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 2
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What do we think is next? Establishing a forward point. Establishing a forward command post, okay. Who is going to be at the forward command post and in the initial stages, do you think? Certainly the incident commanders of the emergency services that are in attendance and the site manager. Yeah. And the site manager. Okay, where do you think that might be? Or where would you like that to be in this scenario, do you think? If it was me, I would... I would put it here. I would put it in this building because we have got an expansive view of the whole site from above, it is almost like a helicopter view, so we can clearly see exactly what is happening on the ground whilst being in a safe zone and good communications with everything below, so you can play it like a chess game. I think you are right, it would be... This is a really good... Because you have got a view of the entire quarry, you can see all the access and egress, so you can see what is going on. And as a tactical command post, it is probably really good. What do you think the limitations might be? I am thinking about the way some other services operate, which more impact on the way you want to do business, where do you think the fire service commander is going to be? In his command post, which is a big truck. Which is going to be where? Well... In the quarry. Yeah, it is going to be in the quarry itself. In the quarry itself. It is going to be somewhere in that bowl, is not it? Yeah, yeah. Right? So actually, you may be forced to actually move down next to the fire service commander if you want to co-locate and have the information. Certainly as more people arrive later on, tactical level commanders, then this building would be ideally suited, but in the initial stages, the co-location is probably more important than they... Certainly, in the initial stages. In the initial stages, yup. Which means it has to be flexible. Okay? In which case it is probably better down on a large area of flat standing where you can still get good access and egress, but you are actually in a large area of hard standing. Ideally, yes, or whether you get that choice is sometimes limited. I certainly have found at jobs, there is no... Trying to nail people to one place and go, "This is the forward command post" can be difficult. And often have to move around the site, just following the fire and police together. And whilst I don't like that, actually putting a flag staff in the ground and going, "It is here", is much easier for all concerned. In the initial stages, you might not have a choice, but the co-location. And why is the co-location important, do you think? Why is that? Is it just because we will all be together? Because then you can share ideas, tackle problems together. Information. And understand risk assessments that each emergency service will carry out. Yeah, if you are geographically disparate from them and they get new information, it is not going to come to you in a short order, you will not be there to make joint decisions, you will not be able to assess the information quickly, you will find yourself situationally unaware quite quickly. Yeah. You have to be flexible and all your suggestions are perfectly valid, but the key point is you have got to be co-located if you want to keep the information. What else might we be thinking about? Roads, actually into site, main roads coming into site, so we are bringing our vehicles down roads that are either cordoned off just for emergency services or accessible by emergency services, we do not want to be coming down country lanes and stuff, we want to be coming down main roads, if we possibly can, so as we have got no access and egress problems to site and through site. So do you think this site will present problems from an access and egress point of view? Yes. It will be because it is limited. Yeah. And having driven in here this morning, the tracks are, in general terms, would require a 4X4, it would be even worse if the ground was wet. Icy as well. Yeah. In winter. Icy in winter, yep, and certainly if you start trying to put 50 Ambulances on the paths up, it is going to be difficult, so there are things that you would want to consider here. What might they be? Weather conditions. You might want to have an RVP point that is nearer to the gates instead of on the quarry itself. Absolutely, so either a rendezvous point or a holding area where you do not have everybody crowding in, but they are close enough at hand that you can call them forward... When they are called. Once you have sorted your life out a bit. What else? What do we now need to at least start thinking about? A casualty clearing station. Clearing station. Casualty clearing station or casualty clearing point. In this scenario, what might you go for out of the two? Just bearing in mind that a casualty clearing station is a sort of semi-permanent structure of some description, whereas as a casualty clearing point is a patch on the ground that you say it is at this particular point in time. Which of the two would you lean towards on this type of scenario, do you think? Probably the clearing point. Yeah. Yeah, you might do in the initial stages. But you have got enough ground, you have got enough space for both, so it is a snapshot decision at the time. It is, so what factors would influence that decision-making, do you think, given this scenario? Number of casualties, the casualties that are coming out already without you rescuing them. Weather conditions. Weather conditions, yep. The lighting as well. The heat, light, power? Yeah. Yeah, okay. And maybe also how many of the emergency services have turned up already. Yeah, so how quickly do you think access