Principles of Major Incident Response

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Slide 1: 

Temple College EMS Professions Principles of Major Incident Response

Major Incident : 

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

Major Incident : 

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

Success depends on: : 

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

Slide 5: 

Temple College EMS Professions Communications Control Command A PLAN

A good plan. . . : 

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

A good plan. . . : 

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

A good plan. . . : 

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

Incident Command System : 

Temple College EMS Professions Incident Command System Effective C3 begins with first unit Establish command Do NOT treat patients

EMS Command : 

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

Triage Officer : 

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

Staging Officer : 

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

Treatment Officer : 

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

Transport Officer : 

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

Support Officer : 

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

Incident Command System : 

Temple College EMS Professions Incident Command System

Incident Command System : 

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

Incident Command System : 

Temple College EMS Professions Incident Command System

Incident Command System : 

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

Triage : 

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

START : 

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

START : 

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

START : 

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

START : 

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

Four Category System : 

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

Rules of Triage : 

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

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