Planned MCI at a Motorcycle Rally

A unique mass-gathering event offers lessons on MCI management

 

 
 
 

Warren A. Johnson | | Tuesday, May 5, 2009


It's called "Rolling Thunder," and it takes place each year during Memorial Day weekend. It's the largest one-day motorcycle rally in the world, and its purpose is to remind politicians and the public of the service men and women who remain prisoners of war or missing in action. The procession starts at noon, and the last motorcycle doesn't leave the Pentagon parking lot until three and a half hours later.

Rolling Thunder started 19 years ago with 5,000 attendees. Now, there's an estimated 50,000 motorcyclists participating and 1 million people who gather along the routeƒa "monstrous" event, says 31-year-veteran District of Columbia Fire & EMS (DCFEMS) Battalion Chief Henry Lyles. Lyles handles this event as a "planned mass casualty incident (MCI)."

Logistical Planning

Chief Lyles oversees the medical coverage for 440 events a year, supplied by an all-hazards fire department and handled by four jurisdictions in Washington, D.C.ƒthe National Park Service Police (a lead agency because of the permits necessary to occupy park grounds), the U.S. Capitol Police, the Washington D.C. Police Department and the only fire agency, DCFEMS. For Rolling Thunder, the cooperation of Arlington County (Va.) Fire Rescue is also required, because the event starts in the north parking lot of the Pentagon, which is in their jurisdiction.

Volunteer and municipal medics provide aidƒsome by ambulance and some by motorcycle. Five on-site stations manned by the Christian Motorcyclist Association (CMA) volunteer first aid personnel surround the perimeter of the Pentagon parking lot. They come heavily equipped with blood pressure equipment, glucometers, bandages and dressings, and a wide range of over-the-counter remedies.

Another volunteer group, "Knights for Life," is made up of physicians, flight nurses, flight medics, and nurses from operating rooms, emergency departments and intensive care units from 11 states. The collaboration of people with different backgrounds and expertise fosters the kind of good rapport necessary at most MCIs. President Jeffery Goldstein leads the Knights. He rides a large "dressed" motorcycle with a paramedic sticker above his license plate. Often, while traveling the public roads, police will ask him and other Knights to treat any trauma patients they come upon. But because these bikers don't look like a standard EMS crew, they have to give patients some background before they start administering care.

In addition to these volunteer crews, Arlington County Fire Rescue stands by with two ALS ambulances, two BLS gators and two engine companies. One of their most popular units is the decon tent set up with chairs, free drinking water and a cool mist fan. These measures are necessary because the parking lot has no shade, and temperatures can reach 100_ on the black asphalt. The first few years of the event these accommodations weren't made, and the fire department had to hook up to hydrants and use hose lines to cool everyone down.

The Gold Star Mothers (who have lost sons or daughters in battle) can be especially susceptible to the hot weather and dehydration, and subsequent chemical imbalance. The Knights for Life are charged with their medical care during the event.

Once the bikers cross the Memorial Bridge on the way to the Lincoln Memorial, DCFEMS crews take over medical care. Chief Lyles sets up a mobile command unit at 3rd and Pennsylvania Avenue. He uses a stick-pin map to illustrate where his units are located along the parade route rather than depend on the high-tech devices in the mobile command centers.

From experience, he knows that certain points on the route need a stationed unit. One of them is at the far west end of Constitution Avenue, where he assigns two ALS ambulances and a BLS engine company. Notoriously, this corner is where many bikers take their plunge, because it's the first place they have the opportunity to "open the throttle." This kind of pre-planning for human behavior is also key at any mass gathering or MCI.

Because Rolling Thunder is approached as a planned MCI, Lyles must be proactive. The three main trauma hospitals serving Washington, D.C., are well aware of the need to have committed beds for patients coming from the event. Triage tags also accompany all patients, which allows providers to use their triage skills on live patients and be prepared for an incident involving hundreds of patients. The multiple agencies involved are all linked to the command center through radio communication.

Patients

Most of the medical issues and injuries that occur during Rolling Thunder are minor, especially because the motorcycles aren't moving very fast. The most common consist of diabetic emergencies, heat exhaustion, hypertension, minor burns (mostly from tail pipes), and a few scrapes. Predicting likely injuries is factored into the event planning and helps ensure adequate EMS supplies are available.

But there was one serious motorcyclist-versus-automobile incident on a freeway exit ramp.

To The Point

Planning, logistics and execution must be well thought out when hosting large events like Rolling Thunder. If your planning indicates that you may lack the necessary number of medical personnel, remember that certain groups in your community are more than willing to volunteer for the challenge, but they might show up on a motorcycle.

Warren Johnsonworks in the private industry setting, is a retired firefighter/paramedic and an NREMT, teaches seminars on scenario training, and rides with a CMA first aid rocker. Contact him atwjohnson@simulaids.com.

For more on MCIs,click here.




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