Principles of Major Incident Response Temple College EMS

Principles of Major Incident Response Temple College EMS Professions

Major Incident z. Cannot be managed with local resources y. Multiple patients y. Special hazards x. Chemical x. Radiological x. Biological y. Difficult rescue Temple College EMS Professions

Major Incident LIMITED RESOURCE SITUATION z. Do the most good for the most people y. Control response y. Control treatment y. Control transport Temple College EMS Professions

Success depends on: y. Knowing what is needed y. Knowing what is available y. Matching needs/resources Temple College EMS Professions

Command A PLAN Control Communications Temple College EMS Professions

A good plan. . . z. Is simple, concise, realistic z. Is designed by the people who will use it z. Defines responsibilities, areas of authority z. Provides for unified command z. Defines initial actions thoroughly, precisely Temple College EMS Professions

A good plan. . . z. Keeps people doing what they do best z. Provides for smooth interaction z. Provides common terminology and a communications interface z. Provides for training, practice, evaluation, revision Temple College EMS Professions

A good plan. . . z. Describes what needs to be done, but… z. Leaves how to do it up to the people using the plan Temple College EMS Professions

Incident Command System z. Effective C 3 begins with first unit y. Establish command y. Do NOT treat patients Temple College EMS Professions

EMS Command z. Perform size-up z. Declare major incident z. Request appropriate assistance z. Designate staging area z. Designate treatment area(s) z. Coordinate with other agencies z. Command until relieved Temple College EMS Professions

Triage Officer z. Coordinate patient removal from danger z. Provide Command with updates z. Identify/correct life-threats without slowing triage z. Assess, categorize, tag z. Coordinate “hazard zone” activities z. Continuously retriage Temple College EMS Professions

Staging Officer z. Assure access routes z. Assure orderly parking, traffic flow z. Categorize units, capabilities z. Assign units as requested z. Inform Command of status Temple College EMS Professions

Treatment Officer z. Locate treatment areas, advise Command Triage z. Evaluate resources needed for treatment z. Assign, coordinate treatment personnel z. Inform Command of status z. Inform Command of available manpower Temple College EMS Professions

Transport Officer z. Establish transport area(s) z. Request ambulances from staging z. Coordinate transport of patients with dispatch or command hospital z. Direct transport to appropriate facilities z. Inform Command of status z. Maintain records of patient destinations Temple College EMS Professions

Support Officer z. Determine equipment, supply needs z. Coordinate procurement z. Maintain inventory z. Allocate equipment, supplies z. Inform command of status Temple College EMS Professions

Incident Command System Temple College EMS Professions

Incident Command System z Positions are functions, not persons z One person can fill more than one position z Until delegated, Command performs all functions z Address communications to functions, not persons Temple College EMS Professions

Incident Command System Temple College EMS Professions

Incident Command System Dispatch EMS Command Staging Officer Hospitals Triage Officer Treatment Officer Transport Officer Temple College EMS Professions

Triage z“To sort” z. Prioritizing patients based on severity Temple College EMS Professions

START Simple Triage & Rapid Treatment z Able to walk? y. Yes = Delayed y. No = Assess Ventilation Temple College EMS Professions

START z. Ventilation present? y. Yes = Greater than 30 per minute? x. Yes = Immediate x. No = Assess perfusion y. No = Position airway. Breathing present? x. Yes = Immediate x. No = Dead Temple College EMS Professions

START z. Perfusion adequate? (radial pulse) y. Yes = Assess mental status y. No = Immediate Temple College EMS Professions

START z. Mental status adequate (follows commands) y. Yes = Delayed y. No = Immediate Temple College EMS Professions

Four Category System y Green: y. Red: x. Immediate life threat y. Yellow: x. Significant morbidity x. Delayed life threat x Minimal life threat y Black: x Dead or will die Temple College EMS Professions

Rules of Triage z. Greatest good for greatest number z. Save lives, then limbs z. One Chief, many Indians z. Squeaky wheels don’t need grease z. You can’t save everyone! So don’t try! Temple College EMS Professions