Is your MCI plan ready for take-off? Lessons From Asiana 214 - - PowerPoint PPT Presentation

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Is your MCI plan ready for take-off? Lessons From Asiana 214 - - PowerPoint PPT Presentation

Feb 03, 2024 108 likes •485 views

Is your MCI plan ready for take-off? Lessons From Asiana 214 Clement Yeh MD Medical Director San Francisco Fire Department San Francisco Department of Emergency Management UCSF Department of Emergency Medicine Disclaimer The opinions

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Is your MCI plan ready for take-off? Lessons From Asiana 214

Clement Yeh MD

Medical Director San Francisco Fire Department San Francisco Department of Emergency Management UCSF Department of Emergency Medicine

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Disclaimer

“The opinions expressed in this presentation are those of the authors and may not reflect the official analyses or opinions of the San Francisco Fire Department, American Medical Response, San Francisco Department of Emergency Management, University of California San Francisco, San Francisco International Airport, San Francisco City & County, County of San Mateo, San Mateo County EMSA or the National Transportation Safety Board.”

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SF General Hospital Foundation Video

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Overview & Objectives

  • Incident Overview
  • Melding of MCI Plans
  • Considerations for

change in your area

  • Pediatric considerations
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Take Home Points

  • Make Disasters “Normal”
  • Plans + Planning + Practice
  • Interoperability Challenges
  • Overall System Management
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July 6th, 2013 11:27AM PST

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Audio: Dispatch SM

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Audio: MCI

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Mass Casualty Transport

  • Ambulance Bus
  • 15 beds + 10 seated
  • 26 seated
  • MCI/Evacuation
  • Fireground rehab
  • Mass gathering

medical care

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SFFD MCT

  • 1 & MCT
  • 2
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Incident Timeline

1132 SF Dispatch Notified of Crash 1134 Initial Dispatch 1134 First Alarm Struck 1140 Yellow Alert Declared 1145 First SFFD Units On-Scene 1146 Second Alarm Struck 1147 Red Alert Declared, First Amb On Scene, IC Established 1151 Third Alarm Struck 1159 Modified Response Declared 1215 Passenger Count & Manifest Reported 1259 All Patients transported from tarmac 1917 IC Closes Incident 1129 Dispatch Notified of Crash 1130 Dispatch of Level 1 MCI 1130 Activation of EMSystems 1130 First Amb On-Scene (AMR NICU Unit) 1134 First 911 Amb On-Scene 1137 Level 8 MCI Requested AMR Supervisor 1142/5 SMC EMSA On-Call Notified 1304 All Passengers/Crew Off Tarmac 1326 SMC 911 Ambulances Released to System 1338 Ground Amb Coordinator; declared sufficient ground transport resources on-scene 1746 EMS Branch Secured

City & County of SF San Mateo County

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Communications

  • Language barriers
  • Instantaneous
  • Comm overload should

be expected

  • Mitigating factors
  • Interpreters
  • Redundancy
  • Fallback plans
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Communications

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Patient Characteristics

  • 307 on board
  • 291 Passengers
  • 16 Crew
  • 175+ patients

transported to area hospitals

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Patient Distribution

  • Language resources
  • Reunification
  • Special populations
  • Trauma
  • Burns
  • Pediatrics
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Patient Distribution: Counties

50% 16% 32% 1% (88) (2)

San Francisco Eden Stanford

(57)

San Mateo

(29)

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Patient Distribution: Hospitals

  • Stanford: 56
  • SFGH: 53
  • Mills Peninsula: 14
  • UCSF: 14
  • Kaiser Redwood City: 10
  • CPMC (all campuses): 9
  • Kaiser San Francisco: 5
  • St. Francis: 7
  • Sequoia Hospital: 5
  • St. Mary’s: 4
  • Eden: 2
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Patient Distribution: Timeline (SFGH)

  • 1300 First Wave:

10 patients: 5 critical, 5 serious

  • 1600 Second Wave:

17 patients: critical to good condition

  • 1700-1900 Third & Fourth Wave

25 patients

  • Sunday 2100: 5th Wave

9 patients

  • Monday: 6th Wave

4 patients, all children

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Patient Distribution

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Surge Capacity

  • Increased space
  • Increased resources
  • Increased staffing?
  • Reverse Triage
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SF 911 System Impact

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SF System Impact

  • UHU = Utilization/ Units x

Staffed Hours

  • Goal Transport UHU = 0.35 - 0.44
  • SF 2013

YTD UHU = 0.38 (SD 0.04)

  • SF 2013 Saturdays UHU = 0.40 (SD 0.04)
  • Saturday 7/6/13 UHU = 0.41

0.125 0.25 0.375 0.5 Goal YTD Sat 7/6/13

0.4 0.38 0.40

0.41

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San Mateo 911 System Impact

7 of 16 911 Ambulances Sent to Crash AMR Surge Plan and MCI Plans Inter-Facility Surge Unit In County Mutual Aid South SF Fire Inter-Facility BLS Inter-Facility Network Providers Special Operations Team Call Back Corporate Resources Response Time Compliance 92.1%

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The End?

  • Patient Reunification
  • Law Enforcement
  • Post Incident Analysis
  • CISD
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Take Home Points

  • Make Disasters “Normal”
  • Plans + Planning + Practice
  • Interoperability Challenges
  • Overall System Management