MCI Action List

STAGE 1 GOALS

◦ Needs Assessment ◦ estimated time-line ◦ injury types ◦ incoming # patients ◦ Incident situation ◦ ED/OR/Hosp capacity assessment ◦ Staff - communicate ◦ Stuff - secure ◦ Space - assign

◦ Activate Response (local) ◦ (understand base concepts of code yellow ED vs. code yellow Hospital) ◦ Declare code yellow ED ◦ Activate local incident command (administration) ◦ Notify clinical departments: ED, trauma for Peds & Adults, radiology & shift coordinators ◦ Partial mobilization of staff: ED trauma nurses, radiology, public affairs, EVS, security, public affairs ◦ Activate local reverse triage

◦ Decide/Assess: ◦ Define staff, space, stuff needs ◦ Acquire/Prepare additional supplies ◦ [partial] mobilization of hospital incident command ◦ Activate concepts of Triage

STAGE 2 GOALS

1. Needs Assessment ⁃ situation/incoming patients needs assessment/estimated ongoing time-line ⁃ Hospital capacity needs assessment

2. Activate Hospital Response ⁃ (understand base concepts of code yellow ED vs. code yellow Hospital) ⁃ Declare code yellow HOSPITAL ⁃ Activate Hospital incident command (HICS) ⁃ Notify clinical departments: wards, trauma for Peds & Adults, radiology & shift coordinators ⁃ Stop elective operations (ORs/Clinics) ⁃ Mobilization of staff: Hospital nursing, blood bank, EVS, radiology, public affairs, security, public affairs, facilities ⁃ Call in additional staff ⁃ Activate hospital-wide reverse triage

3. Decide/Assess: ⁃ [partial] mobilization of hospital incident command ⁃ Define staff, space, stuff needs ⁃ Acquire/Prepare additional supplies ⁃ Establish contact with other hospitals ⁃ Go on ED diversion ⁃ Contact materials management for more supplies (eg, PPE)

4. Activate concepts of Re-Triage

STAGE 3 GOALS

1. Triage + Treat Patients 2. Move Patients Around 3. Expand available space to accommodate more patients 4. Secure perimeter/crowd control 5. Attempt to Resupply

STAGE 4 GOALS

1. maintain contact with other hospitals 2. needs assessment: open ICU/OR beds check 3. borrow supplies 4. re-supply 5. media/crowd management 6. Triage

STAGE 5 GOALS

1. Staff management – getting more fatigue mitigation; food 2. Family management 3. Advanced triage 4. Definitive Treatment - ICU, OR, Home, Psych Liaison, Morgue 5. Ongoing security

STAGE 6 GOALS

1. Send excess staff home 2. Begin elective procedures again 3. Bring in new staff 4. De-escalate security 5. Restock supplies 6. Laundry/Room Flips