Guideline 1-850 - Rescue Task Force

CMH EMS & MIH Protocols

Scope:

Guideline:

Purpose:

Procedure:

EMD:

• Tier one incident (threat of MCI): Dispatch primary agency and notify secondary agency Supervisors.
• Tier two incident (incident with less than six casualties): Dispatch all in-county on-duty agency resources and notify all Supervisors.
• Tier three incident (MCI with six or more casualties): Dispatch on-duty agency resources, notify Supervisors, and follow mutual aid protocols.

EMR:

• Responders do not have an obligation to put themselves in danger. It is the discretion of the crew to enter an unsafe scene in coordination with unified command. Available information, resources, situational awareness, and a risk-vs-benefit analysis should determine actions.
• Wear high-visibility and retro-reflective apparel when appropriate.
• PREPARATION:
• Assemble Rescue Task Force (RTF). Minimum of one (1) Threat Elimination Specialist (TES) assigned to EMS, but four is preferable.
• Gather the bare minimum equipment to perform lifesaving medical interventions and personal protective equipment.
• Medical functions of the RTF shall conduct radio communications on VTAC12.
• DIRECT THREAT CARE (Hot zone - Immediate threat may exist):
• Instruct responsive TES to continue advancing toward eliminating the active threat and to provide self-aid.
• Instruct ambulatory casualties to move to cover and provide self-aid.
• Control massive hemorrhage with Tourniquet.
• Consider moving unresponsive to cover and position to maintain airway.
• INDIRECT THREAT CARE (Warm zone - Secondary threats may exist):
• All weapons on the casualty should be rendered safe and secure.
• Establish casualty collection point(s) and perform hasty triage.
• Conduct abbreviated patient assessment and perform interventions to stabilize patient for extrication. Do not delay extraction for non-life-threatening interventions.
• MARCH:
• Major hemorrhage control: Consider Tourniquet and/or Hemostatic Agent.
• Airway management: Positioning, NPA
• Respirations: Consider vented occlusive dressing.
• Circulation.
• Head/Hypothermia: Treat life-threatening Head Trauma and prevent Hypothermia.
• EVACUATION:
• Reassess all patients and initiate transports as appropriate.

EMT:

• Ensure completion of applicable EMR items above.

AEMT:

• Ensure completion of applicable EMT items above.
• Consider IV LR fluid bolus after addressing active bleeding.

RN

Medic:

• Ensure completion of all applicable BLS items above.
• MARCH:
• Major hemorrhage control.
• Airway management: Consider Intubation.
• Respirations: Consider Decompression Needle.
• Circulation:
• Consider IO LR fluid bolus after addressing active bleeding.
• Consider TXA 1 g in 100 ml LR over 10 min if major injury AND signs of shock.
• Head/Hypothermia: Treat life-threatening Head Trauma and prevent Hypothermia.
• If it will not delay extraction: Refer to Protocol 2-660 - Pain Control.

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Polk, Hickory, Cedar, & St Clair County EMS Protocols is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.