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MID-AMERICA REGIONAL COUNCIL
EMERGENCY RESCUE COMMITTEE (MARCER)
REGIONAL
MASS CASUALTY
INCIDENT PLAN
FOR METROPOLITAN KANSAS CITY
JANUARY 2004
MARCER TABLE OF CONTENTS
TABLE OF CONTENTS
TABLE OF CONTENTS .............................................................................................................. i
RECORD OF CHANGES........................................................................................................... iii
LETTER OF PROMULGATION ............................................................................................. iv
MASS CASUALTY INCIDENT PLAN
INTRODUCTION............................................................................................................................1
PURPOSE AND OBJECTIVES
Purpose...................................................................................................................................1
Objectives ..............................................................................................................................2
PLAN PARTICIPANTS..................................................................................................................2
DEFINITIONS
Mass Casualty Incident..........................................................................................................2
Disaster ..................................................................................................................................2
INCIDENT MANAGEMENT SYSTEM .......................................................................................2
IMPLEMENTING THE MASS CASUALTY INCIDENT PLAN
First Unit on Scene ................................................................................................................3
Criteria for Requesting Mutual Aid and Implementing the Regional Mass Casualty
Incident Plan ..........................................................................................................................4
Procedures for Requesting Mutual Aid and Implementing the Regional Mass Casualty
Incident Plan ..........................................................................................................................4
Identification of Functional Areas and Personnel..................................................................5
Regional Standing Orders for EMS Operations ....................................................................5
Use of Helicopters .................................................................................................................6
Role of Law Enforcement......................................................................................................6
TRIAGE ASSESSMENT AND TREATMENT PROCEDURES
Triage .....................................................................................................................................7
Facility Management .............................................................................................................7
Movement of Patients from the Scene of an Aircraft Accident.............................................8
Treatment Area ......................................................................................................................8
EMERGENCY COMMUNICATIONS
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MARCER TABLE OF CONTENTS
Radio Identification ...............................................................................................................9
Initial Communications by Responding Agency ...................................................................10
Additional Resources Requested by Medical Sector Leader.................................................10
Use of the Med Channel ........................................................................................................10
Use of EMSystem ..................................................................................................................11
Use of the HEAR System ......................................................................................................11
Use of Wireless/Cellular Phones ...........................................................................................12
AVAILABILITY AND USE OF MASS CASUALTY INCIDENT MEDICAL
EQUIPMENT UNITS......................................................................................................................13
TRACKING OF PATIENTS ..........................................................................................................13
REVIEW OF MASS CASUALTY INCIDENTS ..........................................................................13
TRAINING AND EXERCISES......................................................................................................13
APPENDICES
APPENDIX A: Regional EMS Resources.......................................................................................A-1
APPENDIX B: Incident Management System Position Descriptions.............................................B-1
APPENDIX C: Mass Casualty Incident Caches of Supplies ..........................................................C-1
APPENDIX D: Mass Casualty Incident Checklists .........................................................................D-1
APPENDIX E: Non-Acute Care Hospital Resources for MCI Assistance......................................E-1
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MARCER RECORD OF CHANGES
RECORD OF CHANGES
CHANGE DATE OF COMPLETED BY DATE
NUMBER CHANGE COMPLETED
MID-AMERICA REGIONAL COUNCIL iii JANUARY 2004
MARCER LETTER OF PROMULGATION
LETTER OF PROMULGATION
To All Agencies and Readers:
The Mid-America Regional Council Emergency Rescue Committee (MARCER) has prepared
this update of the Regional Mass Casualty Incident (MCI) Plan. The purpose of this plan is to
describe the procedures necessary to ensure an effective and coordinated response to an incident
involving mass casualties in the Kansas City metropolitan area. The plan provides a structure for
coordination and communications among multiple emergency medical agencies and other
organizations providing pre-hospital care in metropolitan Kansas City. This plan has been
endorsed by a number of emergency services associations, including the Heart of America
Metropolitan Fire Chiefs Council, the Johnson County Emergency Medical Services Council and
the Mid-America Regional Council Board of Directors.
This plan will be reviewed and updated at least bi-annually to reflect changes in policies,
technology or operational procedures that affect the emergency response capabilities of the EMS
agencies in the greater Kansas City metropolitan area.
MARCER welcomes your comments and suggestions for improving this plan. Please direct your
comments and suggestions to MARCER, 600 Broadway, 300 Rivergate Center, Kansas City,
MO 64105-1554 or via e-mail to MARCER@marc.org.
Division Chief Brad Mason
Johnson County Emergency Medical Services: Med-Act
Chair, Mid-America Regional Council Emergency Rescue Committee
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MARCER REGIONAL MCI PLAN
REGIONAL MASS CASUALTY INCIDENT PLAN
I. INTRODUCTION
A. The Mid-America Regional Council Emergency Rescue Committee (MARCER)
developed a regional mass casualty incident plan in the late 1970s. The plan
provided definitions that became standards for many local agencies and were
incorporated by the Greater Kansas City Health Council in their Emergency
Communications Plan. For the most part, however, the plan was never endorsed
by local agencies and regular exercises to ensure that it provided meaningful
direction were never held. In late 1997, as part of a strategic planning process,
MARCER determined the need to develop a new Regional Mass Casualty
Incident Plan for metropolitan Kansas City.
