Mass casualty overview

Question 1

According to the Emergency management act what are the three major emergency terms

Answer 1

• Large or complex emergency - Class 1 Emergency- Class 2 Emergency

Question 2

Large or Complex Emergency definition

Answer 2

Large or complex emergency (however caused) which– Has the potential to cause or is causing loss of life or extensive damage to property, infrastructure or the environment; or- Has the potential to have or is having significant adverse consequences for the Victorian community or a part of the Victorian community; or- Required the involvement of 2 or more agencies to respond to the emergency.

Question 3

A Class 1 emergency is defined as

Answer 3

Major fire or any other major emergency which the MFB, Emergency Services Board, CFA or the Victorian State Emergency Services Authority is the control agency in the SERP.

Question 4

A class 2 emergency is defined as

Answer 4

A warlike act, terrorism, hi-jacking, siege or riot

Question 5

What is a major incident as defined by AV

Answer 5

• The clinical requirements of the scene are greater then the capacity of the available resources.- An incident that is spread over a large distance; is difficult to assess; has multiple patients; and is not easy to immediately assess or control.- Each individual incident needs to be assessed on its own merits and the roles of Triage Officer (TO) and Transport Officer (TO) initiated as soon as possible.

Question 6

3 triggers that activate ERP

Answer 6

1.Type of incident (restricted; controlled; complex)2. Potentially protracted duration (>1 hour) 3. Number of patients (> 3)

Question 7

What are the 2 Aims of ERP

Answer 7

Emergency response aims
1. Reduce preventable death and permanent disability
2. Improve patient outcomes by matching the needs of injured patients to an appropriate level of treatment in a safe and timely manner

Question 8

AVs role within the Mass Casualty and Pre-Hospital Operational Response Plan

Answer 8

AV Role is to:
1. Respond to requests for pre-hospital emergency care
2. Triage causalities and determine treatment priorities
3. Transport causalities to appropriate medical care
4. Provide health support to other agencies where appropriate
5. Provide health support to causalities undergoing decontamination

Question 9

What does Ashe stand for ?

Answer 9

Active Shooter Hostile Environment

Question 10

What is a ASHE incident

Answer 10

1. Active armed offender will attempt to kill or injure as many people as possible within the shortest period of time.
2. Generally target places with large numbers of people in close proximity.
3. Sudden, unpredictable and rapid development often mean first responder may include uniformed/plain clothes police, security guards or PSO
4. Often not a hostage situation but can transient into one.
5. Most incident will evolve rapidly and reach resolution quickly
6. Armed offender will continue to harm victims until the threat is neutralised (stop the killing stop the dying)
7. Most incidents will not be resolved through negotiation or peaceful means.

Question 11

Process if ASHE identified at dispatch

Answer 11

• Use standard approach at scene if you don’t believe it is safe don’t enter
• Request police immediately with clear information
• Establish rendezvous point with Vicpol at safe location away from scene
• On arrival maintain ongoing awareness and DRA precess
• Establish a safe area with Vicpol to bring patients back to for Triage Sieve and sort

Question 12

Process if ASHE identified on arrival

Answer 12

ESCAPE, HIDE, TELL
If you find others tell them
This area is not safe.
You need to leave now.
Keep Calm
Follow Me
Stay Low

Question 13

If you cant escape ?

Answer 13

Hide responder safety first
TELL:
Activate the duress alarm immediately
Nature and extent of threat
Exact location and access
Offender description
Known injuries (self and others)
Safety

Question 14

THREAT Agency and role part 1

Answer 14

Question 15

Threat Agency and role part 2

Answer 15

Question 16

Threat agency and role

Answer 16

Question 17

Role of the first crew on scene to a potential mass casualty

Answer 17

• Different from the normal business we perform.
• The first crew becomes part of the scene management structure and is NOT a clinical resource.
• Notify the Operations Centre or Communications Centre of your arrival and activation of TO/TO
• Provide an ETHANE sitrep

Question 18

ETHANE =

Answer 18

E – Exact Location
T – Type of Incident (MVA, Fire etc.)
H – Hazards at Scene
A – Access and Egress
N – Number of Casualties
E – Emergency services on scene & additional services required

Question 19

What is the role of the TO and TO

Answer 19

Triage Officer and Transport Officer:
- These roles are management roles.
- The primary focus is on scene logistical management.
- The level of medical care is limited to basic lifesaving skills (positioning, haemorrhage control).
- The first crew should don the appropriate tabards, locate the blue emergency management folder, portable radio and Smart Triage Pac™.
- Senior Paramedic - Triage Officer
- Junior Paramedic – Transport Officer

Question 20

Triage responsibilities include

Answer 20

• Assume scene leadership role
• Direct the activities of the transport officer
• Reconnaissance of the scene
• Ensure patients are triaged and tagged using Smart Triage Pac cards and allocate clinical priority
• Establish scene layout – location of casualty collecting point, loading point, holding point and any other requirements
• Provide direction for oncoming resources
• Ensure that timely and accurate sitreps are providedLiaise with other services at the scene
• Report to oncoming Incident Health Commander (IHC) when established.
• Liaise with the Duty Manager and Transport Officer

Question 21

Transport officer Role

Answer 21

• Supporting the Triage Officer in the management of the scene and works at their discretions.
• Their task may include:
• Undertaking basic lifesaving patient management (open airway or apply tourniquet)
• Supervising the Casualty Clearing Point (CCP)
• Commence & maintain the Casualty Movement Log record transport of all patients:
• Allocate numbers to trauma triage cards
• Record patients name and a brief description of injuries where possible
• Destination hospital decision and documentationCoordinate transport vehicles to ensure the appropriate transfer of patients
• Ensure appropriate access and egress for responding vehicles

Question 22

Triage at a mass casualty is based on what 3 assessments

Answer 22

Walking at scene
Respiratory Status
Heart rate

Question 23

The CCP should be located

Answer 23

The Casualty Clearing Point should be located:
- A safe distance from the scene (uphill and upwind)
- A location with sufficient space for the number of patients within each priority group
- Somewhere that will provide shelter
- Near the Ambulance Holding Post

Question 24

The ambulance should be

Answer 24

• Where ambulances are held prior to moving to the loading point.
• Allow vehicle rapid access to the loading point when required but reduce congestion at the site.
  The site should be:
• Easily accessible including ease of egress
• Large enough to accommodate all responding vehicles
• Close enough to the loading point to allow appropriate communication to occur
• Vehicle will be directed to this point by the dispatcher. They can then be brought forward when need to allow less congestion and better scene management

Question 25

Other considerations at a Mass Casualty Site

Answer 25

Survivor Reception Point:
- This is where patients with NO injuries should be directed.
- These patients do not require transport to hospital.

Decontamination Corridor:
- Controlled and managed by Fire Services
- Located between the incident site and CCP
- Decontamination of patients and rescuers

Question 26

Major incident chain of command

Answer 26