june, 2012 zone one mci training june, 2012. training objectives focused at the company officer...
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JUNE, 2012
Zone One MCI Training
June, 2012
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Training Objectives
Focused at the Company Officer Level
Review of initial MCI scene size-upOverview of general MCI conceptsSummary of new King County MCI
Plan changes
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Initial Size-up Phase 1
Look for SLUDGE Identify immediate hazardsConsider access/egress optionsObserve base/staging optionsEstimate number of patients
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More Size-up Phase 2
Estimate number of non-ambulatory patients
Consider extrication/relocation issuesScene status: Static or Dynamic?
Decide: Complex…not complex
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No SLUDGE
No Fire, stable scene
Southbound lanes open
Overpass intact
Patients walking around
6-10 Reds
Simple extrication
Static scene
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Commanding the radio
Provide size-upInitiate commandInitial assignments
Safety & handline Triage Treatment
Request “base” resources
Request “transport” resources
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Requesting Resources
Basic MCI Activities Rescue/Extrication Treatment/Transport Ambulance staging
Complex Activities Fire Hazard Material CBRNE Collapse
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Maintain the Transportation Corridor!
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Physical Actions of the First-in Crew
Engine/Ladder Company Recon / Risk Assessment Mitigate immediate high risks Secure Transportation Corridor Begin Triage Direct movement of “Green” Walking wounded Implement Rescue Group
Medic Units/MSO Decide: Patient or Scene mgmt Medical Group Treatment Unit Transport Unit
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Revised 2011 MCI Plan: WHY?
Reduce choke (funnel) points Minimize unnecessary actionsImprove division of laborIncrease plan scalability for all eventsSimplify patient trackingUtilize NIMS terminology
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MCI Changes at a glance
Develop “Rescue Group” to package and move patients
Eliminate formal funnel pointEliminate use of treatment tagsEliminate patient numbering (felt pen)Utilize NIMS Terms: Hospital Control is now
Disaster Medical Control Center (DMCC)
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Changes
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Changes
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The Previous MCI Plan
COMMAND
MEDICAL GROUP
TRIAGE
TREATMENT
TRANSPORT
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Typical MCI Org Chart 2011
COMMAND
RESCUE GROUP
EXTRACTION UNIT
EXTRICATION UNIT
MEDICAL GROUP
TREATMENT UNIT
TRANSPORT UNIT
GREENUNIT
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Are you doing the job…or leading it?
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Unit Leader/Group Supervisor
Don the vestUnderstand Action PlanDetermine supervisors role Develop organizationDevelop relationships Maintain accountabilityProvide progress reports
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So, who does Triage?
Rapid Field Triage -BLS
Minimal TreatmentWho Supervises
Triage: Medical Group Rescue Group
Secondary Triage – ALS
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First Order Second Order
STARTABCSick/Not SickJump STARTTriage Sieve (UK)
Triage Sort (UK)SAVE (Secondary
Assessment of Victim Endpoint) Those who will die anyway Those who will survive
anyway Move only those who will
have a condition change
Current Triage Systems
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Treatment Unit
Locate suitable area
Secure suppliesDevelop
treatment teamsDetermine
transport priorities
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Treatment Unit
Reasons for a Treatment Area Visual indicator for injured No transportation available Immediate life-saving treatment Move the reds, hold others
Assure appropriate treatmentUse Aid/Medic Units for suppliesPrioritize patients for transport
Use a “Treatment Dispatch Manager”Benchmarks:
All reds transported All patients transported
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Expanding the Treatment Unit
Treatment Unit Leader
Red Manager
Yellow Manager
Treatment Dispatch Manager
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Transport Unit
Assure DMCC activation
Establish Ambulance Staging
Confirm transporting resources are inbound
Coordinate patient loading
Track Destinations
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Transportation Unit
Apply tracking bandsCommunicate with
DMCCReceive patient
destinationManage documentationBenchmarks:
All reds transported All patients transported
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Tracking
All transport capable vehicles in King County will have tracking bands
Typically applied at the ambulance loading or DMCC activity area.
Ensures that all patients have a tracking band
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Tracking
Retain one peel-off sticker on a tracking board
All MSO’s and Medic Units will have tracking sheets
Tracking sheets allow for sticker or Barcode tracking
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Tracking
Instruct all transporting personnel to place a tracking sticker on the Medical Incident Report: Hospital form Agency form EPCR agencies need to
enter number in laptop
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Expanding the Transport Unit
Transport Unit Leader
Ambulance Staging Manager
DMCCCoordinator
Ambulance Loading Manager
Tracking Aide
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Rescue Group/Unit
DisentanglementMoves all patients to
Treatment areaPersonnel IntensiveMay report to Medical or
OperationsMay provide field triage
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Expanding the Rescue Group
Rescue Group
Extrication Unit
Extraction Unit
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Expanding the Medical Group
Medical Group
Treatment Unit
Transport Unit
Green Patient Unit
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Incident Command
SafetyPIO
Liaison
Operations
Medical
Treatmen
tYellow Uni
t
Red
Unit
Dispatch Manager
TransportAmbulance
Staging
Ambulance
LoadingD
MCCCoordinatorTracking Aide
Green
Patients
Rescue
Extraction
Extrication
Hazard Mitigation
Decon
Haz Mat Fire
Recon
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Summary of Key Points for MCI
Secure the transport corridorKeep transport units staged separatelyMedics focus on
Medical/Treatment/TransportEarly notification of DMCCSuppression focus on Rescue/ExtractionPerform secondary triage before transportSeparate loading from DMCC activities
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Questions?