Paleerat Jariyakanjana, MD

Faculty of Medicine, Naresuan University

1 Apr 2013

MAJOR INCIDENT MEDICAL MANAGEMENT AND SUPPORT

Definition

Major Incidents: any incident where the number, severity, type or location of live casualties requires extraordinary resources

Disaster: need > resource Mass casualty incident: Healthcare need >

resource

Disaster Management Cycle

Major Incident Medical Management and Support (MIMMS)

major incident training course

systematic, 'all hazards' approach to the principles of pre-hospital, multiple-casualty incident medical management

DISASTER Paradigm

Detection Incident command Scene security and safety Assess hazards Support Triage and Treatment Evacuation Recovery

Management and Support Principles

DISASTER Paradigm Detection Incident command Scene security and safety Assess hazards Support Triage and Treatment Evacuation Recovery

MIMMS Command Safety Communication Assessment Triage Treatment Transport

Command

CSCATTT

Safety

The 1-2-3 of Safety

1. Staff

2. Situation

3. Survivors

CSCATTT

Communication

CSCATTT

Assessment

My call sign/Major incident declared Exact location: Grid ref. Type of incident Hazards: Present/Potential Access: Roads, Landing area Number of casualties: Type, Severity Emergency services: Present and Required

CSCATTT

TRIAGE

CSCATTT

Aim: provide the best possible care for the greatest number of patients

PRIORITIES

Triage sieve

Triage sort

Triage sort

START (Simple triage and rapid treatment)

SALT (Sort, Assess, Life-Saving Interventions, Treatment and/or Transport)

Treatment

Aim: “do the most for the most”

CSCATTT

Transport

Aim: get the right casualty to the right place in the right time

Casualties should be dispersed to different hospitals, most appropriate to their need.

Mechanism of injury Injury found or suspected Signs (vital signs) Treatment given

CSCATTT

Take home message

Sieve ไม่�ม่� disability ถ้�า pt ม่� mental status change ถ้�อเป็�น P1

แต่�ถ้�าจะป็ระเม่�นว่�า death ใน รพ. ต่�องป็ระเม่�น sort

Reference

Ppt ของ นพ. ธนาว่�ทย์� บร�สุ�ทธนาร กษ์�, นพ. ว่�ร�จน� พ�เชี�ย์รเสุถ้�ย์ร, นพ. ป็ร�ญญา เท�ย์นว่�บ%ลย์�

https://sites.google.com/site/dimersarred/disaster-management-cycle

https://sites.google.com/site/sarbook1/excerpt-incident-command

ANY QUESTIONS?