Difference between revisions of "Multi-Casualty Incident (MCI) Response"

Latest revision as of 12:57, 9 July 2025

Section 2 - EMERGENCY OPERATIONS

220.18 Multi-Casualty Incident (MCI) Response

PURPOSE:

The City of Maitland Fire Rescue Department operates under the Incident Command System (ICS). The purpose of this Plan is to establish a framework for supporting the ICS by providing public information, safety, inter-agency coordination, and policy guidance. By means of this direct support, the Incident Commander (IC), and Unified Command (UC) can better coordinate and facilitate incident management, operations, the delivery of services, and the accomplishment of incident objectives.
This Plan will identify the primary and support agencies, and their roles and responsibilities in response to an MCI. Maitland Fire Rescue Department will utilize an ICS response structure. An MCI is defined as one that exceeds the capabilities of the first arriving response units. Some examples of MCI types may be:

• Active Shooter
• Chemical
• Explosive
• Biological
• Building Collapse
• Plane Crash
• Vehicle Accident
• Radiological/Nuclear Incident
• Infectious Disease

When Maitland Fire Rescue responds for an MCI, this Plan will address the following:

• Direction and control of the incident
• Alert and notification of appropriate agencies
• Pre-hospital response measures
• Local, state, and federal resource coordination (if scene dictates, EOC will be activated and coordinate these resource allocations).

PROCEDURE:

City government must be organized and responsive prior to, during and immediately following the occurrence of an event that would generate large numbers of casualties. This plan establishes a framework for mass casualty incident response and sets forth responsibilities for the Maitland Fire Department responders to such events.

As with any mass casualty event, all responding agencies will need to work within the guidelines established by their respective operating guides and coordinate all activities through the Maitland Fire Rescue Department or Orange County’s Emergency Operations Center, when activated. Whatever the nature of the disaster, the basic components confronting emergency response agencies will involve:

• Ensure Scene Safety
• Identifying the incident as a Mass Casualty Incident (MCI)
• Perform triage and designate Casualty Collection Points (CCP)
• Providing emergency medical treatment at the scene
• Transport to hospitals while providing life supportive and sustaining measures.

MASS CASUALTY INCIDENT LEVELS

Mass casualty incidents shall be classified and referred to as four (4) separate response levels The following table defines MCI levels based on number of Potential casualties, and it also provides guidance for possible actions for consideration by emergency management staff.

MCI Level	I	II	III	IV
Potential Casualties	5 - 9	10 - 20	21 - 100	+100
Notification to State Watch		Yes	YES	YES
Notification to Red Cross (if applicable)		YES	YES	YES
Activation of EOC			YES	YES

CONSIDERATIONS

Operational concepts unique to mass casualty responses, responsibilities and efforts necessary for successful management of any mass casualty event occurring within the City of Maitland. MCI events involve triage, treatment, transport and logistical support.

• Once an MCI has been declared, command must establish communication with area hospitals in efforts to identify patient count vs. hospital capabilities (efforts must be made to not overwhelm one particular hospital). This can be completed by command if incident is on a smaller scale, or by treatment group officer if a larger incident has occurred.

ASSUMPTIONS

This plan assumes that the assertions, directions and initiatives found herein are valid for the City of Maitland. That events producing mass casualty incidents may often times overwhelm initial responders. That the mass casualty incidents have the potential to generate mass fatalities. Maitland Fire Rescue Department will conduct emergency operations for MCI events in accordance with this policy, as well as County, State and applicable Federal requirements.

• Mass casualty/mass fatality incidents may be due to a rapidly unfolding incident such as a terrorist attack, aviation incident, or an incident with advanced warning such as a hurricane or pandemic. Depending upon the incident, the casualties/fatalities may be located within a small area or spread throughout the city.
• Maitland Fire Rescue Department will have insufficient personnel, equipment, and transport capability to handle a significant number of victims. Automatic and Mutual Aid Assistance from other public and private agencies, the State, and Federal government may be required to respond to an incident.
• If the number of fatalities exceeds 20 in one incident, a request for a partial or full activation of the EOC may be made.
  • The decision to activate the EOC (whether partial or full), will be determined by the Fire Chief/Deputy Chief (during business hours), or the On-Call Chief (after-hours).
  • The Fire Chief or the On-Call Chief will be notified of the incident by the IC or Dispatch.
    • If the EOC is activated for a Multi-Casualty Incident, it must be understood the EOC is operating in a support mode, not as Incident Command.
    • Incident / Unified / Area – Command should remain at or near where the incident occurred until such time Command deems the scene is under control.

