SOP 209.08  MEDICAL PLAN

 

INTRODUCTION

 

This plan establishes a standard structure and guidelines for the management of Fire Department operations in a multi-casualty emergency medical situation.   The basic system may be applied to any multi-casualty incident.  Such situations may or may not include firefighting and other emergency operations that are not a part of this procedure.   This plan will integrate into the overall fireground management system.   All Ennis Fire Department standard operating procedures will be applied to medical emergencies.

 

IT IS THE POLICY OF THIS DEPARTMENT TO INSTITUTE STANDARD COMMAND STRUCTURE AT E.M.S. INCIDENTS REQUIRING THE COMMITMENT OF THREE (3) OR MORE COMPANIES.  

 

It is the responsibility of Command to make an early determination  of situations requiring the implementation of this plan.  The basic system outlined in this procedure is applicable to all multiple patient situations and will be used routinely in such incidents.

 

Dispatch will automatically begin notification of hospitals and other involved agencies when this plan is initiated.   The extent of this notification and the level of mobilization will depend on the scale of the actual incident.

 

Situations calling for this action are those in which the number of patients involved and/or severity of their injuries requires coordination with several hospitals, and situations in which complex extrication, treatment or patient transportation problems are encountered .  Examples include: major transportation accidents; fires or explosions with multiple injuries; hazardous materials incidents with exposure  victims; and structural collapse incidents.

 

ARRIVAL

 

The first arriving unit at a serious, multiple patient medical incident will assume Command and begin an initial size- up of the situation.   The type of situation and the approximate number and condition of patients should be reported to Alarm as soon as possible.

 

The officer assuming Command should immediately request assistance if the need is indicated.  Dispatch will begin to notify other agencies and medical facilities based on the amount of assistance requested at the scene and the reports from Command.  The initial reports should indicate the scale of the incident to structure an appropriate response from other agencies.

 

 

Assistance should be requested using standard assignments and alarms as much as possible, i.e., 1-3 Assignment, 1st  Alarm, 2nd Alarm, etc.  This will facilitate an incremental approach to the incident, similar to firefighting operations.

 

COMMAND RESPONSIBILITIES

 

*   The officer assuming Command of a medical incident is responsible for the management and control of the following functions:

*   Establishment of a Command Post and appropriate command structure.

*   Determination of resources needed to accomplish objectives. Extrication of trapped patients and movement of patients to appropriate treatment areas.

*   Triage of patients.

*   Field treatment, stabilization  and preparation of patients for transportation.

*   Transportation and distribution of patients to appropriate medical facilities.

*   Provision of medical supplies needed at the scene.

*   Liaison with other departments and agencies involved in the incident.

*   Communication of regular progress reports to Alarm.

 

These overall Command responsibilities may be assumed by the officer in Command of the entire incident or may be delegated to an operation or sector level, depending on the size and complexity of the situation.  In most cases, the responsibilities will be further delegated to individual sectors.

 

  1. The responsibilities would be retained by Command at an incident that is entirely or primarily of a medical nature, with sectors reporting directly to Command.

 

 

 

 

 

 

 

 

 


TRANSPORT SECTOR
 

EXTRICATION SECTOR
 

 TREATMENT SECTOR
 
  

 

 

 

 

2.       The responsibilities would be assigned to an Operations Level (Medical) Incident where the incident involves significant firefighting or other operations.   In this case, a separate channel should be designated for units assigned to the “Medical Operations Officer”.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


3.       The responsibilities may be assigned to a Medical Sector Officer in incidents where the medical functions are a small part of the overall operation and one officer can effectively manage the responsibilities.

 

 

 

 

 

 

 

 

 

 


BASIC OPERATIONAL APPROACH

 

This tactical plan is intended to deal with incidents involving significant numbers of patients in need of emergency medical care. This could range from five or ten patients to hundreds of patients in a major disaster.  The same basic approach should be employed in either case, adjusting operations to the scale of the incident.

 

The first priority is to locate the patients, assess the emergency care they will need, and remove them from any immediate physical danger.  This may require forcible extrication of trapped patients. Ambulatory (Priority 3) patients should be removed immediately to an "Assembly Area” where limited medical care is available.   Priority 1 and 2 non-ambulatory patients shou1d be moved to Treatment Areas for more intensive medical care.

 

Treatment areas should be established for Priority I (life threatening) and Priority 2 (non-life threatening) patients in safe and convenient locations.   The objective is to concentrate medical resources to provide effective field stabilization and treatment. Patients should be moved from Treatment Areas to medical facilities according to their triage priorities and the availability of transportation. Advanced Life Support is provided in Priority I Treatment Areas and Basic Life Support in Priority 2 Areas.

 

Patients are transported from the scene to hospita1s and other medical facilities by ambulances, helicopters and other vehicles when appropriate.   As transportation becomes available, patients must be allocated to medical facilities according to their ability to receive patients of various priorities and categories.      Patients should be treated and transported in priority order:

 

*   First:  Priority 1 patients who cannot be stabilized in the field.

 

*   Second:  Stable Priority 1 patients.

 

*   Third:  Priority 2 patients

 

*   Fourth:  Priority 3 patients

 

The number of patients relative to the personnel and equipment available should govern treatment provided in Treatment Areas.