MCI & Triage A brief overview

Objectives zDefine MCI zDefine Positions within the EMS Branch zClassify Patients within the Triage system

Mass Casualty Incident zDeclared by the Incident Commander when... zactual or potential number of patients needing care exceeds the EMS resources available on scene within 15 minutes. zResponse window is influenced by time of day, day of week, weather, geography, other incidents occurring in region.

How many ambulances? zQuickly estimate the number of injured. zEstimate 1 ambulance for every 4 patients. zIt is better to overestimate. zHow many ambulances do we get on a Phase 4? A Phase 5?

EMS Branch

EMS Control zDesignates personnel for other positions in branch. zDoes not assess or treat any patients. zAdvises hospital of estimated numbers of injured. zCoordinates resources.

EMS Branch

Primary Triage zControl scene hazards then triage. This may mean moving patients to a safe area. zSee every patient. zPerform MCI ABC’s. Open Airway, control severe Bleeding, treat for Shock by elevating & covering. zWork quickly.

Primary Triage zDirect non-injured to assist injured. zContinue to assess patients until all patients are in Treatment area. zMove to Treatment area and continue to perform triage.

EMS Branch

Secondary Triage zUsually not established immediately. zShould have an aide. zTag ALL patients. z“Green” patients wear tags on neck. zOthers patients wear tag on lowest part of left extremity. zDo not write on tags - tear off bottom

Red Tag zImmediate Transport. zImmediately life- threatening injuries z Airway/Breathing z Severe Bleeding z Shock z Open chest/abdomen z Serious head injury z Serious Medical: cardiac, diabetes, poisoning.

Yellow Tag zDelayed Transport zNot immediately life- threatening z Burns w/o shock or breathing problems z Major fractures w/o shock z Back Injuries z Minor fractures

Green Tag zMinor Injuries zTransport needed but not necessarily by ambulance z Other minor injuries not covered yet.

Black Tag zDead at scene by protocol. zCardiac arrest - NO field CPR z Exception to cardiac arrest is made for emergency responders. z Injured responders are tagged RED.

EMS Branch

Treatment zEstablish area designated by IC & EMS Control. zSegregate area by tag color, assign ALS personnel & treatment teams. zDesignate separate area for haz-mat contaminated patients - decon corridor. zEnsure EMS supply depot is close.

EMS Branch

Loading zCoordinate with Operations or IC the travel routes. zCoordinate with Treatment officer the transportation of patients. zRelay to FAHC Patient ID, tag color, brief injury description, ETA of ambulance. z3 patients per ambulance, match EMT level to patient need.

EMS Branch

Staging zDesignate holding area for resources. zCoordinate with Treatment for location of EMS Supply depot. zEnsure drivers stay with their rig. zAssemble teams by certification level, teams to be designated Treatment Team or Field Team.

Treatment Team zComprised of at least one Advanced EMT. zAssigned to Treatment Area. zReport to the Treatment Officer.

Field Team zComprised of 4 “responders”. zAt least one responder needs to be an ECA or higher. zAssigned to an area to collect red tag patients and transport to Treatment area. zOnce all red tag patients are moved from their area, begin collecting yellow tag patients.

Review

Summary zWhen do we declare a Mass Casualty Incident? zWhat are the major positions within the EMS Branch? zWhat are the Triage Tag colors and how are patients classified within each section?

Questions??

Thank You