Guideline 1-850-25 - Mass Casualty

CMH EMS & MIH Protocols

Scope:

Guideline:

A mass casualty incident is defined as an incident with six (6) or more patients or an incident that exceeds the resources available.

Purpose:

To allow resources to be attained and coordinated at a mass casualty incident.

Procedure:

1. A mass casualtiy incident is defined as greater than five (5) patients.
2. EMS responders should follow National Incident Management System (NIMS) guidelines and coordinate with Incident Command (IC) or participate with Unified Command (UC).
3. EMS scene communications should be conducted on VTAC12.
4. Upon arrival and/or when determination that a mass casualty incident has occurred, EMS staff shall ensure potential receiving Emergency Rooms (ER) will be notified of potential patient surge.
5. Ambulance personnel should prioritize transporting patients to the ER and returning to the scene. On-scene and at-destination activities such as triage and treatment should be limited or eliminated.
1. Ambulance staffing and ambulances should always be moving while patients remain on the scene. Only take an ambulance out of service for on-scene activities as a last resort.
2. Consider not getting out of the ambulance. Patients should be directed and assisted into the ambulance quickly. Once the ambulance is full, initiate transport.
6. If appropriate, medical officers may be established. However, transport of mass casualty patients to the appropriate facilities should be a priority.
1. A medical command officer (sector chief) may be established to organize EMS response and interface with UC.
2. A triage officer may be established to prioritize patient treatment, transport, transport methods, and destination.
3. A transport officer may be established to facilitate and coordinate incoming and outgoing ground and air ambulances.
4. In the absence of one or more established officers, the following tasks should be completed by on-scene EMS staff:
1. Establish command, if none exists.
2. Size up the scene noting hazards and number of patients.
3. Ensure mitigation of hazards that might include power lines, hazardous materials, violent subjects, etc.
4. Communicate appropriate sizup information to incoming units and destination facilities.
5. If appropriate, utilize SALT triage method to sort patients into those needing treatment and transport first.
6. If appropriate, establish casualty collection points.
7. Facilitate rapid flow of patients from injury site to destination facilities.
8. Coordinate incoming and outgoing ground and air ambulances.
9. Attempt to document patient information (number, severity, treatments, and destination).
7. Ambulances sitting on the scene not being used as transport should be limited as much as possible. Consider loading ambulances with multiple patients with less emphasis on triaging on the scene to facilitate transporting more patient quickly to appropriate facilities. Patients waiting on transport by ambulance will likely find their own transport methods to destinations not capable to handle their needs.

CMH Pre-Hospital Services Mission: "Provide safe, exceptional, and compassionate care to our communities with an emphasis on highly trained and empowered staff."

CMH Mobile Integrated Healthcare Mission: "Provide exceptional, compassionate, and patient-centered care by a mobile collaborative team to improve patient experience, improve quality outcomes, and reduce healthcare costs."

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