Major Incident Planning and Support (MIP+S) Level 3
Course Content
- Course Introduction and Overview
- Personal Roles
- Ambulance Control
- Arriving on the Scene
- Triage Basics
- What is Triage
- The goal of triage
- Discriminators
- How do we triage correctly
- Initial impression
- ABCDE and triage
- Active listening
- Analgesia in triage
- Assessing pain
- Documentation and triage
- Establishing patient presentations
- Establishing patient history
- Existing medications
- NEWS2 and triage
- Triage categories
- Professional considerations
- Ten Second Triage
- Triage and MIPS
- Problems, Survivors and Casualties
- Radio Communications
- Types of radio
- Using radios
- Right and wrong way to use a radio
- Radio protocols and sending a message
- Phonetic alphabet and numbers
- Prowords in radio communications
- Call signs
- Radio Checks
- Radio check example
- Losing communications
- Broadcasting and talk groups
- Hytera PDC 550 – 4G/VHF/UHF combined
- Workplace radios
- Radio Licences
- Dual Sim Radio
- Increasing battery life
- Carrying and transporting radios
- Basic considerations when using radios
- Transmitting Techniques
- 3G and 4G radios
- METHANE Reports
- Incident at a Quarry
- MIPS Location Introduction at the quarry
- Access and Egress
- Accessing Casualties
- Dealing with the media
- Dealing with the public
- Do all major incidents involve multiple casualties
- Getting further advice
- IIMARCH briefing
- Locally available assets
- Remaining calm
- Site planning
- Tabards
- Updating METHANE
- What is defined as a major incident
- Working with other services and organisations
- Effective communications
- The role of the HSE
- The importance of planning
- Aide memoirs
- Leaving the scene
- Tabletop Exercises - Quarry
- MIPS site planning table top exercise
- Table top exercise - Arrival Part 1
- Table top exercise - Arrival Part 2
- Table top exercise - Arrival Part 3
- Table top exercise - Triage and transportation
- Table top exercise - Liaising with other services - Part 1
- Table top exercise - Liaising with other services - Part 2
- Petrochemical Plant
- Tabletop Exercises - Petrochemical Plant
- Course Summary
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Get StartedTable top exercise - Arrival Part 3
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So where do we think the casualty clearing point, loading, parking, and circuits might be?Well, so, they will all be coming from this way for access. Well, would we want it... We would not want it too close to the actual site because obviously there is potential risks.No. All of your casualty clearing station will be here on the hard standing, where your vehicles can come in and exit. We have had a discussion with the site manager, and site manager tells us there is already a helipad site here, further up this track. So we know there is a helicopter landing site up here and it is accessible. It is not lit, but it is there, it has its windsock, and the managing director of the organisation that owns the quarry lands there. So we know this is the actual area where the incident happened. So this is our danger zone. Vehicles would come in, park, load, so we would have our casual clearing site and our incident command post on the hard standing up here. We would not block the access and egress. If we needed anybody to go up to the helicopters, they would travel north up this, up the track onto the heli site and be lifted from there.We have also... We can go back out this the same way if we need to. So, we have got actually two access and egress routes. All we need to set up then is a shuttle between the accident site itself and the casualty clearing station. So that could be 4x4 capability, it could be something the quarry already has, like a machine with a large bucket on it, where we can put couple of casualties in the bucket and then transfer them to that site. But we are not blocking any routes. We have got a helipad, we have got a casualty clearing site, we have got incident command, and we have got a shuttle set, set up to clear the site itself of casualties.That sounds like a pretty good approach. For your information, the hazard area's response team will have a stretch fit all-terrain vehicle. So that probably solves your shuttle problem.Shuttle? Yeah.It is going to be protracted. So lighting for the HLS can either be improvised by a couple of crossed headlamps from the light of vehicles.And the lighting for the whole area as well.Yeah. Or you can get a night landing kit for the helipad. Where do you think that might come from?Area contingency, strategic contingency.Actually, HEMS itself. Yep. So they actually have that, and the nilos are trained to go and retrieve it and set them up. But again, you need to be thinking about that now, because you need it erected in the daylight ready for when you lose. So, you can see that we have done the command in terms of the fact that we have established a command point and we have co-located. We have looked at safety by the fact that we have incorporated in accord. We have assessed the site in terms of how our footprint might look on it, and we have