MCI Action List

STAGE 1 (INITIATE) GOALS

Needs Assessment

-estimated time-line (Now/10min/60min/hours)

-injury types (COBRA/CBRNE)

-incoming # patients

Incident situation

ED/OR/Hosp capacity assessment

Census, Open Beds, Expandable Space

Asset Assignment

-Staff - communicate/assign

-Stuff - secure/prepare/deliver

-Space - assign/secure

Activate Preparation Response (local)

(understand base concepts of code yellow ED vs. code yellow Hospital) Patients Influx: Mass Casualty - ED

Declare/verify CODE YELLOW ED/Hospital

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

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 (RAMP UP) GOALS

Needs Assessment

⁃situation/incoming patients needs assessment/estimated ongoing time-line

⁃Hospital capacity needs assessment

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

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)

Activate concepts of Re-Triage

STAGE 3 (ACTIVE) GOALS

Triage + Treat Patients

Immediate interventions

Airway (oxygen)

Bleeding (tourniquet)

Chest tube

Antidote

Move Patients Around

- match resources to needs

Expand available space to accommodate more patients

- repurpose space as necessary

Secure perimeter/crowd control

-“Protect the House”

Attempt to Resupply

- Anticipate ongoing needs

- Consider time-limited resources

STAGE 4 (CONSOLIDATION) GOALS

Recursive needs assessment: open ICU/OR beds

Maintain contact with other hospitals

-borrow supplies

-re-supply

Media/crowd management

Re-Triage

STAGE 5 (ON-GOING MANAGEMENT) GOALS

Staff management – getting more fatigue mitigation; food

Family management

Advanced triage

Definitive Treatment - ICU, OR, Home, Psych Liaison, Morgue

Ongoing security

STAGE 6 (RESOLUTION) GOALS

Send excess staff home

Begin elective procedures again

Bring in new staff

De-escalate security

Restock supplies

Laundry/Room Flips