B. Metropolitan Kansas City is fortunate to be served by a sizable number of
emergency medical services (EMS) agencies and hospitals. There are over 40
state-licensed EMS agencies, including, EMS departments, fire departments, air
ambulance services and other providers. The eight-county, bi-state region is
served by 24 major hospitals. MARCER has coordinated regional emergency
pre-hospital care since the mid-1970s. MARCER addresses mutual aid issues,
tracks and advocates for state legislation and manages a regional medical
communications system, the EMSystem for Metro Kansas City, and a cooperative
purchasing program.
C. Coordination between area hospitals is accomplished in a number of ways,
including through MARCER, the Health Alliance of Mid-America, the
Emergency Nurses Association Managers Special Interest Group. The Health
Alliance of Mid-America maintains the Hospital Emergency and Administrative
Radio system (HEAR); conducts semi-annual drills; and provides opportunities
for information sharing and cooperation. The Emergency Nurses Association
Managers Special Interest Group meets as a group to share information,
coordinate training and provide important input to regional emergency medical
issues.
II. PURPOSE AND OBJECTIVES
A. Purpose
The plan provides a structure for coordination and communication among
multiple emergency medical agencies and other organizations providing pre-
hospital emergency care in metropolitan Kansas City. The plan seeks to
maximize existing resources of emergency medical agencies and hospitals.
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B. Objectives
1. The plan will give direction to EMS agencies, hospitals and others
involved in a mass casualty incident, in a manner that is consistent and
compatible with local plans and protocols.
2. The plan will increase knowledge and access to available resources, will
offer consistent definitions and increase understanding and improve
coordination in the use of the region’s various medical communications
systems.
III. PLAN PARTICIPANTS
A. The plan covers mass casualty incidents that occur in the following counties in
metropolitan Kansas City: Cass, Clay, Jackson, Platte and Ray counties in
Missouri and Johnson, Leavenworth and Wyandotte counties in Kansas. All
emergency medical services agencies and hospitals serving all or portions of
those counties or located within those counties are covered by this plan, unless
indicated otherwise. A listing of all agencies and hospitals is included in
Appendix A.
B. The plan also addresses the roles and responsibilities of law enforcement agencies
and the American Red Cross in mass casualty incidents.
IV. DEFINITIONS
A. Mass Casualty Incident
For purposes of this plan, a mass casualty incident, or MCI, is any single incident
that results in a number of patients that tax the responding agencies resources and
as determined by the Incident Commander?
B. Disaster
For purposes of this plan a disaster is any natural or man-made event, civil
disturbance or hostile attack, or any other hazardous occurrence of unusual or
severe effect, threatening or causing injury to multiple individuals. The Kansas
City region may operate in an “operational disaster mode” prior to any formal
declaration of a disaster by local officials.
V. INCIDENT MANAGEMENT SYSTEM
A. The Incident Management System objectives are to ensure central control,
provide for inter-agency coordination and provide that no one individual becomes
overloaded with specific assignments or details. On simple incidents, the Incident
Commander or Medical Sector Leader may well serve multiple roles. The system
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MARCER REGIONAL MCI PLAN
provides the ability to delegate/step to a higher command within the established
structure.
B. While this plan does not supplant or dictate local department operations, it
encourages all agencies to follow consistent procedures. The more a system
can be used on routine operations, the easier it will be to use on complex MCIs.
The Incident Management System is intended to allow even the smallest
department to “fill out” the command staff on a large incident through the use of
mutual aid resources.
C. The key Incident Management System positions necessary to respond to an MCI
are diagrammed in Appendix B. Users of this plan are encouraged to obtain a
copy of the National Fire Service Incident Management System Model
Procedures Guide for Emergency Medical Incidents, First Edition for detailed
descriptions of Incident Management System positions.
D. MARCER encourages the use of the Incident Management System adopted by the
Heart of America Metropolitan Fire Chiefs Council for response to MCIs.
VI. IMPLEMENTING THE MASS CASUALTY INCIDENT PLAN
A. First Unit on the Scene
Regardless of the location, nature or extent of the disaster, the first unit to arrive
on the scene shall have initial command and control authority, and should:
1. Assess the scene and check for unusual hazards.
2. Advise the unit’s communications center of the situation, including patient
count, if any.
3. Establish a preliminary command post, give exact location of the
preliminary command post to the communications center and maintain
command and control of the disaster location until relieved of command.
4. Initiate triage.
5. First arriving management personnel will generally assume command
responsibility and advise the communications center of such action,
including, but not limited to, locations of command post, triage and
vehicle holding areas.
6. The Incident Commander shall determine if the situation is a mass
casualty incident and request mutual aid through the local agency’s
communications center.
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B. Criteria for Requesting Mutual Aid and Implementing the Regional Mass
Casualty Incident Plan
This Regional Mass Casualty Incident Plan will be implemented when the
following circumstances occur:
1. An emergency that meets the definition of an MCI or disaster has occurred
or appears imminent.
