WIXLIB

1/29/201912Topics Mass Casualty Incident (MCI) Communicationsand Drills (small exercises)Regional MCICommunicationsand Exercise (Drill) PlanObjectives Planning process SALT Triage and Materials Regional Hospital Notification System (RHNS) Regional MCI Radios and Talkgroups GDAHA Surgenet MCI Page OHTrac Drill Plan3 Be familiar with Regional Mass Casualty Incident (MCI)Communications Plan and Job Aid Be able to utilize SALT Triage and materials Understand use of Regional Hospital NotificationSystem Be able to locate and use the HSR3 MCI MARCS RadioTalk Group in your radio template Be familiar with the GDAHA Surgenet MCI Page Understand relationship of RHNS, Surgenet MCI Page,OHTrac, and MCI-MARCS Radio TG in Mass CasualtyIncident communications Be familiar with MCI Communications Quarterly TriageDrill Day Plan54DMMRSHospitals(GDAHA)PublicHealthFire, EMS, LawEnforcement, EMA6MCI Communications Planning Recognized need to bring together the pieces ofcommunications during MCIs Developed RHNS Developed plans for use of GDAHA SurgenetMCI page Added MCI Talkgroups to EMS radios (for muchof the region) Hospitals agreed to purchase MCI radios foreach ED Developed Job Aids1

1/29/2019MCI CommunicationsQuarterly Triage Day Drills7SALT Triage8 Agreed on by GDAHA Domestic PreparednessCoalition, GMVEMSC, MVFEA, GMCFCA, et al 24 hours each quarter Day of week will be different each quarter so all ED &EMS personnel have opportunities to participate Day selected each quarter by GDAHACommunications Committee Communicated to all hospitals and EMS agencies More info laterSALT Triage Categories:ID-MED Immediate Delayed Minimal Expectant Dead910 (Ribbon/Tag zebra-striped)Dayton MMRS Contributions toSALT – Two Mnemonics1112 CRAP: C – Follows Commands R – No Respiratory Distress A – No (uncontrolled) Arterial bleeding P – Peripheral Pulse Present “Good or Bad” “Bad” answer to any one or more: Pt. iseither Red or Gray2

1/29/201913REGIONAL HOSPITAL NOTIFICATIONSYSTEM (RHNS)15Regional HospitalNotification System (RHNS)14San Bernardino16 One number for EMS, hospitals, and EMAs to call Makes rapid, simultaneous notifications during MCIor other major emergency Use whenever an incident could involve asignificant number of region’s hospitals Also used to indicate no need for action Montgomery County Regional Dispatch Center(RDC) puts out computerized messageREGIONAL HOSPITAL NOTIFICATIONSYSTEM (RHNS)17 Use RHNS for any incident likely to involve orconcern six or more hospitals ( or -) Examples include “gear up” “Three dozen seriously injured victims beingextricated ” Any request for a CHEMPACK in our region Advise hospitals that patients will need decon EMAs could use for incidents (e.g., tornadoes) involvingmultiple jurisdictionsREGIONAL HOSPITAL NOTIFICATIONSYSTEM (RHNS)18 or to tell hospitals disaster preparations are NOTneeded Middletown school shooting, cyanide spill in Dayton, alocal hospital shooting, et al Dispatch Center Job Aid provided3

1/29/2019REGIONAL HOSPITALNOTIFICATION SYSTEM(RHNS)19 Let hospitals know what is going on And what preparations are needed or not needed Hospitals - do NOT call Dispatch Center torequest additional information Use MCI radio (more to come) Do contact Dispatch to put out an update orto send message to close the incidentnotification Recommended that emergency messages on cell phonesshould get both text and voice (if one system down, othermay go through) Receiving RHNS Messages Alerts hospitals plus regional coordinators, some EMAs,etc. RHNS is tested monthly and during most area exercises21 To activate RHNS (use the MCI CommJob Aid): Call 937‐333‐USAR (8727) Ask for Dispatch Supervisor Request a “Regional Hospital Notification” Provide information below: 20 Numbers for each hospital chosen by that hospital Primary purpose of RHNS is:REGIONAL HOSPITAL NOTIFICATIONSYSTEM (RHNS)REGIONAL HOSPITAL NOTIFICATIONSYSTEM (RHNS)Name of agencyNature of emergencyLocation of emergencyGeneral statement on severity, such as approximate number of victimsAny other information to be conveyed22MCI MARCS Radios &TG Ohio MARCS Multi Agency Radio Communication System Talk group (TG) – channel23“HSR3 MCI” MARCS RadioTalkgroup MCI MARCS - new, additional hospital ED radiobe used solely in an MCI Used to notify each hospital of patients theywill receive Used to provide ALL hospitals with a “commonoperating picture” simultaneously Hospitals can ask questions about incidentover HSR3 Radio Talk Group24HSR3 MCI-MARCS RadioTalkgroup No alerts on MCI TGs! During an event, hospitals turn on MCItalk group (TG) Monitor MCI radio Request to monitor HSR3MCI Radio isincluded in Communications Job Aid, buthospitals should plan to do so on any MCInotification4