here is going to go, is everyone going to arrive quickly or is it going to be more of a dribs and drabs thing? It will be dribs and drabs given the real world location of the quarry itself. Okay. How long is the incident going to last? It is a very important question to ask yourself as a commander, even though it is early stage, well, how long is this going on for then? Why is that question to yourself important, do you think? Because there needs to be strategic planning around people at scene, people that have come into scene. Resources as well. Lighting, food, water. All the other bits you do not think about in the initial stages, but may need six to 12 hours into an incident. Absolutely, so the likelihood of this incident is that it is probably going to be protracted. Why? Because people will be buried in rubble and it will take time to get to get them out. Absolutely, so we are going to be here for a while, this is not going to be 90 minutes, two hours and we are gone. We are probably going to be here at least 12, if not 24 and may be longer. And actually elements of the service may well be there even longer than that. So even after we have probably cleared casualties elements like HART or the NILO and the Tactical Commander may still be on scene even though there are no further ambulance assets as part of that joint response. Where are we? We have started to think about casualty clearing point you lean towards. I would probably think both, yeah, because a casualty clearing point for those casualties that are already released and need immediate treatment, but actually a casualty clearing station for something... Longer-term. Longer-term as people come out slower. So the problem with people coming out slower from being entrapped is what, do you think? Usually, their medical condition's going to be deteriorated somewhat from the initial start of the incident, so there is going to be medical issues with those and possibly more injuries. Which means we all need a higher level of skill set. So we are far more likely to have doctors, basics, higher skill sets on scene for our entrapped victims than we would be for people that we can get to quickly and throw in the back of a vehicle and take to the appropriate destinations. So that needs to be thought about. In order to establish a casualty clearing station, what else do you need to think about? Access and egress and hardstanding, where you are going to put it. Power. Okay. So... Sorry, say that again. Power, as well. Power lighting, that sort of stuff. Yeah. I will come back to that. I want to go with Aid's point here, which I... It is where we are trying to lean towards I think. So access, egress, hardstanding. Why do you want the hardstanding? You do not want to sink anywhere. Do not want to sink. Okay. Because? What do you want to put on the hardstanding? Vehicles. Vehicles. Okay. Which, therefore, makes it a parking point. Yeah. So parking, loading, ambulance circuit is what you are looking to achieve. So casualty clearing point, route in, route out, loading, parking. Interesting, before we actually move on, we have not talked about outer cordon yet. Where is the outer cordon on this likely to be? Main gate. Main gate. Yeah. It is going to be a big cordon because it is a naturally bounded site, so it would make sense for that to be the case. So unusually, you will not see the big blue and white tape, it will just be naturally at the boundaries of where we are. So have a think about where we might... So we know which direction we are coming from. Yep. We know what the roads were like coming in. Have a think about where you want to put your casualty clearing point, slash, casualty clearing station. How your parking and loading and your circuit might work. What other assets might we want because it is a geographically remote area? You want 4 x 4 capability for a start. Okay. 4 x 4. Yep. Helicopter. Yeah. Helicopter. Why the helicopter, do you think? For anybody that is critically injured to get them away quickly if we need to. Yes. Or to specialist units further away. Oh, I will have that. Specialist patients to specialist places. Really good transport policy to have. Right patient, right place. First time, every time. Also police, eyes in the sky and to keep press away and that sort of stuff. So put them up early so you have got a view and also an air cordon. That is actually a very valid point. Times are changing on us, aren't they? So actually normally, I would not have been... In the old days, I probably would not have been too worried about this site in terms of press because, well, they will be stuck on the road out there somewhere and the best they are going to get is a long telephone of vehicles going in and out the front gate. But what have they got now that actually we have got and they will probably use? Helicopters. They have got helicopters. Yeah. That is Sky News. 20 minutes from where it is. But what else? Drones. Drones. Yeah. So that is probably going to be a factor that you are going to need to think as... About as a tribe of commanders. Have a draw on, yeah, of how you would think the casualty clearing point access, egress, parking, loading would look like.
Action Steps at the Quarry: Film Discussion
Overview
This film segment focuses on discussing the critical actions that need to be taken at the quarry in response to a simulated incident.
Key Action Points
- Initial Assessment: Evaluate the situation upon arrival.
- Communicate Effectively: Ensure clear communication with on-site personnel.
- Safety Measures: Implement necessary safety protocols.
- Coordination: Coordinate efforts with relevant stakeholders.
These action points are crucial for effective management and response during a quarry incident.
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