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MCI Incidents - How would you handle this?
5 dead, 7 injured in crash of special needs kids van
January 7, 2010 3:58 p.m. EST
The crash occured near Columbus, Ohio, in Harmony Township.
(CNN) -- Five people were killed and seven injured Wednesday when a tanker truck collided with a school van carrying special needs children west of Columbus, Ohio, according to a paramedic who treated some of the injured at the scene.
Paramedic Tom Freeman said all the dead were in the school vehicle.
The crash happened at about 12:40 p.m. today on Interstate 70 eastbound near State Route 40 in Harmony Township, Ohio.
OK folks, this is current stuff that could happen to any of us, at any time. So... what would you do in this realtime incident that resulted in a mass casualty incident (MCI)?
This incident has occurred in your first-in district and your 2nd in engine company is about 20-minutes out, so your on your own with one ambulance, and (1) one life-flight helicopter enroute. You also have a couple of state troopers on scene with more coming as well as a tow truck.
Using real time incident specifics, you have a gasoline tanker that struck a van carrying handicapped children. You have (5) black tags and an assortment of green, yellow and red tags. For the purposes of this drill scenario, you have (4) four red tags, (2) yellow tags and (1) green tag.
I look forward to hearing how folks do this across the country, down under and elsewhere in the world where any of us have the potential for dealing with a MCI related incident.
I don't intend on this drill being especially difficult and in fact, it is actually a bread & butter operation. But daunting if you have never had the chance to at least discuss it, learn some of the tricks (32 Can Do...) and remember how you eat an elephant... one bite at a time...
This is intended to both challenge you and reinforce issues that are really important. And speaking of challenges... hey explorers and juniors!!! this is your chance to talk about something other than not being respected. I challenge to you read these posts and ask pertinent questions. As mentioned many times by those defending explorers and juniors on the FFN, we ALL had to start somewhere, so take advantage of some free training and learn with eyes wide open. Hopefully, someday you will be in a position to respond to this type of incident and be one of the people who know how to handle it.
Good luck...
As always, train hard & often and be safe, your favorite old Captain... :D
CBz
Update No. 1: This incident has occurred in the middle of the summer on a nice day, not in the snow as the real incident presented itself. This change is necessary to enable focusing on the product inside the tanker truck.
Update No. 2: All patients have been triaged and moved for transport or the morgue. Responding personnel attended one of my command classes and used the following acronym for handling this incident.
SCARIE-PM
sizeup
establish command
ask for assistance
determine whether a rescue is needed or not
isolate the hazard(s) if necessary
evacuate if necessary
try to find a person responsible to help you with specific information
if safe to do so, attempt to identify the material
The also used START Triage...
Does anyone not know about how to use this system? It's very simple and may require a separate post to explain this. Oh wait... I already did... :D
http://www.firefighternation.com/forum/topics/start-triage-system-d...
January 7, 2010 3:58 p.m. EST
The crash occured near Columbus, Ohio, in Harmony Township.
(CNN) -- Five people were killed and seven injured Wednesday when a tanker truck collided with a school van carrying special needs children west of Columbus, Ohio, according to a paramedic who treated some of the injured at the scene.
Paramedic Tom Freeman said all the dead were in the school vehicle.
The crash happened at about 12:40 p.m. today on Interstate 70 eastbound near State Route 40 in Harmony Township, Ohio.
OK folks, this is current stuff that could happen to any of us, at any time. So... what would you do in this realtime incident that resulted in a mass casualty incident (MCI)?
This incident has occurred in your first-in district and your 2nd in engine company is about 20-minutes out, so your on your own with one ambulance, and (1) one life-flight helicopter enroute. You also have a couple of state troopers on scene with more coming as well as a tow truck.
Using real time incident specifics, you have a gasoline tanker that struck a van carrying handicapped children. You have (5) black tags and an assortment of green, yellow and red tags. For the purposes of this drill scenario, you have (4) four red tags, (2) yellow tags and (1) green tag.
I look forward to hearing how folks do this across the country, down under and elsewhere in the world where any of us have the potential for dealing with a MCI related incident.
I don't intend on this drill being especially difficult and in fact, it is actually a bread & butter operation. But daunting if you have never had the chance to at least discuss it, learn some of the tricks (32 Can Do...) and remember how you eat an elephant... one bite at a time...
This is intended to both challenge you and reinforce issues that are really important. And speaking of challenges... hey explorers and juniors!!! this is your chance to talk about something other than not being respected. I challenge to you read these posts and ask pertinent questions. As mentioned many times by those defending explorers and juniors on the FFN, we ALL had to start somewhere, so take advantage of some free training and learn with eyes wide open. Hopefully, someday you will be in a position to respond to this type of incident and be one of the people who know how to handle it.
Good luck...
