1. DR
Mohd Zin Bidin
CMO Malaysian GP

2. DISASTER MANAGEMENT IN F1 RACING
By :
DR MOHD ZIN BIDIN
Chief Medical Officer
Petronas Malaysian Grand Prix
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

3. CMO Sepang International Circuit
Introduction
Disaster can occur anytime, anywhere without warning.
The more you are prepared, the better you will be.
When disaster occurs, our emergency response plan will determine the extent of injuries and damages sustained.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

4. CMO Sepang International Circuit
Questions to ask
How well prepared are we when disasters occur?
What procedures do we have in place?
Who activates the Emergency Response Plan?
What potential emergency situations can occur?
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

5. CMO Sepang International Circuit
AIM
To describe a system for response to a mass casualty incident as a result of disaster in F1 Racing.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

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Scope
Definitions.
Disaster
-Causes
-Declaration
-Initiating a response
Mass Casualty Incident Management Plan.
The Triage System.
Issues and Challenges.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

7. Dr. Mohd Zin Bidin CMO Sepang International Circuit
DEFINITIONS
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Definition
Disaster – “An extreme disruption of the functioning of a society that causes widespread human, material, or environmental losses that exceed the ability of the affected society to cope using only its own recourses”.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

9. CMO Sepang International Circuit
Definition
Mass Casualty Incidents (MCI)
An event that results in a number of victims large enough to disrupt the normal course of emergency and health care services.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

10. Dr. Mohd Zin Bidin CMO Sepang International Circuit
Definition of Triage
1. A process for sorting injured people into groups based on their need for or likely benefit from immediate medical treatment. Triage is used in hospital emergency rooms, on battlefields, and at disaster sites when limited medical resources must be allocated.
2. A system used to allocate a scarce commodity, such as food, only to those capable of deriving the greatest benefit from it.
3. A process in which things are ranked in terms of importance or priority.
The American Heritage® Dictionary of the English Language, Fourth Edition copyright ©2000 by Houghton Mifflin Company. Updated in Published by Houghton Mifflin Company.
Dr. Mohd Zin Bidin CMO Sepang International Circuit

11. DISASTER -Causes -Declaration -Initiating a response
Dr. Mohd Zin Bidin CMO Sepang International Circuit

12. Possible Causes of Disaster in F1
Race cars flying onto spectators.
Building collapse.
Air crash during air shows.
Bomb threat / explosions.
Fire.
Hazardous materials incidents.
Civil disobedience / Riots.
Terrorist incidents.
Stampede.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

13. Declaration of Disaster / Mass Casualty Incident
FIA / FOM and host country officials to assess severity of incidence.
Levels of implementation:
Alert – notification of incident
Stand –by
Full activation and
deployment
Stand-down
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

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Initiating a Response
Recognize when an emergency response must be initiated.
Notify officials, employees, spectators ,etc.
Make sure a single individual is in charge as Incident Commander.
Follow immediate
emergency procedures.
Establish an Emergency
Command Post on site.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

15. Dr. Mohd Zin Bidin CMO Sepang International Circuit
MCI MANAGEMENT PLAN
Dr. Mohd Zin Bidin CMO Sepang International Circuit

16. Goals of MCI Management
Doing the greatest good for the greatest number.
Managing scarce recourses effectively.
N/B Do not relocate the disaster – do not move the incidence to the hospital unless it is able to receive the types and numbers of patients.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

17. CMO Sepang International Circuit
MCI Levels
Level 1 (Local) - EMS personnel able to deal with the MCI effectively.
Level 2 (Regional) – Requires assistance and mutual aids from surrounding communities.
Level 3 (National) – Of such a magnitude that local and regional assets are overwhelmed. National or International assistance is required.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

18. CMO Sepang International Circuit
Medical Command Post
Established at the Track or Public Medical Centre.
CMO or DCMO becomes the Medical Incident Commander.
Unified command
system.
Control, direct,
coordinate.
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CMO Sepang International Circuit 18

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MCI Organization
1.Emergency Operation Center.
Incident commander
Chief operation officer
Chief planning officer
Chief logistic officer –medical supply and transport
2. Emergency Response Team (First team on site).
Onsite commander
Search and rescue personnel
Triage officers
Treatment officers
Transport officers
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

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MCI Medical Set Up
Medical Command Post
Effective Transportation for medical evacuation
Effective communication facilities
Onsite medical facilities
Continuous Medical supply
Extrications facilities and expertise
Efficient Triage System
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

