Major Incident Management Flashcards
What does the acronym ‘METHANE’ stand for?
M - Major incident standby or declared
E - Exact location of incident
T - Type of incident
H - Hazards (present and potential)
A - Access and egress routes
N -Number, severity and type of casualties
E - Emergency services present on scene and further resources required
Example Exam Question: Please undertake an initial triage on the following adult patients by simply listing their category following your triage.
Patient 1 – GCS 8, Airway- Open, Breathing- RR 8, Circulation- HR 40, head injury
Patient 2 – GCS 15, Airway- Open, Breathing – RR 18, Circulation- HR 88, head injury, mobile
Patient 3 – GCS 15, Airway- Open, Breathing- RR 20, Circulation- HR 90, no injury, mobile
Patient 4 – GCS 15, Airway- Open, Breathing- RR 16, Circulation- HR 65, unable to walk with lower limb injuries
Patient 5 – GCS 15, Airway- Open, Breathing- RR 24, Circulation- HR 90, below elbow amputation, mobile
Patient 6 – GCS 3, Airway- Open, Breathing- RR 18, Circulation- HR 80, No obvious injury
Patient 7 – GCS 3, Airway- Open, Breathing- RR 0, Circulation- HR 150, Head Injury (7 marks)
- Patient 1 – P1
- Patient 2 – P3
- Patient 3 – Survivor reception
- Patient 4 – P2
- Patient 5 – P1
- Patient 6 – P1
- Patient 7 – Dead (Could upgrade to P1 if resources sufficient to manage patient)
Example Exam Question: Please undertake an initial triage on the following adult patients by simply listing their category following your triage.
Patient 1 – GCS 3, Airway- Open, Breathing- RR 0, Circulation- HR 40, head injury
Patient 2 – GCS 15, Airway- Open, Breathing – RR 18, Circulation- HR 88, head injury, mobile
Patient 3 – GCS 15, Airway- Open, Breathing- RR 20, Circulation- HR 90, above wrist amputation of the right arm, mobile
Patient 4 – GCS 15, Airway- Open, Breathing- RR 16, Circulation- HR 65, unable to walk with lower limb injuries
Patient 5 – GCS 15, Airway- Open, Breathing- RR 34, Circulation- HR 90, chest injury, mobile (5 marks)
Patient 1 – Dead
Patient 2 – P3
Patient 3 – P1
Patient 4 – P2
Patient 5 – P3 – or if resources allow upgrade to P1
Example Exam Question: You have been called to a road traffic collision involving a car and a minibus on a major motorway network near your ambulance station. On arrival you notice the accident is just past junction 17 of the M1 heading in a northbound direction. There is already a police car on scene and the attending officers are making the immediate area safe. There are currently 20 patients who have removed themselves from the accident and are standing at the side of the road. As you approach the car it is clear that 2 occupants are trapped in the front seats with significant injuries. Your colleague informs you that there are 6 patients left on the minibus that are unable to move because of limb injuries. The attending police officers now inform you that 3 out of 4 lanes of the motorway are closed and there is spilt diesel by the front of the minibus.
Given this information, please formulate a METHANE report. (7 marks)
M- Call sign/name and major incident declared
E- Between junction 17 and 18/after junction 17 heading northbound on the M1
T- Road traffic collision
H- Live traffic and fuel spill
A- Access junction 17 M1 and egress junction 18 M1 and RVP after RTC on M1
N- Approximately 28 patients -8 Trapped/unable to move, 20 T/P 3, non-contaminated
E- 1 x ambulance and 1 x police car on scene, requesting further ambulance, highways agency and fire service response
Example Exam Question: You have been called to a Road Traffic Collision in the left hand bore of the Dartford tunnel on the A282 (M25 anti-clockwise carriageway). On arrival at the incident you are met by the Fire and Service Rescue Service Incident Officer (1 fire resource on scene) who informs you that a lorry has collided with stationary traffic in the tunnel (which is now blocked). There are 6 cars involved in the collision and the lorry is carrying a load of non-toxic waste. There are 6 patients trapped in their vehicles through pressure, 6 patients who are able to mobilise with minor injuries and 4 patients with no injuries who are also mobile. There is oil, water and fuel spillages from the vehicles involved. Currently the Highways agency are on scene there is no other Ambulance, Fire or Police resources on scene.
Please formulate a METHANE report as per the UK Ambulances Services Clinical Practice Guidelines (2016). (10 marks).
M- Major incident declared
E- A282/M25 anti-clockwise carriageway in the left hand bore of the Dartford tunnel
T- Road Traffic Collision
H- Fuel, water and oil spill, live traffic and non-toxic waste. Potential risk of a fire.
A- Access currently A282/M25 anti-clockwise carriageway, egress A282/M25 anti-clockwise carriageway.
N- 6 patients trapped through pressure (possible P1/P2s or dead), 6 P3s, 4 patients not injuried.
E- One fire and Rescue and one Ambulance resource on scene with the Highways Agency. Request Police, further Ambulance and Fire and Rescue resources, Advanced Paramedics, HART, HEMS.
Example Exam Question: Describe the initial steps taken by a first responder to any incident with specific reference to Chemical, Biological, Radiological, Nuclear and Explosive incidents as per the latest JESIP (2015) and UK Ambulance Services Clinical Practice Guidelines (2016). (11 marks)
- Step 1 One person incapacitated with no obvious reason • Approach using standard protocols
- Step 2 Two people incapacitated with no obvious reason • Approach with caution using standard protocols
- Step 3 Three or more people in close proximity, incapacitated with no obvious reason • Use caution and follow step ‘Plus’
- Plus – Follow the CBRN First Responder Flow Chart to consider what actions can be undertaken to save life, using the following principles:
- METHANE report
- Evacuate – get people away from the scene of contamination;
- Communicate and advise – immediate medical advice and reassurance that help is on its way;
- Disrobe – remove clothing;
- Decontaminate – improvised decontamination
- Dry decontamination when a noncaustic agent is suspected and;
- Wet decontamination when a caustic agent is suspected.
