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3500 Series > 3510 - MCI Response > Flashcards

3510 - MCI Response Flashcards

1
Q

Who shall maintain this document

A

The Assistant Chief, Emergency Medical Services

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2
Q

Who are responsible for understanding and being able to execute this policy.

A

All TFD uniform personnel

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3
Q

Who shall be responsible for overall scene operations, including unified command, communications, resources, lines of authority and tactical plans as follows:

  1. Firefighting tactics as needed
  2. Notifying Fire Communications Center of the MCI (if not previously done) and request an appropriate response to handle the incident
  3. Assigning individuals to fill specific roles in accordance with specific needs of the incident
  4. Identifying a staging location and notifying all incoming units of location via the Fire Communications Center.
  5. Establishing a designated landing zone for air transport and allocating adequate personnel resources to staff it
  6. Securing access and egress routes for EMS vehicles coming into the area
  7. Coordinating operations with participating agencies (e.g.; other fire departments, FBI, Medical Examiner, local law enforcement, HazMat teams, Health Department) through the unified command post.
  8. Coordinating with TFD Emergency Management and/or City Emergency Operations Center (EOC) to order resources as needed, including strike teams.
A

The Incident Commander

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4
Q

Who shall be responsible for all operations at the scene of an emergency incident (e.g.; Medical, HazMat, Rescue, Suppression, Extraction), assigning groups or divisions as needed.

A

The Operations Section Chief

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5
Q

Who shall be responsible for all EMS operations including medical triage, treatment and transport as follows:

  1. Sizing up medical needs, casualty number estimates and severity
  2. Contacting the DMCC to:
    a. Declare an MCI and
    b. Request open patient care protocols
  3. Identifying locations for triage, treatment and transport areas and request staffing from the Operations Section Chief or Incident Commander.
  4. Supervising the Triage, Treatment, and Transport Unit Leaders.
  5. Assigning Litter Bearers to areas as needed or requested.
A

The Medical Group Supervisor

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6
Q

Who shall be responsible for:

  1. Placing patients on backboards and stretchers and in wheelchairs
  2. Assisting with the walking wounded
  3. Assisting in processing patients through the triage funnel point and into appropriate treatment and transport areas
A

The Litter Bearers

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7
Q

Who shall be responsible for:

  1. Assisting with the establishment of the triage area(s) and funnel points as designated by the Medical Group Supervisor.
  2. Triaging and prioritizing patients according to their injuries and placing them in the appropriate treatment or transport areas
  3. Numbering and tagging patients for tracking purposes
  4. Coordinate Litter Bearers to facilitate patient movement
A

The Triage Unit Leader

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8
Q

Who shall be responsible for:

  1. Setting up Red, Yellow, and Green treatment areas and equipment to receive triaged patients
  2. Ensuring all patients have treatment tags affixed to them
  3. Requesting personnel and other resources to properly staff the treatment areas
  4. Keeping the Transport Unit Leader advised as to the number of patients, severity of injuries and availability for transport
  5. Coordinate Litter Bearers to facilitate patient movement
A

The Treatment Unit Leader

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9
Q

Who shall be responsible for:

  1. Identifying access and egress routes for patient transport vehicles
  2. Coordinating loading, transporting and registering of all patients
  3. Coordinating with the Treatment Unit Leader regarding patients available for transport
  4. Maintaining communications with the DMCC to determine patient destination
  5. Ensure placement of an orange Washington State Trauma tag and a treatment tag on all transported patients for tracking purposes
  6. Maintaining records with patient number, name, destination and transporting agency
  7. Requesting ambulances, transport equipment and personnel as needed through the Medical Group Supervisor
  8. Coordinate Litter Bearers to facilitate patient movement
A

The Transport Unit Leader

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10
Q

Who shall be responsible for:

  1. Setting up the morgue area
  2. Notifying the Medical Examiner and Tacoma-Pierce County Health Department
A

The Morgue Manager

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11
Q

DMCC.

A

Disaster Medical Control Center; the hospital designated to coordinate patient transport destination.

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12
Q

H.E.A.R. System.

A

Hospital Emergency Administrative Radio system used to communicate from mobile-to-hospital and hospital-to-hospital.

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13
Q

MCI. Mass Casualty Incident;

A

an incident scene that includes 3 or more seriously injured people (triaged as RED) or 5 or more injured people of any severity (any triage color).

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14
Q

Medical “1-11”:

A

An MCI scene to which is dispatched 4 engines, 2 trucks, 2 medic units (one of which shall be the on-duty medic supervisor), a Battalion Chief and 2 private ambulances.

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15
Q

a Fire Department administrative position responsible for the delivery of service and the day-to-day operations the department’s EMS program.

