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Mass Casualty Incidents Flashcards

1
Q

Multi Casualty Incident

A

4 - 24 Pts

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2
Q

Mass Casualty Incident

A

25 - 49 Pts

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3
Q

Medical Disaster Incident

A

50+ Pts

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4
Q

TFD Resources Available

A
  • Metropolitan Medical Response System Strike Team
  • Mass Casualty Unit
  • Rapid Response Team (RRT)
  • Incident Support Team (IST)
  • Logistical Support Unit
  • Interoperable Communications Unit (COMM-1)
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5
Q

Metropolitan Medical Response System

A

(MMRS)

A system that helps local & regional response resources in All-Hazard events, with a focus on major medical incidents

Composed of a Strike Team that is made up & managed by TFD personnel

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6
Q

MMRS Strike Team

A

A local/county/state deployable resource maintained by the TFD

Capabilities of assisting with:
- Decontamination
- Triage
- TX
- Transportation

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7
Q

MMRS Box Truck

A

(MC6)

  • Currently located at Station 6
  • Station 6 personnel maintain and
    staff this unit
  • In the event of a local response or a County/State deployment, the on-duty EN06 personnel will respond in EN06 and the MMRS Box Truck (MC6) as MMRS Strike Team
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8
Q

MC6 Capabilities

A
  • Decontamination (MC6 has an additional Tent & equipment)
  • Triage
  • TX of ALS & BLS Pts
  • Transportation Coordination
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9
Q

Mass Casualty Unit

A

(MC7)

  • Currently located as Station 7
  • Station 7 personnel maintain & staff this unit
  • Utilized for BLS logistical support for mass casualty incidents within the City of Tucson
  • In the event of a response, the on-duty EN07 or LD07 personnel will respond in EN07 or LD07 & MC7
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10
Q

MC7 Capabilities

A
  • Decontamination (There is no additional decontamination equipment on MC7)
  • Triage
  • TX of BLS patients
  • Transportation Coordination
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11
Q

Rapid Response Team

A

(RRT)

State Deployable asset maintained by the TFD Squad 20 and Squad 19

Capabilities include:
- Hazmat
- Technical Rescue

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12
Q

Incident Support Team

A

(IST)

A team of TFD officers that are deployed w/ any county and/or State deployed TFD resources (i.e. RRT, MMRS, etc.)

Primary & Back Up Officers that run both the MMRS & RRT

The IST team’s purpose is
to provide liaison to the jurisdiction’s Incident/Unified Command and to provide leadership/command authority over TFD deployed resources

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13
Q

Primary IST Officers

A
  • Emergency Management Deputy Chief Officer (lead IST Officer)
  • Safety and Wellness Deputy Chief Officer
  • Operations Deputy Chief Officer
  • The on-duty Battalion 1 Chief Officer
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14
Q

Back Up IST Officers

A
  • Emergency Preparedness Assistant Chief Officer (Lead Officer)
  • Training and Safety Assistant Chief Officer
  • Operations Assistant Chief Officer
  • The on-duty Battalion 4 Chief Officer
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15
Q

Purpose of IST

A
  • Provide liaison to the jurisdiction’s Incident/Unified Command
  • Provide leadership/command authority over TFD deployed resources
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16
Q

Logistical Support Unit

A

A TFD logistical support unit that is deployed alongside TFD deployable assets (MMRS and RRT) on county/State events that extend beyond one operational period (12 hrs)

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17
Q

EM Track System

A

Currently Stationed w/ EC-26

Patient-tracking equipment utilized for Multiple or Mass Casualty Incidents throughout the Southern Region

*EC Trucks have similar tracking equipment to be used for Multiple or Mass Casualty Incidents w/in City limits

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18
Q

Procedures for utilizing EM Track System

A
  1. Contact EC-26 or BN09 to initiate an incident
  2. Assign an EC Captain to initiate and perform the EMTrack Scanning
  3. Once the patient has been triaged, the tag’s unique ID bar code should be scanned into the handheld device along with the patient’s level of acuity

