Multi-Casualty Multi-Casualty IncidentsIncidentsTactical StandardTactical Standard

Henderson Fire DepartmentHenderson Fire Department44thth Edition Edition

ObjectivesObjectives

Define MCI Describe the difference between level 1, 2, 3,

4, or 5 MCI Understand the 6 stages of MCI management Explain Unified Command Describe the basic ICS structure of MCI Identify the primary responsibility of each

group or unit of a normal MCI Explain the requirements of the morgue

Objectives cont.Objectives cont.

Describe the role of the medical supply group

Explain the evolution of a MCI event Define “Extreme MCI” Explain the organization of an Extreme MCI Understand the operations of an extreme

MCI Identify the locations of Casualty Collection

Points for Extreme MCI

OverviewOverview

Definition of MCIDefinition of MCI– Level 1, 2, 3,4, or 5Level 1, 2, 3,4, or 5

VarietyVariety FrequencyFrequency Evolution of the MCIEvolution of the MCI Multi-jurisdictionalMulti-jurisdictional

Six Stages of MCI Six Stages of MCI ManagementManagement

1.1. Preplanning & TrainingPreplanning & Training

2.2. Initial ResponseInitial Response

3.3. OperationsOperations

4.4. StabilizationStabilization

5.5. DemobilizationDemobilization

6.6. TerminationTermination

Unified CommandUnified Command

Two Primary SituationsTwo Primary Situations1.1. Single JurisdictionSingle Jurisdiction

2.2. Multi-jurisdictionMulti-jurisdiction

Basic MCI OperationsBasic MCI Operations DispatchDispatch ArrivalArrival Additional ResourcesAdditional Resources ICS AssignmentsICS Assignments

– Traffic/Crowd ControlTraffic/Crowd Control– Rescue/Extrication GroupRescue/Extrication Group– Medical GroupMedical Group

Triage UnitTriage Unit Treatment UnitTreatment Unit

– Transportation GroupTransportation Group– Possibly LZ GroupPossibly LZ Group

Rescue/ExtricationRescue/Extrication

Assigned EarlyAssigned Early Hazard ZoneHazard Zone Prioritize PatientsPrioritize Patients ResponsibilitiesResponsibilities IC

Rescue/Extrication

Medical GroupMedical Group

ResponsibilitiesResponsibilities Triage UnitTriage Unit Treatment UnitTreatment Unit

IC

Rescue/Extrication

Medical Group

Triage Unit Treatment Unit

Transportation GroupTransportation Group

ResponsibilitiesResponsibilities

IC

Rescue/Extrication

Medical Group

Triage Unit Treatment Unit

Transportation Group

Additional Unit, Group or Additional Unit, Group or BranchesBranches

MorgueMorgue SafetySafety StagingStaging Medical SupplyMedical Supply

Basic MCI ResponseBasic MCI Response En-routeEn-route ArrivalArrival Apparatus PositioningApparatus Positioning Secure HazardsSecure Hazards Initial TriageInitial Triage Additional ResourcesAdditional Resources Patient StabilizationPatient Stabilization Traffic/Crowd ControlTraffic/Crowd Control Rescue/ExtricationRescue/Extrication Medical GroupMedical Group Possible LZ GroupPossible LZ Group Possible Transportation GroupPossible Transportation Group

Advanced Plan (MCI-A)Extreme Mass Casualty

An Extreme MCI is an event in which the number of patients exceeds 300 or greater. The Mass Casualty Incident Advanced Plan (MCI-A) is included in the Clark County Multi-Jurisdictional Mass Casualty Plan. It provides guidance and procedures for the response to any incident involving 300 or greater casualties herinto referred to as an Extreme Mass Casualty. It was designed specifically to deal with local disasters including Weapons of Mass Destruction, Chemical, Biological, Radiological, Nuclear, and high-yield explosives or CBRNE.

Organization

Initial Arriving Company - IC & “Sifting”

Rescue/Extrication Group Holding Area Group 2nd Opinion Group Medical Group Transportation Group Casualty Collection Points

Hot Zone - Deceased

Warm Zone non-ambulatory

Holding Area

Initial Arriving Company

•Establish Command BIR

•Request Resources

•Begin “Sifting” ambulatory to Holding Area.

Cold Zone

Sifting

Hot Zone - Deceased

Warm Zone non-ambulatory

De

con

Rescue/Ext

Cold Zone

Triage TX Transport

Ambulance Staging

Loading

To Hospital

2nd opinionHolding Area

CP

To Casualty Collection Point

Hazmat

Medical

Sets & RepsSets & Reps Receive DispatchReceive Dispatch Verbalize Pre-incident Information Verbalize Pre-incident Information Complete En route ResearchComplete En route Research Verbalize En route concernsVerbalize En route concerns Complete Brief Initial ReportComplete Brief Initial Report Conduct Survey of Incident & Identify HazardsConduct Survey of Incident & Identify Hazards Verbalize Securing of SceneVerbalize Securing of Scene Complete Initial TriageComplete Initial Triage Request Appropriate ResourcesRequest Appropriate Resources Assign & Track UnitsAssign & Track Units Complete IC WorksheetComplete IC Worksheet

Brief Initial Report?

Triage Report:

1. Silver Car – 1 delayed, 1 minor, no extrication

2. Black Car – 1 immediate, 1 delayed, extrication needed

3. Green Car – 1 immediate, 2 delayed, 1 minor, extrication needed

Resources Needed?

Brief Initial Report?

Triage Report:

1. Green Car – 2 immediate, 2 delayed, extrication needed

2. Silver Car – 1 delayed, 2 minor, no extrication

Resources Needed?

Brief Initial Report?

Triage Report:

1. Black Truck – 1 dead, 2 immediate, extrication needed

2. School Bus – 2 immediate, 10 delayed, 12 minor, no extrication

Resources Needed?

Brief Initial Report?

Triage report:

1. White Truck – 2 immediate, no extrication

2. White Car – 1 dead, 1 immediate, 2 delayed, extrication needed

Resources Needed?