MCI and Trauma?

[RedAirplane]

I'm confused about something that seems a little contradictory in what I've been taught.

Typically bad trauma patients get taken to a trauma center because the local emergency room can't handle trauma patients.

But we're also taught that in an MCI, every hospital must take at least one red and one yellow patient. Assuming that the MCI patient is traumatic in nature, how does the local emergency room suddenly grow the equipment and personnel to treat that red patient when they ordinarily could not? (Or, if they do have this capability, why is it not used more regularly to relieve the perpetually overburdened trauma centers?)

Thanks for your insight.

 

[Tigger]

I'm confused about something that seems a little contradictory in what I've been taught.

Typically bad trauma patients get taken to a trauma center because the local emergency room can't handle trauma patients.

But we're also taught that in an MCI, every hospital must take at least one red and one yellow patient. Assuming that the MCI patient is traumatic in nature, how does the local emergency room suddenly grow the equipment and personnel to treat that red patient when they ordinarily could not? (Or, if they do have this capability, why is it not used more regularly to relieve the perpetually overburdened trauma centers?)

Thanks for your insight.

Since when must every hospital take certain kinds of patients? Perhaps that is something local to your area.

Here regardless of the incident type, our destination guidelines still apply, as they should. MCIs are not the time to freak and dump a bunch of critical patients on an a community ED. There is a reason we take these patients to trauma centers, it improves outcomes.

 

[DesertMedic66]

It's going to depend on your area as to how MCIs are ran and what hospitals patients will go to. For my area all of our hospitals have agreed to take 1 red patient (critical) before we establish MedCom. Once we establish MedCom that person makes contact with our trauma center and gives them information (how many patients, severity, type of accident, and the closest hospitals).

Our trauma center will decide which patient will go to which hospital. They try to send the most critical ones to the trauma centers but it's not always possible. The other hospitals will usually be able to stabilize the patient and start initial treatments while waiting for a better equipped hospital to have room.

 

[Brandon O]

Never heard the "red plus yellow" thing.

 

[OnceAnEMT]

MCIs are not the time to freak and dump a bunch of critical patients on an a community ED..

Exactly this. The use of an MCI plan that may eventually escalate to the use of NIMS/ICS is the reason we don't spray patients around the area. This is totally area dependent, as just as you argue, some facilities simply can't handle certain patients or certain numbers. The whole "even distribution" concept is a great thing to keep in mind, but it is far too much of a cookie-cutter approach to make that a broad protocol.

Perhaps your instructor was using it as an example, to try and explain the process?

 

[Tigger]

Not to mention that if you have multiple facilities in your area, it makes sense to send patients to EDs that have capacity. Why unnecessarily burden a busy ED with a critical patient when there is another ED of similar capability that has capacity.

Here the first thing I do is have dispatch give me bed availability for our two trauma centers. Once we have that we make our destination choices appropriately. That doesn't really seem like a great role for the hospital to take on given that they're not actually there on scene.

 

[Ewok Jerky]

Methinks the OP has misunderstood the local MCI protocol?

Our regional/local hospitals have a console in the ED that shows bed availability is real time, how many reds and yellows every hospital can take at any moment. With an MCI we will contact the local base for transport decisions. As for trauma we have a crap ton of level 1s and 2s so its never been a problem.

 

[RedAirplane]

I've been using these videos from San Diego to study MCI/ICS since we didn't cover it very much.

Here is the video specifying the 1 RED / 1 YELLOW: (start at 2:48)

 

[DesertMedic66]

Methinks the OP has misunderstood the local MCI protocol?

Possibly not. I haven't looked into San Diego protocols at all but it's completely possible that's how the system runs. In certain county's the hospitals have made agreements with the EMS agencies that say "hey, for an MCI we can take 1 red and 1 yellow patient before we know bed availability".

 

[RedAirplane]

It's probably good that I am asking this, because I'm not in San Diego... they're just the place with the videos.

I suppose I'd know more about my system if I were in a transporting capacity. I work volunteer standby right now, so I only decide if a patient should go, not necessarily where...