Straight forward Mass Casualty (practice for newbies)

[Just Plain Ruff]

You also did not say that there was a third vehicle involved. What was the condition of the driver and occupants of the car.

so we know we have at least the driver of the truck

The driver of the suv and possibly more in it.

The school bus about 15 kids and 1 driver.

So a total of 20 potential victims

One is still critical and one dead (theres the 5% for black)

Any further?

[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).

12 kids, 3 drivers.

Driver of SUV, bus, and truck are out of thier vehicles and standing with 9 kids on the side of the road.

You can see a young womal lying on the side of the road beside the "Tear" in the bus, a young man directly behind the bus, moving his arms in a disorganized fasion, and one still on the bus sitting up.

Your 3rd ambulance and rescue truck are arriving staffed with 2 EMT's and 2 FF (first aid)

[AZCEP]

Send a supervisor type to the hospital to help them manage the mess they are going to be receiving.

Send air resources to the hospital as well if they are able to get there. Not real sure on if the fog precludes this option.

Continue to the cardiac arrest, and work toward an early termination if possible. All resources will be stretched thin with the MCI, but it might be worth trying to get law enforcement or victim's advocate to respond to the arrest. Just to shorten the turn around.

[mobey]

BTW your ambulance that is now at the "code" tells you they will be transporting an active MI, not a code. They will drop thier pt. at the hospital and race back asap.

[mobey]

The helecopter will not leave thier pad.

Dammit!

[Just Plain Ruff]

12 kids, 3 drivers.

Driver of SUV, bus, and truck are out of thier vehicles and standing with 9 kids on the side of the road.

You can see a young womal lying on the side of the road beside the "Tear" in the bus, a young man directly behind the bus, moving his arms in a disorganized fasion, and one still on the bus sitting up.

Your 3rd ambulance and rescue truck are arriving staffed with 2 EMT's and 2 FF (first aid

so you really have three actual patients and 9 walking wounded

You have enough equipment then.

Put the young woman near the tear in the 2nd arriving ambulance - your first in ambulance is your triage ambulance

put the 2nd patietn who is moving his disorganizedly in the 3rd ambulance which just got there.

both those ambos go on to the hosptial

You are now responsible for the kid in the bus and the walking wounded. Since it's only a 10 minute run from the scene to the ER you can work on getting patient 3 out of the bus, packaged and initial treatment started while that first ambulance is on the way back to you. Once that ambulance gets there you put them in and they go

You then put the walking wounded on the bus that just arrived and you and any other emt's available can go with taht bus to the hospital.

Which of the three ended up dying

the girl on the ground next to the tear

the guy with disorganized movement

or the one still in the bus (was she even alive?)

[mobey]

so you really have three actual patients and 9 walking wounded

You have enough equipment then.

Put the young woman near the tear in the 2nd arriving ambulance - your first in ambulance is your triage ambulance

put the 2nd patietn who is moving his disorganizedly in the 3rd ambulance which just got there.

both those ambos go on to the hosptial

You are now responsible for the kid in the bus and the walking wounded. Since it's only a 10 minute run from the scene to the ER you can work on getting patient 3 out of the bus, packaged and initial treatment started while that first ambulance is on the way back to you. Once that ambulance gets there you put them in and they go

You then put the walking wounded on the bus that just arrived and you and any other emt's available can go with taht bus to the hospital.

You instruct the staff of unit #2 to grab the girl and load her up. Your EMT turns to you and says "she has no pulse, but some agonal resps" do you want us to transport?

You instruct the staff of unit #3 to package the male pt up and transport. he has obvious head trauma and moans to painful stimuli.

You jump in the bus to asses the 3rd patient who is complaning of leg pain.

Anyone wants to follow either of the patients in scenarioland feel free.

[Just Plain Ruff]

I think you have enough resources to work both patients.

Transport them both to the hospital.

Work on getting the one in the bus out.

But you have to work both the other kids though.

[ninjaemtff]

I'll be honest, I did not read everyones posts. But I read the scenario.

You stay on the code.

My reasonings for this: you are already past the wreck, if you would go back you would be back tracking, leaving the code for your second unit who is closer to the wreck and further from the cardiac arrest. Plus your second unit would have to go past the MVC to get to the arrest, and it would take longer due to traffic being backed up. So you go to the arrest, you do your job, you drop the pt off at the hospital. Go back to the wreck, by the time you are back, there should be additional units there and the scene should be under control, it should be at the point where you get a pt transport and if needed return again. With it being that big of a MVC, there should be any available units there. You're main focus should be the cardiac arrest you were originally dispatched to until that call is taken care of. After that worry about the MVC.

[smax]

You respond to the first call- and try to get back as fast as you can so you can assist if necessary. For the MVC, the crew responding- call assistance from other services, triage and do the best you can with the resources available.