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
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
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.
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
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
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
42. MCI: Forward Movement
What to do BEFORE the MCI
Hazard Assessment
Pre-Plan
Pre-Stock
Mutual Aid
Dispatch Protocols
Education
Training
Culture Change