MCI Emergency Response Protocol
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Questions and Answers

What is the primary goal of triage in a mass casualty incident?

  • To quickly transport all patients to the emergency department
  • To identify patients who need the most help and prioritize their care (correct)
  • To manage family and friends who arrive at the scene
  • To provide immediate medical treatment to all patients

    • What is the name of the pediatric triage algorithm used in mass casualty incidents?

  • JumpSTART (correct)
  • START Triage
  • Simple Triage
  • Pediatric Triage Algorithm

    • What is the purpose of a full-scale decontamination scenario drill?

  • To test all response components in a simulated scenario (correct)
  • To prioritize patient care in a mass casualty incident
  • To validate the working group's efforts
  • To test the communication skills of the decon team

    • What was the scenario used in the full-scale exercise on December 6th?

    <p>An improvised explosive device (IED) scenario</p> Signup and view all the answers

    What is the primary role of the trauma team in a mass casualty incident?

    <p>To prioritize patient care and manage resources</p> Signup and view all the answers

    What was the key takeaway from the full-scale exercise on December 6th?

    <p>The need for enhancements to triage and decanting</p> Signup and view all the answers

    What is the first step in responding to a Mass Casualty Incident (MCI)?

    <p>Close ED walk-in and EMS entrances</p> Signup and view all the answers

    What is the purpose of the START Triage algorithm?

    <p>To quickly identify the severity of patient injuries</p> Signup and view all the answers

    Where do immediate (red tag) and delayed (yellow tag) patients go during an MCI response?

    <p>Kimmel Core</p> Signup and view all the answers

    What type of training is provided to emergency department nursing staff?

    <p>Quarterly 10-15 minute sessions on each shift</p> Signup and view all the answers

    What is the purpose of the roll-up door in the Kimmel ambulance entrance?

    <p>To move MCI equipment cards from storage to the triage area</p> Signup and view all the answers

    What is the purpose of the MCI equipment cards?

    <p>To keep equipment organized during an MCI response</p> Signup and view all the answers

    What is the primary goal of triage in the Emergency Department?

    <p>To decrease morbidity and mortality for all ED patients</p> Signup and view all the answers

    What is the maximum time allowed for a comprehensive triage assessment?

    <p>2-5 minutes</p> Signup and view all the answers

    What is the purpose of the Emergency Severity Index (ESI) 5-level triage instrument?

    <p>To evaluate patient acuity and needed resources</p> Signup and view all the answers

    What is the first decision point in the Emergency Severity Index (ESI) algorithm?

    <p>Is the patient dying?</p> Signup and view all the answers

    What is the purpose of donning Personal Protective Equipment (PPE) in the emergency department?

    <p>To protect healthcare workers from high-consequence pathogens</p> Signup and view all the answers

    What is the result of a missed case of measles in the emergency department, as evidenced by the NYULI case?

    <p>Over 100 staff, patients, and visitors were canvassed due to possible exposure</p> Signup and view all the answers

    What is the first step in preparing for a Mass Casualty Incident (MCI) response?

    <p>Follow instructions of ED Flow Coordinator</p> Signup and view all the answers

    What is the purpose of the mass decontamination training?

    <p>To prepare for a mass casualty incident response</p> Signup and view all the answers

    Where do walk-in patients enter during an MCI response?

    <p>Kimmel ambulance entrance</p> Signup and view all the answers

    What is the frequency of START Triage training for emergency department nursing staff?

    <p>Quarterly, 10-15 minute sessions</p> Signup and view all the answers

    What is the purpose of the MCI equipment cards?

    <p>To facilitate communication during an MCI response</p> Signup and view all the answers

    What is the focus of the structured walkthroughs?

    <p>Frontline staff in key departments</p> Signup and view all the answers

    What is the primary goal of START Triage in a mass casualty incident?

    <p>To identify patients who need immediate medical attention</p> Signup and view all the answers

    Why are pediatric patients more likely to survive with a longer period of apnea?

    <p>Because they have a higher degree of resilience</p> Signup and view all the answers

    What is the purpose of drills and exercises in emergency medical services?

    <p>To test the response components of the emergency department</p> Signup and view all the answers

    What was the key takeaway from the full-scale exercise on December 6th?

    <p>The need for enhancements to triage and decanting</p> Signup and view all the answers

    What is the primary role of the trauma team in a mass casualty incident?

    <p>To stabilize and treat critically injured patients</p> Signup and view all the answers

    What is the purpose of the trauma team structure and roles?

    <p>To define the roles and responsibilities of each team member</p> Signup and view all the answers

    What is the main objective of performing a brief primary assessment on all incoming patients in the Emergency Department?

    <p>To identify patients who need immediate care and treatment</p> Signup and view all the answers

    Which of the following is a component of the primary assessment in the Emergency Department?

