ED Clinical Pathway for Multiple Patient Events
and Mass Casualty Incidents
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- Laceration, ED
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ED Notified of Multiple Incoming Patients
- Determine number of patients that can be accepted
- Below numbers are a guideline, ED Charge and T1
- Attending can increase or decrease numbers as needed:
- 5 Red Critical, life threatening injuries
- 20 Yellow Seriously injured but stable
- 40 Green Mild injuries
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- ED Roles at CHOP PHL
- Additional Resources
- Family Resources
- HAZMAT Resources
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Team 1 Attending & Charge RN Initial Notifications
- Determine type of alert to be sent: Standby or Multiple Patient Event (MPE) or Mass Casualty Incident (MCI) (See descriptions below)
- Consider trauma level/known injuries, stabilization at OSH, ETA relative to each other, current ED census and time of day/day of week
- If assistance is needed with determining type of alert, staff should contact Emergency Preparedness On-Call by sending a secure chat to:
- Emerg Prep Escalate 1st Contact (Groups folder)
MCI Standby Alert
Multiple Patient Event (MPE) Alert
Mass Casualty Incident (MCI) Alert
Vague Initial Reports Lacking Details
e.g. MVA with unknown number of illness/injuries
e.g. MVA with unknown number of illness/injuries
Suspicion or Concern for 3-7 Seriously Ill/Injured Children
e.g. MVA or shooting with 3-7 children involved
e.g. MVA or shooting with 3-7 children involved
High Suspicion or Concern for 8 or More Seriously Ill/Injured Children
e.g. School shooting with multiple seriously injured pediatric patients or any active shooter in an environment with children
e.g. School shooting with multiple seriously injured pediatric patients or any active shooter in an environment with children
- Activate Appropriate Alert
- Use 4CODE app or dial 4CODE from a desk phone to contact Communication Specialists to send Everbridge alert
- Communication Specialists will send the appropriate Everbridge alert
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ED Team Huddle Outside Resuscitation Room
- Team 1 Attending and/or Charge RN sends secure chat to PHL ED Leaders
to request that they huddle immediately in Team 1 - Provide briefing on situation, including expected patient numbers and their ETA
- Team 1 attending and Charge Nurse assign MPE/MCI leader roles including Physician in Charge and determine resource availability
- Team 1 Attending and/or Charge RN sends secure chat to PHL ED Leaders
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Standby
- Ask staff whose shift is ending to remain in the hospital until further information determines if a MPE or MCI needs to be called
- As more information is learned, Team 1 attending to call Communication Specialists to either upgrade to MPE or MCI alert or cancel the Standby Alert
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Multiple Patient Event
- ED and supporting departments assume MPE roles
- Print, or hand out pre-printed copies of role specific job aids
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Mass Casualty Incident
- ED and supporting departments assume MCI roles
- Print, or hand out pre-printed copies of role specific job aids
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Command Center opened by Emergency Preparedness (x47300)
- Coordinate information between external sources and CHOP ED MCI team
- Coordinate needs with ED Physician in Charge, ED Charge Nurse and ED Resource Nurse
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Cancellation of Standby Alert
- Communication specialist notified to cancel the standby alert
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Upgrade to MPE or MCI
- Communication specialist notified to upgrade alert to: