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Flashcards in Multicasualty Deck (35)
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List the different roles in multicasualty

First on scene Scene commander On-scene controller Triage officer Marshalling officer Liaison officer Transport officer


What is the role of First on Scene?

Windscreen sitrep 1) check personal safety 2) apply triage tags to all casualties (primary survey to determine priority) 3) Basic life support ONLY (ABC) 4) SITREP - METHANE 5) Commence casualty movement to treatment areas 6) Arrange support from other agencies



M - major incident confirmation (advise major incident 'standby' or 'declared' E - exact location (grid reference, road names, landmarks, GPS) T - type of incident (rail, chemical, RTC) H - hazards (actual and potential) A - access and egress (safe directions to approach and depart) N - number of casualties (estimate in first instance then upgrade with severity/type) E - emergency services (present and/or required)


Initial Triage - SIEVE


Define CBR incident

Chemical - blood agents (cyanide), vesicants (mustard gas), choking agents (chlorine/phosgene), nerve agents (anticholinesterases) Biological Radiological


Site management, what does space need to be made for?

- Marshalling - Triage - Treatment - Command centre - Access/egress


Triage Officer - Role description

Most clinically experienced officer Role: coordinating movement of casualties from forward area to treatment area then take charge of that area


Scene Commander - Roles

i. Responsible for all ambulance resources at the site ii. Assumes command of all ambulance resources on site iii. Liaises with other service commanders in joint management iv. Normally will be an area director or operational supervisor v. Identified by red helmet and marked vest vi. Reports to ambulance controller


Scene Commander - Responsibilities

1. Establish and maintain communications with command post, communications center and ambulance controller 2. Liaise with the triage officer and assume command of site 3. Deploy staff for: a. Reconnaissance b. Triage and life support c. Pre-hospital care d. Role specific duties (e.g. transport officer) e. Transport 4. Maintain a unified command post with QPS and QFRS 5. Safety of ambulanced personnel and casualties 6. Ensure sufficient resources are sent 7. Cooperate with other service personnel to assist 8. Site management: a. Casualty management b. Marshalling area c. Ambulance loading point d. Helicopter landing zone 9. Confirm appointment of: a. Triage officer b. Marshalling officer (QPS or tow truck operator) c. Liaison officer (Command post) d. Transport officer 10. SITREP METHANE 11. Ensure all black tags are endorsed (life extinct) 12. Check and authorize scene clear of all casualties and equipment


On-Scene controller - Role

i. Basically, same as ambulance commander but on scene ii. Ambulance commander usually on scene (but arrives later) iii. So probably first crew on scene, whoever is in charge, until someone better trained arrives.


Triage officer - Responsibilities

1. Triage and tag all casualties on site 2. Establish the treatment area 3. Direct the recovery of casualties to the triage area for treatment 4. Ensure all casualties are tagged 5. Coordinate officers working in forward area 6. Ensure no preventable deaths 7. Liaise with other service commanders and medical teams until relieved by ambulance commander 8. SITREPS resources required and number/priority of causalities 9. Once relocated to the treatment area, liaise with the site medical officer regarding clinical management requirements 10. Ensure correct relocation of staff to casualties’ priorities 11. Liaise with transport officer regarding transport priorities 12. Complete primary triage


Marshalling officer - Role

i. Takes control of vehicles in the marshalling area and determine the order of their progress to the scene ii. Responsible for the security of and access to all ambulanced units on site iii. Responsible for the direction of incoming ambulanced resources iv. Identified by: yellow helmet and marked vest v. Reports to transport officer


Marshaling officer - responsibilities

1. Maintain communication with the ambulance commander, communications officer and transport officer 2. Take command of nominated marshalling area 3. Maintain access to the ambulance loading point 4. Arrange QPS to control road access and escorts, if required 5. Direct incoming personnel, as instructed by the ambulance commander 6. Instruct staff to park unit diagonally to the curb, ensure unit keys remain in ignition, and to take only primary response kits on site 7. If emergency support unit is on site, instruct arriving officers to take kits and cardboard stretchers to forward area 8. Assist the transport officer as required


Liaison Officer - Roles

i. Agency representative assigned to a coordination center or command post ii. Makes decisions on matters affecting the agencies participation in the incident iii. Reports to site commander or ambulance controller


