130 Questions
How are mass/multiple-casualty incidents (MCIs) defined?
Incidents where the number of injured exceeds the capabilities of the first-arriving unit.
What is the definition of an active shooter incident?
An individual or individuals actively engaged in harming, or attempting to kill people in a populated area with the use of firearm(s).
In which situations is the MCI protocol applicable?
Everyday MCI when the number of injured exceeds the capabilities of the first-arriving unit and large-scale MCIs.
What does ASHER stand for in the Mass Casualty Incident Response Plan?
Active Shooter Hostile Event Response
In an active shooter or tactical MCI, what is the role of the Rescue Task Force?
Provide Security and treatment of victims
How is triage performed in Mass Casualty Incidents?
Using START or JumpSTART protocols and color-coded ribbons
What are the THREAT actions in the integrated active shooter response?
Threat suppression, Hemorrhage control, Rapid extrication, Assessment by medical providers, Transport to definitive care
What happens to the walking wounded in a Mass Casualty Incident?
They are directed away from the incident for assessment
How are Mass Casualty Incidents classified?
By different levels based on the number of victims
What does the First-arriving unit officer do in an MCI?
Establishes Command, performs size-up, requests response level, and identifies staging area
What additional branches/sections may be required in Mass Casualty Incidents based on incident complexity?
Medical, Hazmat, and Public Information Officer
Who will gather information about each hospital's capability upon notification of an MCI?
Medical Control
What involvement may be necessary in ongoing, long-term MCIs?
Various medical response teams such as MMRS, SMRT, and MRC
What is the radio designation for the first arriving officer in a Mass Casualty Incident?
Command
What does the Medical Branch designation aim to reduce during large-scale or complex MCIs?
Span of control
What is the primary function of the Medical Branch in a Mass Casualty Incident?
Assure Triage, Treatment, and Transport
What should be designated in response to a known or suspected weapon of mass destruction (WMD) event?
Medical Intelligence Officer
What should the first arriving officer do to determine the MCI Level?
Determine the number of victims
What should be considered for large-scale or complex MCIs to reduce the span of control?
Designate a Medical Branch
What should the first arriving officer do if unknown victims are present in an ASHER incident?
Initiate a MCI level 2
What should be requested for setting up a safety perimeter in the event of an MCI?
Law Enforcement
What should the Medical Branch work with Command to assure in a Mass Casualty Incident?
Triage, Treatment, and Transport
What is the purpose of Personal Protective Equipment (PPE) in a mass casualty incident?
To protect the wearer from threats including ballistic, stabbing, fragmentation, or blunt force trauma
What is the function of a Casualty Collection Point (CCP) in a mass casualty incident?
To serve as a temporary location for gathering, triage, medical stabilization, and subsequent evacuation of nearby casualties
What is an Asymmetric Attack in the context of mass casualty incidents?
An attack involving multiple modes such as firearms, explosives, fire, smoke, and vehicle assaults, often coordinated and concurrent at multiple locations
What does the term 'Concealment' refer to in the context of mass casualty incidents?
Protection from observation, preventing direct observation from the threat
What is the role of a Rapid Tactical Force (RTF) in a mass casualty incident?
To locate the suspect(s) and neutralize the threat
What does Ballistic Protection aim to protect against in a mass casualty incident?
Firearms or other hostile weapons
What is the function of a Casualty Movement Team in a mass casualty incident?
To move the injured/uninjured to an area of safety
What does Force Protection (FP) involve in the context of mass casualty incidents?
Preventive measures taken to mitigate hostile actions in specific areas or against a specific population
What is an Improvised Explosive Device (IED) in the context of mass casualty incidents?
A device placed or fabricated in an improvised manner incorporating destructive, lethal, noxious, pyrotechnic, or incendiary chemicals
What does Rapid Treatment and Force Protection involve in a mass casualty incident?
A combination of fire and/or EMS personnel and law enforcement providing force protection and performing tasks such as threat-based care, triage, and victim extraction
What is Unified Command in the context of mass casualty incidents?
An authority structure in which the incident commander role is shared by individuals from all responding organizations responsible for the incident, operating together to develop a single incident action plan
What is the purpose of the Mass Casualty Incident (MCI) protocol?
