2. Incident Sunrise Retirement Home Smoke & flames showing (kitchen) Fire taken care of 45 residents with smoke inhalation At least 2 w/ severe burns 2 distinct incidents Fire MCI

4. WHAT’S NEW in EMS MCI Manual? Incident Priorities Quick Reference Guide Transport Prioritize movement Task Force and MCI Alarm Changes Mutual Aid Resources Guide EMS Branch Positions Transportation Group Supervisor Air/Ground Coordinator Patient Transportation Recorder Patient Accountability Patient Intake Point (PIP) Patient Exit Point (PEP) Patient Tracking Devices (Quick Review) Staging Staging Area Manager Changes in Work-boards

5. What are your Incident Priorities? Find out what you have Triage Transport What are my resources ? Where should your personnel be assigned? What resources do you need? Where is staging and who is running it?

6. Quick Reference Guide that is MCI Specific:

8. TRANSPORT, TRANSPORT, TRANSPORT 1 st EMS transport unit shows up Sets up Transport All other EMS transport unit(s) load and go Move – Move – Move those RED patients LIFE BEFORE PROPERTY

9. Prioritize Movement Prioritize movement of the most critically injured patients (Red Tags) from the scene, to appropriate, definitive care as rapidly and efficiently as possible.

11. EMS Taskforce and MCI Alarm Changes EMS TASKFORCE (less than 10 pts.) (Dispatched Units) MCI ALARM (over 10 pts.) (Dispatched Units) 5 EMS Transport Units 1 Battalion Chief 2 EMS Supervisors 2 Suppression Units Air Transport Units (Upon request) 10 Suppression Units 10 EMS Transport Units (Min. 5 ALS) 3 EMS Supervisors 1 Battalion Chief 1 Mobile Command Post/Communications Unit 1 Green Transport Bus Air Transportation Units (Upon Request) 1 Medical Care Support Unit (MCSU) 1 Medical Ambulance Bus (MAB) One MCI Alarm for every 25 patients

13. AGENCYUNIT DESIGNATION UNIT LOCATION LEVEL UASI FUNDED Washington, D.C. MCU 1 MCU 2 MCSU 3 MAB 1 MAB 2 MAB 3 Eng. Co. 24 Eng. Co. 33 Eng. Co. 24 Eng. Co. 33 III II III YES NO YES NO YES Maryland Frederick County MCSU 928 MCSU Sta. 28 - Point of Rocks II I NO Montgomery County MCSU 722 MCSU 726 MAB 726 MAB 722 Sta. 22 – Germantown Sta. 26 - Bethesda Sta. 26 – Bethesda Sta. 22 - Germantown III YES Prince Georges County MCSU 855 MCSU 841 MAB 830 Sta. 55 – Bunker Hill Sta. 41 – Calverton Sta. 30 – Landover Hills III II YES NO YES Virginia Metro Wash. Airports Authority MCSU-302 MCSU-301 Sta. 302 - Dulles Sta. 301 - Reagan III NO AlexandriaMSU 202Sta. 202 – 213 E. Windsor Ave.III NO Arlington MC 100 MAB 100 Sta. 2 – 4805 Wilson Blvd. IIIYES Fairfax County MCSU 415 MCSU 429 MCSU 435 MAB 427 Sta. 15 - Chantilly Sta. 29 - Tysons Corner Sta. 35 - Pohick Sta. 27 - Springfield II III NO YES Loudoun County MC 699 MC 615 MC 614 MAB 623 Loudoun Training Sta. 15 - Sterling Rescue Sta. 14 – Purcellville Sta. 23 – Ashburn (Moorefield) II III NO YES Manassas CityMCU 501Manassas CityII NO Prince William County MCS 508 MCS 520 Sta. 8 – Yorkshire Sta. 20 - Dale City II NO Stafford County MCSU-12 MAB-12 Sta. 12, Berea IIINO MCSU’s in National Capital Region * MCSU 301 and 302 are Level III x2 Both units can handle 200 patents Level I 25 Patients Level II 50 Patients Level III 100 Patients * *

15. Transportation Group Supervisor The first arriving transport unit establishes Transportation Group. AIC/OIC Assumes role of Transportation Group Supervisor. Once relieved by 2nd arriving EMS Supervisor (assigned to EMS Branch), unit AIC/OIC then becomes Medical Communications Coordinator (MCC). Unit operator shall assume and maintain role of Air/Ground Ambulance Coordinator (to include role of Patient Transport Recorder) until relieved. Why is this SO critical?