communicated in terms of both the first and the second METHANE. So that's probably taken care of the first 20-25 minutes. What do we need to be looking at next? So, you have made decisions where you want the causality clearing point, and parking and stuff. What would we now actually need to do?Implement it.Implement it, establish it. So how will you do that?With people, with staff.With people.Clinicians.Yeah, but they just kind of know what they are going to do, yeah?No, no, they do...No, you are going to have to sort of brief...It needs to be requested or they need to be given jobs.They need to be given jobs. And how are we going to give them jobs?Tabards.Tabards. Right.Yeah and the briefing.Identify roles and briefing.So, we are going to bring them in, brief them, give them the tabards, check the tabards are correct and then set them on a role that you want them to do.Brilliant. So, what type of briefing model would we perhaps want use?Joint decision making model.Joint decision making model, which includes biomarkers, the briefing model. What other key roles do we need to establish? Because we have got an idea, so who are the key roles that we now need to establish to make that plan work?You need a parking officer.Parking officer.Bronze commanders.Forward commander. Yep.CCS commander.Casualty clearing officer. Yeah.Medical.Yeah. You need people in the CCS to actually do the work, don't you? So you will need med team leaders and doers in each of the bays, depending on how big your casualty clearing is. Is there a mnemonic that would help us decide what we need? So let us run the mnemonic. So, what is the first C of CS Cap?Comms.No, it is command.Command.Yeah.That's right. Yeah.Command. So we have a commander. We have a lone commander at this particular point in time apparently.Yeah.So, what else do we need, do you think? Think about the command team.Well, within that team, you need logists, you need a...A logist, yeah.An assistant.Who supports the commander by default if no one else is available, to take the ropes. So, that is sort of part of a command team, isn't it? And it could get more, it is probably protracted and soon, and so there will probably be a few more on that later on. So, what is the second part? What is the next letter in the acronym? So, we had a C.Safety officer.Safety Officer. So there is another one. Okay. Safety officer. Whilst we are on that, where do you think the Safety Officer would be located?Where you would need the sites, health and safety officer.You are sort of leaning in the right direction. Ideally, I would want them at the command point.Yeah.Yeah.But actually, because we are dealing with safety and other organiser... The quarry will have a safety manager, fire and rescue will have a safety manager. I am usually quite happy for the safety officers to co-locate together, providing I have got comms with them. Yeah, because that works too. Yeah. But ideally I want them at the command post. C which is for what?Communications.Communications. They run themselves?Communication officer.Communications officer. Right. So, the CSC is so far. Who is looking after assessment? It's the commander, isn't it, really? Okay. C-S-C... A. So what is next?I would say triageTriage, okay. And how is triage divided?Your initial...Primary and secondary.Yes, primary and secondary.Primary and secondary. So that tells you you are going to need a what?A primary triage.A primary triage officer.And a secondary triage officer.And a secondary triage officer. Okay. Plus people to do their bidding on their will. So you can see, this is growing already. We talked about a Casualty Clearing Station Officer already, so that is part of your treatment. So having triaged them, having moved them, having re-triaged them, and treated them, what do we now need to do with them?Transport them.Transport them.Transport them. In order to get them from Casualty Clearing onto the transport, what are we going to need?A transport officer.Transport officer.A transport, or loading, officer. Actually, all of those roles are sort of pre-done in the action cards. And my point here is, actually... Use the cards.Trying to remember, it is a lot more difficult than you think, but if you have got the cards you can...Pull one out, and look at the aide-mémoires, because that is what they are there for. This is not unusual, but people get so involved in the scene, they actually forget to pull out their own action cards, look at it and see what it is that I actually need to do? And dare not look at the plan. So... Lower hand, have a system, stick to it.So have the action cards and use them.But bear in mind also that the action cards aren't the be all and end all. You can invent roles if they are needed. So just because it doesn't exist or hasn't existed before, it doesn't mean to say you can't make it up.So in a site like this, you could utilise somebody from the company that knows the machines to actually control the way the machines are working for you, because it is not your forte, so you can have somebody inserted into that role that you have still got comms with, that is looking after the vehicles or