A

MSO. Medical Services Officer;

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16
Q

The location to which incident personnel and equipment are assigned on an immediately available status.

A

Staging Area.

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17
Q

S.T.A.R.T.:

A

Simple Triage and Rapid Treatment; triage system used for quick identification and classification of patients into treatment categories.

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18
Q

A set number (5) of like resources.

A

Strike team:

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19
Q

White Triage Tape.

A

Identifies patients that have been decontaminated following a hazardous material or chemical exposure.

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20
Q

For any MCI with three or more RED (immediate) patients or five patients of any severity, the______ shall be notified.

A

DMCC

21
Q

The primary DMCC is:

A

Good Samaritan Hospital with Madigan Army Medical Center serving as back up when necessary.

22
Q

The DMCC will assume responsibility for providing coordination among hospitals in the event of an MCI. The DMCC will direct the destination of patients being transported from the scene to a hospital receiving center under the circumstances described in #4 above. The DMCC also may be used to coordinate patient destination for MCIs of any number.
True or false?

A

True

23
Q

________________ (radio call sign___________) will be initially the officer or medic of the first arriving unit until command is transferred.

A

The Incident Commander

“Command”

24
Q

______________(radio call sign ______________) position typically shall be a Battalion Chief who is appointed by and reports to the Incident Commander. This role is appointed at the discretion of the Incident Commander depending on the size and specific needs of the MCI.

A

The Operations Section Chief

“Operations”

25
Q

________________ (radio call sign _______) shall be the first arriving in charge Paramedic until the Paramedic Supervisor (and subsequently the MSO) arrives. This person is assigned by the Operations Sections Chief, or Incident Commander if an Operations Section Chief has not been assigned, and reports accordingly.

A

The Medical Group Supervisor

“Medical”

26
Q

The Litter Bearers shall be __________. These individuals are assigned by and report to the ____________, until assigned to a specific area (e.g.; triage, treatment, transport).

A

Firefighter/EMTs

Medical Group Supervisor

27
Q

__________________(radio call sign _______) shall be initially the first arriving medic unit driver or another person as assigned by the Medical Group Supervisor, in consultation with the Incident Commander. This person reports to the Medical Group Supervisor.

A

The Triage Unit Leader

“Triage”

28
Q

_____________ (radio call sign________) shall be a Paramedic as assigned by the Medical Group Supervisor, in consultation with the Incident Commander. This person reports to the Medical Group Supervisor.

A

The Treatment Unit Leader

“Treatment”

29
Q

________________ (radio call sign _________) shall be a Paramedic or Fireground Company Officer as assigned by the Medical Group Supervisor, in consultation with the Incident Commander. This person reports to the Medical Group Supervisor.

A

The Transport Unit Leader

“Transport”

30
Q

The Morgue Manager shall be a ______________. If needed, this person is assigned by the _______________, in consultation with the Incident Commander. This person reports to the Medical Group Supervisor.

A

Fire Officer or Firefighter

Medical Group Supervisor

31
Q

The Triage, Treatment and Transport Unit Teams shall be _________________________, as appropriate. The teams will be assigned as needed by their respective unit leaders and report accordingly.

A

Firefighter/EMTs and/or Paramedics

32
Q

All EMS communications with the DMCC will be limited to the ____________________ Units.

A

Medical Treatment and Transport

33
Q

Transport units shall not communicate with receiving hospitals. Information pertaining to those patients will be made by:

A

Transport and the DMCC.

34
Q

Triage tape and treatment tags will be carried on:

A

all TFD apparatus, MSO vehicle and Battalion Chief vehicles.

35
Q

Each patient shall be numbered with a _________________ for tracking purposes and have a treatment tag (if possible) and appropriate color tape affixed to them prior to transport.

A

permanent marking pen

36
Q

In larger MCI events where more than one triage or funnel point exists, the primary funnel point will start numbering patients with the number A1. The second triage or funnel point will start with the number B1. Additional triage or funnel points will start with C1, D1 and so forth.
True or false?

A

True

37
Q

Triage Criteria and Tape Colors:

A

RED (Immediate) A patient who:
• is breathing fast (greater than 30 times per minute)
• has capillary refill greater than two seconds or does not have a palpable radial pulse
• has an altered mental state; not oriented to person, place or time and/or unable to follow commands
YELLOW (Delayed) A patient who:
• Is breathing less than 30 times per minute
• Capillary refill less than two seconds or does have a palpable radial pulse
• Is able to follow simple commands but is injured and unable to walk.
GREEN (Minor/Non-injured) Any person who can initially walk away from an incident scene to a designated triage or treatment area.
BLACK STRIPED/SOLID BLACK (Obvious Dead-DOA) A person who has obviously died or is expected to die because of his/her injuries or a person with no respirations.
ALL WHITE (HazMat) Additional tape used to signify a person has been decontaminated after a hazardous material exposure.

