RedAirplane
Forum Asst. Chief
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I did an extended MCI drill and was impressed.
There's one aspect of the exercise I completely bombed. The secondary triage / ambulance loading area.
You and your three other EMTs walk up to a tennis court full of about 50 moulaged patients. They were supposedly triaged by first responders, but we soon found that the tags were all wrong (or status had changed). Re-triage gave most people red tags.
The first time through I was one of the "heads down" EMTs and it was chaos. Going around trying to "start where you stand" and re-triage / seal chests / put TQs on. Completely lost all of my triage tag stubs trying to stop major bleeding leading to accountability problems later.
The second time through I was the leader. I had a list of five hospitals and how many beds they had for each color. I had to direct triage, order resources, and coordinate transport. I felt about as effective as an invisible traffic cop at an intersection.
Even though I was supposed to be tracking pt destinations, ambulances, etc, I quickly became overwhelmed and ordered a supervisor from the ambulance company and delegated this to him. I focused on trying to get the most sick people out (at this point they were all Red or Green). I was taught to delegate so I asked one of the walking wounded to tag all of the green people and give me all of the stubs. They all vanished, including my stubs, when the bus arrived, so I had no idea where the bus went and how many people it took.
As far as the Reds... I was taught "not all reds are equal" so I was trying to get the sickest out first. I shouted to my team to bring the worst of their patients towards the ambulance loading area, which of course, backfired, because everyone thought the patient in front of them was the sickest, leading to a choke point where ambulances couldn't get in because of a pile up of people.
Enter a bunch of paramedics with gurneys and backboards running around, scooping up people, and vanishing, and I had no idea what I had. I was supposed to collect receipts etc from all patients but was so overwhelmed.
The thing here is: the ambulance company supervisor was able to articulate to me which tag numbers went in each ambulance, what their acuity was, and where the ambulance went. He assigned the destinations based on the MedCom list I gave him.
How did he / how would you manage all this communication and organize such a chaotic situation? I think I could do better with it now that I have been through the training, but I am not comfortable enough to be throw in to a situation of 50 major patients with only 3 EMTs assisting and make order out of chaos.
Thanks for your input.
There's one aspect of the exercise I completely bombed. The secondary triage / ambulance loading area.
You and your three other EMTs walk up to a tennis court full of about 50 moulaged patients. They were supposedly triaged by first responders, but we soon found that the tags were all wrong (or status had changed). Re-triage gave most people red tags.
The first time through I was one of the "heads down" EMTs and it was chaos. Going around trying to "start where you stand" and re-triage / seal chests / put TQs on. Completely lost all of my triage tag stubs trying to stop major bleeding leading to accountability problems later.
The second time through I was the leader. I had a list of five hospitals and how many beds they had for each color. I had to direct triage, order resources, and coordinate transport. I felt about as effective as an invisible traffic cop at an intersection.
Even though I was supposed to be tracking pt destinations, ambulances, etc, I quickly became overwhelmed and ordered a supervisor from the ambulance company and delegated this to him. I focused on trying to get the most sick people out (at this point they were all Red or Green). I was taught to delegate so I asked one of the walking wounded to tag all of the green people and give me all of the stubs. They all vanished, including my stubs, when the bus arrived, so I had no idea where the bus went and how many people it took.
As far as the Reds... I was taught "not all reds are equal" so I was trying to get the sickest out first. I shouted to my team to bring the worst of their patients towards the ambulance loading area, which of course, backfired, because everyone thought the patient in front of them was the sickest, leading to a choke point where ambulances couldn't get in because of a pile up of people.
Enter a bunch of paramedics with gurneys and backboards running around, scooping up people, and vanishing, and I had no idea what I had. I was supposed to collect receipts etc from all patients but was so overwhelmed.
The thing here is: the ambulance company supervisor was able to articulate to me which tag numbers went in each ambulance, what their acuity was, and where the ambulance went. He assigned the destinations based on the MedCom list I gave him.
How did he / how would you manage all this communication and organize such a chaotic situation? I think I could do better with it now that I have been through the training, but I am not comfortable enough to be throw in to a situation of 50 major patients with only 3 EMTs assisting and make order out of chaos.
Thanks for your input.