Katana VentraIP

Mass casualty incident

A mass casualty incident (often shortened to MCI) describes an incident in which emergency medical services resources, such as personnel and equipment, are overwhelmed by the number and severity of casualties.[1] For example, an incident where a two-person crew is responding to a motor vehicle collision with three severely injured people could be considered a mass casualty incident. The general public more commonly recognizes events such as building collapses, train and bus collisions, plane crashes, earthquakes and other large-scale emergencies as mass casualty incidents. Events such as the Oklahoma City bombing in 1995, the September 11 attacks in 2001, and the Boston Marathon bombing in 2013 are well-publicized examples of mass casualty incidents. The most common types of MCIs are generally caused by terrorism, mass-transportation accidents, fires or natural disasters. A multiple casualty incident is one in which there are multiple casualties. The key difference from a mass casualty incident is that in a multiple casualty incident the resources available are sufficient to manage the needs of the victims. The issue of resource availability is therefore critical to the understanding of these concepts. One crosses over from a multiple to a mass casualty incident when resources are exceeded and the systems are overwhelmed.

M Mass incident declared

E Exact location

T Type of incident

H Hazards present

A Access and egress

N Number of casualties and severity

E Emergency services required

[3]

or emergency medical responders may arrive as part of local emergency medical services, or may arrive on their own. They will assist with all aspects of patient care, including triage and treatment at the scene, and transport from the scene to the hospital.

Certified first responders

and emergency medical technician (EMT) personnel may arrive in ambulances, in their personal vehicles, or from another agency. They will have control of all aspects of patient care, as assigned by the medical officer or incident commander.

Paramedic

Ground will be assigned to the transport sector to transport patients and personnel to and from the incident scene, emergency departments of hospitals, and a designated helipad. These ambulances may be municipal services, volunteer services, or from private corporations.

ambulances

will transport patients from the scene or from designated helipads to receiving hospitals.

Air ambulances

  Immediate: Patients who have major life-threatening injuries, but are salvageable given the resources available

  Delayed: Patients who have non-life-threatening injuries, but are unable to walk or exhibit an altered mental status

  "Walking wounded": Patients who are able to ambulate out of the incident area to a treatment area

  Deceased or expectant: Used for victims who are dead, or whose injuries make survival unlikely.

Demobilization[edit]

The final product of an MCI that happens to link up with the M.E.T.H.A.N.E. method is the act of demobilization which is crucial to the entire process. The demobilization process has to be in place from the beginning, once an area has been mobilized. This is critical, as a mass casualty incident can get out of hand quickly. Having everything planned out step-by-step can alleviate these concerns and help cover for the unexpected. The demobilization process also gives the local community and the corresponding agencies an idea for how long their city and specific areas will be consumed with emergency personnel and essentially blocked off. In many events, such as Hurricane Katrina, the demobilization process is not taken into account from the beginning. As a result, the process goes on much longer than necessary, which exacerbates financial costs, and puts a burden on local emergency and law enforcement services to uphold their everyday duties while also maintaining control of the mass casualty incident.[12]

(mnemonic for the information to include when declaring an MCI)

ETHANE

(ICS)

Incident Command System

(NIMS)

National Incident Management System

(French MCI plan)

Orsec-Novi plan

(an MCI drill in 2000)

Pentagon MASCAL

START triage

Marx, John A. Marx (2014). Rosen's Emergency Medicine: Concepts and clinical practice (8th ed.). Philadelphia, PA: Elsevier/Saunders. pp. Chapter.  978-1455706051.

ISBN

Mattox, Kenneth (2013). Trauma (7th ed.). McGraw-Hill Education.  978-0071663519.

ISBN

Trunkey, Donald (2008). Current Therapy of Trauma and Surgical Critical Care (1st ed.). Philadelphia: Mosby.  978-0-323-04418-9.

ISBN

. DelValle Institute Knowledge Base. DelValle Institute for Emergency Preparedness. Archived from the original on 1 September 2017. Retrieved 1 September 2017.

"Activating A Mass Casualty Response"

. FEMA. United States Department of Homeland Security. 6 November 2016. Archived from the original on 30 April 2017. Retrieved 12 May 2017.

"Incident Command System Resources"

. America Trauma Society. American Trauma Society. Retrieved 1 September 2017.

"Trauma Center Levels Explained"