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Zone One MCI Training. June, 2012. June, 2012. Training Objectives. Focused at the Company Officer Level Review of initial MCI scene size-up Overview of general MCI concepts Summary of new King County MCI Plan changes. Initial Size-up Phase 1. Look for SLUDGE - PowerPoint PPT Presentation
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JUNE, 2012
Zone One MCI Training
June, 2012
Training Objectives
Focused at the Company Officer Level
Review of initial MCI scene size-upOverview of general MCI conceptsSummary of new King County MCI
Plan changes
Initial Size-up Phase 1
Look for SLUDGE Identify immediate hazardsConsider access/egress optionsObserve base/staging optionsEstimate number of patients
More Size-up Phase 2
Estimate number of non-ambulatory patients
Consider extrication/relocation issuesScene status: Static or Dynamic?
Decide: Complex…not complex
No SLUDGENo Fire, stable sceneSouthbound lanes openOverpass intactPatients walking around
6-10 RedsSimple extricationStatic scene
Commanding the radio
Provide size-upInitiate commandInitial assignments
Safety & handline Triage Treatment
Request “base” resources
Request “transport” resources
Requesting Resources
Basic MCI Activities Rescue/Extrication Treatment/Transport Ambulance staging
Complex Activities Fire Hazard Material CBRNE Collapse
Maintain the Transportation Corridor!
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
Revised 2011 MCI Plan: WHY?
Reduce choke (funnel) points Minimize unnecessary actionsImprove division of laborIncrease plan scalability for all eventsSimplify patient trackingUtilize NIMS terminology
MCI Changes at a glance
Develop “Rescue Group” to package and move patients
Eliminate formal funnel pointEliminate use of treatment tagsEliminate patient numbering (felt pen)Utilize NIMS Terms: Hospital Control is now
Disaster Medical Control Center (DMCC)
Changes
Changes
The Previous MCI Plan
COMMAND
MEDICAL GROUP
TRIAGE
TREATMENT
TRANSPORT
Typical MCI Org Chart 2011
COMMAND
RESCUE GROUP
EXTRACTION UNIT
EXTRICATION UNIT
MEDICAL GROUP
TREATMENT UNIT
TRANSPORT UNIT
GREENUNIT
Are you doing the job…or leading it?
Unit Leader/Group Supervisor
Don the vestUnderstand Action PlanDetermine supervisors role Develop organizationDevelop relationships Maintain accountabilityProvide progress reports
So, who does Triage?
Rapid Field Triage -BLS
Minimal TreatmentWho Supervises
Triage: Medical Group Rescue Group
Secondary Triage – ALS
First Order Second Order
STARTABCSick/Not SickJump STARTTriage 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
Current Triage Systems
Treatment Unit
Locate suitable area
Secure suppliesDevelop
treatment teamsDetermine
transport priorities
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 treatmentUse Aid/Medic Units for suppliesPrioritize patients for transport
Use a “Treatment Dispatch Manager”Benchmarks:
All reds transported All patients transported
Expanding the Treatment Unit
Treatment Unit Leader
Red Manager
Yellow Manager
Treatment Dispatch Manager
Transport Unit
Assure DMCC activation
Establish Ambulance Staging
Confirm transporting resources are inbound
Coordinate patient loading
Track Destinations
Transportation Unit
Apply tracking bandsCommunicate with
DMCCReceive patient
destinationManage documentationBenchmarks:
All reds transported All patients transported
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
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
Tracking
Instruct all transporting personnel to place a tracking sticker on the Medical Incident Report: Hospital form Agency form EPCR agencies need to
enter number in laptop
Expanding the Transport Unit
Transport Unit Leader
Ambulance Staging Manager
DMCCCoordinator
Ambulance Loading Manager
Tracking Aide
Rescue Group/Unit
DisentanglementMoves all patients to
Treatment areaPersonnel IntensiveMay report to Medical or
OperationsMay provide field triage
Expanding the Rescue Group
Rescue GroupExtrication
Unit
Extraction Unit
Expanding the Medical Group
Medical Group
Treatment Unit
Transport Unit
Green Patient Unit
Incident Command
SafetyPIO
Liaison
Operations
Medical
Treatmen
tYellow Uni
t
Red
Unit
Dispatch Manager
TransportAmbulance
Staging
Ambulance
LoadingD
MCCCoordinatorTracking Aide
Green
Patients
Rescue
Extraction
Extrication
Hazard Mitigation
Decon
Haz Mat Fire
Recon
Summary of Key Points for MCI
Secure the transport corridorKeep transport units staged separatelyMedics focus on
Medical/Treatment/TransportEarly notification of DMCCSuppression focus on Rescue/ExtractionPerform secondary triage before transportSeparate loading from DMCC activities
Questions?