To efficiently triage, treat, and transport victims of mass/multiple-casualty incidents
What is the definition of 'Active Assailant(s)' (AA) in the context of mass casualty incidents?
An individual or individuals actively engaged in killing or attempting to kill people in a confined and populated area with means other than the use of firearms
What does 'Acve Shooter Hosle Event Response (ASHER)' refer to in the context of mass casualty incidents?
An incident where one or more individuals are or have been actively engaged in harming, killing, or attempting to kill people in a populated area by means such as firearms, explosives, toxic substances, vehicles, edged weapons, fire or a combination thereof
What is the role of the Fire Chief’s Association of Broward County (FCABC) in issuing the MCI protocol?
Issuing the MCI protocol for efficiently triaging, treating, and transporting victims of mass/multiple-casualty incidents
What is the primary function of the Rescue Task Force in a mass casualty incident?
Provide forced protection for rescue personnel
In mass casualty incidents, how are victims prioritized during triage according to the provided guidelines?
Immediate care, delayed care, ambulatory, deceased
What is the role of the walking wounded in a mass casualty incident?
They need to be assessed as soon as possible
What does the acronym THREAT stand for in the integrated active shooter/assailant response?
Threat suppression, hemorrhage control, rapid extrication to safety, assessment by medical providers, transport to definitive care
What does Ballistic Protection Equipment (BPE) aim to protect against in a mass casualty incident?
Stabbing, fragmentation, and blunt force trauma
What is the primary function of the Casualty Collection Point (CCP) in a mass casualty incident?
Gathering, triage, stabilization, and evacuation of casualties
What does the term 'Concealment' refer to in the context of mass casualty incidents?
Protection from observation, potentially providing protection from threats
What is the role of the Rescue Task Force (RTF) in a mass casualty incident?
Combining fire/EMS and law enforcement to provide force protection, threat-based care, triage, and victim extraction
What does the THREAT acronym highlight in the integrated active shooter response?
Initial actions to control hemorrhaging
What does Unified Command (UC) involve in the context of mass casualty incidents?
Individuals from all responding organizations developing a single incident action plan
What is the primary function of the Extraction Team/Litter Bearers in a mass casualty incident?
Moving injured/uninjured to safety
What does Force Protection (FP) involve in the context of mass casualty incidents?
Preventive measures against hostile actions, protecting civilians and unarmed responders
What is the definition of an Improvised Explosive Device (IED) in the context of mass casualty incidents?
A device designed to destroy, incapacitate, harass, or distract, made with military or nonmilitary components
What does the term 'Cover' provide in the context of mass casualty incidents?
Protection from firearms or hostile weapons
What does a Complex Coordinated Attack involve in the context of mass casualty incidents?
Multiple asymmetric attack modes, coordinated and concurrent attacks on multiple locations, and often requires multiple attackers
What is the role of the Contact Team/Law Enforcement Entry Team in a mass casualty incident?
Locating and neutralizing suspects
What is the responsibility of the first-arriving officer in a Mass Casualty Incident (MCI)?
Conduct triage
What may be classified by different levels depending on the number of victims in a Mass Casualty Incident (MCI)?
Response units
What is the role of the Medical Intelligence officer in a Mass Casualty Incident (MCI)?
Assist with suspected or known WMD events
What may be required in addition to Triage, Treatment, Transport, and Staging officers in a Mass Casualty Incident (MCI) based on incident complexity?
Extraction branch
What should be reported to a state-approved trauma center for determination of transport destination?
Any victim meeting trauma transport criteria
What is the role of the Medical Control upon notification of a Mass Casualty Incident?
Gather information about each hospital's capability
What should be considered for patients with special needs in a Mass Casualty Incident?
Air transport
What does the Medical Branch ensure in a Mass Casualty Incident?
Adequate medical supplies and personnel
What is the primary function of the Rescue Task Force in a Mass Casualty Incident?
Provide immediate extraction and treatment of victims in the warm zone
What should be designated in response to a known or suspected weapon of mass destruction (WMD) event?
