J U N E , 2 0 1 2
July, 2012

Revised 2011 MCI Plan: WHY?
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Reduce choke (funnel) points
Minimize unnecessary actions
Improve division of labor
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Increase plan scalability for all events
Simplify patient tracking
Utilize NIMS terminology

Training Objectives
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Discuss Updates and Changes of the Plan
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Review of initial MCI scene size-up
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Overview of general MCI concepts
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Demonstrate each element of the MCI process on the drill ground
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Review equipment on MCI-99

MCI Changes at a glance
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Develop “Rescue Group” to package and move patients
Eliminate formal funnel point
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Eliminate use of treatment tags
Eliminate patient numbering (felt pen)
 Utilize NIMS Terms: Hospital Control is now
Disaster Medical Control Center (DMCC)

WMD Incidents

Initial Size-up Phase 1
 Look for SLUDGE

Identify immediate hazards
 Consider access/egress options to secure a transportation corridor.
 Observe base/staging options

Estimate number of patients

Maintain the Transportation Corridor!

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

Requesting Resources
 Basic MCI Activities

Rescue/Extrication
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Treatment/Transport
Ambulance staging
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Complex Activities
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Fire
Hazard Material
CBRNE
Collapse

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

Commanding the radio
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Provide size-up
Initiate command
Initial assignments

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Safety & hoseline
Triage
Treatment
Request “base” resources
Request “transport” resources

Physical Actions of the First-in Crew
 Engine/Ladder Company

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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

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Medical Group
Treatment Unit
Transport Unit

Changes

Changes

The Previous MCI Plan
COMMAND
MEDICAL
GROUP
TRIAGE
TREATMENT
TRANSPORT

Typical MCI Org Chart 2012
COMMAND
RESCUE
GROUP
MEDICAL
GROUP
EXTRACTION
UNIT
TREATMENT
UNIT
EXTRICATION
UNIT
TRANSPORT
UNIT
GREEN
UNIT

Are you doing the job…or leading it?

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

So, who does Triage?
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Rapid Field Triage -BLS
Minimal Treatment
Who Supervises Triage:

Medical Group (small)

Rescue Group (Large)
Secondary Triage – ALS

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

Treatment Unit
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Reasons for a Treatment Area

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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

Expanding the Treatment Unit
Red Manager
Treatment Unit
Leader
Yellow Manager
Treatment
Dispatch Manager

King County MCI Resource Vehicles
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Units that are specifically designed to manage at least 35
MCI patients with medical equipment, backboards, and oxygen supplies.
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There are regionally located:
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MCI-99 North King County
MCI-9 Eastside
MCI-51 and 81 South King County
MCI-1 City of Seattle
MCI-777 Port of Seattle

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

Transportation Unit
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Apply tracking bands
Communicate with DMCC
Receive patient destination
Manage documentation
Benchmarks:


All reds transported
All patients transported

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

Tracking
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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

Tracking

Instruct all transporting personnel to place a tracking sticker on the
Medical Incident Report:

Hospital form

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Agency form
EPCR agencies need to enter number in laptop

Expanding the Transport Unit
Transport Unit
Leader
Ambulance
Staging Manager
Ambulance
Loading Manager
DMCC
Coordinator
Tracking Aide

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

Expanding the Rescue Group
Rescue Group
Extrication
Unit
Extraction
Unit

Summary of Key Points for MCI
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Secure the transport corridor !!
Keep transport units staged separately
Medics focus on Medical/Treatment/Transport
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Early notification of DMCC
Suppression focus on Rescue/Extraction
Perform secondary triage before transport
 Separate loading from DMCC activities

 Questions?