the machines that are actually working part of the rescue.Yeah, because they're going to be rescuing you... You want liaison, you want information from the front scene, so when they find the casualty, you know about it quickly. So actually putting a liaison officer with the rescue team is a viable option, providing you have got the resources.And the other thing with this site, for instances, is that communications is going to be... They have got their own comms system, so if you have got somebody working with you who has their comms, we have expanded the comms to people we can use on-site that don't have comms with us, that don't interact. So we can still liaise...Right. You can kill two birds with one stone there. So if you have got a group of people, it doesn't really matter who they are, that have got their own comms network, that isn't on your comms network, what have you created, just by default?A secondary network.A secondary network, that has got information that you haven't. By inserting somebody in there, in that group with one of your comms, when information comes out here it is immediately passed back...It is being fed back into...To the command post, so that you are informed and situationally aware. Embedding somebody with a radio is often a very useful tool. But all of these roles are resource-dependent. And you may not be able to fill them all immediately. You need to fill them as you go along, as people arrive. And we are not the fire service, we don't arrive in one big lump and go "We are here," or the military, "We are here". We arrive in dribs and drabs, so you have to rethink your process all the time.So the plan grows with the staff. As the staff grow, the plan grows.Yes. So if you are limited on resources, where would you focus your staff first?Safety.Yeah. Well, actually you are using the acronym. So first of all you need to set up the command cell. You need to move forward with establishing a circuit. So my second appointment is normally parking. Because if you don't control parking, it is a nightmare. People park everywhere, block the route. It is a nightmare. It sounds really odd doesn't it? The second person I am going to appoint is the parking officer. You actually realise how important that is, because parking officer tells you when assets have arrived. So that you know, Oh, heart's arrived, right, well, I want them up here now. Thanks mate. The Casualty Clearing Station's arrived. Right hold it there, because we are not ready for that yet." Actually controlling that is good. And then, in this case, if there were casualties, my focus would be to put primary triage in first. I don't need to worry about secondary triage yet, because I haven't done the first bit, so I don't fill the post until I actually need to fill it. So I fill from the front backwards. And the other advantage of primary triage is... What do you think?Clearing people.You also get a bigger picture of what's going on, don't you?You know what you're dealing with.Yes. So triage, whilst it is a clinical tool, is actually a decision-making tool for a commander. So, primary triage figures coming from the front tell me how much resource I need to push forward. Secondary triage figures coming from the Casualty Clearing Station tells me how many holes I need in the hospital and what type. So actually, they are a decision-making tool for the commander. Which is why when you are down there dealing with the patient and someone is nagging you for the triage figures, it is because of course the commander is trying to make decisions about what stuff's going on, not because they are just being a pain in the butt. So, what we will do on the next exercise, or the next tabletop, is we will look at how we expand the scene and what other factors may be taken into consideration and look in a bit more detail at the triage, treatment and transportation elements of the CS-CAT algorithm. What you can see so far is we have covered the C-S-C-A in terms of... We just had a small initial command staff. We have looked at safety, we have co-located with people that are in charge of risks and hazards and know how to mitigate them. We have done an assessment of the scene and we have communicated back the information that we have found.
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Table top exercise - Arrival Part 2
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Table top exercise - Triage and transportation
Planning Incident Response: Setup and Logistics
Location and Setup Discussion
In this segment, we discuss the strategic setup for managing an incident at the quarry.
Key Points for Setup
- Casualty Clearing Point: Located on hard standing for vehicle access and exit.
- Incident Command Post: Positioned to oversee operations safely away from the danger zone.
- Helipad Access: Identified northward with clear access for emergency airlifts.
- Shuttle Service: Established for safe transport of casualties between incident site and clearing station.
This setup ensures efficient management of resources without obstructing access and egress routes.
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