PEER REVIEW:
The article thus far does a great job of summarizing Triage in a way that most "normal" people can understand. Perhaps give a little information on how a person may get BLACK TAGGED without actually being dead yet. Additionally, you may want to mention START Triage, the name of what you have listed. There are a few other forms with are recognized, and some places like FDNY use a modified START system. I would consider moving the information on the chemical/ biological response out of the Triage section of the article. While it is important information it does not feel like it belongs there. Also try to tie it back to the article some more. Also something seams weird with the headings and format flow of the entire article. Make sure the formatting and headings are matching up. I like how you provide information on the after field care and transport. I think it would be valuable to add information on hospital rerouting and how it is determined which hospitals people go to based on their capabilities. It may be worth talking about trauma centers. Also if you have not thought about it you could talk briefly about the mental health impacts on responders. I would not spend a lot of time on this, but I believe it is worth bringing up in some capacity. While from experience I find a lot of what is contained in this article to be true, you need more citations for the article. It looks like some parts have been well edited, while others have had less work. Overall good information, just needs a little bit of clean up.
Wikipedia Assignment Timeline
Contents [hide]
1 Activating an MCI – The activation of an MCI is crucial to the process of a mass casualty incident
1.1 Initial Size Up – This is the initial action performed by dispatch or a call center. This action is not noted in the original Wikipedia article
1.2 Scene Size Up – The size up performed by responding agencies once officially on the scene. Not noted in original article.
1.2.1 M.E.T.H.A.N.E. – Assessment tool used by responding agencies that gives them a good feel for the numbers of personnel and equipment they are going to need on scene. This is critical information for a scene size up.
2 Agencies and responders
2.1 Emergency medical services
2.2 Fire and rescue
2.3 Public safety
2.4 Specialized teams
2.5 Public services
2.6 Hospitals
2.6.1 Trauma Centers
3 Flow of an MCI
3.1 Triage
3.2 Treatment
3.2.1 On-site morgue
3.3 Transport
4 Definitive care
4.1 Interim-care center
4.2 Mass casualty event
5 MCI Demobilization – This is critical to an MCI because when planning an MCI the beginning and end needs to be planned out thoroughly. Nothing in the original article talked about the closing of an MCI
6 See also
7 References
8 Bibliography
Roadmap Part 2
In order to activate an MCI a size-up needs to be done by the initial person receiving an emergency call regarding a multitude of situations involving a mass amount of people or potentially involving a mass amount of people. Once they have done this the amount and type of emergency services needed on scene will report. After the agencies have arrived another size-up will be performed with this one involving more detail and following the M.E.T.H.A.N.E method. This method provides an in depth result for the amount of responders necessary and it allows for the scene to become clearer for the responders on the exact type of situation they are getting into. Many feel that you only need a method of E.T.H.A.N.E noting that the declaration of a mass incident has already been accomplished with the initial size-up given by the call taker but without a declaration from someone on scene false information may be leaked about the situation stirring up speculation from the public and other responding agencies. The declaration is crucial coming from a first responder because the domino effect of other activities in the method hinge upon this declaration.
There are a throng of agencies involved in most mass casualty incidents which means many individuals that require training for these specific situations. The training that many receive is known as incident command system (ICS) and this is established by FEMA. Incident command system allows for the management of the MCI to be done in an effectual way which provides the personnel of all the different agencies converging on a scene to be able to give attention to their specific areas of need without negating any other areas of the incident.
The role of media in a mass casualty incident is a very divisive one that can, if done properly, provide the public with a great sense of what is going on and release notable information to help the responders on scene while also directing the public to resources and other material necessary to traffic, emergency, and response concerns.