As always, train hard & often and be safe, your favorite old Captain... :D
CBz
Update No. 1: This incident has occurred in the middle of the summer on a nice day, not in the snow as the real incident presented itself. This change is necessary to enable focusing on the product inside the tanker truck.
Update No. 2: All patients have been triaged and moved for transport or the morgue. Responding personnel attended one of my command classes and used the following acronym for handling this incident.
SCARIE-PM
sizeup
establish command
ask for assistance
determine whether a rescue is needed or not
isolate the hazard(s) if necessary
evacuate if necessary
try to find a person responsible to help you with specific information
if safe to do so, attempt to identify the material
The also used START Triage...
Does anyone not know about how to use this system? It's very simple and may require a separate post to explain this. Oh wait... I already did... :D
http://www.firefighternation.com/forum/topics/start-triage-system-d...
Replies to This Discussion
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Permalink Reply by Capt.Alex Arnold on
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I have a definite plan in my little melon on how I would handle this situation. I would like to digress though on to an essential part of this call that is all to often forgotten about, CSID.
I would definitly take the steps to assure that it happens and that EVERYONE at that scene goes thru it. I am a big one about CISD when a child or children are involved. Kids, especially the death of, is perhaps one of the most difficult.
I have seen personally a DAM good FF/Medic step away from this service because of an MVI that killed all 5 kids from a family. The department she was with didn't take(my opinion) the needed steps of CISD. It was the good ole' boy mentallity of "Don't let it bother you, and, It'll go away." NEWSFLASH!!!...we are not robots. Yes, with time some of us get a thick skin and de-sensitized I guess. But really, should we?
Be safe and learn something new today.
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Permalink Reply by Jason Hoevelmann on
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Basing this on having three on the engine and two on the lsv, here is what my initial actions would be:
1. Identify tanker placard and immediate hazards.
2. Get Senior medic to start triaging with backstepper and other medic treating life threats.
3. Askig for more equipment, strike a mass casualty alarm and request overhead team, (command staff)
4. Mitigate any hazards from the tanker with engineer, ie: water curtain to keep fumes off of school bus, if needed.
5. Request second unit to have engineer help with water, captain to establish area for transport of patients and backstepper to assist with medical care and extrication.
6. We would need additional extrication, set up landing zones, have police shut down roads and establish perimeter.
I am sure I am forgetting something, so fire away.
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Permalink Reply by Mike Schlags (Captain Busy) Retd on
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there is not a fire but as always, there is the threat of fire considering vehicles with batteries, sparks, etc. combined with a tanker truck which contains a product with this placard and there is signs that some of the fuel in the truck has already leaked directly under the tanker trailer.
there is entrapment issues with several of the vehicles
as noted in the article, all of the special needs kids were unfortunately dead (5) black tags
it's a small rural community so you do not have bystanders immediately available to assist you
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BTW, nice post.
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Your heartfelt point is spot on Alex. Admittedly, I too gave up my paramedic certification after one too many SIDS and a non-caring system. I got into hazmat and never looked back... Thanks for bringing up the Critical Incident Stress Debriefing (CISD) resources that are very much a part of this type of response. This perspective unfortunately only comes from time and experience. Thanks for sharing this. CBz
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take a look at the placard... and rethink the water thing... while this actual scenario occurred in the snow, for the purposes of this exercise let's go with a summer day, where the spilled fuel would be more of an issue. I am trying to draw attention to what is in the tanker by sharing the DOT placard UN number. there is a purpose to this, believe me!
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actual incident per CNN website...
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Hmmmm.. "Keep out of low areas." No problem. I see what you mean by the placard. In the 2008 ERG I am looking at Guide number 127: this is for basically a flammable liquid with ethanol. Definately will need a hazmat team, dike if possible. Keep ignition sources isolated. If all are deceased in the van, you may have to mitigate hazard before removing bodies. The ERG does list as water to reduce vapor, but controlling the runoff is an issue. Foam for spill, will need additional resources for more foam.
If no leak or product release, I say have a hand line ready and someone monitoring the tank and go about getting injured out of there and get perimeters set up.?
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Permalink Reply by WestPhilly on
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"EVERYONE" at the scene has to go through it? What if some don't need it?
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Permalink Reply by Ben "Batman" Barry on
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First declare MCI and implement ICS Operations ang logistics branches. Acess need for HAZMT order apropriate resources. Have PD shut down traffic. Call for at least 5 ALS 4BLS ambulances.Triage injured and set up treatmen arears. Set up for LZ. Treat the reds first, then yellows and so on. Most critical red goes in chopper the rest go ith ALS units, Green and yellows go in BLS. Haave HAZMAT acess the situation and fire extricates the entrapped persons. After call for CISD for emergency responders and debrief.
Anything I miss?
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according to WISER that number does not exist
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I was always taught we can not force CISD but inform them that they can always talk to someone.
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