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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 Ben "Batman" Barry on
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I have no doubts that the Capt is wrong. The computer is.
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Permalink Reply by Joe Stoltz on
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Well... assuming all patients have been moved to safety and that on scene personnel are also safe, one option would be to let it burn. Unless one had the foresight to call for an airport crash truck or two just in case it DID ignite.
The alternative would be to truck in huge quantities of water and ARFF to try and extinguish the fire; then off-load the unburned product, with the constant fear of the thing igniting again.
On a hot summer day the evaporating fuel product would create a highly explosive atmosphere. I might have considered foaming the product as soon as a leak was discovered to keep down the vapors thereby reducing the chance of ignition.
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Permalink Reply by Marvin Hawk on
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Question how long between the incident happening and update #2 taking place? There are definately some differences betwen NY and OH in regards to handling of fatalities.
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Permalink Reply by John Crabbe on
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go with ARFF. water will not work on ethanol.
Are you sure the ARFF rigs are carrying the alcohol resistant foam???? You can have foam for a class "B" fire (which is what most ARFF carry) and it may not be alcohol resistant foam for a fire involving ethanol.
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Permalink Reply by Derek R. on
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I have nothing to add at this time other than this is a great post FULL of information. Thnx CBz.
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Permalink Reply by Mike Schlags (Captain Busy) Retd on
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Update #1 provided clarification regarding the weather which is an important factor when dealing with leaking fuel.
Update #2 provided to move past the START Triage (which I had already put a post together, addressing how to do the process the injured and also included the SCARIE-PM acronym for scene management.
What was not touched on however was the discussion about setting up a morgue and handling dead bodies. I would appreciate it very much if you would comment on how your state handles this issue. Doing so will enable others across the country and outside of the USA to learn how to handle these types of incidents and hopefully make necessary changes as a result of the information presented in this post.
Thanks for being a giver PRN! CBz
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One of the key points for my posting this was to find a round about way to first get you to think MCI, review START Triage and the SCARIE-PM concept that I developed years ago to handle incidents, from a Fire Captain's perspective. Once these basics were covered, then it was time to move on to what I personally feel is the next big issue for us, the fire service which is ethanol fuel production, transport and use.
if a picture says a thousand words, then a video with sound says a lot more... EVERY firefighter unless they no the difference will be opting to use AFFF on a flammable liquid fire. We have never had to deal with anything that couldn't be fought using water and foam. The problem is that this new E-85 fuel behaves much differently than gasoline that does not contain ethanol.
Ethanol fuel, (E-85), is not being used much where I live here in SoCal but I have read that it is very prevalent in other parts of the USA. Research into production shows that the current production levels will double, triple, etc. as years go by. Why? EPA rulings and environmental studies have shown that the methyl tertiary butyl ethers (MTBE's) that are used as a fuel additive in gasoline enables the gasoline to penetrate deeper into the ground, affecting underground water resources (aquifers) and the quality of drinking water. Replacing MTBE with ethanol is great for the environment considering you are dealing with alcohol and not a chemical compound like MTBE. Everyone should be happy right?
Nope... the fire department have been left hanging out to dry. Have you really read much about this major change in how gasoline is being made? Typical bread and butter calls such as vehicle accidents with fuel spills, tanker truck incidents, etc. will all have to be dealt with. The problem however is that when you use AFFF on an ethanol gasoline fire... well... it's not going to work.
Now that I have figured out how to use video on my FFN posts, I can do a much better job teaching you what the difference is between using AFFF foam verses an alcohol resistive (AR) foam or even water to extinguish the flames.
Key Point: Alcohol floats on water. Burning alcohol on top of water will be moved if you add more water. If you are putting hose streams onto a fire that is ethanol based (alcohol) be prepared to take a static incident (ie. tanker truck fire) and have it turn into a dynamic incident because alcohol floats on top of water... this will be exemplified below with a video that shows the Baltimore FD responding to a tanker fire that they did not know contained ethanol. We all can be fooled as well because UN1203 can also be used for ethanol fuels... Don't you just hate it when you are surprised sometimes? CBz
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Permalink Reply by Jason Hoevelmann on
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Cool!
