Bk 70 - MCI Flashcards
The MCI predetermined emergency medical operational procedures must provide for the effective treatment/transportation of multi casualties through the principles of “_______” management.
Triage
The medical portion of a MCI incident may be handled by the Incident Commander and/or the ___________.
Medical Group Supervisor
The Incident Commander of a MCI shall assure the following:
• The Incident Command System is sufficiently implemented to meet the needs of the Multi Casualty Incident (MCI).
• Sufficient ambulances and/or appropriate transport vehicles have been requested.
• The Hospital Emergency Administrative Radio (HEAR) system has been activated through the Medical Alert Center (MAC).
•Sufficient Department personnel have been requested.
The Medical Branch is reserved for incidents with a medical component that includes what criteria?
•an unusually large number of victims
•where patients are spread over a large area (geographical)
•access to patients is separated by a great distance. (Brush fires, metro rail tunnel)
An example of a incident type where the Medical Branch may be implemented:
• Metro Rail Incident: separation of access and egress by as much as _____ feet.
• Airplane Crashes: some victims treated and transported from the runway; others from a remote area.
800 ft
Medical Groups are the basic level established at an LAFD incident when the number of resources exceed the ________ of the Incident Commander or Operations Chief.
span of control.
Subordinates to a medical group supervisor are?
-Triage Unit Leader
-Treatment Unit Leader
-Transportation Unit Leader
-Medical Supply Coordinator
Who are the subordinates to a triage unit leader?
Triage Personnel
Transporters/Litter Bearers
Morgue Manager
MCI ICS:
Who’s function is it to assume responsibility for providing triage management and movement of patients FROM the triage area?
Triage Unit Leader
Note: the movement of patients by Triage Transporters to the treatment location shall be coordinated with the Treatment Unit Leader when implemented, i.e., do not move patients to the treatment area(s) until the treatment area(s) are prepared to accept patients.
Who initially assumes the functions of Treatment Unit Leader until the position is activated?
Triage Unit Leader
MCI ICS:
Who’s duty is it to ENSURE activation of the Hospital Emergency Administrative Radio (HEAR) system through the Medical Alert Center (MAC)?
Medical Group Supervisor
MCI ICS:
Who’s function is it to assume responsibility for treatment, coordination of patient treatment, and preparation for transport, in the treatment areas. Also, directs movement of patients to loading location(s)
Treatment Unit Leader
MCI ICS:
Who’s duty is it to establish the Morgue location?
Triage Unit Leader (or Morgue Manager)
Note: Do not allow deceased patients to be moved from their original locations unless absolutely necessary. If possible, take pictures or mark location of deceased. This information is essential to the Coroner
The Triage Unit Leader gives out job assignments such as:
- Safety
-Records
-First-Aiders
-Transporters with a _____ minute rotation relief
30 min
The Morgue Manager assumes responsibility for Morgue area activities until relieved by who?
Police Dept or Office of the Coroner
Who are the subordinates to the Treatment Unit Leader?
Treatment Dispatch Manager
Immediate Treatment Manager
Delayed Treatment Manager
Minor Treatment Manager
What job assignments should the Treatment Unit Leader consider giving out?
Treatment Managers
Treatment Area Dispatcher
Records
Security
The Treatment Unit Leader should use volunteers during major disasters only, and assign them to _______ Treatment. Coordinate their use through Incident Commander.
Minor
MCI ICS:
During large scale incidents, who’s function is it to coordinate the transportation of patients out of the treatment area?
Treatment Dispatch Manager
(Coordinates with Transportation Unit/Group or Medical Group Supervisor)
The institution of the Treatment Dispatch Manager’s position is generally reserved for LARGE-SCALE INCIDENTS. There is only one Treatment Dispatch Manager per Medical Group.
The Immediate, Delayed, Minor Treatment Managers should coordinate the transportation of patients with who?
Treatment Unit Leader
Or
Treatment Dispatch Manager (if implemented)
Immediate, Delayed, and Minor Treatment Managers are supervised by who?
Who are the subordinates to the Immediate, Delayed, Minor Treatment Managers?
Treatment Unit Leader
Subordinates are:
-MEDICAL TEAMS for Immediate/delayed pts
-TREATMENT TEAMS for minor pts
When planning the treatment area layout, which treatment area should be isolated from the others if possible?
Isolate MINOR Treatment Area from Immediate and Delayed where possible.
What are the job assignments that Treatment Managers should considering assigning out?
Patient Care
Transporters: Ambulance Loading
Records
Security
Treatment Managers:
Consider the span of control when working with extremely large numbers of patients and Treatment Teams.
__________ may need to be established to manage large numbers of Treatment Teams.
Treatment Team Coordinators
MCI ICS:
Who’s function is it to assume responsibility for the coordination of patient transportation and maintenance of records relating to patient identification, patient classification (Immediate, Delayed, or Minor), transporting unit’s identification and destination?
Transport Unit Leader
*Or can be called:
Transportation Group Supervisor (If medical branch is established)
The Transportation Unit Leader [Group Supervisor] is supervised by who?
