Definitions. Number of Patients 10/1/2014. Changes to the Standard of Care. Logistics Driven Incident. Distinction of Upper Limit is semantics

Transcription

1 Seattle / King County Multiple Casualty Incident Plan Number of Patients Definitions Changes to the Standard of Care Logistics Driven Incident Number of Patients Distinction of Upper Limit is semantics Lower Limit problematic 1

2 Stay and Play Standard of Care Scoop and Run Scoop and Treat Triage, Treat and Transport NIMS/ICS Compliant Logistics IC > UC System Planning to Prevent Overload System Approach On Scene ICS State Trauma System with WA DOH Local PH with EMS MPDs Coalitions (NWHRN) DMCC Hospitals Transport Assets LE, EM, Red Cross 2

3 Goals Transport No overloading a single hospital Avoid Trans locating the MCI Triage Key Roles and responsibilities First in unit Incident Command Recon Rescue Medical Initial Incident Command Initial Report Unit Location Initial Impression Scene Description Additional Resources Hazards Estimated number of Patients Command Designator Command Post Location Assign companies Transportation Corridor Base/Staging 3

4 Organizational Chart Incident Command Safety PIO Liaison Medical Rescue Hazard Mitigation Extraction Extrication Transport Green Pt Decon Haz Mat Fire Unit Leader / Supervisor Don the vest Understand Action Plan Understand the supervisors role Develop organization Develop cohesion Maintain accountability Provide progress reports Manage and request resources Organizational Chart Incident Command Safety PIO Liaison Medical Rescue Hazard Mitigation Extraction Extrication Transport Green Pt Decon Haz Mat Fire 4

5 Rescue Group Initial triage Flagging Triage zones Extraction Extrication ALS can be added dictated by the incident Organizational Chart Incident Command Safety PIO Liaison Medical Rescue Hazard Mitigation Extraction Extrication Transport Green Pt Decon Haz Mat Fire 5

6 Medical Group Ensure activation of DMCC Verify Transportation Corridor / ambulance staging Assign/Assume key positions: Team Leader Transportation Team Leader Green Patient Team Leader Communications / talk group Adequate resources and personnel Organizational Chart Incident Command Medical Transport Green Pt Red Area Yellow Area Striped Patient Area Patient Dispatcher Transportation is the priority Location Team Leaders (Red area, Yellow area) Appropriate level of treatment Resources Personnel Equipment Re triage 6

7 Organizational Chart Incident Command Safety PIO Liaison Medical Rescue Hazard Mitigation Extraction Extrication Transport Green Pt Decon Haz Mat Fire Transportation Verify transportation corridor Location: Proximity to treatment area Ambulance loading area consider exhaust, hazards, etc. DMCC coordinator and tracking aid remote location Resources Backboards Tracking bands Transportation units Establish DMCC communication Transportation Assign key positions: Ambulance Staging Ambulance loading DMCC coordinator Tracking Aid 7

8 Possible Scene Layout Maintain the Transportation Corridor! Organizational Chart Incident Command Safety PIO Liaison Medical Rescue Hazard Mitigation Extraction Extrication Transport Green Pt Decon Haz Mat Fire 8

9 MCI with Complexity Fire Suppression HazMat SWAT/Arson Bomb CBRNE *Additional personnel needed for the MCI piece Natural Man made Intentional Contained vs Uncontained 9

10 Significant updates Critical aspect of transportation corridor Significant updates Elimination of formal funnel points Elimination of patient numbering Elimination of the treatment tag 10

11 Patient Tracking and Documentation Significant updates Critical aspect of transportation corridor Use of Recon Warm Zone Decon Staging Transportation corridor Ambulance Loading & Staging 11

12 Significant updates Critical aspect of transportation corridor Use of Recon Triage Criteria Significant updates Critical aspect of transportation corridor Use of Recon Triage Criteria Triage Assigned to Rescue 12

13 Questions / Comments Catastrophic MCI 2005 Hurricanes Katrina and Rita 2010 Haiti 2010 Christchurch, New Zealand 2011 Japan Earthquake and Tsunami 13

14 Situational Awareness Coordination (Scarce) Resource Allocation Coordination Get patients where they need to be initially Get patients where they ultimately need to be Includes return to normal Scenes of Violence Domestic Ordinary criminal (homicide, robbery, etc) Fire as a weapon Explosives Active Shooter Beware Secondary Devices 14

15 Scenes of Violence MCI Operations vs. Active Shooter Operations Cold Zone Warm Zone Hot Zone Cp Jonathan Larsen Lt Joshua Pearson 15