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Baltimore FD Ethanol Tanker Fire (8,000 Gallons)
First responders initially used water to control the fire. But after learning that the tanker contained ethanol and losing some vehicles on the street below, AR Foam was used to finally extinguish the fire. Prior to this, vehicles were destroyed from fire protection water moving the burning ethanol down to the street below, running down gutters igniting seven vehicles.
This video and discussion is shared to help us all learn from the Baltimore Fire Department that what was thought to be gasoline required a different foam agent (AR Foam) to mitigate the incident.
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Copy that Chief. Like others, when I read about this incident coupled with the time wasting jr/explorer discussions, I thought it was time to raise the bar and get back on track to why many of us participate on the FFN. To learn and share. Since starting this gig in 1973, I have found that what I enjoyed most was teaching things. So, this is what I've done for years and will continue to do so as I progress toward getting finally retired from the fire service. Having written about 1/3 of the original hazmat technician series for CA, authoring UFC Article 80 requirements for mapping (A-N / 1-17) Appendix II-E, and teaching UFC Article 80 nationally I feel pretty good about doing small drills like this to share stuff and help folks out that don't have a training division in a large department. I fully intend for anyone reading my posts to rip me off blind. You can even put your name on my stuff, don't care. What's most important here is to remember something that Ronald Reagan said, "you would be amazed at what you can accomplish if you don't care who get's the credit...". Looking forward to reading the after action report. Pre-drill or post-drill, please consider making use of five videos that I have stashed away somewhere that were done by another fire academy / college focusing on ethanol. It does an exceptional job explaining polar solvents, fire behavior and extinguishing agents. Take care. I will post them on this blog for reference and sharing... CBz
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this is part of the puzzle that I don't understand. why? for ems issues that everyone is used to, and a system that does not make use of the fd as a primary ems provider, well... if it ain't broken then don't fix it is the prevailing attitude. if it's not a problem then so what?
here's the problem... if a WMD event occurs, especially when explosive devices cause structural damage or create an IDLH atmosphere, the EMS folks don't get to play in the sandbox with us... the responsibility to triage folks, and quickly will fall onto the fire departments, whether it be volunteer or full time, doesn't matter. we are the ones trained to deal with rescuing patients, conducting USAR ops, setting up staging, and on and on... it's what we do right? I have a heard time thinking that I would be working for the EMS folks who in my county are private ambulance providers. In my world, the EMS folks are a resource and I am the incident commander until you arrive on scene and pass command. Also, making use of our ICS system lends itself very well when dealing with anything requiring the use of triage tags. Again, it's what we do, and we do it oh so well!
CBz
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Permalink Reply by Trainer on
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ARFFF and lots of it and don't run it through a cafs, needs to be applied the old fashioned way and at least 2ft thick. No production plants in our district, however 3 plants within 40miles but we get the tankers with the production chemicals running through. Illinois mutual aid is second to none, with 1 call to dispatch I can have most of what is needed within 20min, specialty items in less then an hour. Now with this incident I'd have to call 2 box cards, an MCI and hazmat let me try to list what and when.
Ist due-1 eng, 1 heavy rescue, 2 ambo's this is our normal response
MCI card, depending on level, (can't remember exactly) level 1 brings 2ambo's, level 5-15ambo's and a mobile triage trailer, most within 20min including trailer.
Hazmat, again depending on level, 1 brings a fully equipped 10man team, level 5 brings 5 ten man teams, recon personal will be there in 20min, full team strength in 1 hour.
Special request, BNSF foam trailer, brings 1500gal of ARFFF with a pump and full compliment of deck guns, hose and nozzles, this will probably take close to an hour.
As for the casualties, we would setup a Zumro tent and call the coroner.
This is set up through the entire state, 1 call get's it all with our MABAS system(mutual aid box alarm system), 62 hazmat teams, 43 TRT teams way to much stuff to mention and all but a handful of depts belong, but the idea is with a response like this, to have everything within 1 hour and not deplete any dept of more than 20% of their resources.
Almost forgot to mention the Chaplin Corps, I don't think I have them on a box card, have to fix that.
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