*Each time the Pt’s location or destination is changed, that information should be
entered into the tracking system along with the bar code

*The Pt tracking system should also be used to track the personal belongings of incident victims, utilizing the long bar coded tabs to seal the private possession bags provide in the decon kits

*Once collected and scanned these items may also be tracked through the system and eventually returned to the owner

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19
Q

Interoperable Communications Unit

A

(COMM-1)

A mobile Interoperability Communications Van that provides 2-way radio communication links between multiple city, state, and county agencies

The intended use
of this resource is to link different public safety agency’s radio communications together,
which operate on different frequencies, during large scale long duration incidents involving multi-jurisdictional and/or multi-agency

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20
Q

Requesting COMM-1

A

WHO:
- The Incident Commander = for local deployment
- The City of Tucson Emergency Operations Center (EOC) = for local and statewide deployment
- The TFD Incident Support Team (IST) Officers = for statewide deployment

Deployed at the discretion of:
- The City of Tucson
- Communications Administrator (or designee)
- In collaboration w/ the TFD Officer requesting the resource (based on the incident needs, incident length, & available Communications Department personnel)

  • Deployed from the Communications Maintenance Division w/ it’s Communications Techs (who will ultimately operate it)
21
Q

COMM-1 Deployment

A
  1. The request to deploy COMM-1 will be coordinated through Tucson Fire Dispatch
  2. Tucson Fire Dispatch will contact the communications on-call technician, who in-turn, will
    contact the COMM-1 personnel to be deployed
  3. COMM-1 will be on-scene or en route, depending on the location of the incident, within 1-½ hours of receiving the call
  4. COMM-1 will contact fire alarm on F2 when leaving communications maintenance, to be assigned a frequency to monitor
  5. On arrival, COMM-1 will report to the Incident Commander, and will set up communications according to needs/instructions
  6. The on-scene Incident Commander shall provide a Tucson Fire Liaison to COMM-1
22
Q

Arizona’s Emergency Medical Services Communications (EMSCOM)

A

The system in charge of providing a communication link between EMS Personnel and Statewide medical facilities

23
Q

Utilizing EMSCOM

A
  1. The Officer assigned to communicate w/ the Hospital will initiate EMSCOM through Meds Control
  2. Meds Control will assign a Meds Channel & notify ALL hospitals to come up on that channel

*If ALL hospitals are needed, they will All be notified & required to come on, otherwise the Officer should only request Communication w/ the Hospitals needed for Pt transport

  1. The officer should then switch to the assigned channel wait for each hospital to come up on that channel,
    and then communicate with the hospitals
  2. After communication is complete, the officer should switch back to Meds Control and notify that them
    that the channel is clear
24
Q

What Info needs to be communicated to the Hospital

A
  1. Brief Description of incident
  2. Number of patients, based on triage category (i.e. immediate, delayed, etc.)
  3. Which hospitals will be receiving which patients
25
Q

Local Response

A

The TFD MCI resources (MC6 and MC7) are available to be utilized during local mass casualty
or greater incidents

The closest available MCI resource will be dispatched w/ a full medical response

A TFD Full medical response will consist of either:
- MC6 with EN06; or
- MC7 with EN07 or LD07

A second full medical response to the same incident will include the response of the other TFD
MCI resources not on the initial response

26
Q

Automatic Local Dispatch (w/in the City of Tucson)

A

One of the closest, available TFD MCI resources will be utilized & dispatched automatically, for any of the following incidents:

  1. Major Medical Response Incidents with a report of 10 or more patients
  2. With the HazMat Units when there is a report of 10 or more victims/patients
  3. With the TRT Units when there is a report of 10 or more patients
  4. With the RRT Team for local responses when there is a report of 10 or more patients
27
Q

Request of TFD Incident Commander

A
  • Any uniformed TFD first responder who is on the scene can declare a Multi-Casualty or larger incident
  • The decision to implement the protocol should be made by a TFD officer assigned to IC
  • The IC shall give an effective size-up of the emergency situation, & consider EMS and hospital resources that may be required
28
Q

