Establishing a mass casualty management system.

PREFACE iii ACKNOWLEDGEMENTS vi 1. INTRODUCTION 1 A. DIFFERENT APPROACHES TO MASS CASUALTY INCIDENTS 1 1. Basic Approach 1 2. Classical Care Approach 1 3. Mass Casualty Management Approach 1 B. PROBLEMS IN DEVELOPING MASS CASUALTY MANAGEMENT 1 1. Limited Human Resources 1 2. Limited Material Resources 2 3. Poor Communications 2 C. OBJECTIVES OFTHIS MANUAL 2 2. DEFINITIONS 3 /. Mass Casualty Incident 3 2. Emergency Services 3 3- Health Care Services 3 4. Mass Casualty Management 3 5. Mass Casualty Management System 3 6. Rescue Chain 3 3. FIELD MANAGEMENT 6 A. DEFINITION 6 B. FIELD ORGANIZATION 6 1. Alerting Process 6 2. Pre-Identification of Field Areas 7 3. Safety 7 4. Security Measures 9 5. Command Post 9 C. MANAGEMENT OF VICTIMS 13 /. Search and Rescue 13 2. Field Care 13 3- Evacuation Management Center (EMC) 27 D. FIELD MANAGEMENT PLAN 27 4. TRANSFER ORGANIZATION 29 A. DEFINITION 29 B. PREPARATION FOR EVACUATION 29 /. General Procedures 29 2. Preparation for Transport 29 C. EVACUATION PROCEDURES 30 /. Regulation of Evacuation 30 2. Control of Victim Flow 30 D. EVACUATION OF NON-ACUTE VICTIMS 32 E. CASE STUDY 32 iv Contents 5. HOSPITAL ORGANIZATION 35 A. INTRODUCTION 35 B. ACTIVATION OF HOSPITAL MASS CASUALTY MANAGEMENT PLAN 35 1. Alerting Process 35 2. Mobilization 35 3. Hospital Command Post 37 4. Clearance of Receiving Facility 37 5. Estimate of Hospital Care Capacity 37 C. RECEPTION OF VICTIMS 37 1. Location 37 2. Personnel 39 3. Links with the Field 39 D. HOSPITAL TREATMENT AREAS 39 /. Red Treatment Area 39 2. Yellow Treatment Area 39 3. Green Treatment Area 39 4. Hopeless Victim Area 41 5. Deceased (Black Category) Victims Area 41 E. SECONDARY EVACUATION 41 F. CASE STUDY (Continued) 41 G. HOSPITAL MANAGEMENT GENERAL SCHEME 42 6. NATIONAL MASS CASUALTY MANAGEMENT PLAN 44 A. NATIONAL RESPONSE TO MASS CASUALTY EVENTS 44 B. DISTRICT RESPONSE TO MASS CASUALTY EVENTS 44 7. ASSISTANCE FROM NEIGHBORING COUNTRIES OR TERRITORIES 45 A. MOBILIZATION 45 B. INTEGRATION OF EXTERNAL STAFF 45 8. IMPLEMENTATION OF A MASS CASUALTY MANAGEMENT SYSTEM 46 A. PHASE 1 -ADOPTIONAS NATIONAL POLICY 46 B. PHASE 2 - SENSITIZATION 46 /. National Consultation 46 2. Sectoral Consultation 46 3. Multisectoral Consultation 46 4. Community Sensitization 46 C. PHASE 3 -TRAINING 47 D. INSTITUTIONAUZATION OFTHE SYSTEM 47 1. National Emergency Act 47 2. Job Description 47 3- Training 47 E. MAINTENANCE OF A MASS CASUALTY MANAGEMENT SYSTEM 47 ANNEX 1 - Action Cards 49 ANNEX 2 - Standard Job Profiles 55 BIBLIOGRAPHY 58