OPERATIONS

Upon the occurrence of an MCI in the City of Maitland, the concept of operations for this plan incorporates several key actions, and because victims may have received life-threatening injuries, these actions must be initiated as soon as possible.

• The first action is to identify that an MCI has occurred or is threatening to occur, and to classify its level to aid in the mobilization of resources.
• In situations with 5 or more victims requiring transport to an emergency receiving facility for further medical attention, an MCI shall be declared. The first arriving officer who identifies the MCI incident, shall immediately declare an MCI via radio and establish Incident Command; mitigating the scene utilizing the ICS system as defined in SOG 110.01.
• In cases of a mass casualty or mass fatality, a multi-discipline approach is needed for command and control of scene. Therefore, a Unified Command with Law enforcement should be established early into the event to help coordinate efforts.
• If the scene spans multiple blocks, combines separate areas, or is simply expansive – Area Command may be established.
• If the number of fatalities is 21 or more in one incident, a request for a partial or full activation of the EOC may be made.
• Then, all appropriate organizations and facilities must be notified of the occurrence of an MCI, necessary resources mobilized, and command over the response established. Under this command, access to the site must be gained, security established, and the necessary operational areas located at or in proximity to the incident scene.
• Command must also establish the objectives for the response effort in order to control its scope, and timing. Other appropriate resources also must be activated or placed on standby.
• Triage, Treatment, and Transport must be established. Injured victims must be extricated, or decontaminated, if necessary, and triaged. If appropriate, initial medical treatment can be provided in the field, and injured victims transported to emergency departments at hospitals with available capacity.
• Fatalities among the victims must be relocated to a temporary storage collection area. As required by the magnitude and characteristics of the incident, there must be a way to obtain additional resources and personnel, as well as the services of facilities on a timely basis, particularly when the MCI involves unusual conditions or situations. Command must coordinate this with Orange County resources such as Fire Rescue and Medical Examiner’s office.
• From the outset, there must be an effective way to quickly provide accurate and up-to-date information to family members of victims and the media, and to fully document all emergency actions taken. Command must establish a Media Information Staging Area and contact the city PIO to report to that location.
• When all incident objectives for the emergency have been met, the emergency response must be terminated appropriately, and debriefings shall be provided for responders.

COMMAND and EOC ASSIGNMENTS / RESPONSIBILITIES

Incident / Unified / Area – Command is responsible for tactical objectives such as, but not limited to:

• Identification of MCI Event – Establishes Incident, Unified, or Area Command
• Scene Operations / Incident Action Plan (IAP)
  • Triage, Treatment, Transport
  • Hazard Mitigation (Suspicious packages, bombs, hazmat, biological, etc.)
  • Resource Management
  • Operating Personnel Safety
  • Accountability for Personnel
  • Accurate Patient Counts

The Emergency Operations Center for an MCI event will operate as a Joint Information System (JIS), and is responsible for scene support such as, but not limited to:

• Developing and delivering coordinated interagency information
  • Acts a centralized information hub for a multi-agency, multi-discipline response
• Developing, recommending and executing public information plans and strategies
  • Coordinates evacuation zones identified by Command
  • Coordinates large scale perimeters and commerce detours
• Advises on public affairs issues that could affect the IC’s management of the scene
  • Establishes media center locations for information sharing
  • Establishes reunification centers (if applicable)
• Addresses and manages rumors and inaccurate information that could undermine public confidence.
  • Shares appropriate information with elected officials
  • Holds regular press conferences to disseminate accurate information