Principles of Major Incident Response 2/17/2019 Principles of Major Incident Response Temple College EMS Professions Temple College EMS Professions

Temple College EMS Professions Major Incident Cannot be managed with local resources Multiple patients Special hazards Chemical Radiological Biological Difficult rescue Temple College EMS Professions

Major Incident Do the most good for the most people LIMITED RESOURCE SITUATION Do the most good for the most people Control response Control treatment Control transport Temple College EMS Professions

Temple College EMS Professions Success depends on: Knowing what is needed Knowing what is available Matching needs/resources Temple College EMS Professions

Temple College EMS Professions Command A PLAN Control Communications Temple College EMS Professions

Temple College EMS Professions A good plan. . . Is simple, concise, realistic Is designed by the people who will use it Defines responsibilities, areas of authority Provides for unified command Defines initial actions thoroughly, precisely Temple College EMS Professions

Temple College EMS Professions A good plan. . . Keeps people doing what they do best Provides for smooth interaction Provides common terminology and a communications interface Provides for training, practice, evaluation, revision Temple College EMS Professions

Temple College EMS Professions A good plan. . . Describes what needs to be done, but… Leaves how to do it up to the people using the plan Temple College EMS Professions

Incident Command System Effective C3 begins with first unit Establish command Do NOT treat patients Temple College EMS Professions

Temple College EMS Professions EMS Command Perform size-up Declare major incident Request appropriate assistance Designate staging area Designate treatment area(s) Coordinate with other agencies Command until relieved Temple College EMS Professions

Temple College EMS Professions Triage Officer Coordinate patient removal from danger Provide Command with updates Identify/correct life-threats without slowing triage Assess, categorize, tag Coordinate “hazard zone” activities Continuously retriage Temple College EMS Professions

Temple College EMS Professions Staging Officer Assure access routes Assure orderly parking, traffic flow Categorize units, capabilities Assign units as requested Inform Command of status Temple College EMS Professions

Temple College EMS Professions Treatment Officer Locate treatment areas, advise Command and Triage Evaluate resources needed for treatment Assign, coordinate treatment personnel Inform Command of status Inform Command of available manpower Temple College EMS Professions

Temple College EMS Professions Transport Officer Establish transport area(s) Request ambulances from staging Coordinate transport of patients with dispatch or command hospital Direct transport to appropriate facilities Inform Command of status Maintain records of patient destinations Temple College EMS Professions

Temple College EMS Professions Support Officer Determine equipment, supply needs Coordinate procurement Maintain inventory Allocate equipment, supplies Inform command of status Temple College EMS Professions

Incident Command System Temple College EMS Professions

Incident Command System Positions are functions, not persons One person can fill more than one position Until delegated, Command performs all functions Address communications to functions, not persons Temple College EMS Professions

Incident Command System Temple College EMS Professions

Incident Command System Dispatch EMS Command Staging Officer Hospitals Triage Officer Treatment Officer Transport Officer Temple College EMS Professions

Temple College EMS Professions Triage “To sort” Prioritizing patients based on severity Temple College EMS Professions

START Able to walk? Simple Triage & Rapid Treatment Yes = Delayed No = Assess Ventilation Temple College EMS Professions

Temple College EMS Professions START Ventilation present? Yes = Greater than 30 per minute? Yes = Immediate No = Assess perfusion No = Position airway. Breathing present? No = Dead Temple College EMS Professions

Temple College EMS Professions START Perfusion adequate? (radial pulse) Yes = Assess mental status No = Immediate Temple College EMS Professions

Temple College EMS Professions START Mental status adequate (follows commands) Yes = Delayed No = Immediate Temple College EMS Professions

Temple College EMS Professions Four Category System Red: Immediate life threat Yellow: Significant morbidity Delayed life threat Green: Minimal life threat Black: Dead or will die Temple College EMS Professions

Temple College EMS Professions Rules of Triage Greatest good for greatest number Save lives, then limbs One Chief, many Indians Squeaky wheels don’t need grease You can’t save everyone! So don’t try! Temple College EMS Professions