Liaison officer - Responsibilities

1. Obtain briefing 2. Establish communication contact list 3. Maintain unit incident log 4. Represent QAS in combined decision making 5. Act as QAS contact for other agencies, at command post or coordination center 6. Report to regional ambulance coordination center on all matter that will impact on operation 7. Be mindful of security and controlled information at command post 8. Have constant contact with site commander 9. Attend briefings 10. Gain approval prior to release of information 11. Identify any inter-agency conflict of priorities 12. Cooperate fully with other agencies 13. Provide input on the use of agency resources and strategies 14. Consider safety of all responders and patients 15. Maintain incident log


Transport Officer - Role

i. In consultation with the site medical commander, supervisors the loading and movement of all causalities by road, air, sea to a designated medical facility ii. Responsible for documentation on the transport worksheet of all patients evacuated from scene iii. Identified by yellow helmet and marked vest iv. Reports to ambulance commander


Transport Officer - responsibilities

1. Coordination with site medical commander, regarding the dispersal of patients to hospitals 2. Establish and ambulance loading point, adjacent to treatment area 3. Ensure access and egress is established and maintained. QPS to control routes to and from the scene. 4. Maintain a record of patient movements. Consider alternate transport such as buses for walking patients. 5. Liaise with the commuTranications officer or center as to the requirements and availability of units 6. Ensure that all units departing the loading point are fully utilized, regarding stretcher/patient capability 7. Monitor staff requirements and transport capability 8. Ensure that transport details are relayed to the communications center 9. Negotiate return of units to scene if required 10. Negotiate with QPS, QFRS, SES for drivers


Role of Medical teams at site

Treat patients


Other emergency services on site



Safety Officer - Role

1. Identifies hazards and ensures control measures are taken 2. Instigates an incident safety plan to deal with PPE and operational risks 3. Support QAS staff, not to control the event or operational management of the hazard 4. Reports to ambulance commander


Safety Officer - Responsibilities

a. Identify hazards b. Record potential risks c. Establish control measures d. Identify operational risk to community e. Implement control measures and strategies f. Identify PPE required g. Identify data sheets available h. Identify likely symptoms i. Identify impact on operation j. Commence reports and ensure occupational health and safety requirements are met


Sector Commander - Role

1. Appointed when necessary, decision influenced by: a. Span of control is excessive for 1 person to manage b. Geographical areas are determined by boundaries c. Access, time and space factors d. Better management of specific operations and communication 2. Reports to ambulance commander


Sector Commander - Responsibilities

a. Receive briefing and instructions from commander b. Report on progress of command operations within sector c. Appoint functional positions within sector d. Control and deploy assigned ambulanced resources e. Implement incident action plan for sector f. Review sector assignments and activities with crews g. Coordinate activities with adjacent sectors h. Casualty management at an impact zone i. Provide regular SITREPS pertaining to operation, numbers and priorities of injured j. Observe safe work practices within sector k. Project resource needs and forward planning l. Maintain log of activities m. Ensure safety and welfare of personnel under command



i. Confirm location ii. What can you see? iii. Obvious hazards iv. Best access





Triage SIEVE

Insert Diagram (Don't need to know score system)


CBR - Chemical incident - Onset of symptoms - Hazard concerns

Onset - manifest quickly unlike biological weapons Hazards - be aware of secondary contamination


Chemical incident - 4 basic classes

Nerve (Organophosphates) Vesicant (Blistering/Mustard - second degree burns) Blood (Cyanide - inhibit cellular oxygen use) Pulmonary (Phosgene and chlorine / Choking - inflammation of upper airway)


Biological Incident - 3 groups

Bacteria, virus and toxin


Biological Incident - Common causes

Aerosol common presentation - causing respiratory signs and symptoms Anthrax, plague, smallpox, botulism, viral hemorrhagic fever, tularemia


Radiological - causes

Nuclear weapons Radiological devices stolen from hospital and set to detonate


Radiological - symptom presentation

1. Common syndromes associated with radiation exposure include dermal burns, bone marrow failure, and gastrointestinal dysfunction (e.g., vomiting and gastrointestinal bleeding)


MCI - Extent of management

a. Early i. Primary survey (basic) b. Later i. Normal if adequate resources ii. Treat reds, then yellows, then greens (if appropriate)


MCI tasks order of priority

a. Safety first b. SITREPS c. Command post setup d. Triage – sort and sieve e. Decontamination f. Appropriate resources g. Treat when appropriate


Appropriate hospitals

a. PA – trauma, neurological, cardiac b. Mater c. QE2 - trauma d. Ipswich e. RWBH – burns f. Lady cilento - children