North Central C-MED, Region 3 Mass Casualty Incident,
Protocol, Pre-Hospital, by North Central Connecticut EMS Council Management of
Hartford, Connecticut
Mass Casualty Incident Communications
MCI LEVELS
The establishment of MCI levels is to automatically trigger
operational movement of resources without the CMED communicator needing special
authority/direction. In theory, the EMS officer would declare an MCI (level 1-4)
and CMED following established protocol on page 4 of the aforementioned manual.
Sandy Hook was a level 2 MCI:
Level 2 MCI (21-50 victims)
15 ambulances
3 EMS Supervisors
1 Regional MCI trailer
Consider 1 bus
RED Plan Notification
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On page 6 of the
North Central Connecticut EMS Council Management manual we read:
SETUP the scene for management of the casualties:
Establish staging.
Identify access and egress routes.
Identify adequate work areas for Triage, Treatment, and
Transportation.
SMART triage:
Begin where you are.
Ask anyone who can walk to move to a designated area.
Use SMART Triage tags to mark patients.
Move quickly from patient to patient.
Maintain patient count.
Provide only minimal treatment.
Keep moving!
Staging Areas
All responding EMS units should go directly to the assigned
STAGING AREA and await further instructions. Do not leave the staging area until
you are instructed to do so by the
Medical Branch Director/Medical Group Supervisor or the direction
of North Central CMED.
Patient Dispersal from the Scene
Patients will be sorted according to SMART Tag criteria of
RED/YELLOW/GREEN/BLACK. Upon receiving direction from the Medical Branch
Director/Medical Group Supervisor, CMED will contact all area hospitals to
determine RED/YELLOW/GREEN capabilities.
Red: Priority 1
Life-threatening but treatable injuries requiring immediate
medical attention
Yellow: Priority 2
Potentially serious injuries, but are stable enough to wait
a short while for urgent medical treatment
Green: Priority 3
Injuries that can wait for longer periods of time for
delayed treatment
Black/Blue: Dead/Expectant
Dead or (expectant still with life signs but injuries are
incompatible with survival in austere conditions
To assure hospital capabilities have not reached
capacity, transporting units will be assigned hospital destination by North
Central CMED.
Patient Dispersal to Receiving Hospitals
Purpose
The purpose of this protocol is to assure that the
treatment of patients at the scene of a mass casualty incident and
transportation to receiving hospitals is done in accordance with accepted
medical and communication standards. Radio traffic should be kept at a
minimum. In accordance with the statewide program of Mass Casualty Care
in Connecticut, patients requiring advanced life support will have effective
medical control communications providing guidance for, advanced life support
care without the need for individual orders, alternative transportation for
patients receiving advance life support when insufficient MICU unit are
available, and assurance that trauma patients are taken to appropriate trauma
centers. Communications to hospitals and requests for medical control will be
processed through the individual that has assumed responsibility for the EMS
function at the scene of an incident.
Scene Management
Upon arrival at the scene of a mass casualty incident, the
EMS provider sets up EMS scene control and designates and the Medical Branch
Director/Medical Group Supervisor per their Mass Casualty Incident Plan.
Whenever possible, CMED should be advised of the incident’s scope. CMED will
alert the hospitals closet to the incident’s scene. During the incident, CMED
will provide periodic updates to the hospitals in the affected area. These
hospitals should report any changes in their status during an incident that may
affect scene management, directly to CMED.
Ambulance Coordinator
The Ambulance Coordinator reports to the Patient
Transportation Unit Leader, manages the ambulance staging area(s), and
dispatches ambulances as requested.