Principal JJMS Group 25 years in Emergency Services Certified CSTI Outreach Instructor CCSF Adjunct Faculty Hazardous Materials Specialist 1
Preparing to manage the Mass Casualty Incident 2
What we are going to cover Coordination Requirements Vulnerability Reduction Threat Identification Risk Identification Managing the Mass Casualty Incident Tactical Considerations 3
Coordination Requirements National Response Framework HSPD - 8, National Prepardness The Voluntary Private Sector Preparedness Program -- PS-Prep CCR Title 8, Section 3220 Rescue and medical duties for those employees who are to perform them 4
Vulnerability Reduction 5
Threat 6
Threat + Risk 7 July 30, 2015 Genentech Conference Center
Threat + Risk = Vulnerability 8
Is there a threat? Haz mat Accidents Fires Terrorism Natural Disaster 9
West Fertilizer Company Explosion West, Texas April 17, 2013 15 Dead 160 Injured 10
Asiana Flight 214 Crash SFO July 6, 2013 3 Dead 187 Injured 11
The Station Night Club Fire West Warwick, Rhode Island February 20, 2003 100 Dead 230 Injured 12
Century Movie Theater Shooting Aurora, Colorado July 20, 2012 12 Dead 70 Injured Century movie theater 13
Texas City Refinery Explosion Texas City, TX March 23, 2005 15 Dead 170 Injured 14
Tokyo subway sarin attack Tokyo, Japan March 20, 1995 12 Dead Over 5000 Injured 15
Murrah Federal Building Bombing Oklahoma City, OK April 19, 1995 168 Dead More than 680 Injured 16
Hurricane Katrina Gulf Coast August, 2005 1833 Dead Unknown number of Injured 17
Loma Prieta earthquake Loma Prieta Fault, CA October 17, 1989 63 Dead 3757 Injured 18
What do these events have in common? 19
They all highlight a key Risk Mass Casualties 20
How do we decrease this Risk? 21
How do we decrease this Risk? Planning and training 22
Goals of planning Identify the threats Anticipate the impact Identify the vulnerabilities Understand the Public Safety response Gap identification Develop plans to address the gaps 23
The management goal of MCI s is to maximize available resources 24
The goal of disaster triage? To prioritize resource allocation to provide the best outcomes for the most patients when demand drastically exceeds available resources 25
Lets get to work 26
Threat Haz mat Accidents Fires Terrorism Natural Disaster 27
Threat Haz mat Accidents Fires Terrorism Natural Disaster 28
Threat Earthquake 29
What are the Risks? 30
What are the Risks? Structural damage Facilities damage Infrastructure damage Casualties 31
Addressing the Casualty Risk Triage 32
The management goal of MCI s is to maximize available resources 33
The goal of disaster triage? To prioritize resource allocation to provide the best outcomes for the most patients when demand drastically exceeds available resources 34
Triage Systems 35
Triage Systems 36
Triage Systems START Simple Triage and Rapid Treatment 37
Triage Systems START Simple Triage and Rapid Treatment 38
Triage Systems START Simple Triage and Rapid Treatment FDNY Fire Department of New York 39
Triage Systems START Simple Triage and Rapid Treatment FDNY Fire Department of New York CareFlight 40
Triage Systems START Simple Triage and Rapid Treatment FDNY Fire Department of New York CareFlight Sacco Triage 41 July 30, 2015 Genentech Conference Center
Triage Systems START Simple Triage and Rapid Treatment FDNY Fire Department of New York CareFlight Sacco Triage SALT Triage sort assess lifesaving interventions treatment/transport) 42
Each of these systems has their positives and negatives. Universally they are all flawed, 43
Each of these systems has their positives and negatives. Universally they are all flawed, 44
Each of these systems has their positives and negatives. Universally they are all flawed, But 45
While imperfect, the triage system used most often in the prehospital arena is START 46
During the disaster phase the focus shifts from that of patient care to a public health mindset. Do the Best for the Most 47
Are you Ready? The Three Guiding Questions 48
Are you Ready? The Three Guiding Questions What do I have? 49
Are you Ready? The Three Guiding Questions What do I have? What to I need to do? 50
Are you Ready? The Three Guiding Questions What do I have? What to I need to do? What do I need to get it done? 51
Tactical Considerations Location, Location, Location What is it? Where is it going? What / Who else will be coming? Access & Egress Utilize natural borders and barriers 52
Location, location, location 53
Location, location, location 54
Location, location, location 55
Location, location, location 56
Location, location, location 57
What is it? Where is it going? 58
What / Who else will be coming? 59
Access & Egress 60
Utilize natural borders & barriers 61
What s next? 62
What s next? Planning and training 63
Questions? 64
Questions? Thank you for your time 65
John Cavanaugh, MS, EMT-P POB 461 Lagunitas, CA,94938 1855 367-5567 (FOR-JJMS) john@jjmsgroup.com 66