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King County MCI Plan 2011 Updates

King County MCI Plan 2011 Updates. Batt Chief Marty La Fave Bellevue Fire Department. A Review of Mass Casualty Management. Company Officer: First five minutes MCI Plan: New Changes Division of Labor: Groups and Units. Initial Size-up Phase 1. Look for SLUDGE

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King County MCI Plan 2011 Updates

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  1. King County MCI Plan2011 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

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

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

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

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

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

  8. Maintain the Transportation Corridor!

  9. 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

  10. 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

  11. 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)

  12. Changes

  13. Changes

  14. The Previous MCI Plan

  15. Typical MCI Org Chart 2011

  16. Are you doing the job…or leading it?

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

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

  19. 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

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

  21. 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

  22. Expanding the Treatment Unit

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

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

  25. 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

  26. 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

  27. 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

  28. Expanding the Transport Unit

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

  30. Expanding the Rescue Group

  31. Expanding the Medical Group

  32. 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

  33. Questions?

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