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mikeinet

MCI

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Trying not to sound cocky... I've noticed a lot of people talking about "MCI"'s involving multiple patients (no this isnt directed to one person either) - I feel like there's a misconception of what the term means... MCI = Mass CASULTY incident.. people should not be declaring an MCI or using the term if everyone's alive... multiple patients would be the correct term.

Just my rant, not meant to offend anyone.

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While in a literal sence MCI means Multi Casualty Incident, the definition of such is as follows:

An incident where there is more than one patient and system resources are taxed.

Anytime there are more patients than rescuers

Here's the link to a good power point presentation on MCI responses: www.asisonline.org/councils/fire/MCI.ppt

Here's another link for a Dutchess County Fire Department that institutes their MCI Plan when "the number of patients exceeds immediately available resources": http://www.nkfd.org/SOG/NK-314%20Mass%20Casualty.html

One more from the Reginal MCI for Metropolitan Kansas City defines an MCI as "a single incident that results in more patients than the responding agency can handle and as determined by the Incident Commander". http://www.raytownfire.com/MCIplanpdf.pdf

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hmm, ok... I guess I've just always considered it by its literal sense becuase what happens when you have an incident when there ARE mutliple casulities... when you say "MCI" over the radio, how can you distinguish 4 DOA's vs 4 Injured?

shrug

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A Mass Casualty Incident is any incident that has a number of patients greater than your specific VAC's transport capabilities. For instance, mine has 5 ambulances which are capable of transporting 2 patients each; so any incident within my VAC's area of coverage that has 11 or more patients woulc be considered an MCI.

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Just to point out your misconception, the word casualty doesn't mean death, it also means injury. Casualties can also be injuries, not fatalities. In the military sense of the word it means "men down"... So, as everyone has already pointed out (contrary to your rant), an MCI is a situation where the injuries (or in fact, some--if not all--fatalities) exceed the resources of the response agency.

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NYC REMSCO

"MCIs are generally defined as five (5) or more patients with the potential need for extraordinary resources. However, the criteria for the definition of MCIs are not primarily dependent upon the number of patients."

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A while back in EMT classes (at leas the one's I assisted with) we started teaching a difference between and MCI and an MPI (Multiple PAtient Incident). MCI is as people defined above. MPI is an incident where you have multiple patients but not necessarily taxing the local resources. For instance if we have a bad accident in, say, Peekskill but only 3-4 patients only one or two requiring ALS, then the local resources canc handle that easily and we'd probably term it an MPI, not and MCI. Now if we have twice that and we need to start calling rigs from Mohegan, Cortlandt, Yorktown and need to start pulling medics from Yorktown, Ossining, or Putnam, then I'd consider that an MCI.

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I know this was already pretty much cleared up but just wanted to add a bit.

How do you distinguish 4 DOA's vs 4 injured?

On scene via triage. A casualty is an injured party, dead is dead. Before anyone declares an MCI, which with our dispatching being all over for EMS really means nil, you need to get an immediate approximate count of patients you will or may be dealing with and then go from there.

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Well, I have taken 6 to the hosp in one ambulance so was that an MCI????? 3 motor vehicles involved in a collision...all walking wounded...1 in the pass seat, 1 in the captains chair, 3 on the bench and 1 on the stretcher...me, I just stood there and handed everyone an acr...they can read and write, right?...901 was my partner at the time...just make sure you carry extra pens somewhere in the ambulance...in fact there have been times in Yonkers where an EMT has remained upon a school bus with excess of 15-20 patients that were either un-injured or had minor injuries and the bus followed the "bus"to the hospital and the 2 EMT's were responsible for all the paperwork...so does that qualify?

An MCI is a situation where the number of victims outweigh the amount of resources available without extending transport times of victims to area hospitals...in this case units are set up, the first EMS team at the scene triages the case and determines what is needed...a potential MCI may not be a true MCI...

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While we are on the MCI Issue. Two things come to mind.

Triage, next time you have an MVA or something with a bunch of patients MCI or not. Use triage tages, will help you to learn and will help the ER to learn.

2nd. What system is being used for Triage.

I teach "Start RPM" as I have come to call it. It's the START system, but we check for Pulse absent/present.

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