Mass casualty incident

Pre-hospital

ICS

ICS Organization Structure

• Ensure the scene is safe
• Establish Incident Commander (IC)
• Request additional appropriate resources
  • Additional ALS/BLS
  • Fire resources (HAZMAT, heavy rescue, ect.)
  • Medevac
    • Establish landing zone
• Establish staging areas for resources
• No more than 8 people per supervisor
  • 3-5 preferred

Medical operations

• Establish triage area
  • Utilize START triage
  • Ensure all patients receive physical tag
  • Depending on size on incident, setup shelter for triage area
    • In large incident, setup area for dead away from triage
• Call area hospitals and determine how many patients each can take
  • Keep record of where each patient goes by tag number

Hospital

• Expect no more than 10 minutes notice for arrival of patients
• Discharge/move current ED patients to accommodate surge
• Ensure large quantity of resources are easily accessible in the (medications, stretchers, ect.)
• Triage all patients as they arrive, even if they were triage in prehospital setting
• Optimal to have 1:8 trauma teams per patient

Differential Diagnosis

Mass casualty incident

• Radiation exposure (disaster)
• Dirty bomb
• Bioterrorism
• Chemical weapons
• Mass shooting
• Natural Disaster (e.g. Hurricane, Earthquake, Tornado, Tsunami, etc)
• Unintentional large-scale incident (e.g. building collapse, train derailment, etc)
• Major pandemic
• Explosions

Diagnosis

• Mass casualty incident triage