2. The requesting jurisdiction or agency has committed all of its available
resources and determines additional resources are needed to ensure quality
pre-hospital patient care
C. Procedures for Requesting Mutual Aid and Implementing the Regional Mass
Casualty Plan
1. When it is determined by the Incident Commander of the affected
jurisdiction that EMS assistance is required, he shall communicate this
through the respective communications center. Requests for assistance
shall include:
a. The nature and location of the emergency.
b. The number of personnel requested and type of specialized
personnel or equipment needed.
c. The location where assisting units should report.
2. The Incident Commander will determine if mutual aid is required, and the
level of mutual aid necessary to respond to the situation. For larger
incidents, local mutual aid in Missouri will be coordinated by the Lee’s
Summit Fire Department through Region A of the Missouri Mutual Aid
System. In Kansas, mutual aid will be coordinated by the Johnson County
Emergency Communications Center.
3. Contact for mutual aid may be made in one of the following ways:
a. Incident Commander requests his/her agency’s dispatch center to
request mutual aid.
b. Using the fire mutual aid frequency in the field, request mutual aid
from appropriate local agencies.
4. The Incident Commander should contact the appropriate EMSystem
Coordination Center (EMCC) and request an MCI Alert. The alert can be
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MARCER REGIONAL MCI PLAN
local in nature, i.e., issued to the five hospitals closest to the incident, or it
can be issued metropolitan-wide.
5. Information on issuing an MCI Alert are found in the EMSystem Protocols
and Policies Manual.
D. Identification of Functional Areas and Personnel
1. The following functional areas may be set up to accomplish management
of the incident. These areas may be identified by color-coded lights
and/or flags:
a. Command Post (green flashing light).
b. Staging Area (flag).
c. Triage Area (flag).
d. Treatment Area (flag).
e. Transport area (flag).
f. Public Information Area/Joint Information Center (flag).
2. All emergency responders on the scene of the mass casualty incident,
including EMS personnel, should wear identification designating their
jurisdiction/agency. Incident command officials should be identified by
vests.
E. Regional Standing Orders for EMS Operations
1. When communications with area hospitals or other medical advisors
cannot be used effectively or when there is an unavoidable delay in the
transport of a patient to a medical facility, standing orders for EMS
operations may be used.
2. These standing orders will allow ALS and BLS units providing mutual aid
outside of their jurisdiction to administer all drugs and perform all
procedures as contained in their own jurisdictional written protocols.
F. Use of Helicopters
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1. Helicopter support may be a valuable and effective resource in providing
timely patient care and transportation, depending on weather conditions,
the location of the incident and other factors.
2. When the Medical Sector Leader determines that conditions exist for the
use of air evacuation services, the communications center will request the
appropriate response. Such requests should be routed through the Incident
Commander.
3. An appropriate landing site will be identified and cleared. Fire department
personnel will assume responsibility for clearing and holding the landing
area.
4. After landing, helicopter medical crews will report to and accept direction
from the Medical Sector officer or designee for operational purposes.
G. Role of Law Enforcement
1. Law enforcement officials may be the first responders to the scene of a
mass casualty incident. The officers should be trained to report the nature
of the incident to their communications center, which would contact the
appropriate fire department and/or emergency medical services agency.
2. In an MCI, the roles of law enforcement may include:
a. Securing the scene of the incident to prevent additional casualties,
control ingress and egress, and allow emergency responders to
treat casualties.
b. Providing traffic control to facilitate movement of emergency
vehicles and to restrict other traffic.
c. Preserving the crime scene.
d. Investigations to determine the cause of the incident and the
responsible party.
VII. TRIAGE ASSESSMENT AND TREATMENT PROCEDURES
The purpose of the Regional Triage Assessment and Treatment Procedures is to establish
standard procedures in the event of a mass casualty incident. The primary objective is to
evaluate, treat and transport patients in an orderly and expedient manner.
A. Triage
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1. The first arriving unit will survey the incident area to make a quick
evaluation of all injured persons, stopping only to treat airway or
breathing casualties and severe, copious uncontrolled bleeding.
2. The Incident Commander will notify their communications center of the
nature of problem, exact location, approximate number of injured persons
and additional resources needed. This information must be relayed to
the designated EMCC so that the information can be relayed to the
hospitals.
3. The first arriving unit should conduct triage after the initial evaluation to
the extent possible. On extremely large incidents, such as large buildings,
the triaging may be subdivided into smaller areas (geographic sectors).
4. When conducting triage, patients should be divided into four categories,
Red, Yellow, Green and Black. Color-coded triage tags should be used.
The four categories include:
a. Red - First priority in patient care, these are victims in critical
condition whose survival depends upon immediate care.
Treatment of the Red victims should begin as soon as possible.
b. Yellow - Victims that need urgent medical attention and are likely
to survive if simple care is given as soon as possible.
c. Green - Victims who require only simple care or observation.
