jeffrey regis ems at an mci 1.2m
TRANSCRIPT
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Today’s Schedule
EMS Function in ICS EMS at an MCI SMART Tag System
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Multiple or Mass Casualty
Multiple-one more patient than immediately available resources can manage
Mass-catastrophic event9/11Hurricane Katrina Ice Storm of 1998Sports Function at your School
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EMS Function in ICS
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CSCATTT at an MCI
Command & Control Safety Communication Assessment Triage Treatment Transport
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EMS In An MCI
Initial Problem-Casualties out-weight resources at initial response
Objective-effective scene management & optimum use of resources
Avoid Crainal-Rectal Syndrome at all costs
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Primary Triage
Patients rapidly assessed Life-threatening conditions corrected Airway Bleeding Shock
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Primary Triage Officer
Assigned by EMS Control Officer Primary Triage Vest Rapidly & continuously assessing patients Identifying life-threatening conditions Assigning & directing care for patients with
life-threatening conditions Monitoring changes in conditions of
patients
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Primary Triage Officer
Three questions To what degree is the condition life-
threatening Will interventions save a life Impact on resources
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Primary Triage Officer
Three critical conditions managed during Primary Triage: ABSAirwayBleedingShock
CPR not performed
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Primary Triage Officer
Difficulty or not breathingOpen airway
Blood flowing from wound Instruct another patient to apply direct
pressure Progressing into shock
If not contraindicated elevate extremities and cover patient
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Primary Triage Officer
Is patient responsive Is bleeding found Signs or symptoms of shock
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Primary Triage Officer
Appointed by & reports to EMS Control Officer
Circulates among patients Identifies life-threatening conditions: ABS Directs others to manage ABS Continues to circulate among patents Relieved by EMS Control Officer
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Smart Tape Similar to Broselow Tape Alert & moving all limbs or walking-Green,
Priority 3 If not Green-then use Smart Tape Lay Smart Tape as flat as possible If between two sections-use section for
LONGER child Infants under 50cm are unlikely to be out of
hospital-Red, Priority 1
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Secondary Triage
Patients sorted for evacuation to Treatment Area
Four Categories:RedYellowGreenBlack
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Secondary Triage Officer
Assigned by EMS Control Officer Secondary Triage Vest Identify & correct life-threatening
conditions Classifies patient for further treatment Applies Triage Tags Reports number/type tags to EMS Control
Officer
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Secondary Triage Officer
Category 1-RedMajor blood lossMultiple system injuriesSevere respiratory distressSerious head injuries
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Secondary Triage Officer
Category 2-YellowDo not require immediate transportNon-life or limb-threatening injuriesDislocationsLacerationsNon-shock injuries
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Secondary Triage Officer
Category 3-GreenMinor or no injuriesSmall abrasions & bruisesSeparate from Red & Yellow Tagged
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Secondary Triage Officer
Category 0-BlackCPR not indicated with limited resourcesLeft where found at scene-if possible
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Secondary Triage Officer
Patient in cardiac arrest before critical needs of group met
Will patient need ambulance transport Will delay in transport jeopardize life or
limb
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Secondary Triage Officer
Care at MCI is BASICBleeding controlAirway managementShock management followed by Immobilization on backboardsClassification with Triage Tags
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Secondary Triage Officer
Appointed by & reports to EMS Control Officer
Identify & correct ABS Classifies & Tags patients Provides number and category of patients to
EMS Control Officer
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Treatment Officer
Appointed by & reports to EMS Control Officer
Supervises patient care Communicates with receiving hospitals-in
some systems Monitors & requests additional supplies Prioritizes patients for transport Communicates with Transport Officer Updates EMS Control Officer
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Treatment Officer
Treatment AreaOne Check-In point-towards MCI sceneOne Exit-Point-towards loading area6 ft. between patients
Red (A/B if needed) and Yellow Green Area nearby
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Treatment Officer
Triages all patients againRetags if necessary-up or downUses A/B if lacking resources
Care rendered documented on Triage Tag
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Loading/Transport Officer
Appointed by & reports to EMS Control Officer
Sets up Loading AreaAdjacent to Treatment Area-Red TagsMultiple vehiclesMinimize “backing up”Exhaust fumes
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Loading/Transport Officer
Sorts patients for loading priorityRed A/B, Yellow, Green, Black
Assigns patients to ambulancesParamedic, Intermediate, Basic
Assigns ambulances to hospitals-include directions
Communicates with Treatment Officer
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Loading/Transport Officer Communicates with hospitals:
Tag colorLast 4 digits of tag numberSex & age of patientMajor injury/problemsEstimated time of arrival
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Loading/Transport Officer
Completes report on patients loaded/transportedTag colorLast 4 digits of tag numberHospital destinationTransporting serviceTime of departure
Updates EMS Control Officer
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Loading/Transport Officer
Balance resources to patientsHow does transport of one patient affect
the restUse limited resources to assist the
greatest number of patients
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Supplies
Vests for EMS OfficersEMS ControlPrimary TriageSecondary TriageTreatmentLoading/Transport
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Supplies
Broselow Tape Sunscreen Biohazard bags w/twist ties Trash bags w/twist ties Clip boards/Pencils 2 each 100 ft. colored extension cords:
Red/Yellow/Green Camera
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Smart Incident Command System
Developed in Europe