Safety perimeter
What is the role of the Fire Chief’s Association of Broward County (FCABC) in issuing the MCI protocol?
Issue guidelines and standard operating procedures
What should be requested for setting up a safety perimeter in the event of a Mass Casualty Incident?
Law enforcement
How many MCI Task Forces are available for MCI Level 4 (101-1000 victims)?
5 MCI Task Forces
How many ALS Transport Strike Teams are available for MCI Level 4 (101-1000 victims)?
2 ALS Transport Strike Teams
How many Mass Transit Buses are available for MCI Level 4 (101-1000 victims)?
2 Mass Transit Buses
What is the designation for a Medical Branch in a Mass Casualty Incident?
Medical
How is a Mass Casualty Incident (MCI) Level determined?
By the first arriving officer
What is the primary responsibility of the Triage Officer in a Mass Casualty Incident?
Assessing and prioritizing victims based on the severity of their injuries
What does the Medical Branch ensure in a Mass Casualty Incident?
Proper security of incident site, treatment area, and loading area
What is the primary function of the Treatment Officer in a Mass Casualty Incident?
Providing medical treatment to victims
What is the role of the Fire Chief’s Association of Broward County (FCABC) in issuing the MCI protocol?
Issuing the MCI protocol
What does a Mass Casualty Incident Task Force consist of?
Two ALS Transport Units, two BLS Transport Units, and one Suppression Unit
What is the role of the Medical Intelligence officer in a Mass Casualty Incident (MCI)?
Assist with decontamination, antidotes, and treatment of victims
What is the designation for a Command established by the first arriving officer in a Mass Casualty Incident?
Command
How many MCI Task Forces are available for MCI Level 5 (more than 1000 victims)?
10
What is the role of the Extraction Team/Litter Bearers in a mass casualty incident?
Transporting victims to medical treatment areas
What does ASHER stand for in the Mass Casualty Incident Response Plan?
Active Shooter/Hostile Event Response
What does ASHER stand for in the context of mass casualty incidents?
Active Shooter Hostile Event Response
What is the purpose of the After Action Report (AAR) in the context of mass casualty incidents?
To document the actions taken and lessons learned from an operation
What is the definition of Active Assailant(s) (AA) in the context of mass casualty incidents?
One or more individuals actively engaged in harming, killing or attempting to kill people in a populated area with means other than the use of firearms
What does Ballistic Protection Equipment (BPE) aim to protect against in a mass casualty incident?
Use of firearm(s)
What is the primary purpose of Ballistic Protective Equipment (BPE)?
Protection from ballistics threats, stabbing, fragmentation, or blunt force
What is the function of a Casualty Collection Point (CCP) in the 'Strong Hold' (warm zone)?
Treatment area for life-threatening injuries
What does code three (3) response involve?
Emergency response with lights and sirens
What does the Cold (Green) Zone provide for first responders?
Operational area with minimal threat for first responders
What does competence refer to in the context of ASHER procedures?
Possessing the knowledge, skills, and judgment needed to perform objectives
What is the role of a Contact Team/Contact Officer in an ASHER situation?
Locating and stopping an Active Killer
What does containment mean in law enforcement terminology?
Designating a perimeter position to control and isolate suspect movement
What does the Emergency Operations Plan (EOP) coordinate during ASHER incidents?
Activities of police, Fire Rescue, and supporting agencies
What does Force Protection (FP) involve in the context of ASHER procedures?
Preventive measures to mitigate hostile actions
Where is the Hot (Red) Zone located and who is authorized to operate in it?
Operational area with immediate threat, only SWAT Tactical Medics are authorized
What is an Improvised Explosive Device (IED) in the context of ASHER procedures?
An explosive device constructed and deployed in unconventional ways
What does the Incident Management System (IMS) define?
Roles, responsibilities, and operating procedures in managing emergency operations
What is the primary function of a Rescue Task Force in a mass casualty incident?
To provide security and treatment in the warm zone
What does the acronym S.A.L.T. stand for in the context of mass casualty incidents?
