Medical crews ready for disaster

Local stations stay prepared for mass casualty situations

LEWISTOWN — Mass shootings typically evoke a sense of horror and worry for many people across the world, and for some they evoke wonder of how the emergency services handled that kind of event.

Locally, there have not been many incidents which the emergency medical fields consider mass causality. Pat Shoop Sr., chief of Fame EMS, said a mass casualty incident is any type of incident that has patients which exceed the amount of care that can be provided.

Shoop said this is something that does not happen very often, but he said it is still something that everyone involved in emergency services should be prepared for.

To help with this, Fame is hosting a mass casualty incident management seminar Saturday and Sunday at the Mifflin County High School.

The seminar, organized by Shoop and Captain Troy Long, is going to help teach those in attendance the procedures and techniques to make patient care move quickly. This will be through learning about identification of injuries, the transfer and the distribution of those patients.

The seminar will be taught by A.J. Heightman, who is an EMT-Paramedic and the editor of the Journal of Emergency Medical Services.

According to Heightman’s biography for the class, he got his start working for emergency medical services in the Bethlehem area, eventually becoming the Executive Director of the Eastern Pennsylvania Emergency Medical Services Council. He was also the Director of Operations for Cetronia Ambulance, in Allentown, and the regional MEDCOM Advanced Medical Communications Systems director.

Shoop said Heightman has been to the Central Pennsylvania area before. In fact, there was a mass casualty incident in the Allentown area that really piqued his interest in those kinds of incidents, according to Shoop.

“At this point he began to develop a program to help control the flow of patients coming to EMS at an incident,” Shoop said.

Shoop continued to explain that he personally first took the program in the early 1990s.

“That is when we adopted and implemented the program,” he said.

The Rehab unit which Fame uses on a fire scene is only half equipped to help with the medical needs of firefighters. The other half is equipped with bags and equipment needed for a mass casualty incident.

“We never really want to have to use the equipment, but at least we know we have it when we do need it,” Shoop said.

Fame tries to bring Heightman to the area every five years to teach a class. Shoop explained that just several months after the class was held, there was a major fire at Elseers Apartment in Lewistown.

“We had so many patients,” Shoop said. “However, the class was fresh in our minds and we were able to clearly identify patients and move them out. It was great seeing the class in action.”

Shoop said, since he has first taken the class, Fame has created three different response levels for resources depending on the number of patients.

“We have eight ambulances, which means we can handle eight patients,” he explained. “If there are more than that, then we have to bring in more resources.”

Shoop said the levels are already programmed into the computers at the Mifflin County Communications Center. The levels are: Level I, no more than 10 patients; Level II, between 11 and 25 patients; and Level III, more than 25 patients. At each level the appropriate number of ambulances and units are called.

For example for a Level I response all of Fame’s ambulances are called, along with both ambulances from Milroy, one from McVeytown and one from Port Royal. It also calls for two helicopters. In contrast, a Level III response brings all of those resources, plus another ambulance from McVeytown and one more from Port Royal, two ambulances each from Big Valley EMS, Central Juniata EMS, Mount Union, Penns Valley, Centre Life Link and Thompsontown, along with one ambulance from Beaver Springs, Fayette, Beavertown and Richfield. It also adds a medical response from Newtown Wayne and four additional helicopters.

“You never realize what all is around, until you have to call them,” Shoop said.

Long said he himself has taken the class multiple times and has learned something new each time. He said that the class runs similar to other multiple day classes with the first day being most of the classroom learning with the second day having the group run through scenarios.

“Our goal is to run the final exercise with outside resources to really bring the seminar together,” Long said.

There are several levels of treatment that are involved and used to not only evaluate the patients, but also to get them through the medical personnel and then on to a hospital. The different levels include immediate, secondary, delayed and deceased. Each level has a different color. Red goes with immediate, yellow for secondary, green with delayed and black with deceased.

“With each level the amount of patient care decreases, with the most care in the immediate category,” Shoop said.

While green is the level most associated with the least amount of care needed, Shoop said sometimes, green is used for patients that even if care is given, it will not save the person’s life.

“That is where knowing the difference in treatments and medical assessments, even basic, can come in handy,” he said. “Sometimes it is about making the tough calls, and they are tough to make.”

In general, Long said they really want to put emphasis on the way patients are received by EMS during a mass casualty incident. He said that is where fire departments and their personnel can come in handy.

“Medical personnel typically go through and tag patients,” Long explained. “While they are doing this, a freighter can look at the tag and take the patient to that area for treatment.”

That is why the class was opened up to all first responders, including police. Both Shoop and Long said that everyone on the scene could benefit from this type of class, simply because everyone on scene some sort of role during an event.

Using the resources on Fame’s Rehab ambulance, those taking the class will be shown all the basics and be able to use the tarps, flags and checklists already available. While a mass shooting will be the focus, as those are more common incidents and more familiar to many, they are not the only type of mass casualty incident that will be discussed.

“He will touch base on everything to include accidents, weather related incidents and pandemics,” Shoop said. “Even some you don’t realize.”

Shoop said it is unfortunate that this world is one where first responders have to train for mass casualty events, but at least they will be able to respond efficiently because of the training.

Last year, the Mifflin County Regional Police Department hosted an active shooter training which brought together all law enforcement in Mifflin County to include the sheriff’s office. The class helped them to learn how to subdue an active shooter and enter a building when one is present. Shoop said this is the next level up.

“It is all about everyone working together,” he said.

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