Hoffman Estates Fire Department Standard Operating Guidelines PDF

HOFFMAN ESTATES FIRE DEPARTMENT STANDARD OPERATING GUIDELINES SOG Category & Identification Number: EFFECTIVE DATE: SPECIALIZED OPERATION - 006 January 1, 2022 NIMS COMPLIANT...

HOFFMAN ESTATES FIRE DEPARTMENT STANDARD OPERATING GUIDELINES SOG Category & Identification Number: EFFECTIVE DATE: SPECIALIZED OPERATION - 006 January 1, 2022 NIMS COMPLIANT SOG Title: Multiple Patient Incident Revision: 2 APPROVED BY: NUMBER OF PAGES: Re-evaluation Date: Alan Wax January 1, 2025 Fire Chief 8 PURPOSE The purpose of this plan is to enable the Hoffman Estates Fire Department and area hospitals to respond effectively and efficiently to small to medium/large scale incidents, so as not to tax the resources of any single facility and to provide optimal patient care. The plan is generally activated upon the recommendation of Incident Command at a small to medium/large scale incident, or in conjunction with hospital officials. POLICY: IMPLEMENTATION OF PLAN The need to activate a small to a medium/large incident is not always obvious to the emergency responder. Small scale incidents are handled very differently than a medium to large scale incident. Criteria and application are illustrated below: A SMALL SCALE INCIDENT RESPONSE WILL USUALLY BE ADEQUATE IF: 1. The number of injuries, and resources that can arrive at scene within 15 minutes (secondary response time) make normal level of EMS care achievable for most serious injured. 2. All time-sensitive patients can be transported within a 10 minute scene time. 3. “Business as usual” – within scope of normal operation. PRACTICAL APPLICATION FOR A SMALL SCALE INCIDENT:  START/JUMP start triage is required  Triage tags are optional  Number in patient compartment – 1 ALS + 1 BLS or 2 BLS if no HIPAA violation  OLMC when transporting is mandatory  PCRs are mandatory  Trauma Center criteria still applies  Patient distribution; usual transport patterns  Refusal process still applies 1  IMPORTANT! In a SMALL SCALE INCIDENT transport up to 2 of the most critical patients to each hospital that can be reached in 30 minutes to help clear the scene.  Contact hospital (through local protocol) to distribute remaining patients.  Radio reports MUST be given from the field on all victims who are being transported  No hospital shall become initially overwhelmed with patients from the same scene THE MEDIUM TO LARGE SCALE INCIDENT SHOULD BE ACTIVATED WHEN: 1. The number of patients and the nature of their injuries make the normal level of stabilization and care unachievable; AND/OR 2. The number of responders/ambulances that can be brought to site within secondary response times is INSUFFICIENT to manage scene and provide normal levels of care and transport under normal operating procedures; AND/OR 3. The stabilization capabilities of the hospitals that can be reached within ground transport time of 30 minutes are INSUFFICIENT to handle all the patients. May need to activate disaster plan. PRACTICAL APPLICATION FOR A MEDIUM TO LARGE SCALE INCIDENT:  START/JUMP start triage is required  Triage tags are mandatory  Ambulances may transport more than one patient Number in patient compartment – 1 stretcher; 3 seated or 2 stretcher patients – all occupants must be safely secured  OLMC when transporting is not required; Rx per SOPs  PCRs are optional; may use triage tags only  Patient distribution; usual transport patterns do not apply; Transport times > 30 minutes OK  Trauma Center criteria does not apply  Refusal process can be attempted – may not be possible IMPORTANT! In a MEDIUM TO LARGE SCALE INCIDENT Transport up to 2 of the most critical patients to each hospital that can be reached in 30 minutes to help clear the scene. 