Houston Fire Department – Mass Casualty Management (Guideline III-09)

Fifty flashcards summarizing key definitions, roles, procedures, triage methods, response levels, and resource requirements found in Houston Fire Department Guideline III-09 for Mass Casualty Incident management.

What is the primary goal of the Houston Fire Department’s response to a Mass Casualty Incident (MCI)?

To provide appropriate and coordinated efforts that minimize loss of life, disabling injuries, and human suffering.

Which national framework must HFD’s mass-casualty operations integrate with?

The National Incident Management System (NIMS).

Define “Advanced Life Support (ALS).”

Medical care provided by paramedics performing advanced procedures under a physician’s delegated practice.

How many patients can a standard ground ambulance carry?

Two patients lying OR one lying and four sitting.

Where is HFD’s Base Station located and what is its primary function?

Inside the Houston Emergency Center (HEC); it coordinates movement and transportation of HFD patients city-wide.

What does BLS stand for and who provides it?

Basic Life Support, provided by EMT-Basic personnel.

What is an EMS Strike Team?

A responding group of like assets, e.g., three BLS ambulances.

List the composition of an EMS Task Force.

One EMS Sector Supervisor and five transport units, with at least two ALS-capable units.

What regional web-based program reports hospital bed status and diversion information?

EMResource.

Name the regional patient tracking program used on scene to follow patients through the disaster continuum.

EMTrack.

In triage terminology, what does "Expectant" mean?

Patients not expected to survive given their injuries and the resources available.

State the patient range for a Level 1 MCI.

Approximately 10–20 potentially transportable patients.

State the patient range for a Level 2 MCI.

Approximately 20–50 potentially transportable patients.

When is a Level 3 MCI declared?

When there are more than 50 casualties and significant medical mutual aid is likely required.

Differentiate Level 1 and Level 2 staging.

Level 1: units stage one-two blocks in direction of travel; Level 2: formal staging area designated by Command.

What triage method is initially used on all MCIs?

SORT triage.

Which two ribbon colors are applied during initial SORT to non-ambulatory patients?

Red for non-ambulatory alive; Black for deceased.

How are ambulatory patients identified during SORT?

They are directed to walk to a designated area and considered Minor (Green); they receive no ribbon initially.

When is Modified START triage used?

During prolonged incidents or in the Treatment Group to further delineate patient acuity.

Explain the mnemonic difference: “Triage = Ribbons, Treatment = ___.”

Tags (Regional Disaster Tags).

According to guidelines, how many BLS apparatus crews should be assigned for every four immediate (Red) patients during triage?

At least one BLS apparatus company.

What vehicle designation is MPV-602 and where is it housed?

The AMBUS multiple-patient vehicle housed at Station 8.

Maximum patient capacity of the AMBUS (MPV-602) in stretcher configuration?

18 lying patients (or 24–26 seated).

Who is responsible for declaring an MCI level and requesting the appropriate response?

The Incident Commander (IC).

List the extra resources automatically dispatched for a Level 1 MCI (beyond initial units).

1 EMS Task Force, 1 Senior EMS Supervisor, 3 BLS apparatus, and 1 District Chief plus EMS District Chief.

What additional specialty units appear in the automatic Level 3 MCI response but not Level 1?

Safety Officer, Rehab Van, Communications Van, and the on-duty Shift Commander.

What is the radio call-sign for the Medical Branch Director?

"Medical."

Name the three groups under the Medical Branch.

Triage, Treatment, and Transportation Groups.

Primary duty of the Triage Group Supervisor?

Triage all patients, estimate victim count, and move patients to Treatment.

Primary duty of the Treatment Group Supervisor?

Re-triage, treat, and prioritize patients for transport.

List the three treatment units set up within the Treatment Group and their colors.

Immediate (Red), Delayed (Yellow), Minor (Green).

Minimum suggested staffing for the Immediate Treatment Unit (per four red patients)?

One ALS unit and one BLS apparatus.

Key responsibilities of the Transportation Group Supervisor (name any two).

Assign patients to transport units/hospitals, ensure disaster tags placed, maintain hospital status board, operate tracking system.

Rule of thumb for ordering transport units: one ambulance per how many stretcher patients?

One ambulance for every two stretcher patients.

What EMT/paramedic staffing ratio is required on a Metro bus transporting minor patients?

At least one EMT or paramedic per ten patients.

Who can authorize deviations from normal transportation guidelines during an MCI (e.g., all ambulances running lights-and-sirens)?

The Physician Director of EMS.

During an MCI, what documentation must ultimately be completed for every patient in addition to the Regional Disaster Tag?

A full HFD electronic Patient Care Report (laptop record).

Under what two general circumstances may CMOC be activated during an MCI?

Need to redistribute large numbers of patients beyond Greater Houston or to coordinate non-HFD ambulance resources.

Who initiates CMOC activation and through which agency is the request routed?

The Incident Commander or Medical Branch Director, via OEC contacting the on-call OEM administrator.

Which federal agency investigates mass-transit (e.g., aircraft, train) incidents, requiring preservation of bodies/body parts?

The National Transportation Safety Board (NTSB).

During SORT, what colors designate responsive but contaminated and unresponsive contaminated patients in the Hot Zone?

Orange ribbon for responsive; Blue ribbon for unresponsive contaminated patients.

State the minimal ribbon/tarp color scheme for triage categories.

Red = Immediate, Yellow = Delayed, Green = Minor, Black = Dead.

What identification item is mandatory for every patient before leaving the scene?

A Regional Disaster Tag.

List any three items carried in every EMS Supervisor vehicle specifically for MCIs.

100 Regional Disaster Tags, complete MCI checklists, triage ribbon pouches, hospital status board, MCI management vests.

How many Immediate and Delayed patients should be sent in the first hour to a Level I/II trauma center according to Appendix E?

10 Immediate and 15 Delayed patients.

What is the recommended staffing of an AMBUS (MPV) during patient transport?

Five crew members, with at least two being ALS-qualified, plus a driver.

Who is responsible for maintaining the multiple-casualty register or EMTrack entries at the Transportation Group?

Assigned Recorders under the Transportation Group Supervisor.

At what point may command of an incident be transferred from the IC to the Medical Branch Director?

When the IC determines the incident has entered the demobilization phase.

What two critical communications must the Transportation Group Communicator relay to Base Station before each unit departs?

Unit ID and destination hospital, plus patient count by triage category.

Why must Base Station be notified before releasing any unit from the scene?

To prevent units from arriving at hospitals that have not been informed and to maintain coordinated distribution.