An Overview of

MASS CASUALTY EMERGENCY

PLAN
June 2004 DKA/MED

Mass Casualty Emergency

Plan
Characteristics:

Unpredictable event
Within unusual environment
Overwhelming number of victims
As a part of ERP:

Involves several departments

Crisis management (MRT, ECC) for

coordination
Requires planning and procedures.

Mass Casualty Emergency

Plan

On the scene
Rescue team/First Aiders extricate victims from
disaster site (RSES/Safety).

Medical: DKA/MED
Triage, basic treatment, transport to hospital.

Non medical: logistical support

Security.
Communication.
Transportation.
Local Authority etc.

Mass Casualty Emergency

Plan
Security

OUTER PERIMETER
WIND
INNER PERIMETER

DISASTER
SITE

ERT

VICTIM
EXTRICATION

DKA/MED

FIRS

Triage
Officer

Expectant

Immediate

Delayed

Transport
Officer

To area
hospitals

NNEL
T FU

Ambulances

Non medical

Minimal

SECOND FUNNEL

Command post

Staging
area

Mass Casualty Emergency

Plan
Yes

Able to walk

Minimal

No

Breathing ?

No

Position Airway

Yes

Breathing ?

No

CPR

Yes
> 30 x / minute

Respiratory rate

Immediate

Response

No Response

< 30 x / minute

Capillary Refill

> 2 second

Control Bleeding
Yes

< 2 second

Follows Commands ?

No

Yes

Expectant

Delayed

Adopt from CURRENT Emergency Diagnosis & Treatment edition

Mass Casualty Emergency Plan

GUIDELINES for Management Team

Issued 2002, part of the Crisis Management Plan
Available on Intranet
Give details on triage area, available manpower on site,
possible support from other sites/medical facilities
Revision scheduled 09/2004
Suggestion: integrate as an additional scenario.

Mass Casualty Emergency Plan

Equipment
Specific stock of equipment
Easily accessible
Quick to activate
Split between BPN and sites
Purchasing still on going (extremely slow process)
Issue of proper storage
OK in BPN
Clinic extension CPU
Most sites: room for improvement

Mass Casualty Emergency Plan

Equipment (contd)
Additional equipment will be required (recommendation
Pr Baer)
Consider specific equipment (antidotes,
decontamination)
Suggestions:
Prepare storage capability (with incoming second
part in mind)
shortcut procedure for purchasing the second part

Mass Casualty Emergency

Plan
OUTER PERIMETER

INNER PERIMETER (HOT ZONE)

WIND
HAZMAT
DISASTER SITE
REMOVE CROSS
CONTAMINATION

DECONTAMINATION AREA

Access Control
Point

???

Remove Clothing
Wash and Rinse
Final Wash and Rinse
New Clothing or Stretcher
Access Control
Point

Triage Officer

Expectant

Immediate

Delayed

Transport
Officer

To area hospitals

Ambulances

Minimal

Command post

Staging area

Mass Casualty Emergency Plan

Manpower

Rescue team on disaster site (part of ERP)

Security
GNS
Communication
Medical team
Support from BPN/other sites
SSI in progress: give details of responsibilities.

Mass Casualty Emergency Plan

Situation in JHO:
Setting is designed as a support in equipment to the
government authorities actions
Equipment is complete
Stored in a medical facility outside the JHO building
MOU regarding maintenance and access/activation to
the equipment almost complete.

Mass Casualty Emergency Plan

Situation in Balikpapan:
ERT not clearly identified, people are spread around
in/out of town (vs sites).
Skills of First Aiders/Rescuers need to be assessed
(refreshed? Internally or outsourced?)
Result: first line of action may not be optimal
Need for further teamwork between departments, and
clear understanding that Mass Casualty Management is
not only a medical issue

Mass Casualty Emergency

Plan
Conclusion:
1. Medical procedure/facilities are available
2. Management guidelines are available
3. Equipment is still incomplete (60% 1st part achieved),
storage is not the best possible
4. Specific risks (chemical, biological, neurotoxic,) need
to be considered in the future
5. Commitment of non medical departments needs to be
clarified.

Workshop planned

Message to send: Everybody will have a part to play

Integrate additional scenario in Crisis Management

Plan