Mass Casualty Incident Management: Part 10

While mass casualty incidents occur without warning, appropriate planning, preparation and practice help to minimize the impact of such events and maximize provider safety and patient outcome.

In this installment we focus on ways you can keep yourself and others educated and trained in mass casualty incident management.

Publications

Reading publications like EMS World Magazine is one of the best ways to stay current on new technology, best practices and ideas in prehospital medicine from around the world. Articles, including this series, are intended not just to inform the reader of the “new and improved,” but also to remind them about information they knew, but perhaps haven’t used in some time. Most important, these publications provide the reader with ideas as to how they can take this information and integrate best practices within their own service, serve their own community and share this information with fellow providers.

Conferences

Reading about ideas is a start, but sharing and talking about these ideas face-to-face is even better. Conference presentations provide the opportunity to learn directly from industry and subject matter experts, to ask questions and to share your thoughts with other providers. Local, regional and national conferences, such as the upcoming EMS World Expo, provide unique opportunities to collaborate with peers and experts from around the world to help improve the service that you provide to your constituents.

Table-Top Exercises

When you’re ready to put your preparation and plans into practice the best way to start is a table-top exercise. Table-tops are a great way to give participants a birds-eye view of how MCI plans translate into real-world operations.

These exercises can be as simple as sitting down with MCI stake-holders and verbally “walking-through” the phases of a mass casualty incident making note of key positions (Incident Commander, EMS Officer or EMS Branch Director, Triage, Treatment, Transport and Staging), as well as establishing lines of communication and forward movement of patients. Table-top exercises can also work as scaled-down simulations of past or predicted events and include index cards, scale models or other place-holders representing victims, staff, vehicles, resources and any other influencing factor you can think of. However you use them, a table-top exercise is a great way to give MCI plans (and the people expected to implement them) a run-through to elicit questions, identify issues, shake-out bugs and make necessary changes before a real-life incident occurs.

Task Training

As we’ve learned in this series, there’s no such thing as a one-person or even one-agency MCI operation. Mass casualty incidents demand cooperation and collaboration by multiple services. Collaboration with other municipalities, agencies and services in the planning process and even table-top exercises is a beginning, but for an MCI operation to be functional, everyone who will have to work together during the MCI must work together before.

This could be as simple as having firefighters run through decontamination or practice evidence preservation procedures with police officers, or establishing “Triage Tuesdays” where one Tuesday a month EMS crews run through utilizing their services’ triage systems and tags in order to better familiarize themselves (and hospital staff) with the equipment and procedures.

Full-Scale Exercises

Of course, one of the best ways to prepare for an MCI is to participate in a full-scale MCI simulation, but the commitment of time and resources that a well-executed simulation requires can be expensive and time-consuming. The Department of Homeland Security Exercise and Evaluation Program (HSEEP) offers resources to guide you through getting the most out of local, regional, statewide and even international exercises. The purpose of HSEEP is to provide responders with resources and standards for exercise design, development, conduct and evaluation.

National Fire Academy

Finally one of the best sources of both education and hands-on practical exercise is the National Fire Academy in Emmitsburg, MD. Beginning in 2011 the NFA began offering the two-day EMS Functions in ICS and the six-day EMS Incident Operations programs to help prepare first responders from across the United States to manage MCIs and large-scale incidents.

In addition to classroom courses, the NFA offers additional resources such as the online program EMS Operations at Multi-Casualty Incidents and the just-released MCI print resource Operational Templates and Guidance for EMS Mass Care Incident Deployment.

With all of these resources available, you can be assured that whatever size incident you're planning for and whatever size agency you work with, you won't have to reinvent the wheel to prepare your first responders for the next mass casualty incident to impact your community.

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.