46 Questions
What is the primary purpose of the policy described in the text?
To define the organizational plan for effectively triaging, treating, and transporting patients in multiple casualty incidents
What is the first action the officer of the first arriving unit should take according to the procedure?
Perform a size-up
Which of the following is NOT a triage category mentioned in the text?
Critical
What is the purpose of locating and removing the walking wounded to a separate location?
To ensure they receive treatment as soon as possible
According to the procedure, what is the officer of the first arriving unit responsible for requesting?
A Level 1, 2, or 3 response
What is the purpose of using the color-coded ribbons found in the MCI bag?
To categorize victims according to the START triage system
What is the responsibility of the TREATMENT OFFICER at an MCI scene?
Complete a 'Treatment Officer Log' for each patient
What should the first arriving units do to establish command/control at an MCI scene?
Assign positions for triage, treatment, transport, and staging
What is the primary role of the MEDICAL BRANCH during an MCI?
Work directly with the COMMAND to ensure coordination
Why is the consideration of private ambulance services mentioned in the text for managing MCIs?
To assist in transporting patients in case of a mass casualty event
During large scale or complex MCI's, what should be done to reduce span of control according to the text?
Designate a Medical Branch
What should the TRIAGE OFFICER do upon completion of triaging duties at an MCI scene?
Report to COMMAND for further assignments
Why might the use of Mobile Command Vehicles (MCV) or Triage Trailers be considered in managing MCIs?
To establish a centralized treatment area
What does COMMAND do during large-scale or complex MCI's?
Establish a Medical Branch to reduce span of control
What should Fire Rescue Communications do upon contacting hospitals during an MCI?
Maintain a log of each hospital's capability
Why is it crucial for TREATMENT OFFICERS to re-triage patients after initial assessment at an MCI?
To ensure all patients receive priority treatment
What does the START method of triage aim to achieve?
Quickly assess a large number of patients
What should be done if borderline triage decisions are encountered?
Triage to the most urgent priority
What information does the TRANSPORT provide to Fire Rescue Communications?
Number of patients on board, their priority, and special needs
What is the role of the STAGING OFFICER during an incident?
Coordinate incoming units and establish a staging area
What should personnel do according to the protocol during an incident?
Ensure keys stay with each vehicle if assisting in another function
How should triage decisions be made using the START Method?
Always triage to the most urgent priority in case of borderline decisions
What should Fire Rescue Communications do during an incident requiring high medical resource demand?
Maintain a status on patients and hospital readiness, coordinate transportation, and direct patients to appropriate hospitals
What is one responsibility of a Documentation Aide assigned by TRANSPORT?
To assist with paperwork and communications
Why should ground transported patients be assigned to hospitals on a rotating basis?
To avoid any pattern in patient assignment
What role does Fire Rescue Communications play in coordinating patient transportation during incidents?
Coordinating patient transportation and directing them to appropriate hospitals
What should be done if a patient is identified as Red during initial triage and transport is available?
Do not delay transport to perform a secondary assessment
What should be done with the walking wounded patients?
Locate them in one area away from the incident and assign someone to keep them together
What is the mnemonic used to remember the order of assessment during triage?
RPM (Respirations, Perfusion, Mental Status)
If a patient's respiratory rate is over 30/min, what triage tag should be assigned?
Red
How is perfusion assessed during triage?
By palpating a radial pulse or assessing capillary refill time
If a patient follows commands and is oriented to time, place, and person, what triage tag should be assigned?
Green
What should be done if the first assessment produces a Red tag?
Stop further assessment and tag the patient as Red
What should be done for children less than one year of age during triage?
Fully screen them using the standard triage process
What is the AVPU scale used for during triage?
Assessing mental status
If a patient has a respiratory rate of 15-45/min and a palpable peripheral pulse, what triage tag should be assigned?
Green
What is the role of the officer designated as TRIAGE?
