In my [link url=”https://amuedge.com/coordinated-attacks-mass-casualty-planning-part-i/” title=”last article”], I discussed how terrorists could coordinate explosive devices in one metropolitan area to create a disaster within the mass casualty management realm. Some metropolitan areas span across state and county lines, which are often the division of emergency services and emergency management agencies.
The Need to Open the EOC
While most emergency operations centers (EOC’s) are reserved for large-scale disasters, it may not become evident initially that the event is large.
For example, the FDNY may transmit a 10-60, which is a major alarm, but much of the response to the mass casualty could be handled as the responder level. Because this happened in New York, there is a heightened availability of the EOC, as opposed to most areas that could not staff this facility 24-7.
How would you relay information from multiple incidents to the EOC in the initial stages? How close or far apart do the different disasters areas need to exist before it overwhelms the local fire and EMS resources? This is something you should be able to calculate or discuss during a tabletop exercise.
Have you considered how normal epidemics such as heroin overdoses and seasonal flu could affect your resource count?
Medical Disaster Network
The key components of a mass casualty is connecting the scene incident command system–hopefully, the transportation group supervisor, the local EOC, and the hospitals in the metropolitan area.
Some metropolitan areas have developed a hospital disaster network. This network links the hospitals and some will show real-time information of the capabilities of the hospital. This ensures that patients are taken to the most appropriate hospital, considering the specialty resources, distance, and overall capabilities of the hospital.
If the coordination of the transports does not match capabilities and capacity, the disaster will move from the disaster scene to the hospital. No matter how good the system, training of the responders that could fill the role of transportation group supervisor or the EMS branch director are key to its use.
Surge Capacity and Resource Attainment
In the next article, I will discuss surge capacity, the Hospital Incident Command System, and the need for regular drills and tabletops to keep mass casualty procedures fresh in the minds of everyone who needs to know the information.
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