Emergency Plan: Rescue, Extrication, and Triage - Thesis Example

Emergency plan Emergency plan Triage is the first stage in examining patients on emergency of casualty incident. It includes assessing three major body systems; they are the neurological, cardiovascular and respiratory (Born, 2007). This basically involves patient’s level of consciousness and posture; presence of other foreign material or presence of blood about the patient; visual assessment of ventilation pattern and effort (Cross, 2004). The ability to assess rapidly and accurately marks the difference between a good examiner and an excellent one (Maurer, 2009). Most mass casualty/fatality occurrences take place without notice but require a response effort nevertheless. They might come as a result of: terrorism, strong tornado, a passenger airplane crash, major highway accident and hazardous material release (Dr. K. Qureshi, 2005). If one of these incidents happens, there should be an emergency plan put in place to respond to this call. Generally, this involves the county emergency department in the U.S. Every county has a unit to respond to these calls. These standard operation procedures outline how to manage and respond to incidents that are different than the normal response system (Graham, 2010). These procedures are applicable for EMS incidents involve more than four ALS units to provide assistance and patient care. The main objectives of this units is to minimize human suffering, disabling injuries and most important minimize loss of life (Downey, Andress, & Schultz, 2013). Another objective is to provide integrated and adequate resources required to mobilize teams and units to manage casualties effectively, while maintaining the resources and capability to respond to other situations within the community (Gordon, 2002). In creation of this plan, the first stage should be establishing of the incident Command System (ICS) (Frykberg, 2002). This organization is to manage resources in response to state objectives and in relation to the incident. Respecting each organizations jurisdiction and command should be a mandate to any team involved (Maurer, 2009). The incident command should consider identifying the Medical Branch with its Medical Branch Director and a Resource Assembly Point (RAP) (Socha, 2002). The Medical Branch Director should ensure safety of the scene for both responders and patients, and also coordinate with other groups to provide additional resources and equipment, establish triage, decontamination, rescue and extraction, treatment and transportation (Risavi, Terrell, Lee, & Holsten, 2013). Rescue and extrication This process may be incorporated in the triage. This is the first stage of an emergency incident; the process is managed by the rescue/extraction Group Supervision (Joint Commission Resources, 2002). This is the first responder, and is responsible for responder safety, site safety, and movements made into a safe zone by the patients/victims. This process involves the removal of victims from a danger zone (Socha, 2002). The first priority of safety scene is to locate patients and victims, remove them from any danger or from the ‘hazard zone’. Ensure that Victims who are trapped get advanced life support care as feasible and required (Halpern P, 2003). Triage As discussed above this is the first emergency care personnel that arrive at the scene to count the patients and determine injury severity. This information is then passed on to the Incident commanded (Frykberg, 2002). This information will be used directly during patient initial treatment and transportation process. The rescue/extrication Group Supervisor will be in charger and will be the determinant of whether to provide initial triage or move the victims to a Treatment Area. The triage uses START System (Simple Triage Rapid Treatment) method to assess and rapidly triage mass casualty patients (Joint Commission Resources, 2002). Medical Treatment and Tracking This function involves provision of advanced life support and definitive basic for tracking process and stabilization, and the continuous care of patients, until the time they are transported to a favorable medical facility (Maurer, 2009). Here there is a form to be filled that indicates the priority in relation to injuries, vital signs, and other patient pertinent information while doing the tracking process simultaneously. Treatment of casualties should begin with the priority first then followed by the others. The Treatment/Tracking Group Supervisor whose function is to establish a treatment area and in charge of operation in the treatment area, is also in charge of initiation of patients in the tracking process (Gordon, 2002). The supervisor should never delay transport unless; an important issue like stabilization life treatment injuries arises in the process. The treatment area should be readily accessible to transport means like ambulance but also should be isolated and away from conditions associated with the incident (Friedman, 2007). The Treatment Area should be identifiable to every individual at the scene. This can be done by barrier taping, putting up flags and signs, traffic cones and markers to mark different areas. The area should be divided into zone to distinguish seriousness of victims’ injuries ((Pa.)., 1999). They can be marked with different colored barrier tape and situated strategically in a manner to show who should be transported first, in terms of priority. In case of death at the scene the Medical Examiner Officers will offer assistance to the Incident Commander upon a request through the EMS office or EOC ((Pa.)., 1999). Transportation This function Offers facilities that enable patient movement out of the incident area to a hospital after the treatment area approval (Erickson, 2006). The Transportation Group Supervisor is in charge of coordination and provision of all the patient transportation. The supervisor will work closely with the treatment supervisor, incident site commander, air and local ambulances and the hospital to run the transportation processes smoothly (Alexander, 2002). It is important that there is no delay involved in the patient transport to the hospital. Involvement of air operation may enhance survivability of victims but this should be done in a safe way by first acquiring a landing zone, creating communication with arriving aircrews, assisting in aircraft loading and provision of security of the landing zone (Administration, 2013). During this process the tracking process should be running simultaneously. A case involving WMD in Kenya on Monday, 24th October 2011 The incident occurred at Machakos bus terminal, whereby a grenade was tossed out of a moving salon car (David, 2012). The rescue/extrication group supervisor through the incident commander confirmed 69 human casualties. Businesses in the busy street were put to halt as the rescue mission started. A treatment area was created next to the bus station and signs put in place to signal motorist and business people of the emergence (David, 2012). The treatment/tracking group supervisor ensured that business in the business center called Muthurua, about 300metres from the incident did not interfere with the preceding in the treatment area and that some avenues leading the scene were temporary closed, this included the temple road and the street leading to Muthurua shopping center. The Medical Examiner officer at the scene confirmed death of five people (David, 2012). The casualties were thereby rushed to the Kenyatta National Hospital for further treatment, activating the tracking process for the victims in the incident (Wachira & Smith, 2013). Some victims were discharged at the scene because of enduring minor injuries. Transport was provided by the Kenyatta National Hospital Ambulance department, this referral hospital is 2km from the scene (Odula, 2011). The transport/tracking group supervisor confirmed a smooth run of events as far as transport and tracking process were concerned. Most of the victims were discharged the following day from the hospital as the total of death increased to 9 people. It was a successful mission. References (Pa.)., B. C. (1999). Berks County emergency operations plan: Radiological emergency response plan for incidents at the Limerick Generating Station. Pennsylvania: Berks County Emergency Management Agency. Administration, M. S. (2013). Mine Emergency Response Plan: Responding, Managing, Monitoring District 5. 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Joint Commission Resources, I. (2002). Guide to Emergency Management Planning in Health Care. U.S.A: Joint Commission Resources. Maurer, S. M. (2009). WMD Terrorism: Science and Policy Choices. Berkeley: MIT Press. Odula, J. S. (2011, October 25). 2 blasts in Nairobi amid fears of terrorist reprisal. Retrieved from Associated Press: http://www.sfgate.com/world/article/2-blasts-in-Nairobi-amid-fears-of-terrorist-2325504.php Risavi, B. L., Terrell, M. A., Lee, W., & Holsten, D. L. (2013). Prehospital Mass-Casualty Triage Training—Written Versus Moulage Scenarios: How Much Do EMS Providers Retain? Prehospital and Disaster Medicine,, 1-6. Socha, T. M. (2002). Facility Integrated Contingency Planning: For Emergency Response and Planning. Michigan: iUniverse. Wachira, B. W., & Smith, W. (2013). Major Incidents in Kenya: the Case for Emergency Services Development and Training. Prehospital and Disaster Medicine, 1-4. Read More