Medical Group Supervisor
or
Medical Branch Director if Activated
Who are the subordinates to the Transportation Unit Leader [Group Supervisor]?
Medical Communications Coordinator
Transportation Recorder
Ambulance Staging Manager
MCI Transportation of Patients:
Patient destination will be determined by Department personnel based upon hospital information provided by the __________.
Medical Alert Center (MAC).
MCI Transportation of patients:
For efficient use of transport resources, consider having each ambulance transport a ______ patient with each immediate patient.
Delayed
MCI ICS:
Who’s FUNCTION is it to assume RESPONSIBILITY for communications with the Medical Alert Center (MAC)?
This position will assure proper patient transportation and destination. And coordinate information through Transportation Unit Leader/Group Supervisor and Transportation Recorder.
Medical Communications Coordinator (first RA onscene?)
*At a large incident, this position may require a separation of communications:
One person managing incident medical communications; and One person managing hospital communications.
The Medical Communications Coordinator is supervised by who?
Transportation Unit Leader/Group Supervisor
MCI ICS:
Who’s FUNCTION is it to assume responsibility for records of patients, triage classification, mode of transportation, hospital status, and destination?
Transportation Recorder
The Transportation Recorder is supervised by who?
The Transportation Unit Leader [Group Supervisor]
MCI ICS:
Who’s function is it to assume responsibility for managing the Ambulance Staging Area and dispatch ambulances as requested?
This position also provides an inventory of medical supplies at Ambulance Staging Area for use at the scene.
Ambulance Staging Manager
MCI ICS:
The Ambulance Staging Manager will assume the responsibility of the __________ until the position is activated. This involves acquiring and maintaining control of medical equipment and supplies assigned to Medical Group.
Medical Supply Unit Leader
MCI ICS:
Once activated, whos function is it to assume responsibility for acquiring and maintaining control of appropriate medical equipment and supplies from units assigned to the Medical Group?
Medical Supply Unit Leader
The Ambulance Staging Manager is supervised by who?
Transportation Unit Leader [Group Supervisor]
The Medical Supply Unit Leader is supervised by who?
Medical Group Supervisor
What is the definition of a MCI according to Book 70 MCI Operations Manual?
The combination of numbers of injured persons and type of injuries exceeding the capabilities of an initial EMS response.
What does the acronym S.T.A.R.T stand for?
(S) Simple
(T) Triage
(A) And
(R) Rapid
(T) Treatment
According to the MCI Quick Reference Starter Guide:
First On-Scene shall….
• Size up.
• Develop incident action plan.
• Request resources.
• Provide protection from fire or other further injury to patients.
• Recon area to ensure all patients are identified.
• Establish a medical group command post.
• Secure operational area.
• Ensure HEAR system activation through the MAC.
What shall be done with dead bodies onscene of an MCI during an active incident?
Leave dead bodies in place unless absolutely necessary to move them (i.e. if they interfere with rescue operations).
The Simple Triage and Rapid Treatment (START) plan allows the first responders to triage patients in ____ seconds or less, depending on what three physical assessment observations?
60 seconds
Ventilation, Perfusion, Mental status
(The START plan does not attempt to make diagnoses.)
Which category of triage?
-Ventilations present only after repositioning the airway (or breathing with no intervention)
AND
-Respirations over 30 per minute
or
-Capillary refill takes over 2 seconds
or
-Patient fails to follow simple commands
Immediate
Which category of triage?
-No ventilation present even after attempting to reposition the airway.
Deceased
Which category of triage?
These patients are separated from the general group at the start of triage by ordering “anyone who can walk” followed by an area assignment where the patients should proceed.
Minor
Which category of triage?
Any patient who does not fit the Immediate category nor the Minor category. (Or deceased)
Delayed
Triage flow chart:
Medical Branch ICS Chart (Operations)
Medical Branch ICS Chart (Expanded)
Medical Branch ICS Chart #2
Under normal circumstances, the dead should not be moved from the location in which they were discovered at the disaster site.
What circumstances would exist in order to move dead bodies?
For rescue work or the health and safety of others
The Multi-Casualty form is used to record available patient information that will be communicated by the ___________ to the base hospital or the Medical Alert Center (MAC).
Medical Communications Coordinator
The triage tag has left and right yellow corners that are perforated.
One corner can be retained by the ______ Unit Leader, the other can be retained by the ________ Supervisor.
The hospital destination can be marked on the tabs.
-Treatment Unit Leader
-Transportation Supervisor
Triage Tags:
If the triage priority of the patient changes, remove the entire bottom portion leaving the injury information and do what to re-triage the patient?
Add a second tag identifying the new triage priority and the reason for the change
Triage personnel must tag ALL patients. IT IS A TIME CONSUMING AND OFTEN FATAL MISTAKE TO TRIAGE IN THE FIELD WITHOUT TAGGING A PATIENT.
Patients are tagged so that?
Rescuers arriving later can immediately turn their attention to the patients most in need.
A PRIMARY GOAL of triage is to select the patients in the GREATEST NEED of urgent care.
Minimal intervention to _______ is done AT THE SAME TIME as the initial triage.
STABILIZE the AIRWAY
Or
Control HEMORRHAGE