To assess and prioritize the medical needs of patients
What is the minimum number of suppression units required for an MCI Level 2 incident?
3
What is the primary responsibility of the officer designated as TRANSPORT?
To coordinate the movement of patients to transport units
Which of the following is NOT one of the additional officer positions that may be required depending on the complexity of the incident?
RESOURCE
How many hospitals will Fire Rescue Communications contact to determine status and patient capacity for an MCI Level 3 incident?
4
What is the minimum number of ALS transport units required for an MCI Level 4 incident?
10
Which of the following is NOT a responsibility of the officer designated as STAGING?
Determining the appropriate level of response needed
What is the primary role of the officer designated as TREATMENT?
To oversee the medical care and treatment of patients
How many Battalion Chiefs are required for an MCI Level 3 incident?
2
What is the primary responsibility of the officer designated as LANDING ZONE?
To establish and manage the landing zone for air transport units
Study Notes
MCI Response Plan
- Purpose: Define the organizational plan to effectively triage, treat, and transport patients in multiple casualty incidents (MCI's).
Command Structure
- COMMAND officer establishes command and performs a size-up
- Requests a Level 1, 2, or 3 response based on the number of patients
- Requests additional units and/or specialized equipment as required
- Identifies a staging area
- Directs crew members to initiate triage using START method
Triage and Treatment
- Triage uses color-coded ribbons to identify victim status:
- Red: Immediate
- Yellow: Delayed
- Green: Ambulatory (minor)
- Black: Deceased (non-salvageable)
- Walking wounded are removed to a separate location and assessed as soon as possible
- TREATMENT officer:
- Completes a "Treatment Officer Log"
- Assigns a "Documentation Aide" to assist with paperwork
- Ensures all patients are re-triaged through a secondary exam
- TRANSPORT officer:
- Assigns a "Documentation Aide" to assist with paperwork and communications
- Coordinates transportation of patients to hospitals
MCI Levels
- Level 1: 5-10 patients
- 4 ALS transport units
- 1 Battalion Chief and 2 suppression units
- Level 2: 11-20 patients
- 6 ALS transport units
- 2 Battalion Chiefs and 3 suppression units
- Level 3: 21-100 patients
- >8 ALS transport units
- 2 Battalion Chiefs and >4 suppression units
- Level 4: 101-1000 patients
- >10 ALS transport units
- >2 Battalion Chiefs and >6 suppression units
START Triage Method
- Assess RESPIRATIONS:
- Respiratory rate >30/min: Tag Red
- Respiratory rate ≤30/min: Go to PERFUSION assessment
- Assess PERFUSION:
- Radial pulse present or capillary refill ≤2 seconds: Go to MENTAL STATUS assessment
- No radial pulse or capillary refill >2 seconds: Tag Red
- Assess MENTAL STATUS:
- Patient follows commands and is oriented: Tag Green
- Patient does not follow commands or is disoriented: Tag Red
JumpSTART for Pediatrics
- Ages 1-8 years old
- Assess BREATHING:
- Spontaneously breathing: Go to RESPIRATORY RATE assessment
- Apneic or irregular breathing: Open airway and assess for peripheral pulse
- Assess RESPIRATORY RATE:
- Respiratory rate 15-45/min: Go to PERFUSION assessment
- Respiratory rate >45/min or irregular: Tag Red
- Assess PERFUSION:
- Peripheral pulse present: Go to MENTAL STATUS assessment
- No peripheral pulse: Tag Red
- Assess MENTAL STATUS:
- Patient responds to verbal commands or pain: Tag Green
- Patient does not respond to verbal commands or pain: Tag Red
Test your knowledge on the Standard Operating Procedure Chapter 98 of St.Johns County Fire Rescue regarding Mass Casualty Incidents (MCI) and the Simple Triage and Rapid Treatment (START) system. Learn about the organizational plan for triage, treatment, and transport in multiple casualty incidents.
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