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Mass Casualty Training invites all to save lives

Times Observer photo by Katie Miktuk From left Game Commission Officer Savinda, Diana Knepp, Art Lane and Kyle Walker performing a secone triage on the human-shaped cutouts.

A mass casualty incident is defined as any incident in which the number of casualties and severity is more than what the available resources can handle.

It’s an incident that taxes the system and reduces the effectiveness of the response.

The Clarendon Volunteer Fire Department hosted a Mass Casualty S.T.A.R.T. Triage Class on Monday, in response to the newly-implemented Warren County Mass Casualty Incident Plan.

The plan has been developed due to money awarded to Warren County by the Hospital Coalition.

The class was organized by Scott Rose, Warren County Department of Public Safety, and was previously held at both Garland and Russell volunteer fire departments.

Times Observer photo by Katie minute Teddy bears that have been triaged are placed onto mats representing their triage status. Green for minor, yellow for delayed, red for immediate and black for morgue (deceased).

Anyone who could be involved with responding to a mass casualty incident was invited to attend.

All licensed QRS, BLS and ALS services that attended received a Mass Casualty Kit, that includes a fanny pack with triage tape, tourniquets, and the Mass Casualty Incident Plan pocket guide.

Erie County worked for nearly a year on its mass casualty plan. The outlying counties — Warren included — have taken that plan’s blueprint and adjusted it to fit their county’s needs.

The underlying reason for this method is that we are neighboring counties. Any one of these counties could be called to help another neighboring county in the time of a mass casualty incident. The more similar the plans, the more effectively counties can work together.

Don Erbin, Jr., was guest speaker for the night to go over the new plan.

Erbin has been in this business, both fire and EMS, for 29 years. He is a full-time paramedic and fire chief in Erie County.

The goal is to save the largest number of victims possible.

It is important that anyone involved in responding to these incidents is intimately familiar with the plan and understands all job functions and how they work. This will establish a framework for responders to effectively work and manage mass casualty incidents.

Mass casualties can be caused by tornados, winter storms, flooding, transportation accidents, fires and explosions, energy emergencies, hazardous material incidents and criminal activity. These are all disasters with a high possibility of occurrence that could cause the most significant impact according to a recent statement from the Hazard and Vulnerability Analysis (HVA).

The plan contains a checklist for each job description in order to ensure everything gets done amidst the chaos of a mass casualty.

The initial checklist used would be by the first onscene, the incident commander and the command staff. The incident commander’s responsibility is to ensure safety, size up the size of the mass casualty, declare that there is a mass casualty, then begin triage and ensure that everything gets checked off.

Triage is defined as the rapid sorting and organization of patients and is used to send people to the proper destination for the appropriate treatment and care. Patients will be put into categories of severity including minor, delayed, immediate or morgue (deceased).

The incident commander will use the mass casualty level chart to size up the incident’s impact. The different levels are based upon the number of victims present. This declaration will let those at the 911 center know what kind of resources to send.

Another function of the incident commander checklist is to ensure that all job functions are fulfilled. These include jobs such as operations position, staging position and a public information position.

The operations position is the one with the boots on the ground, letting the incident commander know what is needed on the ground.

The staging position remains at the staging center — an area pooling vehicles and other resources to await the call for duty — to keep track of incoming and outgoing resources.

The public information position is one of the most important functions. This person ensures that those people with the media are notified in a timely manner with factual information on what is occurring.

When people want to know something and factual information is not given to media sources in a timely manner, they may begin speculating on what they see and write something that is untrue or is a reach of the situation.

Another checklist present within the plan, is the treatment unit leader checklist. It asks to write down whether the victim is a male or female, their age, the problems that they are experiencing and the time when they arrived and then left the treatment area. It is a basic checklist to keep track of what has happened within the treatment area.

From there, the transport officer will then decide who is transported and where they are transported to. It is essential that there is a hospital administrator present within the 911 center for the transport officer to work with. This hospital administrator will know who to contact in order to receive the information on the level of trauma a particular hospital can handle and how many patients they’re able to see.

The transport officer, in this area, would be sending patients to Warren General Hospital and UPMC Chautauqua. On a nice day, they may be able to send patients via helicopter to Pittsburgh, Buffalo or Erie.

Another job present at the scene of a mass casualty incident, is the casualty collection point. Here is where victims wait to be transported and are constantly triaged and treated until transport arrives. This optimizes available resources and increases the efficiency in reporting status.

The transport area/officer should be adjacent to the casualty collection point.

When it comes to triaging victims, the plan includes a RMS treatment chart. Check for respirations, perfusion (pulse) and mental status.

The chart is a flow chart of yes and no answers that lead medical personnel to pronounce each victim either minor, delayed, immediate or morgue (deceased). The chart is modified slightly when it pertains to triaging children.

A victim’s triage status may change multiple times depending on how long they remain on the scene. A victim could show progress and go from immediate to minor, or they may decline and go from minor to immediate.

It is important to stress that each victim is constantly checked and triaged to ensure the proper and timely treatment.

The newly-implemented plan creates a framework of hierarchy so that no one person is trying to accomplish all tasks.

You can’t be the chief and the warrior.

EMS personnel are discouraged from moving any victims. They should be utilizing firefighters and law enforcement, who don’t have the medical knowledge they do, to bring victims to them in times where it is hard to get to a patient.

Erbin had personnel present, practicing triage on teddy bears and human shaped cut-outs. Each bear and cut-out contained a mass casualty incident and the health status of the person. They were asked to triage each object and place them into minor, delayed, immediate or morgue. The groups then switched and re-triaged each object.

Erbin also presented mass casualty incidents that had happened in the past including the Columbine massacre and a two-mile long pile-up on I-90 in the January of 2007 that resulted in one fatality and numerous injuries, which he was a responder at. He asked the group what they would have done and what steps they would have taken to handle each situation.

Boyd Freeborough, Warren County School District public affairs, was also on hand to speak about what is happening in schools to ensure the safety of staff and students.

They’ve been working for the past couple of years on the implementation of safety devices and kits within the school buildings.

As of now, there’s a “Stop the Bleed” kit in the office of each building containing 24 tourniquets. There is already an emergency bucket with supplies in each classroom and by next year they hope to implement a two tourniquet “Stop the Bleed” in each classroom.

They are working to get staff in schools trained to use these kits.

Warren County School District, in partnership with local emergency agencies, will be hosting it’s 2nd Annual Multi-Agency Active Intruder Drill August 20. There will be two sessions, one at 1 p.m. and a second at 6 p.m.

District personnel, the Department of Public Safety, 911, law enforcement agencies, both paid and volunteer fire departments, fire police, EMS both paid and volunteer, hospitals and many more will be involved in the mock shootings.

Volunteer actors are also needed for the drills to serve as victims, teachers, and students..

For information, contact Freeborough at (814) 723-5223, freeboroughb@wcsda.org or Melissa McLean at (814) 723-5223, mcleanm@wcsdpa.org.

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