DR
Mohd Zin Bidin
CMO Malaysian GP
DISASTER MANAGEMENT
IN F1 RACING
By :
DR MOHD ZIN BIDIN
Chief Medical Officer
Petronas Malaysian Grand Prix
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
Introduction
• Disaster can occur anytime, anywhere
without warning.
• The more you are prepared, the better you will
be.
• When disaster occurs, our emergency response
plan will determine the extent of injuries and
damages sustained.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
Questions to ask
• How well prepared are we when disasters
occur?
• What procedures do we have in place?
• Who activates the Emergency Response Plan?
• What potential emergency situations can
occur?
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
AIM
• To describe a system for response to a mass
casualty incident as a result of disaster in F1
Racing.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
Scope
• Definitions.
• Disaster
-Causes
-Declaration
-Initiating a response
• Mass Casualty Incident Management Plan.
• The Triage System.
• Issues and Challenges.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
DEFINITIONS
Dr. Mohd Zin Bidin CMO Sepang
International Circuit
Definition
• Disaster – “An extreme disruption of the
functioning of a society that causes widespread
human, material, or environmental losses that
exceed the ability of the affected society to cope
using only its own recourses”.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
Definition
• Mass Casualty Incidents (MCI)
An event that results in a number of victims
large enough to disrupt the normal course
of emergency and health care services.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
Definition of Triage
• 1. A process for sorting injured people into groups
based on their need for or likely benefit from
immediate medical treatment. Triage is used in
hospital emergency rooms, on battlefields, and at
disaster sites when limited medical resources must be
allocated.
• 2. A system used to allocate a scarce commodity,
such as food, only to those capable of deriving the
greatest benefit from it.
• 3. A process in which things are ranked in terms of
importance or priority.
The American Heritage® Dictionary of the English Language, Fourth Edition copyright ©2000 by Houghton Mifflin Company. Updated in
2009. Published by Houghton Mifflin Company.
Dr. Mohd Zin Bidin CMO Sepang
International Circuit
DISASTER
-Causes
-Declaration
-Initiating a response
Dr. Mohd Zin Bidin CMO Sepang
International Circuit
Possible Causes of Disaster in F1
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Race cars flying onto spectators.
Building collapse.
Air crash during air shows.
Bomb threat / explosions.
Fire.
Hazardous materials incidents.
Civil disobedience / Riots.
Terrorist incidents.
Stampede.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
Declaration of Disaster / Mass
Casualty Incident
• FIA / FOM and host country officials to
assess severity of incidence.
• Levels of implementation:
a. Alert – notification of incident
b. Stand –by
c. Full activation and
deployment
d. Stand-down
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
Initiating a Response
• Recognize when an emergency response must be
initiated.
• Notify officials, employees, spectators ,etc.
• Make sure a single individual is in charge as
Incident Commander.
• Follow immediate
emergency procedures.
• Establish an Emergency
Command Post on site.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
MCI MANAGEMENT
PLAN
Dr. Mohd Zin Bidin CMO Sepang
International Circuit
Goals of MCI Management
• Doing the greatest good for the greatest
number.
• Managing scarce recourses effectively.
N/B Do not relocate the disaster – do not move the
incidence to the hospital unless it is able to receive the
types and numbers of patients.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
MCI Levels
• Level 1 (Local) - EMS personnel able to deal
with the MCI effectively.
• Level 2 (Regional) – Requires assistance and
mutual aids from surrounding communities.
• Level 3 (National) – Of such a magnitude that
local and regional assets are overwhelmed.
National or International assistance is required.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
Medical Command Post
• Established at the Track or Public Medical
Centre.
• CMO or DCMO becomes the Medical Incident
Commander.
• Unified command
system.
• Control, direct,
coordinate.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
MCI Organization
1.Emergency Operation Center.
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Incident commander
Chief operation officer
Chief planning officer
Chief logistic officer –medical supply and transport
2. Emergency Response Team (First team on
site).
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Onsite commander
Search and rescue personnel
Triage officers
Treatment officers
Transport officers
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
MCI Medical Set Up
• Medical Command Post
• Effective Transportation for medical
evacuation
• Effective communication facilities
• Onsite medical facilities
• Continuous Medical supply
• Extrications facilities and expertise
• Efficient Triage System
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
Incident Scene Assessment
• Establish safety of the scene.
