While many in the fire service focus on large scale mass casualty events, most providers don’t recognize the threat of MCI in their own first alarm area. Captain Schorr combined the capabilities of the engine company with their pre-existing assignments and focused on the initial five minutes of an MCI in his session “Engine Company: First Strike MCI,”presented Thursday, April 21 at FDIC in Indianapolis.
Captain Schorr focused on initial reporting and estimating crowd sizes. Specific tasks are assigned to specific riding positions on the engine, just like a fire or CPR case. The officer establishes command and makes the initial radio report. Before doing so, however, there are a number of observations that must be made including occupancy type (not all MCIs are transportation related), evacuation type and the location of the immediate treatment area.
To drive the point home, Captain Schorr used an engine company we all recognized: LAFD Engine 51 from the TV show Emergency! Captain Stanley, engineer Stoker and firefighters Kelly and Lopez helped differentiate each position’s responsibility.
Next the firefighter and engineer positions were explained as triage and red treatment, respectively, and Captain Schorr had specific elements each member should accomplish and how to make sure their needs were met by the companies also responding. Attendees were shown examples of large occupancy events they likely didn’t realize were in their first due area, such as high school football games, church concerts and parades. Additional considerations were also presented for special events like shopping mall sales (Black Friday) and how to handle the throngs of walking wounded the first lights and sirens vehicle, likely the engine company, will encounter.
Many MCI training sessions begin with the first triage team gathering all the walking wounded away from the others. “You just lost your best resource!” Captain Schorr reminded the class, pointing out that able-bodied people can extricate critical injuries far faster than waiting for help.
Clear communications are key to a developing incident and examples were made of many situations from the officer reporting an organized school evacuation, the triage team asking for help in an additional train car and even the treatment unit leader advising ambulances yet to arrive of a safe avenue of approach for the treatment area.
In the end a number of attendees had the opportunity to give initial radio reports on images presented ranging from a crowd outside a theater, a van into a building and, of course, the dreaded school bus MVA.
Here are some big takeaways from Captain Schorr’s presentation:
- Set expectations before the emergency. We don’t wait for a fire to figure out who is on the nozzle, why wait for an MCI to determine who is triaging?
- Train small. Start with colored tape on cones. Work on radio communications. We can all read a sticker with the RPM triage criteria, how well can you transmit your counts and move victims to treatment?
- Triage the neighborhood. Much in the same way a progressive engine company will stop and describe their actions at a building in their district should it catch fire, the same needs to be done with MCI in mind. “OK guys, that store, reported chemical release, maybe 20 people running towards us. What are our priorities?”