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Multi-Casualty Incidents

Multi-Casualty Incidents . And the Incident Command System (ICS). Multi-Casualty Incidents. MCI MVI Definitions vary slightly more than one patient planning becomes the goal. It is not a new concept. There has always been MCIs. MCI. Must plan and organize

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Multi-Casualty Incidents

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  1. Multi-Casualty Incidents And the Incident Command System (ICS)

  2. Multi-Casualty Incidents • MCI • MVI • Definitions vary slightly • more than one patient planning becomes the goal

  3. It is not a new concept There has always been MCIs

  4. MCI • Must plan and organize • Often our natural response leads to a bad decision • Beware “the slide”

  5. MCI • The first consideration is safety • Has the “Patient Generator” stopped? • The second consideration is planning

  6. Call resources early • Do the “ Windshield assessment” • Based on gross estimate from your vehicle (through your windshield) • OVER ESTIMATE

  7. Fire Apparatus Ambulances Police Utility company Command Staff Buses Medical Supplies Special Teams Red Cross and ... Resources

  8. Triage French: “To Sort” Goal: • The greatest good for the greatest number of patients

  9. Triage • Sorting by severity of injury • Treatment and transport decisions are based on the results of triage.

  10. Triage Triage Categories • Immediate • Delayed • Minor / Walking Wounded • Dead

  11. Triage Other terminology • Class 0, I, II, III, IV, • Red, Yellow, Green, Brown, Blue • Unsalvageable, Expectant

  12. Triage • First step in triaging is to separate the walking wounded • Get rid of bystanders during this process • Designate a collection area for these patients

  13. S.T.A.R.T. • Simple Triage and Rapid Treatment • Developed 1983 • Los Angeles County Fire Chiefs • Hoag Hospital and Newport Beach F.D. • Adopted nationally

  14. S.T.A.R.T. • Designed for personnel with minimal medical training • RESPIRATIONS • CIRCULATION • MENTAL STATUS

  15. S.T.A.R.T. Respirations Under 30 Over 30 0 DEAD Immediate Check Circulation

  16. S.T.A.R.T. Circulation Delayed Capillary Refill Good Capillary Refill Immediate Check Mental Status

  17. S.T.A.R.T. Mental Status Does not follow Verbal Commands Follows Verbal Commands Immediate Delayed

  18. S.T.A.R.T. Limitations of S.T.A.R.T. • Cold weather • Excitement / Emotional • Pediatric Patients Use Initial Assessment / Primary Survey

  19. Initial Assessment • Airway • Breathing • Circulation • Level of Consciousness • Skin signs • Chief Complaint / Obvious injuries

  20. Tagging • Attach tag to patient • Upper extremities - visible • Categorizes severity • Colored tags, ribbon, and other methods

  21. METTAG Front Back

  22. Triage After all patients are triaged and tagged • Begin treatment or direct movement of patients to treatment areas • Anticipate reassignment

  23. When you are NOT first in • Absolutely no freelancing - Check In • Be sure to take time to understand your assignment - ask questions • Obtain required materials - vests, forms, channel assignments

  24. Incident Command System ICS

  25. ICS System of: • policies and procedures • roles and responsibilities Designed to maximize the impact of resources on an emergency

  26. Basic ICS concepts • Unity of command • Span of Control • Management by Objectives • Common terminology • Use only what positions needed

  27. Incident Command System • Developed in the early 1970’s • As a direct result of costly wildland fires • FIRESCOPE Certification & Training

  28. Field Operations Guide • ICS “Bible” • Incident Command System Publication • FIRESCOPE

  29. The End That’s all folks

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