IC’s initial actions on Multi-Casualty or Larger Incidents

A
  1. Verify &/or announce the Multi-/Mass Casualty Incident & assume command
  2. Contact Comms & relay nature of incident (MVC, fire, or chemical release etc.), estimated number of Pts and their acuity
  3. Determine the need for additional resources & special circumstances that may impact the receiving facilities & relay that info to Comms

*Comms upon receiving
the notification/request for MCI Resources will dispatch one of the closest, available TFD MCI Units

29
Q

County / State Response

A

Up to the following:
1. MC6 with EN06 (MMRS Strike Team)
2. Logistical Support Unit
3. An Additional Engine
4. Two Paramedic Units
5. COMM-1 Unit

*Lead IST Officer & the Ops Chief determine what TFD Resources will be deployed with the approval of an Assistant Chief Officer

30
Q

Initial actions after Multi-casualty Incident Resources have been requested

A
  1. TFD Dispatch Center will notify the Incident Support Team
    (IST) Lead Officer
  2. The IST Lead Officer will contact the remaining IST Officers. Based upon the assessment by the IST Lead Officer and the TFD Operations Section Deputy Chief or Assistant Chief, a determination will be made as to whether or not to deploy the TFD MMRS Strike Team as well as what TFD MMRS Strike Team components will be deployed. The MMRS Strike Team may by deployed with the RRT team for multi-casualty or larger incidents
  3. The IST Lead Officer, through the Tucson Fire Department Dispatch Center, will notify the appropriate TFD MMRS Strike Team of the Deployment as well as the location to
    report for a briefing
  4. The IST Officers, will brief the TFD MMRS Strike team prior to deployment
  5. The IST Officers will report to the designated Command Post and receive a briefing on the operation
  6. The IST Officers will coordinate and supervise the MMRS Strike team throughout the incident. The MMRS Strike Team will remain under the leadership of their Department
    IST Officers
31
Q

MCI/Large Incident Ops Flow Chart
Part 1

A
  1. The 1st arriving officer will assume command, determine if an MCI or larger incident exists & if so, declare the MCI over the radio w/ a size-up
  2. Once an MCI or larger is declared locally, the IC shall be responsible for determining the Pt destination & notification of the hospitals involved

*When Trauma is involved, the IC will insure the Trauma Center is contacted to determine the number of Pts they can take. The trauma center may also assist in determining the final destination for all trauma related Pts.

*The IC should assign an officer to communicate w/ the hospitals. The Officer assigned to communicate with the hospitals can do so by using Meds Control

32
Q

MCI/Large Incident Ops Flow Chart
Part 2

A

Upon receiving an initial report from IC, Comms will alert the
appropriate area hospitals by using any of the following:

  • Dedicated phone line
  • EMResource
  • Channel 9 Conference Line
  • MEDS radio
33
Q

Facility Choice

A
  1. Closest facility for 1-4 Pts
  2. Closest two facilities for 5-7 Pts
  3. All hospital alerted for 8 or more Pts
  4. Trauma Center per SAEMS Trauma Triage Criteria
  5. Preferred pediatric facilities include UMC and TMC
  6. Preferred maternal/neonatal facilities include UMC, TMC, NWH and SJH
34
Q

MCI/Large Incident Ops Flow Chart
Part 3

A
  1. IC will initiate ICS & assign needed Divisions, Groups, ect.
  2. Terminate Incident once tasks have been accomplished
35
Q

Likely Mitigation activities for MCI &
MMRS events..

