Major Emergency
Response
Libby McGugan
Consultant in Emergency Medicine
Major Emergency
 Location, number, severity or type of live
casualties requires extraordinary
resources
 3 - 4 times per year in UK
 We have a statutory duty to provide
response
In a nutshell
 SAS will inform the duty charge nurse in
A&E
 CN / duty A&E consultant decide on
‘standby’ vs ‘declared’
 Switchboard put out call to duty staff
How do you know
what to do?
 Action cards are made up to tell staff
what to do.
 Do what it says on the card!
Major Incident Standby
 Consult with your duty consultant
 Go to Junior Doctor’s Mess, ground floor
next to Admission Unit 2 (surgical) to
collect action card
 Know how to access phone numbers for off
duty staff in your team
Example of action card
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ACTION CARD 7
DUTY SURGICAL REGISTRAR
Informed by switchboard
Duties
STANDBY
1. Consult with Consultant Surgeon
2. Proceed to the Junior Doctor’s Mess and collect your Action Card
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DECLARED
3. Cascade to all General Surgical Registrars and Surgical Doctors.
4. Assess General Surgical wards for patients who could be transferred or
discharged
and advise the ward Nurses in Charge.
5. Advise the Hospital Control Centre (extensions 27984/27985) of staff or
resource
deficiencies.
6. Proceed to A&E for tasking
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Major Incident Declared
 Cascade call out to all off duty medical
staff in your team
 Keep a record of who you have
contacted and their response
 Tell them Major Incident Declared.
Report to Junior Doctor’s Mess.
Bring identity badge
APPENDIX 1 : CASCADING CALLOUT
NAME OF CASCADING STAFF MEMBER _______________ DATE ______
Tell staff
1. There is a major emergency
2. Report to Junior Doctor’s Mess (entrance opposite lab
block)
3. Bring ID badge
Name / Grade
Time
Attend : Y / N / UC
UC = unable to contact
Cascade call out
 You need to know how to access to phone
numbers of your team
 External call barriers will be removed for calls
 YOU ARE PIVOTAL TO NHS FIFE’S
RESPONSE TO A MAJOR INCIDENT
Major Incident Declared
 Depending on scale of incident, some
staff may asked to remain on standby for
next shift – coordinator will advise
 Consider which patients on wards can be
discharged
 Clear theatres
Major Incident Declared
 Other specialists eg O&G / paeds /
maxillofacial / ENT may be contacted if
required or if incident large enough to
need all hands on deck
Site Medical Team
 Team may be requested to attend scene by
MIO if
- scene overwhelmed, delayed egress
- specific incident
 Team likely to consist of
- ED cons
- Anaesthetic reg / cons
- Orthopaedic reg / cons
- Surgical reg / cons
Site Medical Team
 Equipment / PPE stored in Major
Accident Store A&E
 Specialists need to be familiar with kit
Where to find out
 Intranet
 Search for MAJOR EMERGENCY
Any Questions?
Summary
 It’s not rocket science
 Need to have access to updated off duty
contact numbers
 Be clear about your role in cascading