16. Transportation Group Supervisor Responsibilities: Confirm initial (and follow up) Communication with RHCC. Request dedicated radio channel for Transportation group. Determine total patient count and transportation needs. Ensure best access and egress for patient loading area. Ensure patient information and destination recorded for all patients prior to departure from scene. Identify and establish patient transport corridors. Establish contact with: Staging area Treatment Unit Leader Assign Patient Loaders Coordinate air and ground transportation of all patients. Monitor operations with Group; make requests to EMS Branch Director. Maintain log of activity. Demobilize Transportation Reconcile all records through: Medical Communication Coordinator Air/Ground Coordinator(s) RHCC

18. Air/Ground Ambulance Coordinator Establish position, announce location, and don appropriate vest. Maintain communications with the Transportation Group Supervisor Establish loading area for ground or air ambulances. Designate points and paths of entry and exit for all transport units. Supervise the Transportation Recorder. Ensure all patients leaving scene have a COG disaster tag. Request additional transportation resources through the Staging Area Manager. Request additional patient transfer resources as needed. Provide any needed receiving facility directions to ground transport units. Effectively manage all transport resources within assigned area. Obtain Air/Ground Ambulance Coordinator Worksheet and Transport Recorder Worksheet, ensuring all appropriate documentation is completed. Reconcile all patient transport records through the Transportation Group Supervisor. Each Air/Ground Ambulance Coordinator reports to the Transportation Group Supervisor and manages their respective areas.

20. Patient Transportation Recorder Responsibilities: Establish position, announce location, and don appropriate vest. Alert Air/Ground Ambulance Coordinator of any patient within the loading area who does not have a COG disaster tag, or whose tag does not have an assigned receiving facility destination. Request instructions from Air/Ground Ambulance Coordinator. Obtain Patient Transport Recorder Worksheet. Maintain records of all patients departing the scene. Maintain appropriate incident documentation relevant to the patients transported from the scene, to include: COG disaster tag and unique identifying number (UIN). Ensure disaster tag is attached to each patient & scanned with PTD, if available. Record the transporting unit number. Record destination receiving facility. Record total number of patients (per unit). Triage status, age, sex, chief complaint of patient when transported off scene. A Patient Transportation Recorder MUST be assigned to each established patient loading area. (i.e., multiple LZ/ground ambulance transportation corridors).

21. Patient Transportation Recorder

24. Definitions: Staging: Staging Area: The location where units awaiting tasking are assigned. This location is usually located within a short travel distance but far enough away to not interfere with ongoing operations. A location near the incident where incident personnel and equipment are assigned on a three-minute available status.

25. Staging Area Manager Critical that Incident Staging established early in the incident Must be assigned sufficient resources to support this function (i.e., an entire suppression unit crew).

26. Staging Area Manager Responsibilities: Establish position, announce location, and don appropriate vest. Utilize Check-in Sheets as a reference for anticipating resource needs Establish staging area layout. Ensure adequate transportation resources are available within the Staging Area and that ingress and egress is controlled for patient transport vehicles (staffed and unstaffed). Respond to requests for resource assignments. Maintain log of activity as required. Establish and maintain communication with Air/Ground Ambulance Coordinator(s). Facilitate the movement of transport units from the Staging Area to the appropriate transportation loading areas. Ensure transporting units leaving Staging Area switch to assigned Transportation Channel. Demobilize Staging Area in accordance with Incident Demobilization Plan.

29. Patient Accountability In rapidly evolving incident, critical Red Tag patients may bypass Treatment Area and taken directly to transport. Can be done by: Placing COG disaster tag on patient. Scan disaster tag with Patient Tracking Device (PTD) if available. Scan TRANSPORT RECORD sticker with PTD if available and update information that patient was transported and to which receiving facility. Complete as much of front side of disaster tag as possible with emphasis on PATIENT INFORMATION section at top and TRANSPORT RECORD at bottom of tag. Remove large TRANSPORT RECORD sticker from bottom of disaster tag, placing it on Transport Recorder Worksheet corresponding to destination receiving facility.

30. PIP and PEP Formalizes two naturally occurring patient transit points to require higher degree of victim accountability. Patient Intake Point (PIP): The physical location(s) prior to entering Treatment areas through which all patients are funneled and where a Disaster Tag is applied. When possible, the disaster tag shall be scanned into the Patient Tracking System. Patient Exit Point (PEP): The physical location through which the patient exits the scene via the transport unit (air or ground) in which the transport stub is collected (by the Transport Recorder) from the disaster tag and affixed to the Transport Record. If available, the departure shall be scanned into the Patient Tracking System

35. Patient Tracking Device

36. Command Situational Awareness

39. 2-1-1 Virginia The Virginia Hospital Alerting and Status System (VHASS) was established by the Virginia Hospital and Health Care Association and the Virginia Department of Health. All hospitals across the Commonwealth and the Office of the Medical Examiner (OME) participate in the system. It is available for use during an MCI where a large number of patients need to be cared for initially onsite and then transported to a hospital. Hospitals and the OME enter the MCI patient information into the system.

40. Review: Incident Priorities Quick Reference Guide Transport Prioritize movement Task Force and MCI Alarm Changes Mutual Aid Resources Guide EMS Branch Positions Transportation Group Supervisor Air/Ground Coordinator Patient Transportation Recorder Patient Accountability Patient Intake Point (PIP) Patient Exit Point (PEP) Patient Tracking Devices (Quick Review) Staging Staging Area Manager Changes in Work-boards

41. End