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Defination of a major incident

- Any Occurrence that presents serious threat to the health of the community, disruption to the service or causes such numbers or types of casualties as to require special arrangements to be implemented


Some of the roles and responsibilites of the Ambulance service in a Major incident

-1. Treat casualties by extrication, triage, decontamination (if appropriate), on site treatment and transport to hospital.

2. Liaise with all other agencies involved in the management of the incident and provide an effective ambulance command structure - Interoperability.

3. Establish an effective communications network both within and external to the scene for all NHS staff including the deployment of the MEOC vehicle.

4. Notify the wider NHS and manage NHS resources at the scene.

5. Co-ordinate the medical and first aid services. Arrange if necessary, for the attendance of a Medical Incident Advisor.

6. Liaise with receiving hospitals, through the MIA and Ambulance EOC / RCC, confirming bed availabilities, casualty numbers and the casualty distribution to appropriate hospitals ( Major Trauma Network).

7. Request “mutual aid” from neighboring Ambulance Services, alerting voluntary aid organisations and PTS providers to supply support.


What does CSCATT stand for

C establish Command and Control

S Safety of Self, Scene and Survivors

C Communication

A on-going Assessment

T Triage Sieve and Sort

T Treatment

T Transport


First ambulance on scene of a major incident should try to

1. Assume the role of Ambulance Incident Commander until relieved by an Ambulance Service Manager.

2. Don high visibility jacket and protective helmet - DO NOT ATTEMPT RESCUE OR TREATMENT OF CASUALTIES.

3. Assess the scene and if safe to enter, carry out the reconnaissance of the scene and provide a METHANE report to EOC:

4. In liaison with the other Emergency Services, initially set up:
Access and egress to the site
Ambulance Parking Point
Ambulance Control Point
Casualty Clearing Station
Area for decontamination (if appropriate)

5. Prepare “brief” for the first Ambulance Manager on scene (who will assume the Ambulance Incident Commander role).


What does METHANE stand for

M my call sign, Major incident declared or standby

E exact location of incident

T type of incident ( RTC,HAZCHEM etc)

H hazards actual and potential

A access and egress to incident ?RVP

N no of casualties (quick first estimate)

E Emergency services present or required

S Start a Log


What is the JESIP doctrine

Joint Doctrine sets out what responders should do and how they should do it in a multi agency working environment, in order to achieve the degree of interoperability that is essential to successful joint response.


What are the five principles of working together with other agencies

- Co location

- Communication

- Co ordination

- Joint understanding of the risk

- Shared situational awareness


What is the Joint Decision Model

- Gather intelligence and information

- Assess risk and develop a working strategy

- Consider powers, policys and procedures

- Identify options and contingencies

- Take action and review what happened



What is a HAZMAT incident

- Hazmat (Hazardous Materials incident) - “accidental release of substance, agent or material which results in injury or illness to the public or denial of an area or interruption of the food chain.”


What does CBRN stand for and mean

- C.B.R.N. e (Chemical, Biological, Radiological, Nuclear & explosive) – “Is a deliberate, malicious and murderous act, the intention of which is to kill, sicken or prevent society from continuing with their normal daily basis.”


What does a Electroic Personal Dosimeter detect

- Beta - Surface contamination

- Gamma - Passes through the air

Its a piece of equiptment that detects the measuring of radiation


Routes of entry for Nerve agents

- Inhalation

- Absorption

- Ingestion


Severe signs and symptoms of nerve agent attack

- Severe difficulty breathing

- Copious secretions from lungs/airway

- Severe muscular twitching and general weakness

- Involuntary urination and defecation

- Convulsions

- Unconsciousness

- Respiratory arrest (leading to death)