Straight forward Mass Casualty (practice for newbies)

[mobey]

You are a BLS service with 2 full time ambulances, a third can be called in if enough staff are around to run it.

On a very foggy day you are dispatched to a Cardiac arrest. You and your partner respond with a third EMT to a rural residence. On the way out you hear a call come over the radio for a 3 vehicle MVC on the highway about 3 miles behind you. Gravel truck vs SUV vs school bus with 15 total potential patients.

Dispatch states there are at least 2 ejected, no other info.

Fire has been dispatched

You are about 7 min out from your code..... and 3 miles from the MVA (behind you).

Ready, set, go....

(For those of you who know of this call, I will not be replicating the details for respect of the families involved. This is not a replay of the actual events, just a general overview with some omissions and additions)

[Just Plain Ruff]

well it's a toughie

You continue on to the cardiac arrest. They called first. Even though the dude is probably gonna die anyway.

But we all want to be involved with the big one so I bet someone will say turn around.

But then again, you are 7 minutes out of the arrest - 3 minutes out from the wreck.

Your other crew is gonna have to work the wreck until you are done with this call.

There is no easy answer.

I had a similar incident. We were rolling on a car wreck about 10 miles outside of a small town. We were 2 miles out from the small town with 10 miles left to go to the wreck when our second unit was toned out to a cardiac arrest in the same town we were just about to drive thru on the way to the wreck.

We did not divert to the arrest. Our 2nd unit went on it because the wreck call came out first. It was reported to have 3 patients inside with 2 unconscious. We were also going to be first on scene before police and fire due to the distance that we all had to travel.

On arrival we realized our decision was right because we had 2 critical patients who were flown out by air and the other one coded quickly after we started to transport to the hospital. The cardiac arrest was indeed Dead right there when the crew got to him - he had been dead for a good long time.(>12 hours)

But I'd like to see what others say about this.

[Just Plain Ruff]

Your dispatch center should be mobilizing all the resources they can though.

helicopters - all should be utilized that can respond to your area. (is it too foggy for air transport? I think it might be so you may not get them)(edited by poster)

Heavy rescue - from wherever you can get them from

As many ambulances as you can get from your mutual aid orgainzations. (if helicopters cannot fly then you will need a lot more ambulances than you think you need)

If you have a military base near you could request their ambulances and their medevac helicopters

Call the local school district to bring a new bus to transport the non-injured.

prepare for at least 20% reds, 20% yellows, 55% greens or not hurt and 5% blacks.

Mobilize law enforcement to shut down the highway both ways.

[spenac]

Had Mobile ER been enroute to get granny for a doctor appointment I would divert. But you were enroute to a 911 call, so you stay on course to original call. Do a load and go. Drop patient at hospital and roll to assist wreck scene.

That is hard to do, but thats the way it goes. Now if I got to the first call and found a stubbed toe rather than the stated cardiac. I would tell them hell no and go to the wreck.

[Just Plain Ruff]

Spenac, I'm in full agreement.

If the patient can wait and you can evaluate that wait and explain to the patient that there are 15 patients on the road down a ways who are really hurt the patient may say sure go take care of that and then come back and get me. Then by all means you can do that but if the patient says

Hell no, I want you to take me then you don't have much choice do you?

I'm not gonna go any further off topic I'll post a new one.

Sorry Mobey

[spenac]

prepare for at least 20% reds, 20% yellows, 55% greens or not hurt and 5% blacks.

Why is it always about race? Sorry could not resist. You are right need to get your self geared up. Hope you are wrong but err on side of caution and request outside resources based on worst case.

[mobey]

Great!

in our area it is up to us to tell dispatch what we want.

Police are now enroute (15 min responce)

Mutual aide ALS ambulances x2 enroute approx 45 min away

Heavy rescue 1.5 hrs away (local FD have power tools and are well versed in extrication)

Helicopters will not fly due to weather

School bus will respond asap.

Note: Accident occured about 10min from town. This will be a small town hospital not to used to trauma and 3 General docs.

[Just Plain Ruff]

Great!

in our area it is up to us to tell dispatch what we want.

Police are now enroute (15 min responce)

Mutual aide ALS ambulances x2 enroute approx 45 min away

Heavy rescue 1.5 hrs away (local FD have power tools and are well versed in extrication)

Helicopters will not fly due to weather

School bus will respond asap.

Note: Accident occured about 10min from town. This will be a small town hospital not to used to trauma and 3 General docs.

You need more ambulances for starters.

Is anyone on scene yet to provide sizeup?

And the hospital is gonna have to take it in the rear and get ready. They are gonna need to call in everyone they can. They are also going to need to contact the next 2 -3 closest hospitals to them and tell them to expect the minor casualties.

the local hospital is gonna have to treat the criticals and the yellows. There being not used to trauma should not have any bearing on whether they get these patients. They will adapt because they are going to have to adapt for this scenario

Put all the greens when you round them up in the school bus and send them with ONE emt to one of the neighboring hospitals or send them to the local doctors office unless that doctor is going to be over at the hospital and even then they can go to the doctors office for initial care by their nurses (perish the thought).

But like I said, do we have a scene sizeup yet?

[mobey]

http://www.ctv.ca/servlet/ArticleNews/stor...0409?hub=Canada

I was just trying to post the pics... but anyhoo :roll:

this is what you roll up on.

Forget the media story, this is scenarioland.

(consider yourself on the 2nd car)

[Just Plain Ruff]

holy crapola that was bad.

I can see the fog that precludes helicopters.

it also doesn't appear extrication needed, the truck did all the work for the heavy rescue crew.