1. Chapter Special Operations Twenty-Eight

6. Point out to new EMT-Bs that the EMS commander who doesn’t delegate, but instead attempts to wear all the vests, cannot possibly get the overall picture of the incident, because he or she has taken on too much responsibility. P RECEPTOR P EARL

8. Multiple-Casualty Incident (MCI) An incident that places a great demand on EMS equipment and personnel Sorting multiple casualties into priorities (3 levels) for care or transportation Triage K EY TERMS

9. Encourage new EMT-Bs to practice declaring EMS Command, establishing a triage sector, donning sector vests, giving an arrival report to dispatch, and applying triage tags at all incidents involving three or more ambulances. In this way, the procedures will be second nature to them at larger incidents. P RECEPTOR P EARL

14. MCI Triage Tag

20. If patient is not breathing, and opening airway does not cause patient to start, he is priority 4. START Step #1: Assess respirations.

22. If the patient has no pulse, is unresponsive, and is not breathing, he is priority 4. START Step #2: Assess radial pulse .

25. Assess all the patients who walked to the designated area using the same 3 steps. START Re-triage the walking wounded.

28. Identify substances from a distance.

29. Hazmat Placard

30. Vehicle with Placards

33. Emphasize to new EMT-Bs that they must not rescue people from the hot zone unless they have been trained to the proper level and are dressed with the appropriate protection for the chemical involved. P RECEPTOR P EARL

35. Emergency Response Guidebook

38. Point out to new EMT-Bs that it is important to ask if patients have been properly decontaminated and exactly how this was done before patients are loaded into their ambulance. The last thing anyone wants to do is transport contaminated patients to the hospital. This could lead to a shutdown of the entire ED in order to decontaminate the department’s personnel. P RECEPTOR P EARL

39. 1. What should an EMT-B do when first to arrive at a hazmat scene? 2. What resources are available to identify hazardous substances? 3. What are the responsibilities of the EMS sector officers at an MCI? 4. What is the difference between the NFPA 704 and DOT UN placards systems? R EVIEW QUESTIONS