Even though victims in this category may appear uninjured and
emotionally stable, they must be evacuated to a medical facility for
evaluation by trained medical personnel.
d. Black - These victims are dead or whose injuries make them
unlikely to survive and/or extensive or complicated care is needed
within minutes.
B. Fatality Management
Fatalities will be managed in accordance with local medical examiners’ plans and
the mass fatalities or medical examiners components of local emergency
operations plans.
C. Movement of Patients from the Scene of an Aircraft Accident
1. If patients are dead, they should be tagged and left where they are until the
appropriate federal authority arrives.
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2. If a dead patient is moved, a tag should be placed at the site where found.
3. The crash scene should be sealed off from the public and debris should not
be moved unless absolutely necessary.
D. Treatment Area
1. A treatment area may be needed for a large incident when many people
are injured.
2. All patients not immediately transported are to be sent from the triage area
to this area.
3. The Medical Sector Leader will decide if a treatment area is needed. If so,
a Treatment Officer will be designated. The Treatment Officer will be
responsible for:
a. Re-evaluating the patient’s condition.
b. Directing definitive care such as medications, IV, etc.
c. Notifying the Medical Sector Leader of needs for personnel,
medical supplies and equipment.
d. Coordinate patient disposition with the Transport Officer.
e. Coordinating the actions of physicians and/or other medical
personnel.
4. MMRS trailers and decontamination trailers are equipped with portable
shelters and tents and may be used to establish the treatment area. MMRS
resources may be requested through contacting the Lee Summit Fire
Department.
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VIII. EMERGENCY COMMUNICATIONS
Only essential radio communications should be made during a mass casualty incident in
order to keep radio traffic to a minimum.
A. Radio Identification
1. When communicating during response to a mass casualty incident, all
responding units will identify themselves on radio with “Department
Name - Unit Type – and Unit Number”, e.g., “CJC MEDIC 1 to
INDEPENDENCE COMMAND.”
2. Once a unit is assigned a task, it should identify itself with the Task or
Sector as appropriate, e.g., “Triage Team 1 to Triage Sector.” When a
task is complete, the unit should report back to the assigning officer that
the given task is complete and that the Department Name - Unit Type is
available.
3. All communications shall be made in plain language (no “10 codes”
should be used).
4. Units using radio communications should first make sure that the
receiving unit is ready to copy before sending body of message. The
receiving unit should then repeat in summary the body of the message or
order.
5. Generic radio channel names will be used instead of numeric
nomenclature.
6. In order to provide for maximum safety and clarity of operation, certain
key words must be understood to mean the same to all involved:
a. Withdraw - In an orderly manner, back out of the area taking all
equipment with you as you go.
b. Evacuate - Immediately leave area, dropping in place any
equipment that would slow down retreat. On the Missouri side of
the metropolitan area, the evacuation signal is a radio message
followed by five long air horn blasts. In Johnson County, the
evacuation signal is a radio tone. It is recommended that all
agencies responding to an MCI within the metropolitan area
use a radio message followed by a long air horn blast. This
protocol will avoid problems of incompatibility among multiple
agencies’ radio systems.
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c. All Clear - It has been determined that the hazard to civilians has
been eliminated or does not exist. If involvement precludes search
of involved/threatened areas, an announcement from Command
that “No all clear will be given” will be issued. Either
announcement signifies that objectives are switching primarily to
exposure/confinement operations.
B. Initial Communication by Responding Agency
When the initial responding agency’s communications center determines that an
MCI exists or may exist, that communications center will begin mutual aid
contact of other agencies to provide appropriate resources.
C. Additional Resources Requested by Medical Sector Leader
Once the Incident Command System is in place, the Medical Sector Leader will
determine if EMS personnel or equipment is needed in addition to that requested
by the first responding agency’s communication center.
D. Use of the Med Channel System
1. The Medical Channel System (Med Channel) managed by MARCER is a
two-way communication system allowing EMS field crews from over 30
agencies to communicate with Kansas City area hospitals on pre-hospital
patient care or to alert the hospitals to in-coming patient situations.
2. The primary backbone for the med channel system is the trunked 800
MHz radio system of Johnson County, KS, backed up by the systems in
Kansas City, KS and Raytown, MO. Every hospital is equipped with an
800 MHz radio. All communications to hospitals occurs over this radio.
The trunked 800 MHz radio system is currently used on a daily basis and
would be used during a MCI event.
3. Radio contact with the hospitals occurs in one of three modes. 1. Direct
800 to 800 radio traffic. 2. UHF to 800 patch facilitated by MARCER
Control. 3. A phone patch to 800 facilitated by MARCER Control.
4. During MCI operations MARCER Control has the ability to patch
multiple hospitals into one tactical talk group to facilitate wide area
announcement type communications. Request this type of patch through
MARCER Control.
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MARCER REGIONAL MCI PLAN
5. The UHF radios operate on channels reserved by the Federal
Communications Commission for medical communications. The 10
channels are shared with MAST (1 through 4 are used by MARCER and 4
through 9 by MAST; 10 is used to request a patch).
6. 3 UHF repeater stations located throughout the metropolitan area allow for
regional coverage.
