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First in Fort Hood, Mass Casualty 101
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Paramedics and EMT’s are always on alert with respect to violence in and around the workplace. Since 9/11 emergency services from around the world have been learning and practicing mass casualty scenario's usually involving terrorist. Incidents such as the Columbine school Massacre and Virginia Tech shootings remind everyone that these incidents can occur at any time, and with respect to the mass shootings at Fort Hood, any place.
When medical teams first arrive at the scene of a mass casualty incident, the first thing that must be done is to establish order. This is called “establishing command” or taking charge, and is usually done by the senior ranking official. Let’s face it, someone needs to be in control.
Usually, with shootings, this task is handled by the police or fire departments as medical teams are busy working on patients. As the situation grows, the command function becomes a joint or “unified” command. This means all agencies share in the responsibilities of controlling scene as one team.
Once the scene is deemed safe by police, medical crews are allowed into the area as they begin triaging or sorting the patients. This is a huge undertaking in large incidents. Patients that cannot walk are immediately assisted. Patients that can walk are moved to another location quickly.
The senior medical officer (medical command) must break his/her area up into three divisions. They are; the triage area, the treatment area and the transport area. Three “T’s” for short. Each division must have a person in charge and be responsible to the unified commanders. Hospitals are put on alert instantly and agencies from other jurisdictions are called to assist.
Once everyone is in place, the movement, tracking and follow up of the wounded begin. Of these, patient tracking is the most critical component as family members and co-workers want answers, fast.
Once the scene is under control and the patients are transported to the hospitals, it’s time for the dead to be removed. This is usually the last component as dead bodies are considered evidence until the investigators release them. In large scale operations the DMORT (Disaster Mortuary Operational Response Team) unit is called to handle with the identifying and removing of the bodies.
In all, the first 30 minutes of any mass casualty incident are the busiest for team members. Everyone has a job and they are all doing them at the same time. Unfortunately, we the media want answers that are fast and accurate. This isn’t always possible. This is why “Joint Information Centers” or JIC units are established. Public information officers from each group submit information so it can be circulated to the public.
Finally, once the incident is completed, the task of immediate critical incident stress defusing’s take place. This allows the incident responders to vent and release stress they may be feeling, when dealing with these types of catastrophes. Later, these defusing’s become debriefing’s. Usually days after the event. Allowing the responders time to digest what they saw and emotions they felt.
For more info: http://www.examiner.com/Category-Fort_Hood_Shootings.html
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