38
Q

Patient Treatment

1-4

A
  1. Each patient shall have a treatment tag affixed (if not already affixed during triage) that outlines injuries, records vital signs, and identifies patient name (when possible). This tag accompanies the patient to the designated hospital receiving center.
  2. Treatment shall be in accordance with the Pierce County Patient Care Protocols.
  3. If open protocols are declared, on-line medical control is not necessary for starred (*) items in the Pierce County Patient Care Protocols.
  4. TFD personnel may still contact the base station for medical guidance as they deem necessary and appropriate (e.g.; amputation for entrapped patients).
39
Q

Deceased Persons

1-2

A
  1. Deceased persons will be tagged and covered with a sheet or blanket if possible. For investigative reasons they should remain where they are whenever possible and not be moved.
  2. The Incident Commander will coordinate with the Medical Examiner representative to arrange for disposition of the deceased.
40
Q

Under all circumstances, patient information shall be documented on the:

A

Patient Tracking Chart controlled by the Transport Unit Leader.

41
Q

PROCEDURE FOR ACTIVATING AN MCI

A

The officer or paramedic of the first arriving unit shall establish incident command and then:

  1. Size up the incident
  2. Estimate the number of casualties
  3. Initiate action to set up an MCI scene by requesting a Medical “1-11”
42
Q

PROCEDURES FOR FIRE COMMUNICATIONS WHEN AN MCI IS DECLARED

A

When a Medical “1-11” is requested, dispatch personnel shall:

  1. Dispatch the appropriate number of units to the scene.
  2. Notify the Assistant Chief for Emergency Medical Services (194).
  3. Notify the Medical Services Officer (221).
  4. Coordinate with the on-scene Incident Commander regarding the need for additional transport resources.
43
Q

PROCEDURE FOR PATIENT TRIAGE

A

Step 1: Identification of “walking wounded”–patients who, at least initially, have sufficient respiratory, circulatory, mental and motor function to walk
Step 2: Evaluation of non-ambulatory patients
Step 3: Perfusion Assessment
Step 4: Mental Status Assessment
Step 5: Evaluation of “walking wounded”

44
Q

Step 1: Identification of “walking wounded”–patients who, at least initially, have sufficient respiratory, circulatory, mental and motor function to walk

A
  1. The initial medical responder enters the incident area, identifies him/herself and directs all patients who can walk to gather and remain in a safe place.
  2. Most of these patients will be given delayed (GREEN) tags. They are not tagged at this time, but triaged separately later at which time their status may be changed.
45
Q

Step 2: Evaluation of non-ambulatory patients

A
  1. Begin evaluation of non-ambulatory patients where they are lying.
  2. Assess patient’s respirations. Are they normal, rapid or absent?
  3. If absent, reposition airway to see if breathing begins.
  4. If respirations remain absent, tag BLACK. Do not perform CPR.
  5. If the patient requires help maintaining an open airway or has a respiratory rate greater than 30 per minute, tag RED. Attempt to use bystanders to hold position of airway as necessary.
  6. If respirations are normal (greater than 10, less than 30 per minute) proceed to Step 3.
46
Q

Step 3: Perfusion Assessment

A
  1. Assess patient’s perfusion by performing the capillary refill test or by palpating a radial pulse.
  2. If the capillary refill is greater than two (2) seconds or if the radial pulse is absent, tag RED.
  3. If the capillary refill is less than two (2) seconds or if the radial pulse is present, go to Step 4.
  4. Any life threatening bleeding should be controlled at this time. If available, a non-EMS person may be used to hold pressure and assist with bleeding control.
  5. If possible, elevate the patient’s legs to begin shock treatment.
47
Q

Step 4: Mental Status Assessment

A
  1. Assess patient’s mental status. If the patient has not already demonstrated that s/he can follow simple commands, ask him/her to perform a simple task.
  2. If the patient cannot follow simple commands, tag RED.
  3. If the patient can follow simple commands, tag YELLOW or GREEN depending on his/her condition. Patient injuries will determine the designation of YELLOW vs. GREEN; multiple fractures would require a higher level of treatment than superficial lacerations.
48
Q

Step 5: Evaluation of “walking wounded”

A
  1. Return to patients initially identified as GREEN.
  2. Triage for potentially threatening injuries.
  3. Reassign to different treatment classification as appropriate and necessary and refer to treatment area accordingly.

3500 Series (8 decks)

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