In the wake of the terrible atrocity that happened at the Boston marathon, you may be thinking that your organization requires an update/creation of a process to deal with a mass casualty incident (MCI). If you don't know about triaging a mass casualty incident, you may find this useful to help you understand what the emergency services do at a large scale incident. Instead of giving you a complete 'how to' we will supply you with some useful points to think about. We have purposely referenced already available sources, so you can do a full study on 'best practice' for your organization. Throughout this article remember - 'Tag, Treat, Transfer'
To build the bones of your MCI protocol you must first define the triage process as relevant to your area and your responders skill level. The triage process is intended to assign a level of priority to each patient at the sharp end of pre-hospital care. Your responders should follow their clinical practice guidelines (CPG's) in denoting what 'priority' each patient is. A good example of a CPG process that we found online, is taken from the "Charlevoix County Medical Control AuthorityState Model { CBRNE } Protocol"
This process is usually done by the first EMT's or Fire Fighters who arrive on scene. It must be remembered that this is a dynamic, quick and tough process. The responder(s) should asses each casualty as per their CPG's and tag appropriately. Minimum time should be given to each patient so as all can be tagged accordingly. No treatment should be given at this stage, as this wastes triage time.
After all patients have been 'tagged' appropriately and other responders are on scene you can now provide essential treatment depending on your responders skill level. You may have to provide treatment at the site or create a treatment area similar to the the one belwo which was described in "Establishing a Mass Casualty Management System".
Evacuation should be done via the most appropriate means for the appropriate patients. Simply put, get the most serious ones to the hospital as quickly as possible. Another consideration is to initiate a 'one-way system' so all ambulances will travel in one direction. Your MCI protocol can be as simple or as complicated as your response area requires. Just remember "Tag, Treat & Transfer".
Documenting protocols, recording incidents and training in an open and collaborative environment is one of the reasons we built Decisions [D4H] - Multi-Award Winning Emergency Response Team Software.
Written by Adam Scott, [D4H] Customer Success Dept, EMT & SAR Responder