In this micro-lecture, APC Hon. Snr. Lecturer Sam Willis talks about managing a Mass Casualty situation, the role and responsibility of the first crew on-scene. Such as that of the Commander, who is the communication officer, and a triage officer.
In today’s micro lecture, we’re going to talk about mass casualty incidents.
Now, mass casualty incidents are defined as any situation that puts the strain on the healthcare system. This can be anything from a one-vehicle road traffic collision, where there are four really seriously injured people, all the way through to an act of terrorism, whereby there has been an intentional calculation to cause harm to mass populations.
Regardless of the situation, the first crew arriving on the scene has a very specific role to play.
Number one, they have a responsibility to identify that it is a mass casualty incident if it hasn’t already been declared. Declaring a major incident can be as simple as following the METHANE mnemonic. Once you’ve declared it by stating, “Mass casualty incident declared,” follow the METHANE or the CHALET Report and tell dispatch that you are facing a mass casualty incident. If ever you are unsure, it’s better to declare a major incident than to not declare the major incident and for it to all unfold later.
The first crew on scene have got a very specific role to play. There’s a commander, who is the communication officer, and a triage officer. As stressful and as difficult as these situations are, if you do happen to be the first crew on scene, you have to go in and really do follow your protocols. The triage officer has to take their mass casualty triage pack, walk around all the different injured patients and give them a code. There’s a priority one, there’s a priority two, there’s a priority three, and there’s a dead priority. There’s four priorities.
A priority one when the ambulance crews start to arrive, they will be treated first and so on and so forth, two, three, and dead are not treated at all. T
he commander has a responsibility of maintaining communications between the person who’s gone in there to do the triaging and to maintain communications with dispatch and the other systems and the other people.
You have to tell them the best access, the safest access, the type of incident that’s unfolded, the nature and the type of help and support that you need. Then when a more experienced person arrives on scene, they will take over from that commander. Then that paramedic who was previously off operating as a commander, will go into the scenario and start helping out.
In summary then, first person on scene declares the major incident. One person is a triage officer.
One person is a ‘commander’ who maintains communication. Once you’ve gone and started to triage, you will give people codes and tags.
You will place a tag on their wrist or their legs. When, ultimately, the other ambulances start to arrive and the other help, they will then undertake a secondary triage. They’ll remove them out of the situation if it’s safe to do so and they will do something called Sought, Sieve and Sought. They will then transport them to hospital in the order of which they need to go. The most serious will go first.
Of course, the hospitals will manage this in their own methods. For example, they will page the Chief Executive Officers, will get everybody in who was on overtime or not working.
There are systems in place and of course the more you practice for this, the better you get.
That’s a micro lecture on mass casualty incidents. I hope you’ve enjoyed it. My name’s Sam Willis (APC Hon. Snr. Lecturer), I look forward to talking to you again later.
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