7. The patching system is operated by the Johnson County Emergency
Communications Center. MAST uses a separate communications system.
8. If the Incident Commander determines that an MCI exists, the Incident
Commander will contact his communications center and request that the
appropriate EMCC be contacted and an MCI Alert issued. EMSystem
will be used to alert area hospitals to the MCI and poll hospitals for their
patient bed status.
E. Use of EMSystem
1. EMSystem is a web-based program providing real-time information on
hospital emergency department status, hospital patient capacity,
availability of staffed beds and available specialized treatment
capabilities.
2. EMSystem links all acute care hospitals and many EMS agencies in the
greater Kansas City metropolitan area. It is the region’s primary method
of communicating hospital status and capabilities and coordinating
patient routing during an MCI.
3. Refer to the EMSystem Protocols and Policies Manual for detailed
information on EMSystem and its use.
F. Use of the HEAR System
1. The Hospital Emergency Administrative Radio (HEAR) system links all
acute care hospitals in metro Kansas City and many area EMS agencies on
a single channel radio system (155.340 MHz). The HEAR system serves
as a backup to the EMSystem in the event of an MCI. Baptist Medical
Center (816/276-7000) is the primary control hospital for the HEAR
system.
2. The HEAR system is operated from Baptist Medical Center’s Security
Department, located in a separate building from the Emergency
Department.
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3. The HEAR system may be used if both the EMSystem and the Med
Channel System fail and an incident results in enough injuries to
overwhelm the two or three nearest hospitals to the scene. The initial
responding agency’s communications center will contact Baptist Medical
Center and request that the HEAR system be activated.
4. Once an alert is issued, Baptist Medical Center contacts each hospital and
collects treatment capability information, including the patient treatment
capacity for three categories: severely injured, significant injuries and
non-life threatening injuries.
5. All communications with Baptist Medical Center’s HEAR system or
directly with all hospital emergency rooms should be made in plain
English. The information should include a brief description of the
incident (e.g., building collapse) and estimate of the number of casualties.
6. Based on the information about hospital capabilities collected by Baptist
Medical Center, the Medical Transportation Officer determines the mode
of transportation and coordinates patient disposition to the hospitals. The
Medical Transportation Officer should report back to Baptist Medical
Center on the number of patients being transported and to which hospitals.
7. The hospitals should call back to Baptist Medical Center to report on bed
capacities.
8. The control hospital, Baptist Medical Center, will monitor the flow of
patients to hospitals and notify the Medical Transportation Officer of
hospitals that reach capacity. Those with the capability should monitor
the HEAR system and communicate with the command post at the scene
of the incident.
9. In the event that Baptist Medical Center cannot be contacted, agencies in
Kansas should contact the Johnson County Emergency Communications
Center (913-432-1717) and agencies in Missouri should contact MAST
(816-924-0600) to coordinate patient transportation and treatment.
G. Use of Wireless Phones
1. Historically wireless phone systems have failed during disasters. Reliance
upon these systems for public safety communications during periods of
disaster is questionable. However, depending upon the scope and type of
the incident, wireless or cellular phones may provide a backup
communications system between dispatchers for area EMS agencies and
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MARCER REGIONAL MCI PLAN
the Medical Sector Leader, between the EMS Transportation Officer and
an EMCC, and with other organizations.
2. Available wireless phones at the incident scene should be identified to the
Communications Officer, in the event that they are needed at specific
times.
3. If the incident is one of longer duration, area wireless companies will be
asked to provide wireless phones and priority access at the scene of the
incident.
IX. AVAILABILITY AND USE OF MULTI-CASUALTY INCIDENT MEDICAL
EQUIPMENT UNITS
A. There are Mass Casualty Equipment Caches located throughout the metropolitan
area. Each cache has a capability to treat approximately 50 to 100 patients. Some
of the equipment is ALS capable.
B. Descriptions of the caches and how to request their response are included in
Appendix C.
X. TRACKING OF PATIENTS
The triage tags should be filled out with as much information about the patient as the
Triage personnel are able to ascertain and complete. A portion of the tag should be
retained, including the hospital to which the patient is being transported. The
Transportation Officer will retain the tag portions and make them available to American
Red Cross representatives or others responsible for notifying family members or
determining the location of victims.
XI. REVIEW OF MASS CASUALTY INCIDENTS
Within two weeks of an MCI, MARCER will appoint a task force to review the response
to the incident. This task force will present its findings to MARCER at its next regularly
scheduled meeting.
XII. TRAINING AND EXERCISES
MARCER will review the plan bi-annually, determine training needs and schedule
appropriate training. At a minimum, the plan will be exercised annually in conjunction
with area hospital disaster drills.
