203.04 Treatment Sector

Extrication Sector Responsibilities

• Determine location, number, and condition of all patients, coordinating with Triage
• Decide on triage location: in place or at the treatment area entrance
• Determine resources and assign/supervise extrication teams
• Extricate and deliver patients to treatment areas or casualty collection points
• Provide frequent progress reports to Command
• Ensure patient and personnel safety and accountability
• Coordinate with other sectors
• Notify Command when all patients are removed and companies are available for reassignment

Extrication Sector Officer Guidelines

• Wear a sector vest for identification
• Position in a visible, accessible location with a view of the scene
• Maintain face-to-face communication within the sector
• Use messengers to relay information to the sector officer
• Provide frequent progress reports to Command

Patient Removal Priorities

• IMMEDIATE patients removed to treatment areas without delay
• DELAYED patients removed after IMMEDIATE patients, unless access is restricted
• Non-ambulatory patients moved on backboards with cervical spine precautions if necessary

Resource Allocation

• Initial commitment: one company per five victims
• Assign companies to specific areas or groups of patients
• Company officers responsible for patient needs and requesting assistance
• Divide responsibility geographically in large incidents, with designated sector names (e.g., "North Extrication")

ALS Personnel and Specialized Equipment

• Most ALS personnel assigned to the Treatment Sector
• Some paramedics may be assigned to the Extrication Sector for critical patients
• Ladder companies assigned for forcible extrication
• Request specialized equipment (wreckers, cranes, cutting torches) through Command

Safety and Congestion Control

• Ensure safety of the extrication area
• Commit personnel with protective lines and extinguishing equipment where a fire risk exists
• Reduce confusion and congestion by directing MINOR patients to a specific area
• Extrication Sector responsible for further assessing and transporting MINOR patients to an "Assembly Area"

Treatment Sector Overview

• A Treatment Sector is established to manage the treatment of multiple IMMEDIATE and DELAYED patients.
• The Treatment Sector is responsible for setting up a treatment area to provide stabilization and continuing care of patients until they can be transported to a medical facility.

Treatment Sector Responsibilities

• Identify whether patient treatment will occur “in place” or in a designated treatment area.
• Determine resources and assign treatment teams.
• Ensure all patients have been triaged, assessed, and re-triaged as needed.
• Provide aggressive treatment and rapid packaging of patients.
• Provide frequent progress reports to Command.
• Ensure safety and accountability of all patients and assigned personnel.
• Verify transportation priorities with Transportation Sector.
• Coordinate with other sectors.

Establishing a Treatment Area

• The Treatment Sector officer establishes a large treatment area, separate from the incident scene.
• If the incident is large, separate "IMMEDIATE" and "DELAYED" treatment areas are established.
• The treatment area must be readily accessible for patient entry and transportation loading, away from dangerous conditions.
• The area should be large enough to absorb all patients and treatment personnel.

Treatment Area Operations

• Patients are arranged in an orderly manner, with adequate space provided between patients for treatment personnel.
• First arriving patients are placed near the exit point, and rescuers fill from exit towards the entrance as patients are delivered.
• Non-triaged patients arriving at the treatment area are triaged and tagged at the entrance.
• ALS treatment is given primarily in the "IMMEDIATE" treatment area, with less intensive patient monitoring and treatment in the "DELAYED" treatment area.
• Medical information is documented on the triage tag.

Treatment Sector Officer Responsibilities

• The Treatment Sector officer assigns personnel to meet and direct first arriving litter-bearers.
• The officer advises Command when ready to receive patients.
• The officer ensures treatment is rapid, adequate, and appropriate numbers of treatment personnel are assigned to each patient.
• The officer maintains awareness of which patients are ready for transport.
• The officer ensures close coordination with the Transportation Sector officer for rapid transportation.