Prepared by B. CarrModule 2/5

Defining and Implementing TEMS OPS: MCI and Casualty Collection Points

Concepts in Tactical

EMS

Review of Module #1 and Overview of Module #2

Tactical EMS is an emergency posture designed for response to dynamic threats. TEMS involves coordination between F/EMS and Law Enforcement units.

JH F/EMS SOP 17.6.1 addresses response to a range of threats and implementation of TEMS methodologies .

Review of Module #1 and Overview of Module #2

Module #2:• Assumes familiarity with SOP 17.6.1 and understanding of

where and when responders will implement TEMS standards

• Reviews MCI environments and obstacles to care

• Provides guidance for MCI operations

• Introduces operational procedures for casualty collection points

Mass Casualty Incidents (MASCAL)

Also known as “Multi-Casualty Incidents”

A mass casualty event overwhelms immediately available medical capabilities to include personnel, supplies, and/or equipment.

Demands rapid transition from routine to contingency medical operations

Effective TRIAGE is the guiding principle for establishing order during a confused situation

START REVIEW

TRIAGE PRINCIPLES

Triage is a constant and dynamic process as casualties move within and through the system of care.

F/EMS's ultimate goal is organizing casualties to determine necessary treatments and to complete rapid transport to definitive medical care.

Effective triage requires establishing areas for sorting, treating, and holding casualties

Jackson Hole Fire/EMS's Mass Casualty Guidelines

Division 20

Review policy HERE

Casualty Collection Points (CCP)

Differ from standard triage collection areas due to nature of incident

Forward operating area secured—but not cleared—from ongoing risk

Require additional PPE mandated by incident type (e.g. ballistic armor and helmet; chemical protective clothing)

Casualty Collection Points (CCP)

GUIDELINES

Involve Planning and Execution phases.

ALWAYS consider—

• Location

• Security

• Transport (MEDEVAC)

• ambulance and air• Equipment

• supply and consolidation

BASICS OF CASUALTY COLLECTION POINT STRATEGY (PLANNING PHASE #1/2)

Consider location of CCP based on pre-planning and surveillance of soft targets.

• schools, shopping centers, grocery stores, etc.• COVER/CONCEALMENT• “reasonably” close to hot zone operations• anticipate need to manage “choke points”

Plan for patient exchange areas• ambulance exchange points (AXP), helicopter landing zones

(HLZ)

BASICS OF CASUALTY COLLECTION POINT STRATEGY (PLANNING PHASE, #2/2)

Have command and control in place BEFORE committing to location

• ICS roles• Security established for CCP and (possibly) HLZ/AXP• CCP Unit leader and operators determined• Communications plan

Formulate plan for evacuation from hot zone• Will their be “aid and litter” teams to assist in patient extraction

from point of injury?

What are alternate plans?

CASUALTY COLLECTION POINT TACTICS(EXECUTION PHASE)

Establish and secure casualty collection point (CCP).• Plan early for security maintenance even after threat is

neutralized

Gather and distribute casualty collection point equipment.• PPE, medical, extraction, and tagging supplies• Consider establishing locations for dedicated supplies

• Airway, IV, etc.

CASUALTY COLLECTION POINT TACTICS(EXECUTION PHASE)

Secure accountability for F/EMS and LE personnel.• “Unity of Command” in place• confirm contact-superior’s call name/number and

communications plan

Request MEDEVAC link-up point and communication.  Plan for resupply and need to expand if/when casualty load increases. Assign area for “black” patients/victims.

SUGGESTED TRAINING ACTIVITIES

Review “soft targets” in area of response• Jackson and Wilson Schools• Albertsons, Smiths, St. Johns

(re)Familiarize crews with Casualty Collection Point Kits• MS 82, 35, 78, 76

Review included CCP templates• Modify/adapt to demands

REVIEW and NEXT TIME

Purpose of MCI protocols and CCP are:

• provide resilience in response• provide for rapid extraction and sorting• provide life saving interventions• shorten time for victims and officers from point of

injury to initial care• streamline transport to definitive care

NEXT TIME

Module 3 will introduce and review:• Ballistic Protection, Medical Supplies, Chemical Protective

Clothing

Additional resources:

•FEMA Guide for Active Shooters and MCI (link)•Included Casualty Collection Point Templates

• adapted for civilian TECC from U.S. SOCOM Tactical Emergency Medical Protocols