MID-AMERICA REGIONAL COUNCIL 13 JANUARY 2004
APPENDIX A
REGIONAL EMS RESOURCES
MARCER REGIONAL MCI PLAN
REGIONAL EMS RESOURCES
AGENCY NUMBER OF AMBULANCES
AVERAGE ADDITIONAL
NUMBER IN AMBULANCES
SERVICE 24 IN SERVICE
HOURS A DAY WITHIN ONE
HOUR OF A
CALL-BACK
JACKSON COUNTY 24 HR. PHONE
MAST (Numbers include Jackson, Clay and Platte 816-923-3456 or 18 30
Counties) 816-924-0600 x5
Central Jackson County Fire Protection District 816-228-0151 3 1
Ft. Osage Fire Protection District 816-969-7407 2 1
American Medical Response 816-461-3699 11 5
Grandview Fire Department 816-316-4800 1 1
Raytown EMS 816-737-6040 1 1
Sni Valley Fire Protection District 816-969-7407 2 0
Lee’s Summit Fire Department 816-969-7407 4 1
John Knox Village EMS 816-524-8400 or 1 2
816-246-4343
x2262
JOHNSON COUNTY, KS 24 HR. PHONE
Med Act (serves all cities located in Johnson 913-432-1717 non emr 14 9
913-432-2121 emerg
County)
Lenexa Fire Department 913-432-1717 non emr 3 1
913-432-2121 emerg
Johnson County Fire District #2 (Rural) 913-432-1717 non emr 2 0
913-432-2121 emerg
Leawood Fire Department 913-432-1717 non emr 2 0
913-432-2121 emerg
WYANDOTTE COUNTY 24 HR. PHONE
MAST 816-923-3456 or 6 10
816-924-0600 x5
Bonner Springs EMS 913-596-3050 2 0
LEAVENWORTH COUNTY 24 HR. PHONE
Leavenworth County EMS 913-682-5724 4 2
CLAY AND PLATTE COUNTIES 24 HR. PHONE
Gladstone Public Safety Department 816-436-3550 1 1
Claycomo Fire Department 816-452-4614 1 1
Liberty Fire Department 816-792-6002 2 1
Excelsior Springs Fire Department 816-630-3000 2 1
Kearney Fire & Rescue 816-628-4122 2 0
North Kansas City Fire Department 816-274-6025 2 2
Northland Regional Ambulance District 816-858-1904 2 2
Holt Community Fire Protection District 816-320-3612 1 1
CASS COUNTY 24 HR. PHONE
South Metro Fire Protection District 816-331-0530 2 1
Belton Fire Department 816-331-1500 1 1
Harrisonville EMS 816-380-8940 2 1
Pleasant Hill EMS 816-540-9109 1 1
West Peculiar Fire Department 816-969-7407 4 2
Central Cass Fire Protection District 816-380-5200 1 1
MID-AMERICA REGIONAL COUNCIL 1 JANUARY 2004
APPENDIX A
REGIONAL EMS RESOURCES
MARCER REGIONAL MCI PLAN
AGENCY NUMBER OF AMBULANCES
AVERAGE ADDITIONAL
NUMBER IN AMBULANCES
SERVICE 24 IN SERVICE
HOURS A DAY WITHIN ONE
HOUR OF A
CALL-BACK
RAY COUNTY 24 HR. PHONE
Lawson Fire and Rescue 816-470-2021 1 1
Ray County Ambulance District 816-470-2021 2 1
OTHER GROUND EMS
Miami County EMS 913-294-3232 3 1
Franklin County EMS 785-242-3800 4 0
Lawrence-Douglas County Fire & Medical 785-843-0250 5 2
Johnson County, MO Ambulance District 660-747-5511 2 5
AIR AMBULANCE SERVICES 24 HR. PHONE
LifeNet 1-800-981-3062 3 Rotary Wing 6 Rotary Wing
1 Fixed Wing (From out of area)
LifeFlight Eagle 1-800-422-4030 2 2
Life Star – Topeka/Lawrence 1-800-666-9111 12-14 minutes Based in
Lawrence
GROUND and AIR EMS
PROVIDERS OUTSIDE METRO AVERAGE
RESPONSE
KANSAS CITY TIME TO KC
METRO AREA
GROUND AGENCY 24 HR. PHONE
Topeka 785-232-2222 1 hour
Wichita 316-383-7077 4 hours
Columbia (Joint Communications) 573-442-6131 2 hours
Springfield 417-874-1212 2.5 hours
St. Joseph 816-271-6675 1 hour
AIR AGENCY 24 HR. PHONE
KS/MO Guard & Reserves – activate through EOC
12-14 hours activation time required, if available
May not be available due to world events
MID-AMERICA REGIONAL COUNCIL 2 JANUARY 2004
APPENDIX A
REGIONAL EMS RESOURCES
MARCER REGIONAL MCI PLAN
HOSPITAL PRIMARY SERVICE AREA EMERGENCY DEPARTMENT
DIRECT PHONE LINE
Baptist Lutheran Medical Center Central Kansas City, MO (816) 276-7380
Cass Medical Center Cass County, MO (816) 380-3474
Children’s Mercy Hospital * Metro (816) 234-3430
Children’s Mercy South ***
Cushing Hospital Leavenworth (913) 684-1144
Excelsior Springs Medical Center Excelsior Springs (816) 630-6081
Independence Regional Medical Independence (816) 836-4602
Center**
Lee’s Summit Hospital Lee’s Summit (816) 251-7310
Liberty Hospital** Liberty (816) 792-7000
Medical Center of Independence Independence (816) 478-5252
Menorah Medical Center Johnson County (913) 498-6533
North Kansas City Hospital** North Kansas City (816) 691-2098
Olathe Medical Center Johnson County (913) 791-4357
Overland Park Regional Medical Johnson County (913) 541-5340
Center
Providence Medical Center Kansas City, KS (913) 596-4180
Ray County Hospital Richmond, MO (816) 470-5432 ext. 262
Research Belton Hospital Belton (816) 348-1250
Research Medical Center** Central Kansas City, MO (816) 276-4155
St. Mary’s Hospital Blue Springs (816) 655-5450
