Mass Casualty Incident

Mass Casualty Incidents suck really bad and we can never be truly prepared for them.  Even the pros find themselves wanting when something truly goes wrong.  Recently, the marathon bombing in Boston has reminded us that we are on our own to help our fellow citizens in the immediate aftermath of an incident.  It’s not law enforcement’s or emergency personnel’s fault.  They want to help, but need to ensure that more people aren’t going to be hurt and that they are not going to become part of the problem by getting hurt themselves.  That just leaves us on our own for a little while.  Emergency personnel will regroup, clear areas, and help people.  It is just going to take time.

What do we do in the mean time? “Help as many people in as little time as possible,” straight from Community Emergency Response Team’s (CERT) handbook.  First of all, you have to get some medical training.  Get yourself a book, any book is better then nothing.  This book is on my to-read list, Beating the Reaper, and may be a good place to start.  Once you are okay, then you can start helping others.

We help others best by creating a triage.  If you are the only one there, you are in charge.  Create three triage locations and levels.  The first one is the easiest.  People that aren’t going to die right away without help, the ones that will survive for the next hour or two without anyone doing anything.  Think of these as the walking wounded.  Simply stand up and start telling people what to do.  Go to the area you want them to be.  Someplace out of the way of responding emergency people and someplace they won’t get hurt.  Simply call out, “if you are hurt and can walk, come towards the sound of my voice.”  Be careful to get out of the way if someone panics.

The next two groups are much harder.  You need to do the most good for the most people that you can, and that means there could be people that you simply can’t help.  They need to go in one location or area.  When a formal incident command is set up and EMTs arrive, they will start tagging people.  These will most likely be black tagged.  While they have more equipment and knowledge than you do, they are looking at pure numbers.  What are the chances of saving this person?  If the chances are slim, then they can best use their resources for others they are sure they can save with help. The ones that need some help to survive will normally be given a red tag.

For you, this is going to be difficult, at best, and next to impossible in reality.  You have to look at your supplies and knowledge and do the best you can.  Save the people that you know how to save.  At a mass incident, those are the people that are generally bleeding heavily.  Use pressure and makeshift tourniquets to stop the bleeding.  Get others to help you.  There will be a lot of people standing around that just don’t know what to do.  With a little coaching (“Hold pressure here”), they can help you save others.

We have to deal with the world as it is during an emergency.  In a mass casualty incident, I would want to save everyone, but the reality of the situation is that you may not be able to.  Four people died in Boston and there were a lot of professionals on the location with a bunch of resources for the race.  If you are ever caught in a mass casualty incident, you may not have that many resources and those resources may need your help.

Stay Safe,

Ben