Three phases of major incident:
Triage » Treatment » Transport
Do not progress with in-depth treatment until all SIEVE triaging is complete.
KEY CONSIDERATIONS
- Appropriate tabard and PPE must be worn
- Initial treatment should consist of life-saving interventions only:
- Open airway
- Lateral patient position if possible
- Control life-threatening bleeding
- Maintain documentation
- SMART Tags
- PCRs
- Incident book
- Scene safety assessment: Do not enter/proceed into scene until deemed safe.
- Provide METHANE to State Operations Centre (SOC)
- Major Incident Confirmed
- Exact Location
- Type of Incident
- Hazards Present
- Access
- Number and type of casualties
- Emergency Services present/required
- Assume Acting Ambulance Commander & Forward Commander Roles
- Establish on scene liaison with other agencies
- Maintain communications with SOC
- Establish Ambulance Assembly Point (AAP) & Casualty Clearing Post (CCP)
- Consider need for Mass Casualty Kits (MCKs) and/or Emergency Support Vehicles (ESV)
Report to Ambulance Commander
- Park vehicles at AAP & leave keys in vehicle
- Undertake the role delegated by the Ambulance Commander
- Use equipment/consumables from ESVs & MCKs if available
- Use radio channel designated for incident
- Maintain incident chain of command
Obtain SITREP & establish the following:
- Maintain incident documentation
- Establish command & communication structure
- Confirm setup of AAP & CCP
- Ensure availability of hand held radios
- Ensure safety of all ambulance personnel
Continue to:
- Liaise with HMA Incident Controller & other agency commanders
- Liaise with SOC & other key field staff
- Direct Hospital Response Teams (HRTs) to Health Commander
- Monitor adequacy of ambulance resources
Reports to Ambulance Commander.
Appointed once adequate incident resources are available.
- May begin initial Triage SIEVE until more resources become available
- Take responsibility for forward operational activities
- Ensure casualty Triage SIEVE & labelling undertaken using SMART tags
Reports to Forward Commander.
Designated if size of scene requires incident to be sectored for ease of management.
- Supervise Primary Triage Officers ensuring Triage SIEVE activities are undertaken
- Direct walking wounded to CCP
- Supervise necessary treatment before the CCP
- Report ‘Triage SIEVE’ as required
- Assist the Casualty Clearing Officer once Hot Zone/Extrication Point cleared of casualties
Officer must:
- Obtain SMART Triage Pac; place on uniform belt
- Triage each casualty and attach SMART Tag to CASUALTY’S RIGHT ARM
- Only provide treatment consisting of body positioning, opening airways & stopping life-threatening bleeds
- Maintain a written record of each casualty triaged on the back of the SMART Tag
Reports to Ambulance Commander:
- Appoint Loading Officer
- Supervise setting up and running of CCP
- Appoint staff to undertake SORT Triage
- Ensure SORT casualty log is maintained
- Liaise with Senior Doctor & Senior Nurse if Hospital Response Teams (HRTs) present
- Liaise with other key field staff
Reports to Casualty Clearing Officer:
- Checks all casualties correctly SMART Tagged
- Maintain casualty Transport Log Sheets
- Supervise casualty transfer from loading area to ambulance
- Liaise with Transport Nurse if Hospital Response Teams (HRTs) present
- Take direction from SOC or the Department of Health on casualty destinations
Transport Considerations
- Triage priority
- Treatment and packaging
- Appropriate destination
Reports to Ambulance Commander:
- Check Access/Egress routes established
Meet arriving ambulance crews and direct incoming staff to Ambulance Commander or delegated person, ensuring that arriving crews have:
- Left keys in vehicles
- Appropriate tabards & PPE on
- Parked vehicles orderly & all lights turned off
- Taken appropriate equipment into the scene
Key Terms & Links
Document Control
Clinical Resources Website
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