St. John’s Hospital Leavenworth (913) 680-6100
St. Joseph Health Center ** South Kansas City, MO (816) 943-2710
St. Luke’s Hospital * Central Kansas City, MO (816) 932-2171
St. Luke’s Northland Hospital Kansas City North (816) 891-6010
St. Luke’s Smithville Hospital Smithville (816) 532-7706
St. Luke’s South Hospital Johnson County (913) 851-7100
Shawnee Mission Medical Center Johnson County (913) 676-2218
Truman Medical Center Lakewood Eastern Jackson CO (816) 373-4415 ext. 1071
Truman Medical Center West * Central Kansas City, MO (816) 556-3100
University of Kansas Medical Ctr. * Kansas City, KS (913) 588-6500
VA Med Center - Kansas City Metropolitan Area (816) 922-2102
VA Med Center - Leavenworth Leavenworth (913) 682-2000 x2900
Miami County Medical Center Miami County, Kansas (913) 294-2327
Lawrence Memorial Hospital Lawrence/Douglas County (785) 749-6162
Atchison Hospital Atchison County (913) 367-6624
Lafayette Regional Health Center Lafayette and Ray Counties (660) 259-6862
Western Missouri Medical Center Warrensburg (660) 747-8824
Heartland Regional Medical Center St. Joseph (816) 271-6122
W
* Level I Trauma Center
** Level II Trauma Center
*** No Emergency Department
MID-AMERICA REGIONAL COUNCIL 3 JANUARY 2004
APPENDIX B
INCIDENT MANAGEMENT SYSTEM POSITION DESCRIPTIONS
MARCER REGIONAL MCI PLAN
INCIDENT MANAGEMENT SYSTEM POSITION DESCRIPTIONS
Incident Commander
The Incident Commander is responsible for overall incident activities and disaster response. The
Incident Commander will also designate the Medical Sector Leader or determined by local
protocol
Medical Sector Leader
The Medical Sector Leader is responsible for overall EMS operations at an incident, for
appointing all other EMS team members, and forwarding all EMS recommendations to the
Incident Commander.
Liaison Officer
The Liaison Officer is responsible for coordinating with other appropriate agencies as needed,
including other local agencies, federal, state or private sector agencies. These agencies may or
may not be located at the command post.
Public Information Officer
Public Information Officer is responsible for formulating and disseminating factual and timely
information about the incident to the news media and other appropriate agencies. Other
personnel should not give statements to the media unless authorized by the Public Information
Officer.
Safety Officer
The Safety Officer is responsible for monitoring emergency operations to ensure the safety of all
personnel and equipment and reporting directly to Incident Commander.
Planning Section Chief
The Planning Section Chief is responsible for understanding the current situation and predicting
the probable course of the incident. This individual also makes recommendations on optional
courses of action. Under this team member’s direction, a Status Unit Leader will be responsible
for collection and display of current situation information, including the current status of
resources (personnel, equipment, apparatus, etc.), and Technical Advisory Unit Leader, who is
responsible for collecting, evaluating and dissemination information concerning specialized
technical data.
MID-AMERICA REGIONAL COUNCIL 1 JANUARY 2004
APPENDIX B
INCIDENT MANAGEMENT SYSTEM POSITION DESCRIPTIONS
MARCER REGIONAL MCI PLAN
Logistics Section Chief
The Logistics Section Chief is responsible for managing those units that provide personnel,
ambulances, equipment, facilities, and personal needs in support of the incident activities. Under
this team member’s direction, a Supply Unit Leader will order, receive, store, distribute and
maintain inventory of all supplies, and a Communications Unit Leader will be responsible for
establishing and supervising the handling of radio and telephone communications. Under this
team member, the Water Unit Leader will be responsible for the development of adequate water
sources in a fire suppression situation.
Sector Leader
The Sector Leader is responsible for a specific geographic area or specific function other than
those listed (e.g., Hazardous Materials Sector Leader, Cave-In Sector Leader, etc.).
Triage Officer
The Triage Officer is responsible for the management of victims where they are found at the
incident site, and for sorting and moving victims to the treatment area. This officer shall ensure
coordination between extrication teams and patient care personnel to provide appropriate care for
entrapped victims. This individual reports to Medical Sector Leader.
