MCI: Forward Movement Hurricane Andrew – 8/1992 Brand new EMT. Let’s go. Widespread damage. Rules are rules.
- 6. MCI: Forward Movement New Fairfield, CT School Buses -1996 Three School Buses > 200 patients Paramedic and Volunteer Fire Officer Treatment Officer Establishment of Command and Coordination No Freelancing! Scene Controls.
- 7. MCI: Forward Movement WTC – September 11th, 2001
- 11. MCI: Forward Movement WTC Building 7 Collapses
- 12. MCI: Forward Movement Liberty Plaza
- 13. MCI: Forward Movement Broken CoC Freelancing Self-Dispatching No Credentialing Improper PPE Resource Leeching Taxed Rescuers
- 14. MCI: Forward Movement WTC Tower #2 Ambulance Staging RehabFood Triage / Transport Critical Care Supplies Primary Care
- 17. MCI: Forward Movement Identifying the MCI Definition Needs outstrip resources Threshold More than initial response can treat / transport Varies
- 18. MCI: Forward Movement MCI Management Why Not Declare an MCI? Bystanders – Expectations Peers - Can’t handle it? Hospitals – Treatment / Golden Hour Supervisors – Cost Self – Unfamiliarity
- 19. MCI: Forward Movement Identifying the MCI Why? Low Impact MCI Increased Efficiency Coordination Communication Culture High Impact MCI Increased Manageability Increased Survivability
- 20. MCI: Forward Movement MCI Management Types of MCI Mass Transit Crash Personal MVA Structural Collapse Fire / Explosion Crime Scenes Terrorist Events / Haz Mat Mass Gatherings / Events Others Train for what you get.
- 21. MCI: Forward Movement Initial Hazards Examples Physical Hazards Haz Mat WMD Crowds Active Shooter Weather Area Access Traffic Angry Bees Other?
- 22. MCI: Forward Movement Initial Hazards What can you SAFELY MAKE SAFE? Call 4 Race Horses Protect Yourself, Your Crew, Your Public Time Distance Shielding Secondary Events Accidental Targeted
- 23. MCI: Forward Movement MCI Management
- 25. MCI: Forward Movement First Due Triage Treatment Transport Staging
- 26. MCI: Forward Movement ①Size Up ②Set Up ③Move Forward
- 27. MCI: Forward Movement First Due!
- 29. MCI: Forward Movement First Due ① Size Up Incident Area Hazards Ingress Egress Command Post Initiate MCI ② Set Up Assign Triage Treatment Transport Staging ③ Move Forward Monitor Conditions Actions Needs
- 30. MCI: Forward Movement Triage ① Size Up Patients Patient Generator(s) Ingress Egress Treatment Area ② Set Up Triage Kits Delegate Assistants Aim for Treatment Area ③ Move Forward Global Triage Non-Injured HERE - Injured HERE - Raise You’re Hand – Not Moving– Individual Triage Breathing Y/N?-> B Obeys, Pulse, Breathing OK, Bleeding OK-> Might Survive? -> Portage to Treatment Continuous Triage
- 31. MCI: Forward Movement Triage Victim #1 66 y/o Male CC: Facial Lacerations R: 22 P: < 2 sec. M: Follows Commands
- 32. MCI: Forward Movement Triage Victim #2 22 y/o Female CC: L Ankle Fracture R: 28 P: < 2 sec. M: Follows Commands
- 33. MCI: Forward Movement Triage Victim #3 18 y/o Male CC: None Verbalized R: 32 P: > 2 sec. M: Unresponsive
- 37. MCI: Forward Movement Treatment ① Size Up Ingress Egress Holding Areas ② Set Up Resources Structure Staff Stuff Think BIG Have a backup Checkpoints Tarps / Flags / Designators ③ Move Forward Treatment Assist? – First In, Last Out- Delayed– Immediate – Morgue / Dependant – B Batter Up Double Up
- 38. MCI: Forward Movement Transport ① Size Up Patients Ambulances Destinations ② Set Up Ingress Egress Staging Communications Local Dispatch Regional Dispatch Hospitals Patient Tracking ③ Move Forward Open Channels Local Dispatch Regional Dispatch Hospitals Designate Patient(s) Ambulance Crew Destination Track Patients Priority ID Ambulance Destination
- 39. MCI: Forward Movement Staging ① Size Up Needs Resources ② Set Up Ingress Egress Incoming Resources Open Channel with Transport ③ Move Forward Track Resources Drivers Stay Crew Goes Take Gear
- 40. MCI: Forward Movement Danbury, CT Anthrax – 9/2007
- 41. MCI: Forward Movement Sandy Hook, CT – 12/2012
- 42. MCI: Forward Movement What to do BEFORE the MCI Hazard Assessment Pre-Plan Pre-Stock Mutual Aid Dispatch Protocols Education Training Culture Change
- 43. MCI: Forward Movement First Due Triage Treatment Transport Staging
- 44. MCI: Forward Movement ①Size Up ②Set Up ③Move Forward
- 45. MCI: Forward Movement • What this was not… • What this was… • Who I am… • Who you are… • Because we’re EMS, and we’re here to help.
Editor's Notes
- Graphic descriptions of emotionally intense events.