    <p>All of the above</p> Signup and view all the answers

    What is the maximum time allowed for a comprehensive triage assessment in the Emergency Department?

    <p>2-5 minutes</p> Signup and view all the answers

    Which of the following countries is NOT among the top 10 countries with high consequence pathogens?

    <p>Turkey</p> Signup and view all the answers

    What is the purpose of the hotline for high consequence pathogens?

    <p>To receive immediate assistance and guidance in case of a high consequence pathogen</p> Signup and view all the answers

    What is the category of patients who should be seen immediately in the Emergency Department, according to the Emergency Severity Index (ESI) algorithm?

    <p>Level 1</p> Signup and view all the answers

    Study Notes

    Management of Mass Casualty Incidents

    • Five key steps to prepare for MCI:
      • Close ED walk-in and EMS entrances
      • Decompress Kimmel Core by rapidly admitting ED patients to inpatient units and moving Kimmel Core patients to Tisch Core
      • Move MCI equipment cards from storage to the triage area
      • Perform mass decontamination and triage patients using the START algorithm and colored acuity tags
      • Manage patient flow by separating immediate, delayed, and minor/ambulatory patients

    Preparedness Activities

    • Regular planning team meetings
    • Hands-on mass decontamination trainings
    • Discussion-based and operational exercises (e.g. April Radiation Injury Influx Tabletop, December MCI Full Scale, January 2023 Executive Tabletop)
    • Special event planning (e.g. structured walkthroughs, proactive decon team staffing)

    START Triage Training

    • Rapid and streamlined triage with two goals: speed and identification of patients who need the most help
    • Training for emergency department nursing staff, with quarterly 10-15 minute sessions on each shift
    • Hands-on decontamination training open to all NYULH staff, with four trainings offered annually (half and full day)
    • Structured walkthroughs for frontline staff in key departments, regularly and prior to high-risk events (30-60 minutes)

    JumpSTART Pediatric Triage

    • Slightly different START triage for pediatric patients, who have a higher degree of resilience and are more likely to survive with long periods of apnea

    Drills and Exercises

    • Operational exercises (e.g. decon team comms drills, functional exercise focusing on triage and decanting)
    • Discussion-based exercises (e.g. HRO crisis management drills, Executive TTX in January)
    • Full-scale decontamination scenario with donning, doffing, and decontamination of actors, testing all response components

    Mass Casualty Incident Full Scale Exercise

    • Record emergency department volume on December 6th (127 ED patients, 54 awaiting bed requests)
    • Improvised explosive device (IED) scenario in Midtown, triaging and simulating placement of 30 patient actors, managing arrival of 12 actors portraying family and friends
    • 27 participating departments, with takeaways including need for enhancements to triage, decanting, and surgery prioritization

    Trauma

    • Trauma team structure and roles, communication, and debriefing
    • Trauma care progressively increases based on organism/pathogen, with need to inform high consequence pathogen hotline 24/7

    Infectious Disease and High Consequence Pathogens

    • Donning PPE, including visual inspection, disinfecting hands, inner/routine gloves, coverall, boot covers, N95 respirator, gown, provided hood, outer gloves/extended cuff, and face shield
    • Verifying PPE, with measles addendum noting a recent case at NYULI resulting in canvassing over 100 staff, patients, and visitors due to possible exposure
    • Top 10 countries for measles: Kazakhstan, Azerbaijan, Yemen, India, Iraq, Ethiopia, Kyrgyzstan, Russia, Pakistan, and Indonesia

    Emergency Department Triage

    • Objectives: identify patients who need immediate care and treatment, perform a brief primary assessment, assign an appropriate acuity level, and assign a location of care
    • Primary goal: decrease morbidity and mortality for all ED patients
    • Primary assessment: subjective data collection (brief one-line statement from patient, precipitating event/onset of symptoms, mechanism of injury, progression of condition from first symptom) and objective data collection (airway patency, breathing effectiveness, circulation effectiveness, disability, environmental exposure)

    Emergency Severity Index

    • 5-level triage instrument categorizing ED patients based on acuity and needed resources
    • Algorithm uses 4 decision points to sort patients into one of the five triage levels:
      • Level 1: seen immediately
      • Level 2: seen within 15 minutes
      • Level 3: seen within 60 minutes
      • Level 4: seen within 120 minutes
      • Level 5: seen within 240 minutes
    • Decision Point A: Is the Patient Dying?

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    Related Documents

    EN Exam 2 Study Guide PDF

    Description

    Test your knowledge of the emergency response protocol in case of a Mass Casualty Incident (MCI). This quiz covers the steps to take in response to an MCI, including closing entrances, decompressing areas, and moving equipment and patients. Are you prepared to respond in an emergency situation?

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