21. Incident Scene Assessment
Establish safety of the scene.
Obtain briefing from Scene Commander
Assess extent of damage ,number and types of casualties.
Assess logistic requirements - Food, water, comm and tpt.
Establish a command center.
Identify onsite management areas.
Working areas
Collection points
Medical posts
N/B. First action need not be medical.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

22. CMO Sepang International Circuit
First EMS Provider
Establish Medical Command Post
Directs triage of all patients
Assign tasks and responsibilities
Assign resources to get key functions running
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

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Zoning System
Red Zone
Yellow Zone
Green Zone
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CMO Sepang International Circuit

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Zone System
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CMO Sepang International Circuit

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Red Zone
Incident site.
Search and rescue teams.
Fire, police, emergency services or those with certain expertise.
Recommended distance
(> 100m)
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

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Yellow Zone
Mobile crisis centre
Posts for the search and rescue teams and other supporting teams
Recommended distance (>200m)
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CMO Sepang International Circuit

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Green Zone
Media.
Relatives waiting area.
Counseling post.
Food and refreshment.
Mortuary and other voluntary agency.
Recommended distance (>300m).
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

28. Incident Management System
List of ambulances who will respond.
Contact hospitals.
Hospitals should implement MCI plan.
Identify ambulance who will cover regular emergency calls.
All responders should report to
IC first.
Duties and responsibilities of
staff
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

29. Positioning Arriving Vehicles
IC directs to appropriate sector.
Report to sector officer.
First ambulance on scene can be the Mobile
Command Centre
Designate with a flag or device
Once task is completed report
back to sector officer.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

30. CMO Sepang International Circuit
Patient Tagging
High Priority (1) = Red
Second Priority (2) = Yellow
Low Priority (3) = Green
Priority 0 = Grey or Black
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

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Priority Levels
Priority 1
Airway and breathing difficulties.
Uncontrolled or severe bleeding.
Decreased mental status.
Severe medical problems.
Poisoning, diabetic, cardiac
Severe burns
Shock (hypo perfusion)
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

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Priority Levels
Priority 2
Burn without airway problems.
Major or multiple bone or joint injuries.
Back injuries with or without spinal cord injuries.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

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Priority Levels
Priority 3
Minor Burns or joint injuries.
Minor soft tissue injuries.
Obviously dead.
Cardiac arrest
lowest priority
If EMS has enough personnel-highest priority.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

34. Dr. Mohd Zin Bidin CMO Sepang International Circuit
THE TRIAGE SYSTEM
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Triage
“To sort”
Separates those requiring immediate care
Rapid and simple life-saving intervention
Reduces burden on capabilities
Provides rational casualty distribution
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

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Goals of triage
Assess the patient’s condition.
Determine the urgency.
Transport to appropriate hospital.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

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Ideal Triage System
Easy to perform
Requires no advance skill
No specific diagnosis
Rapid and simple life-saving
intervention
Easily taught and learnt
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

38. Doing the Greatest Good
Greatest good for the greatest number
Intensive care in shortest possible time at site
Salvage the most number of patients possible
Do not try heroic resuscitation
Concentrate on those we can treat
DO NOT RELOCATE THE DISASTER
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

39. CMO Sepang International Circuit
Managing a Triage
Initial Assessment
Airway open? If not, open manually. If patient responds move to next casualty.
If patient is unresponsive, check breathing and pulse.
Check bleeding, if severe, apply pressure.
Then move to next patient.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

40. CMO Sepang International Circuit
Managing a Triage
Begin where you stand
Move those that can walk away from site
(green tag) – the walking wounded
Not breathing? Open and maintain airway
(Red tag)
No radial pulse ? Perform CPR (red tag)
Can stand a delay in treatment and transport (Yellow tag)
Deceased or unresponsive with no circulation (Black tag)
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

41. Dr. Mohd Zin Bidin CMO Sepang International Circuit
ISSUES AND CHALLENGES
Dr. Mohd Zin Bidin CMO Sepang International Circuit

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Issues and Challenges
No top management commitment
Poor or no planning in Emergency Response Plan.
Lack of coordination among agencies.
Chaos in communication.
Lack of training and practice
Problem of selection of designated leaders.
Procedures for shutting down critical functions and equipment.
Accesibility to disaster areas
Shortage of materials and logistics
Crowd control
VIP visitors
Dr. Mohd Zin Bidin
CMO Sepang International Circuit

43. Dr. Mohd Zin Bidin CMO Sepang International Circuit
THANK YOU
Dr. Mohd Zin Bidin CMO Sepang International Circuit