Mass Casualty Incident Management: Part 9

There’s an MVA on the highway involving three cars and you and your partner are responding. It doesn’t sound like the end of the world, but it might involve more patients than your city has ambulances immediately available for.

You arrive closely behind the first-in units and see a few people obviously hurt, some in their cars, some walking around, and a bunch of people who could be bystanders or more patients.

The first due crew has designated this a mass or multi casualty incident (MCI) and assigned you to be the staging officer. What next?

In this series we are describing the staging officer as the position applies to EMS operations. During larger incidents the position of staging officer may entail additional responsibilities and the procurement and deploying of resources to a variety of operational areas.

Step 1) Take the Job: The first thing that you do is coordinate with the EMS officer to get briefed. He should be able to give you an approximate idea of the number and capabilities of incoming resources. This will be key when it comes to coordinating the deployment of these resources for the treatment and transport officers.

Step 2) Dress for Success: You will need to obtain and don the staging officer vest to identify yourself. You will also need to obtain any checklists and materials that are specific to the MCI management system that you use. Finally you’ll need to accessorize with radios (or other appropriate devices to communicate with transport units), and, if at all possible, acquire at least one assistant or runner.

Step 3) Set Up Your Work Space: Arguably the most important decision that you will make as staging officer (if it has not already been made for you), is your choice of location for the staging area. This choice will largely be guided by proximity to a suitable loading area adjacent to the treatment area, the amount of space you will need to stage incoming resource and transport units, and suitable ingress and egress to and from the staging area. In addition, a good staging area must be easily found by incoming units, some of which may be unfamiliar with your location.

Step 4) Go to Work: Your work as staging officer will have two primary goals: to deploy resources (EMS personnel and materials) to the treatment area and to deploy transport units to the loading area. One of the easiest ways to accomplish these goals together, especially during larger incidents, is to have the crews from arriving units leave a driver with their transport (or non-transport) vehicle while they carry portable equipment to the treatment area. Arrangements may need to be made if the staging area is distant from the treatment area. You may direct units to deploy their crews/resources after leaving the staging area on their way to the loading area. The idea is that the “driver-only” transport units will pick up the staff the treatment officer assigns to each patient, regardless of who works for what service. Crews and equipment will be reunited with their units once no patients remain to be transported.

To accomplish your job as staging officer you’ll need to coordinate with:

a) The EMS officer to exchange information on the availability, capabilities and capacities of units responding to (and arriving at) the incident;

b) Transport units to ensure that they understand their role and responsibilities in the MCI operation;

c) The transport officer to send transport units to the loading area.

Step 5) Communicate: The staging officer should communicate upstream with the EMS officer to obtain resource and transport units and will sometimes communicate directly with the units themselves. The staging officer will also communicate downstream with both the treatment officer who will be receiving resources and the transport officer who will be receiving transport units.

The position of staging officer will vary greatly from incident to incident, sometimes coordinating diverse sources of numerous types across multiple staging areas, while other times the responsibilities of the staging officer will be handled directly by the incident commander or EMS officer. Regardless of whom handles the responsibilities of the staging officer or exactly how they are addressed, the needs for staff and equipment will always require some level of staging.

In the next installment: Furthering your MCI training and practice.

An emergency responder for more than 20 years with career and volunteer fire departments, public and private emergency medical services and hospital-based healthcare, Rom Duckworth is an internationally recognized subject matter expert, fire officer, paramedic and educator. He is currently a career fire lieutenant, EMS coordinator and an American Heart Association national faculty member.