2 GENERAL FIRE DEPARTMENT RESPONSIBILITIES - MEDIUM TO LARGE SCALE INCIDENT  Contact the NWCH ASAP  Provide the NWCH with the following information: o Nature of the incident o Incident site (e.g. nearest major intersection) o Closest hospitals (SAMC, Sherman Hospital, ABMC or NWCH, etc.) o Estimated number of patients at incident site o Estimated patient category: # red, yellow, green, deceased o Let them know which hospitals are already getting their first 2 patients o General age groups (peds, adults, elderly) o Types of illness/injuries (blunt/penetrating trauma, burns, inhalation, toxins, biological/chemical exposure) o Any special needs – i.e. decontamination, medications for WMD, medical teams to the scene o Exchange call back numbers The NWCH will contact potential receiving hospitals and, depending on the scale of the incident, will provide TRANSPORTATION MANAGEMENT:  Receiving hospital capacities for accepting victims will be provided (e.g. “XYZ hospital can accept two red, four yellow and six green victims”.) Large-scale transportation management issues should be the responsibility of a specially assigned Transportation Officer who establishes and maintains direct contact with NWCH EARLY COMMUNICATION WITH THE RESOURCE HOSPITAL IS INDICATED EVEN IF PATIENT COUNTS AND CONDITIONS HAVE NOT BEEN REFINED! Example: “Fire Department Ambulance #26 to the Resource Hospital. We have just arrived at the scene of a train vs. bus incident at Lake Street and Apple Road. At this time we know that we have two DOAs, eight red patients, and multiple yellow and green patients. We are currently in the process of triage. We have called for 20 additional ambulances and will contact you with additional information as soon as it becomes available. My cell phone number is (847) 123-4567.” 3  REGION IX Hospital Command will be assumed by Northwest Community Hospital for the following: Arlington Heights Hoffman Estates Prospect Heights Barrington Itasca Rolling Meadows Bloomingdale Lake Zurich Roselle Buffalo Grove Long Grove Schaumburg Des Plaines Mount Prospect Schiller Park Elk Grove Township Palatine Wood Dale Elk Grove Village Palatine Rural First Alternate: Saint Francis Hospital Second Alternate: Highland Park Hospital Important notes: 1. ALL COMMUNICATION MUST GO THROUGH NWCH a. Do not attempt to contact the scene b. Do not attempt to contact dispatch c. Do not divert individual ambulances 2. MABAS dispatchers will NOT be in contact with hospitals. 3. The ‘ALL CLEAR’ will be issued directly from the scene to Hospital Command MODEL POSITION DESCRIPTIONS The position descriptions contained herein are dictated by experience as necessary for the successful management and resolution of a small and medium to large scale incident. The performance outlines are simply suggestions and are not intended to be viewed as a requirement for activation of the plan. 4  INCIDENT MANAGEMENT SYSTEM ORGANIZATION MEDICAL GROUP The Medical Group may be organized as either a separate division or a branch under the Incident Management System, depending on the scope of the incident. Functions of the medical group include triage, patient treatment and transportation. A single Medical Group Supervisor at a small scale incident may coordinate all these functions. However, such duties may be delegated as appropriate to a separate Triage Unit Leader, Treatment Unit Leader and/or Transportation Unit Leader in a medium to large scale incident, overseen by a single Medical Group Supervisor who reports directly to Incident Command. MEDICAL GROUP SUPERVISOR Appointed By Incident Command General Description Oversees the medical group of a medium to large scale incident. May appoint and supervise triage, treatment and transportation sectors. Responsibilities include:  Determining the approximate number of victims and extent/type of injuries 5   Immediately advising NWCH that an incident has occurred, utilizing normal modes of communication.  Communicating patient numbers and acuity to NWCH  Advising NWCH of the hospitals closest to the incident scene.  Maintaining communication with NWCH throughout the incident, OR appointing a sector officer to assume communication with the hospital.  Continually assessing the need for additional ambulances, personnel and equipment, making such requests through Incident Command.  Assessing the need for medical teams and aero-medical transportation (according to local system policy) in consultation with NWCH and Incident Command.  If aero-medical transportation is required, staging must be notified by the Medical Group Supervisor to set up an appropriate landing zone.  