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King County MCI Plan 2011 Updates

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Presentation on theme: "King County MCI Plan 2011 Updates"— Presentation transcript:

1 King County MCI Plan 2011 Updates
Batt Chief Marty La Fave Bellevue Fire Department

2 A Review of Mass Casualty Management
Company Officer: First five minutes MCI Plan: New Changes Division of Labor: Groups and Units


4 Initial Size-up Phase 1 Look for SLUDGE Identify immediate hazards
Consider access/egress options Observe base/staging options Estimate number of patients

5 More Size-up Phase 2 Estimate number of non-ambulatory patients
Consider extrication/relocation issues Scene status: Static or Dynamic? Decide: Complex…not complex

6 No SLUDGE No Fire, stable scene Southbound lanes open Overpass intact Patients walking around 6-10 Reds Simple extrication Static scene

7 Commanding the radio Provide size-up Initiate command
Initial assignments Safety & handline Triage Treatment Request “base” resources Request “transport” resources

8 Requesting Resources Basic MCI Activities Complex Activities
Rescue/Extrication Treatment/Transport Ambulance staging Complex Activities Fire Hazard Material CBRNE Collapse

9 Maintain the Transportation Corridor!

10 Physical Actions of the First-in Crew
Engine/Ladder Company Recon / Risk Assessment Mitigate immediate high risks Secure Transportation Corridor Begin Triage Direct movement of “Green” Walking wounded Implement Rescue Group Medic Units/MSO Decide: Patient or Scene mgmt Medical Group Treatment Unit Transport Unit

11 Revised 2011 MCI Plan: WHY? Reduce choke points
Suspend unnecessary actions Improve division of labor Increase plan scalability for all events Simplify patient tracking Align plan with NIMS Concepts

12 MCI Changes at a glance Develop “Rescue Group” to move patients
Eliminate formal funnel point Eliminate use of treatment tags Elimination of patient numbering (felt pen) NIMS Terms: Hospital Control is now Disaster Medical Control Center (DMCC)

13 Changes

14 Changes



17 Are you doing the job…or leading it?

18 Unit Leader/Group Supervisor
Don the vest Understand Action Plan Determine supervisors role Develop organization Develop relationships Maintain accountability Provide progress reports

19 So, who does Triage? Rapid Field Triage -BLS Minimal Treatment
Who Supervises Triage: Medical Group Rescue Group Secondary Triage – ALS

20 Current Triage Systems
First Order Second Order START ABC Sick/Not Sick Jump START Triage Sieve (UK) Triage Sort (UK) SAVE (Secondary Assessment of Victim Endpoint) Those who will die anyway Those who will survive anyway Move only those who will have a condition change

21 Treatment Unit Locate suitable area Secure supplies
Develop treatment teams Determine transport priorities

22 Treatment Unit Reasons for a Treatment Area
Visual indicator for injured No transportation available Immediate life-saving treatment Move the reds, hold others Assure appropriate treatment Use Aid/Medic Units for supplies Prioritize patients for transport Use a “Treatment Dispatch Manager” Benchmarks: All reds transported All patients transported


24 Expanding the Treatment Unit
Treatment Unit Leader Red Manager Yellow Manager Treatment Dispatch Manager

25 Transport Unit Assure DMCC activation Establish Ambulance Staging
Confirm transporting resources are inbound Coordinate patient loading Track Destinations

26 Transportation Unit Apply patient trackers Communicate with DMCC
Receive patient destination Manage documentation Benchmarks: All reds transported All patients transported


28 Tracking All transport capable vehicles in King County will have tracking bands Typically applied at the ambulance loading or DMCC activity area. Ensures that all patients have a tracking band

29 Tracking Retain one peel-off sticker on a tracking board
All MSO’s and Medic Units will have tracking sheets Tracking sheets allow for sticker or Barcode tracking

30 Tracking Instruct all transporting personnel to place a tracking sticker on the portion of the MIRF that will stay with the hospital. The transporting agency will also retain one sticker

31 Expanding the Transport Unit
Transport Unit Leader Ambulance Staging Manager Coordinator DMCC Ambulance Loading Manager Tracking Aide


33 Rescue Group/Unit Disentanglement Moves all patients to Treatment area
Personnel Intensive May report to Medical or Operations May provide field triage

34 Expanding the Rescue Group
Extrication Unit Extraction

35 Expanding the Medical Group
Treatment Unit Transport Unit Green Patient Unit

36 Incident Command Operations Medical Treatment Yellow Unit Red Unit Dispatch Manager Transport Ambulance Staging Ambulance Loading DMCC Coordinator Tracking Aide Green Patients Rescue Extraction Extrication Hazard Mitigation Decon Haz Mat Fire Recon Safety PIO Liaison

37 Summary of Key Points for MCI
Secure the transport corridor Keep transport units staged separately Medics focus on Medical/Treatment/Transport Early notification of DMCC Suppression focus on Rescue/Extraction Perform secondary triage before transport Separate loading from DMCC activities

38 Questions?

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