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ANNEX 5: MASS CASUALTY

The Municipality will coordinate mass casualty incident response to minimize loss of life and human suffering. A mass casualty incident is an event with critical injuries or deaths exceeding the normal response capability of an emergency medical services organization. A major earthquake, hazardous materials release, or acts of terrorism are examples of emergencies where a mass casualty incident might occur.

OPERATIONAL CONCEPTS

A.      Direction and control of emergency medical functions at hospitals remain the responsibility of each facility's management and staff during a mass casualty incident.

B.      The Municipality will make a reasonable effort to triage known family members to the same hospital.

C.      The Municipality may activate a congregate care facility to deliver non-critical mass medical care to ease congestion at area hospitals. Hospitals may also establish additional areas to deliver non-critical mass medical care and triage.

D.     During a mass casualty incident, qualified medical providers, non-acute care hospitals, outpatient clinics and other medical facilities should be prepared to treat minor injuries and perform triage when necessary.

E.      If normal communications are disrupted during a disaster, medical personnel are encouraged to report to the hospital where they practice for possible reassignment.

F.      The Ted Stevens Anchorage International Airport will direct FAA mass casualty protocols during a mass casualty incident caused by aircraft crash.

G.     The Alaska State Troopers will augment local search and rescue efforts to support a mass casualty incident.

H.    The State Medical Examiner’s Office should be contacted as soon as practicable when a mass casualty incident has been identified.

I.        A Hospital Emergency Alert Response Network (HEARNet) will be established between emergency medical responders and area hospitals. Efforts to include hospitals outside the local area will be made as necessary and as technological capabilities allow.

J.        Responders at a hazardous materials incident and medical facilities receiving victims from a hazardous materials site will ensure they fully understand the incident commander’s situational assessment and take full precautions to protect themselves.

K.      During a mass casualty incident caused by a chemical, biological, radiological, or nuclear event, the Municipality may provide security at hospital emergency rooms to prevent further contamination.

L.      Initial victim decontamination must be performed in the field to minimize further contamination as not all hospitals may have adequate decontamination facilities.

M.    The EOC in coordination with area hospitals will request a Disaster Medical Assistance Team immediately upon awareness that an incident may overload area hospitals.

N.    The Municipality will coordinate a locally based response to support a mass casualty incident in another Alaskan community.

RESPONSIBILITIES

The responsibilities listed herein are not intended to be departmental checklists. Each agency will develop internal policies and procedures to perform its assigned duties. At the discretion of the incident commander not all functions may be performed and nor all agencies used.

Primary Agencies

Anchorage Office of Emergency Management / Emergency Operations Center

1.      Coordinates overall strategic disaster response during a major emergency or disaster.

2.      Secures additional resources through state and federal agencies as needed.

3.      Coordinates with and supports requests from field agencies during a major emergency or disaster.

4.      Assumes strategic long-term planning for a mass casualty incident.

5.      Coordinates dissemination of critical public information and instructions, including public health advisories, evacuation instructions, and shelter information.

6.      Notifies area hospitals immediately upon identification of a mass casualty incident.

7.      Coordinates with local hospitals to determine the need to request outside resources immediately upon awareness that an incident may overload area hospitals.

8.      Ensures activation of communication links between emergency responders and area hospitals, including HEARNet activation.

9.      Directs coordination of patient needs, transportation, and hospital capabilities between field units and area hospitals.

10.  Assists the state medical examiner in the establishment of morgues.

Area Hospitals

1.      Provides medical care.

2.      Provides updates to the EOC regarding hospital capabilities and capacity.

3.      Restocks consumable medical supplies to field units upon EOC request as able.

4.      Ensures participation in HEARNet communications.

5.      Maintains a record of patients transported to its facility by municipal Emergency Medical Services.

6.      Supply a medical liaison to the EOC.

7.      Establishes onsite decontamination capabilities whenever decontamination is necessary.

Fire Department

1.      Ensures early notification to the EOC when an incident has the potential to become a mass casualty incident.

2.      Provides emergency responders for emergency care and basic life support.

3.      Establishes field medical and triage sites.

4.      Establishes decontamination facilities and ensures appropriate and effective victim and responder decontamination prior to transport.

5.      Coordinates victim transportation and hospital capabilities with the EOC.

6.      Assists agencies in establishing safe decontamination and patient treatment areas.

7.      Maintains a record of patients transported from the incident site to medical facilities.

8.      Dispatches an officer to hospitals to assist transport of incoming patients as able.

9.      Assists hospitals with decontamination activities once field decontamination and other field objectives have been accomplished.