• Obtain briefing from Scene Commander
• Assess extent of damage ,number and types of
casualties.
• Assess logistic requirements - Food, water, comm
and tpt.
• Establish a command center.
• Identify onsite management areas.
• Working areas
• Collection points
• Medical posts
• N/B. First action need not be medical.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
First EMS Provider
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Establish Medical Command Post
Directs triage of all patients
Assign tasks and responsibilities
Assign resources to get key functions running
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
Zoning System
• Red Zone
• Yellow Zone
• Green Zone
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CMO Sepang International Circuit
Zone System
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CMO Sepang International Circuit
Red Zone
• Incident site.
• Search and rescue teams.
• Fire, police, emergency services or those with
certain expertise.
• Recommended distance
(> 100m)
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
Yellow Zone
• Mobile crisis centre
• Posts for the search and rescue teams and other
supporting teams
• Recommended distance (>200m)
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
Green Zone
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Media.
Relatives waiting area.
Counseling post.
Food and refreshment.
Mortuary and other voluntary agency.
Recommended distance (>300m).
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
Incident Management System
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List of ambulances who will respond.
Contact hospitals.
Hospitals should implement MCI plan.
Identify ambulance who will cover regular
emergency calls.
• All responders should report to
IC first.
• Duties and responsibilities of
staff
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
Positioning Arriving Vehicles
• IC directs to appropriate sector.
• Report to sector officer.
• First ambulance on scene can be the Mobile
Command Centre
− Designate with a flag or device
• Once task is completed report
back to sector officer.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
Patient Tagging
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High Priority (1) = Red
Second Priority (2) = Yellow
Low Priority (3) = Green
Priority 0 = Grey or Black
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
Priority Levels
• Priority 1
− Airway and breathing difficulties.
− Uncontrolled or severe bleeding.
− Decreased mental status.
− Severe medical problems.
 Poisoning, diabetic, cardiac
− Severe burns
− Shock (hypo perfusion)
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
Priority Levels
• Priority 2
− Burn without airway problems.
− Major or multiple bone or joint injuries.
− Back injuries with or without spinal cord injuries.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
Priority Levels
• Priority 3
− Minor Burns or joint injuries.
− Minor soft tissue injuries.
− Obviously dead.
• Cardiac arrest
− lowest priority
− If EMS has enough personnel-highest priority.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
THE TRIAGE
SYSTEM
Dr. Mohd Zin Bidin CMO Sepang
International Circuit
Triage
• “To sort”
• Separates those requiring
immediate care
• Rapid and simple life-saving
intervention
• Reduces burden on
capabilities
• Provides rational casualty
distribution
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
Goals of triage
− Assess the patient’s condition.
− Determine the urgency.
− Transport to appropriate hospital.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
Ideal Triage System
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Easy to perform
Requires no advance skill
No specific diagnosis
Rapid and simple life-saving
intervention
• Easily taught and learnt
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
Doing the Greatest Good
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Greatest good for the greatest number
Intensive care in shortest possible time at site
Salvage the most number of patients possible
Do not try heroic resuscitation
Concentrate on those we can treat
• DO NOT RELOCATE THE DISASTER
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
Managing a Triage
• Initial Assessment
− Airway open? If not, open manually. If patient
responds move to next casualty.
− If patient is unresponsive, check breathing and
pulse.
− Check bleeding, if severe, apply pressure.
− Then move to next patient.
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
Managing a Triage
• Begin where you stand
• Move those that can walk away from site
(green tag) – the walking wounded
• Not breathing? Open and maintain airway
(Red tag)
• No radial pulse ? Perform CPR (red tag)
• Can stand a delay in treatment and transport
(Yellow tag)
• Deceased or unresponsive with no circulation
(Black tag)
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
ISSUES AND
CHALLENGES
Dr. Mohd Zin Bidin CMO Sepang
International Circuit
Issues and Challenges
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No top management commitment
Poor or no planning in Emergency Response Plan.
Lack of coordination among agencies.
Chaos in communication.
Lack of training and practice
Problem of selection of designated leaders.
Procedures for shutting down critical functions and
equipment.
Accesibility to disaster areas
Shortage of materials and logistics
Crowd control
VIP visitors
Dr. Mohd Zin Bidin
CMO Sepang International Circuit
THANK YOU
Dr. Mohd Zin Bidin CMO Sepang
International Circuit