What are the three MCI types?
- Hazardous Materials Incidents (decon prior to movement to casualty collection point)
- High-threat Environments (Joint Action guide for High-threat Environments guides)
- Evacuation of a medical facility (may have to have a CCP)
what two responses are designed to assemble necessary resources for a MCI?
EMS Task Force (10 patients; assigned directly to EMS units; no treatment area)
MCI Response (25 patients; initial MCI alarm assignment is designed to complete the structure of the EMS branch)
EMS Task Force Response
10 patients; no treatment area
- 5 EMS Transport Units
- 1 BC / 1 EMS Sup or Command Staff
- 2 Suppression Units
MCI Alarm Response
25 patients; initial MCI assignment designed to complete structure of the EMS branch
- 10 EMS Transports
- 10 Suppression units
- 1 BC
- 3 EMS SUPS / Command Staff
- 1 Mobile Command Unit
- 1 Green (Civilian) Transport Bus
- 1 Medical Care Support Unit (MCSU)
- 1 Medical Ambo Bus (MAB)
2nd and Subsequent MCI Alarms
provides resources to supplement initial MCI; 25 additional patients
- 10 EMS transport units
- 5 suppression units
- 1 medical care support unit (MCSU)
- 1 medical ambo bus (MAB)
- 1 green transport bus
Five S’s of MCI
- Safety (identify IDLH/high-threat situation; warn upcoming units)
- Size-up (det need for additional resources; approximate number/severity of patients)
- Send (situation report; request appropriate alarm based on # of patients; activate RHCC; announce pt tracking)
- Set-up (identify staging area; identify/announce scene access and egress)
- Start (initiate triage)
Staging Manager
- IC/Ops Manager assigns staging manager
— or, first suppression unit officer - during MCI, the 8/9/10 engines go direct to staging
EMS Branch Director
- established by the first arriving BC
- reports to Ops Section Chief
- manages medical group and transportation group
Transportation Group
- first arriving transport unit, first EMS Sup, and 2 & 7 suppression units
- set up/operation of transportation section
- coordinate and track patient transportation
- goal: expedite transportation of most critically injured
Transportation Group Supervisor
- established by first arriving transport unit OIC/AIC, then assumed by first EMS Sup
— transport unit OIC/ACI then becomes medical comms coordinator
Medical Comms Coordinator
- AIC/OIC of first arriving transport unit
- ONLY ONE MCC regardless of size/scope
responsibilities:
- establish/maintain comms with RHCC
— maintains count of available beds (5 hospitals/2 trauma centers closest to incident)
— advises RHCC if additional beds/hospitals required
- uses med comm coordinator form to maintain status of receiving facility availability and capability
- assigns patient destination to transport units
Transport Recorder
- established by the driver-operator of the first arriving transport unit
- responsibilities
— ensure disaster tag attached to each patient
— transport records have: sex, destination, transportation agency/unit, departure time/time out, triage status
Ambulance Coordinator
- OIC of second arriving suppression unit
- manages access, egress, positioning and loading of transport units
Air Ambulance Coordinator
- member of suppression unit assigned to the landing zone
- reports to transportation group supervisor (first arriving transport OIC and then first arriving EMS Sup)
- liaison between air medical crews and transportation group supervisor
Transport Loaders
- 2nd/7th suppression unit personnel
- retrieve patients from treatment areas or impact area, bring them through the PEP to the loading area
Transport Units
- intent of MCI management is to transport immediate (red tags) ASAP
- initial responding transport units will be directed to the transport corridor
- while transporting DIRECT COMMS NOT NECESSARY; info relayed by RHCC
Responsibilities:
- AIC/OIC reports to PEP to receive patient/hospital assignment
- ensure driver stays with unit
- ensure completed disaster tag given to transport recorder
- assist with patient loading
- transport patient to assigned facility
- complete disaster tag/patient tracking system entry
- return to service by contacting comms center managing incident
Medical Group Supervisor
- second arriving EMS Sup on initial MCI alarm
Triage Unit Leader
- OIC first arriving suppression unit
- Responsible for triaging patients within the impact area or CCP
- uses START/JumpSTART triaging
Triage Crews
- 2-3 people
- perform triage (START/JumpSTART)
Initial Treatments with START/JumpSTART Triage
- position airway
- deliver 5 rescue breaths (JumpSTART)
- TQ/pressure on severe bleeds
- chest seals/occlusive dressings
communicate accurate counts, triage status, and locations of patients to triage unit leader
treatment unit leader
- responsible for the location, set-up, and operation of treatment areas (secondary triage happens at treatment area)
- OIC of 4th arriving suppression unit