Health and Human Services

1.      Coordinates public health information with the EOC.

2.      Coordinates public health workers and nurses to assist with health-related services at mass casualty sites.

3.      Coordinates assistance for vulnerable populations as able.

4.      Assists in the provision of any necessary pest control.

5.      Maintains a database of medical assets and ensures its availability to the EOC.

6.      Analyzes public health impact of the incident and provides information to the EOC.

7.      Coordinates recommendations with the Policy Group regarding public health threats that may necessitate the deployment of the Strategic National Stockpile, Disaster Medical Assistance Teams, or Disaster Mortuary Teams.

8.      Provides a medical officer to order public health or medical interventions and guidance as needed.

Support Agencies

Alaska Professional Volunteers/ Medical Reserve Corps

1.      Assists the delivery of non-critical medical services at mass care sites as directed by the EOC.

Amateur Radio Emergency Services

1.      Provides equipment and resources to enhance emergency communications capabilities between the EOC, hospitals, and other mass care sites.

American Red Cross of Alaska

1.      Provides basic first aid assistance at non-critical medical mass care sites as able.

2.      Activates its Air Incident Response Team to perform the following functions at an aviation disaster declared by the National Transportation Safety Board:

3.      Establishes a staff processing center at or near the site to coordinate staff and volunteer activities.

4.      Directs the delivery of mental health services to meet the needs of victims, their loved ones, and Red Cross personnel responding to the incident.

Civil Air Patrol

1.      Assists transport of victims to hospitals, and transporting of equipment or supplies.

Police Department

1.      Establishes required security at the incident site and establishes a perimeter as necessary.

2.      Conducts investigative and law enforcement activities associated with a manmade mass casualty incident.

3.      Provides traffic control at incident site and ensures access for emergency vehicle ingress and egress.

4.      Assists fire department with rescue operations as able.

5.      Assists state medical examiner in the identification of the deceased.

6.      Assists in providing death notifications to next of kin.

7.      Provides required security at medical facilities, including temporary medical facilities and triage centers.

8.      Coordinates with the EOC Mental Health Unit to provide chaplains to deliver

Public Transportation

1.      Assists victim transport as directed by the incident commander or the EOC.

Salvation Army

1.      Provides food for emergency responders at a mass casualty site as needed.

2.      Coordinates with the EOC Mental Health Unit to provide comfort and solace for emergency workers and disaster victims as able.

School District

1.      Provides nursing services as needed within the Anchorage School District system.

2.      Augments nursing services as directed by the EOC and as appropriate based on the availability of nurses after student needs have been met.

MUTUAL AID, STATE, AND FEDERAL ASSISTANCE

All state and federal assistance is coordinated through the State Emergency Coordination Center. 

Mutual aid agreements with the Matanuska-Susitna Borough Department of Emergency Services may be activated to support fire, EMS, or rescue operations.

Hospitals in neighboring jurisdictions may be able to provide medical or facility support including the Third Medical Group at Elmendorf Air Force Base, Mat-Su Regional Medical Center, Central Peninsula General Hospital, Bartlett Memorial Hospital, and Fairbanks Memorial Hospital.

The Alaska Disaster Medical Assistance Team is coordinated through the Alaska Native Medical Center and may be deployed at the request of the Governor.

A federal Disaster Medical Assistance Team may be requested through the Federal Emergency Management Agency during a federally declared disaster.

The state medical examiner can provide support for identification, storage, disposition, and documentation of the deceased.

The Alaska State Scientific Crime Detection Laboratory may provide support for laboratory analysis including DNA and evidence testing.

The Alaska State Troopers will augment local search and rescue efforts with helicopter support and through their management of Alaska Search and Rescue Dogs, Alaska Mountain Rescue group, and the Anchorage Nordic Ski Patrol.

The Anchorage International Airport will support municipal emergency services as able.

The Federal Emergency Management Agency may provide assistance including the deployment of Disaster Medical Assistance Teams, Disaster Mortuary Teams, and Crisis Counseling Assistance Teams.

The Strategic National Stockpile may be deployed through the Centers for Disease Control and Prevention.

The National Transportation Safety Board will provide assistance in transportation-related mass casualty incidents.

The Federal Aviation Administration will assist response to mass casualty incidents.

The Federal Bureau of Investigation may assume victim identification responsibilities in incidents involving interstate commercial carriers, hostage situations, or acts of terrorism.

REFERENCES

Anchorage Emergency Operations Plan, Annex 3: Congregate Care

Alaska Statewide Interagency Mass Casualty Response Plan

National Response Plan, ESF #8: Public Health and Medical Service

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