Sort, Assess, Lifesaving Interventions, Treatment/Transport
What is the
Unified Command
What does
Threat-Based Care
What is the
Warm (Yellow) Zone
What does the
Rescue Team
What does
Staging
What is the
Strong Hold
What does the acronym T.H.R.E.A.T. stand for in the context of mass casualty incidents?
Threat Suppression, Hemorrhage Control, Rapid Extrication to Safety, Assessment, and Transport to Definitive Care
What is the definition of 'Secured' in the context of mass casualty incidents?
A location with no obvious threat and constant presence
What does the term 'Third party complainants' refer to in the context of mass casualty incidents?
Reports from individuals not directly involved in an incident, to be evaluated for necessary response
What is the minimum response time required for accessing the structure in ASHER situations?
Immediately after clearance by Law Enforcement
Where is the Incident Safety Officer (ISO) allowed to address arising issues?
In the cold zone
When is a Casualty Collection Point (CCP) established in ASHER situations?
In the warm zone
Who must be immediately notified upon recognition of an ASHER situation?
Fire Chief, Public Information Officer (PIO), and Command Staff
What does dispatch automatically do if the victim count is unknown in ASHER situations?
Upgrades the response to Level 2 MCI
What should the CSPFD IC request depending on the complexity of the incident?
Three mutual aid communication channels for operations, medical, and staging
What is the primary choice for command in ASHER situations?
Unified Command with Law Enforcement
What must CSPFD take a proactive approach in activating if multiple or coordinated complex incidents occur?
Emergency Operation Center (EOC)
What should the Public Information Officer (PIO) do before releasing any information in active shooter incidents?
Coordinate with the police PIO
What should the CSPFD tactical channel be patched with for communication with mutual aid units from other agencies?
A regional tactical channel
What should be considered for requesting a Communication Center Supervisor?
More direct communications support
What does the Incident Commander (IC) have the authority to initiate based on the incident?
Mass casualty incident (MCI) procedures
Who should determine safe paths for access and egress from the scene in an active shooter/hostile event response (ASHER) situation?
The Incident Commander (IC)
What is the primary responsibility of CSPFD personnel, apparatus, and equipment in an ASHER situation?
Emergency response
By whom should the Incident Command System (ICS) be initiated in response to an ASHER situation?
By the first arriving unit
Who should work in the hot zone in an ASHER situation?
Only law enforcement
What should be conducted according to EMS protocols and the department AS/VI plan in an ASHER situation?
Triage, treatment, and transport
What is the role of CSPFD SWAT-Medics in an ASHER situation?
Respond to the scene and operate in their SWAT-Medic capacity
What should the CSPFD staging area provide in an ASHER situation?
Cover for all personnel
What should be followed by all personnel (Fire Department & Law Enforcement) when responding to ASHER incidents?
The National Incident Management System (NIMS) and Incident Command System (ICS)
What should the CSPFD IC seek out when establishing a Unified Command post in an ASHER situation?
The law enforcement IC
What should CSPFD personnel not be used for in an ASHER situation?
Crowd control
What should be the location of the CSPFD staging area in an ASHER situation?
Not in view from the affected structure and provides cover for all personnel
Study Notes
Mass Casualty Incident Response Summary
- Definition of a mass casualty incident: an incident where one or more individuals are actively engaged in harming, killing, or attempting to kill people in a populated area using various means such as firearms, explosives, toxic substances, vehicles, edged weapons, fire, or a combination thereof.
- Personal Protective Equipment (PPE): gear intended to protect the wearer from threats including ballistic, stabbing, fragmentation, or blunt force trauma, typically consisting of a ballistic vest, helmet, and/or shield.
- Casualty Collection Point (CCP): a temporary location for gathering, triage, medical stabilization, and subsequent evacuation of nearby casualties, usually occurring in the warm zone with limited vehicular access.
- Asymmetric Attack: frequently involves multiple attack modes such as firearms, explosives, fire, smoke, and vehicle assaults, often coordinated and concurrent at multiple locations.
- Concealment: protection from observation, preventing direct observation from the threat.
- Rapid Tactical Force (RTF): a team of law enforcement officers tasked with locating the suspect(s) and neutralizing the threat.
- Ballistic Protection: protection from firearms or other hostile weapons.