1/29/201925HSR3 MCI-MARCS RadioTalkgroupGDAHA Surgenet MCIPage and OHTrac26 90% of EMS communication duringMCI should come from Transport Officeror Transport Comm Aide Hospital radios may have two primaryTGs HSR3 MCI MARCS Talkgroup HSR6 MCI MARCS Talkgroup Can be patched together by Dispatch Centers2728gdaha.surgenet.org29GDAHA Surgenet MCIPage Increasingly emphasized to EMS importance ofdistributing patients to hospitals during MCIs GDAHA Surgenet MCI Page allows hospitals to indicatehow many patients received, by category During MCI, MCI Web Page allows hospitals to indicateby category how many more can be handled Update the GDAHA Surgenet MCI page30Surgenet: OHTrac State of Ohio tool for patient tracking usedduring any MCI or disaster situation for familyreunification MCI incident alerts can be sent Not primary method of communication Regional Drills/Exercises and Real World Incidents Hospitals responsible for ensuring patientsreceived from incident entered and trackinginformation updated Including “walk-in” patients5

1/29/20193132OHTrac AppSurgenet: OHTrac App designed for EMS Can allow dispatch centers to assist aTransport Officer in hospital destinationdecisions EMS & dispatch centers can (at their option)log on and view numbers of each triage level ateach hospital Integrating all communication methods helps EMSensure triaged patients are transported to appropriatehospitals3335 For agencies using it, allowspatient tracking to begin at thescene OHTrac Allows increased patient trackingaccuracy Provides for family reunification Allows hospitals and otheragencies to see the number andacuity of patients en-routeMCI ScenarioHospitals Receive RHNSNotification:3436Scenario County Fair Stage collapse Summer One EMS unit on site at fair as standby Initial estimate of 50 injured, somesevere “There has been an MCI reported as aresult of a stage collapse at the CountyFair, with initial estimates of 50 injured.All hospitals should update theirGDAHA Surgenet MCI page. Allhospitals monitor HSR3 MCI MARCStalkgroup.”6

1/29/201937Hospital Actions38Scenario (continued) Receives RHNS Monitors HSR3MCI Radio Updates MCI page County Fair Stage Collapse 1 EMS unit on scene, full response requested Multiple Victims (Roughly 50) Initial Triage: 26 Red, 14 Yellow, 10 Green, 2 Black Indicate number of Red, Yellow, and Greenpatients you are able to receive Prepare to receive casualties Make internal notifications Prepare for use of OHTrac39ScenarioMCI CommunicationsGDAHA Quarterly TriageDay Drills (QTD Drills)40 When does it end? IC or delegate should use RHNS againto indicate that all or most patientshave cleared the scene Hospital receives 2nd RHNSnotification: Incident is nearly over; patients haveall been transported41Quarterly Triage Day DrillsQTD Drills or Exercises: Use GreenTags but Real Ribbons!42 Every patient in every ED gets aTriage Ribbon and Triage Tag If not applied by EMS, ED will apply Each EMS & ED receiving supply ofGREEN Triage “Drill” Tags7

1/29/20194344Quarterly Triage Day DrillsQuarterly Triage Day Drills All patients arriving via EMS shouldhave a Triage Ribbon and a GREENTriage Drill Tag Tags do not have ties – use TriageRibbon to attach the Tag Each Tag will have a bar-code and amatching number. Patient’s Tag can bescanned into OHTRac ED personnel place a Triage Ribbon andDrill Tag on any patient (regardless of modeof arrival) without one45Quarterly Triage Day DrillsQuarterly Triage Day Drills46 Each EMS has a Blue Triage Ribbon Kit for usein actual MCIs Use actual Triage Ribbons during QTDs Each EMS is receiving a supply of GREENTriage “Drill” Tags through County EMAs EMS places and fills outone GREEN Triage DrillTag on every patientduring QTD Drills Assign patient toappropriate triagecolor/category Use actual patientinformation on triage tags Fill out run report asusual White Tags for real incidents;Green forDrills4748MCI Radio Talk GroupsDrills will incorporate use of the MCI TGsEMS agencies will make brief reports to the hospital over the HSR3MCITG Only items to be covered are number of patients and triage color Possibly one or two word description ofmedical issue, e.g., chest injury e.g., “Wayne Hospital, this is Greenville Medic 591 en route with oneYellow” Any more extensive information or requests, the Medic Crew will callby cell phone or on the hospital’s regular radio channel No call will be made on MCI TG if crew workload does not permit8

1/29/201949505152Handout Materials Attached to this training are copies of: SALT Hospital Handout MCI Communications Job Aid Real and Current exercise versionContinuing Education Complete the accompanying quiz EMS Con Ed for this program (for EMSand nurses) provided courtesy ofGMVEMSC9

Middletown school shooting, cyanide spill in Dayton, a local hospital shooting, et al Dispatch Center Job Aid provided 18. 1/29/2019 4 REGIONAL HOSPITAL NOTIFICATION SYSTEM (RHNS) Primary purpose of RHNS is: Let hospitals know what i