A
  • Decon
  • Triage
  • TX
  • Transportation
36
Q

Decon

A
  • Decon will be prioritized
  • Will be tailored, to the extent possible, to the agent Identified
  • Emergency (Gross) Decon will be initiated by the first Fire Units on scene
  • MMRS Strike Team’s duty is to ensure all Pts are Deconed before transport
37
Q

Triage

A
  • Handled by the Triage Group under the Medical Branch
  • START Triage, Arizona Triage Tags, & EM Track System will be utilized
38
Q

TX

A
  • Part of the Medical Division/Branch
  • Initial TX will take place at the
    scene, except in cases where the scene is too unstable or volatile to support a TX sector
  • Medical TX addresses the supportive needs of Pts (Antidote administration is initiated or continued as appropriate)
  • If appropriate, TX personnel will oversee Pts to monitor or deliver continuing care as necessary
39
Q

TX Zones

A
  • Established in TX areas w/in the Cold Zone
  • When the TX must be located away from the scene for safety reasons, a location will be determined by Command (potential treatment areas may be located outside hospitals or at a central treatment area)
  • Will be designated in or near TX areas to serve as collection points for
    patients to be transported
40
Q

Transportation

A
  • Under the Medical Division/Branch
  • The transportation group (supported by PD as needed) manages movement & loading of vehicles at the scene
  • Only Pts who have been deconed will be transported (All vehicle used will be deconed after use)
  • Non-emergent ambulatory victims, once given initial assessment, decon & TX, can be transported in-mass on
    designated vehicles (buses & other multiple patient transports belonging to the City or available through formal agreements)
  • Emergency patients are transported to medical facilities via ambulance
  • If appropriate and if such transport will not further disperse the
    product, air transportation may be used
  • Acquisition of additional
    vehicles & equipment will be handled through the Incident Commander or the EOC, if activated
  • All Pts, without regard to mode of transport or level of injuries, will be
    tracked through the START triage tag system and the EM Track System
  • Deconed, uninjured Pts may be released or transferred to mass shelter locations as determined by the Medical Branch Officer
41
Q

Once Incident is Terminated

A

After a local incident is terminated by the IC:
- Units will go back in service
following decontamination & restock of supplies, equipment, & units

After a county/state incident is terminated by the IC and/or the Unified Command staff:
- The IST Officers will notify the TFD MMRS Strike Team of that termination & the location to report for a coordinated return to the City of Tucson
- Decontamination of equipment & units will occur prior to reporting to that location and returning to City of Tucson

42
Q

S.T.A.R.T

A

Simple
Triage
and
Rapid
Transport

  • All patients involved shall be triaged & tagged with a triage card
  • Triage of each Pt taking less then 30 seconds
43
Q

4 Categories

A
  1. Minor (Green)
  2. Morgue (Black)
  3. Delayed (Yellow)
  4. Immediate (Red)
44
Q

Minor (Green)

A

Walking wounded can be directed to staging

45
Q

Morgue/Deceased (Black)

A

Dead & dying, no action until after investigation or all other patients transported

46
Q

Delayed (Yellow)

A

Movement & TX of these Pts can be delayed

47
Q

Immediate (Red)

A

Require immediate movement, TX, & transport

48
Q

Assessment (Non Contaminated)

A
  1. Remove “contamination” strips & discard
  2. Initiate START triage based on RPM
  3. Assign Pt into 1 of the categories & tag to where other providers can see
  4. One tag remains with the patient and on the original card
  5. One tag should be given to the Triage Officer
  6. Any known patient information should be recorded on the card as time allows.
    This includes:
    - Patient name, age, birth date, medical history, etc….
    - Any treatment, medication given, vital signs
  7. If any personal belongings are removed from the Pt, they should be placed in a bag with the personal property tag from the card (This will facilitate tracking of both patients and their respective
    belongings)
49
Q

Assessment of Contaminated

A
  1. Determine if they are contaminated
  2. If Contaminated, leave the contaminated tag on the triage card
  3. Initiate START triage, and place the patient into a category
  4. Pts will be deconed as soon as possible & before transport to the hospital
  5. TX of contaminated patients should begin as soon as possible
    - The only TX that should be performed prior to decon is opening the pt’s airway and C-spine precautions
  6. The triage cards can be deconed with water
  7. When the Pt’s clothes are removed for Pt decon, place the clothes in a clear, plastic bag
    - Remove the contaminated strip & place it in the bag for evidence tracking
  8. Pts should not be transported to the hospital w/ the contaminated strip on the triage card

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