- Casualty Movement Team: personnel used to move the injured/uninjured to an area of safety.
- Force Protection (FP): preventive measures taken to mitigate hostile actions in specific areas or against a specific population, including civilians and unarmed responders.
- Improvised Explosive Device (IED): a device placed or fabricated in an improvised manner incorporating destructive, lethal, noxious, pyrotechnic, or incendiary chemicals and designed to destroy, incapacitate, harass, or distract.
- Rapid Treatment and Force Protection: a combination of fire and/or EMS personnel and law enforcement providing force protection and performing tasks such as threat-based care, triage, and victim extraction.
- Unified Command: an authority structure in which the incident commander role is shared by individuals from all responding organizations responsible for the incident, operating together to develop a single incident action plan.
Mass Casualty Incident Response Procedures
- Ballistic Protection Equipment (BPE) includes vests, helmets, and shields to protect against ballistic threats, stabbing, fragmentation, or blunt force trauma.
- Casualty Collection Points (CCP) are temporary locations for gathering, triage, stabilization, and evacuation of casualties, often in the warm zone with limited vehicular access.
- Complex Coordinated Attack involves multiple asymmetric attack modes, coordinated and concurrent attacks on multiple locations, and often requires multiple attackers.
- Concealment refers to protection from observation, potentially providing protection from threats.
- Contact Team/Law Enforcement Entry Team is a group tasked with locating and neutralizing suspects.
- Cover provides protection from firearms or hostile weapons.
- Extraction Team/Litter Bearers move injured/uninjured to safety.
- Force Protection (FP) involves preventive measures against hostile actions, protecting civilians and unarmed responders.
- Improvised Explosive Device (IED) is a device designed to destroy, incapacitate, harass, or distract, made with military or nonmilitary components.
- Rescue Task Force (RTF) combines fire/EMS and law enforcement to provide force protection, threat-based care, triage, and victim extraction.
- THREAT acronym highlights initial actions to control hemorrhaging, including threat suppression, hemorrhage control, rapid extraction to safety, assessment by medical providers, and transport to definitive care.
- Unified Command (UC) involves individuals from all responding organizations developing a single incident action plan, typically consisting of law enforcement, fire, and EMS representatives.
Active Shooter/Hostile Event Response (ASHER) Procedures
- The procedures detail resource deployment, including apparatus and ambulances, under the direction of the Incident Commander (IC) or Unified Command (UC).
- Personal Protective Equipment (PPE) should be worn by personnel, and they should not enter the warm zone without direction from the IC.
- Only law enforcement should work in the hot zone, and personnel may be assigned to rescue task forces (RTFs) with law enforcement.
- The UC should determine safe paths for access and egress from the scene, and extraction teams should extract viable patients from the warm zone to the Casualty Collection Point (CCP).
- Triage, treatment, and transport should be conducted according to EMS protocols and the department AS/VI plan, with consideration for alternative transportation modes based on local protocol and training.
- ASHER situations present unique dangers requiring situational awareness and a unified command structure between the Coral Springs-Parkland Fire Department (CSPFD) and law enforcement.
- CSPFD personnel, apparatus, and equipment should not be used for crowd control, and decisions should balance personnel safety with the department’s responsibility for emergency response.
- The National Incident Management System (NIMS) and Incident Command System (ICS) should be followed by all personnel (Fire Department & Law Enforcement) when responding to these incidents.
- ICS should be initiated by the first arriving unit and expanded as additional resources arrive, with the CSPFD IC seeking out the law enforcement IC to establish a Unified Command post.
- Law enforcement will actively engage the threat and secure the perimeter, and CSPFD SWAT-Medics will respond to the scene and operate in their SWAT-Medic capacity.
- The remaining crew shall stage and wait for further orders from the incident commander unless a personnel staging area has been designated.
- The CSPFD staging area shall be in a location not in view from the affected structure and provides cover for all personnel.
Test your knowledge of mass casualty incident response with this quiz. Explore topics such as personal protective equipment, casualty collection points, asymmetric attacks, force protection, and more. Evaluate your understanding of rapid tactical force, improvised explosive devices, and the concept of unified command in managing such incidents.
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