The final product of an MCI that happens to link up with the M.E.T.H.A.N.E. method is the act of demobilization which is crucial to the entire process. The demobilization process has to be in place from the beginning, once an area has been mobilized. This is so critical because with a mass casualty incident it can get out of hand in a quick way and having everything planned out step by step can alleviate these concerns and help cover for the unexpected. The demobilization process also gives the local community and the corresponding agencies an idea for how long their city and specific areas will be consumed with emergency personnel and essentially blocked off. In many events such as hurricane Katrina the demobilization process is not taken into account from the beginning and the process goes on much longer than necessary which exacerbates financial costs and puts a burden on local agencies such as law enforcement to uphold their everyday duties while also maintaining some grasp on the mass casualty incident.
Roadmap Part 3
Trauma Centers play a crucial role in the mass casualty incident timeline. They are specific hospitals who have voluntarily applied to complete the verification process which is controlled and selected by the pertinent governmental forces and entities. Trauma centers have a multitude of levels ranging from level 1 all the way to level 5. Each level varying in different responsibilities and resources provided.
· Level 1: Level 1 facilities are able to offer complete care to the patients they receive from initial care to seeing the individual’s injury all the way out through rehabilitation.
· Level 2: Level 2 facilities are able to provide almost everything a level 1 facility offers except for tertiary care such as heart surgery.
· Level 3: Level 3 facilities being the next tier down in the trauma center hierarchy gives them the ability to provide prompt assessment of a patients injuries and respond quickly to decide whether they can perform the surgery or need to transport the individual to a level 1 or 2 facility.
· Level 4: Level 4 facilities are capable of performing advanced trauma life support and they are also capable of providing a diagnostics assessment of the individual’s injuries and transport them smoothly to a higher level facility.
· Level 5: Level 5 facilities are the bare minimum in terms of trauma centers but they still serve a vital role in the assessment stage and give the higher level facilities the proper information that they need to react correctly.
Mental health is something that is becoming more predominant in today’s society and culture, and first responders are not exempt from this. It is written off as a hazard of the job but there are many things that can be done to reduce the effect of traumatic events. These things include practicing self-care and learning the cues of trauma taking a toll on one’s life. These practices are definitely unique to each individual person and each individual case but applying these to a first responder’s life helps tremendously. Even with these practices many first responders don’t know when to seek professional help. The signals to look for according to medical experts are: hyper arousal, avoidance, intrusions, and psychic numbing. A first responder dealing with any number of these conditions should seek help immediately before it’s too late.
References:
https://delvalle.bphc.org/mod/wiki/view.php?pageid=89
https://www.fema.gov/incident-command-system-resources
http://www.amtrauma.org/?page=traumalevels
http://www.goodtherapy.org/blog/when-helping-hurts-traumas-effects-on-first-responders-0212154
Benson, M., Koenig, K., & Schultz, C. (1996). Disaster Triage: START, then SAVE—A New Method of Dynamic Triage for Victims of a Catastrophic Earthquake. Prehospital and Disaster Medicine, 11(2), 117-124. doi:10.1017/S1049023X0004276X
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It seems as though you are saying Incident Command System (ICS) is a training program. It is a system used to set an organized hierarchy of command without jurisdiction boundaries. I would advise rewording that section of your statement so it doesn’t sound like a special training that has taught specific individuals how to command during an incident. Also, in the last sentence of the last paragraph the statement went from past to present tense and back to past tense. I would advise rewording this section to make it more uniform in its’ tense with the section above. Also, you put the acronym M.E.T.H.A.N.E and then you put the acronym E.T.H.A.N.E., are these different methods? My final critique is the first section discussed what sounds like a recommendation and not a statement of authority. I have not read the article that you have so I do not know if that was your intention. Other than those things I enjoy the way the information is presented. It seems to be clear that you are attempting to clarify confusion from the original article. I also liked the addition of demobilization. It seems to really clarify that there is an exiting strategy for emergency response groups. Finally, I like the example of hurricane Katrina and the lack of planning. This allows the reader to remember back or research the emergency disaster that was the emergency command of hurricane Katrina. Excellent job, this road map adds to the article and helps complete the full understanding of the process from beginning to end of the incident. Hammockdude1 (talk) 01:57, 4 May 2017 (UTC)