Determining the extent of documentation required per incident, relaying information to the Transportation Unit Leader who will pass the information to transporting ambulance crews. MEDICAL SUPPLY OFFICER Appointed By Medical Group Supervisor General Description Secures and organizes medical supplies and equipment  Supplies and equipment include, but are not limited to, backboards, oxygen supplies, dressings and bandages, large dose medications, volumes of sterile water, IV fluids and equipment. This logistical function will be necessitated in medium to large scale incidents or when specialized equipment and/or supplies are required. Additional supplies and equipment may be obtained by requesting the mass casualty trailer to be brought to the scene. TRIAGE UNIT LEADER Appointed By Medical Group Supervisor General Description Provides coordination necessary for effective categorization of patients. Responsibilities include:  Supervision of triage personnel during initial phase of a medium to large scale incident  Determine and relay number of patients and general acuity to the Medical Group Supervisor, updating information as necessary  Report any needs regarding equipment and manpower to the Medical Group Supervisor  Confirm that ALL patients have a triage tag present and that the appropriate area of the met-tag has been retained by triage personnel 6   Upon completion of triage and movement of patients to the Treatment Unit Leader, report to the Medical Group Supervisor for reassignment TREATMENT UNIT LEADER Designated By Medical Group Supervisor General Description Establishes and manages a patient treatment area. Responsibilities include:  Frequent reassessment of patients in the treatment area to determine need for re- categorization.  Prioritization of patients for transport to hospitals. The designation of the Treatment Unit Leader is intended for use in larger incidents where the Medical Group Supervisor would be unable to coordinate activities in the patient treatment area TRANSPORTATION UNIT LEADER Designated By Medical Group Supervisor General Description Establishes loading of ambulances and records patient destination. Responsibilities include:  Communication with NWCH (initial communication may have been established by Medical Group Supervisor, or their designee) o The Transportation Unit Leader will….  Give patient numbers and triage categories  Receive hospital capabilities  Give specific hospital destination for each ambulance, including number of patients and triage categories  Establishment of patient loading area allowing for safe and coordinated access and egress of ambulances.  Communication with Staging Area Manager, requesting specific number and capabilities (ALS, BLS) of available ambulances.  Notation of each patient’s MET TAG number on a log sheet  Notification of destination hospital for each transporting ambulance 7  STAGING AREA MANAGER Designated By Medical Group Supervisor General Description Management of all incoming fire/rescue apparatus, ambulances and other resources. Note: -The staging area is designated by Incident Command. -The first unit at the staging location will assume the role of Staging Officer until such time they are relieved by an officer designated by the Medical Group Supervisor. Responsibilities include:  Maintaining communication with the medical group (either Transportation or Treatment Unit Leader) to supply necessary ambulances.  Maintaining communication with Incident Command to advise on available resources  Sending requested resources to the scene  Management of the staging area, assuring orderly parking, maintaining clear access to the incident site.  Maintaining an accurate log of currently available equipment, apparatus and manpower.  Upon request from the Medical Group Supervisor, collection of mass casualty bags located on each ambulance in staging.  Ensuring all incoming units are equipped with a passport. A passport make-up kit must be available at staging to supply proper accountability materials to any units that may be operating at the incident that do not have a passport, such as private ambulances or hospital teams. In a large-scale incident, the Staging Area Manager may need to request one or more aids from Command to assist in these functions. PROCEDURE DEFINITIONS EXCEPTIONS REFERENCES MABAS Illinois Policies and Procedures current online reference MABAS 1 Operating Guidelines/Policy Statements MABAS Division I, III and IV, Region X (Incorporating the NWCHEMSS portion of Region IX) Multiple Victim and MASS CASUALTY PLAN; Revised January 2005 Region IX, NWCH EMMS Standard Operating Procedures; Implemented: June 1st 2014; Multiple Patient Incidents – (Page 8) End of Document 8