Treatment Officer
Responsible for sorting patients at the treatment area to establish priorities for treatment and
transport, and for directing coordination with medical professionals mobilized to the scene. The
treatment area should be headed by an individual who routinely functions in pre-hospital EMS,
or a previously identified individual who is designated by position, and participates in pre-
hospital mass casualty drills. If at all possible, this person should be a physician or the highest
ALS available. This individual reports to Medical Sector Leader.
Medical Transportation Officer
The Medical Transportation Officer is responsible for arranging appropriate transport vehicles
(ambulances, helicopters, buses, vans, etc.) for those patients that the Treatment Officer has
selected for transport.
MID-AMERICA REGIONAL COUNCIL 2 JANUARY 2004
APPENDIX C
MCI CACHES OF SUPPLIES
MARCER REGIONAL MCI PLAN
MASS CASUALTY INCIDENT CACHES OF SUPPLIES
There are caches of equipment intended for use during an MCI located throughout the
metropolitan area. Each cache has a capability to treat approximately 50 to 100 patients. Some
of the equipment is ALS capable. Caches include the following:
Western Missouri Fire Chiefs Association MCI Trailer
Located at Central Jackson County Fire Protection District Station #4
Contact: Fire Mutual Aid to Central Jackson County Fire Protection District or call (816) 228-
0151
• Capacity to treat up to 50 patients
• Carries ALS (IV and intubation equipment) and oxygen
North Kansas City Fire Department
Located at North Kansas City Fire Department Station #2
Contact: Call (816) 274-6010 or (816) 274-6013
• Capacity to treat up to 50 patients
• BLS equipped
Johnson County MED-ACT
Two trailers available, one in Mission and one in Olathe
Contact: Johnson County Emergency Communications Center at (913) 432-2121
• Each trailer has a capacity to treat up to 100 patients
• ALS and BLS equipped
• Multiple oxygen delivery devices
• Equipped to handle mass fatalities
Kansas City International Airport
Note: This trailer cannot leave airport grounds
• Capacity to treat up to 100 patients
MAST
Located at MAST Headquarters
Contact: Call (816) 924-0600
• Can assemble supplies in delivery vans to be delivered to an incident on short notice.
MID-AMERICA REGIONAL COUNCIL 1 JANUARY 2004
APPENDIX C
MCI CACHES OF SUPPLIES
MARCER REGIONAL MCI PLAN
There is no cost for the use of the equipment, other than the replacement of expended supplies.
To request the cache be deployed to an incident, contact the communications center or listed
contact for each jurisdiction, or make the request through Lee’s Summit Fire Department
(Missouri Mutual Aid System Region A) at 816-969-7407 or the Johnson County Emergency
Communications Center at 913-432-2121
MID-AMERICA REGIONAL COUNCIL 2 JANUARY 2004
APPENDIX D
MCI CHECKLISTS
MARCER REGIONAL MCI PLAN
MASS CASUALTY INCIDENT CHECKLISTS
MEDICAL SECTOR LEADER
Responsible for overall EMS operations an at incident, for appointing all other EMS team members and
forwarding all EMS recommendations to the Incident Commander
Assume assignment as Medical Sector Leader from Incident Commander
Identify yourself as Medical by wearing vest
Perform a medical size-up and relay information to Command
Assess need for decontamination of patients prior to treatment or transport
Develop an initial strategy for the medical aspects of the incident, including
Contact appropriate EMCC and request the issuance of an MCI Alert (refer to the EMSystem
Protocols and Policies Manual for instructions)
Options for making contact include:
Ask agency’s dispatch center to make contact
Use wireless phone
Establish a medical staging area and notify Command
Order additional medical resources needed through Command to include
ALS Units/BLS Units
Mass Casualty Unit (Trailer, Van)
Buses
Helicopters
Assistant to track resources being dispatched to the scene
Appoint a Triage Officer, if not established
Appoint a Treatment Officer
Appoint a Transport Officer
Communicate regular updates to Command on medical branch operations
Communicate back to the appropriate EMCC with ongoing information on the status of the incident
MID-AMERICA REGIONAL COUNCIL 1 JANUARY 2004
APPENDIX D
MCI CHECKLISTS
MARCER REGIONAL MCI PLAN
TRIAGE OFFICER
Responsible for the management of victims where they are found at the incident site, and for sorting and
moving victims to the treatment area. The officer shall ensure coordination between extrication teams
and patient care personnel to provide appropriate care for entrapped victims. Reports to Medical Sector
Leader.
Assume position as Triage Officer and identify yourself by wearing vest
Observe scene for hazards and take necessary precautions
Confer with Safety Officer
Determine the location, number and condition of patients involved in the incident
Advise Medical Sector Leader of the approximate number and severity of injuries
DO NOT PROCEED UNTIL THE ABOVE TASKS ARE DONE
Establish a strategy for triage with the Medical Sector Leader, including
Triage patients where they are found OR
Move patients to a designated area for triage
Assign personnel to direct walking wounded to triage area
Determine and order any additional resources through Medical Sector Leader, including
Additional personnel
Additional equipment or supplies
Assign and control all personnel in the triage sector to include
Establish triage teams and define operating zones
Make sure that sufficient quantities of triage tags are available
Coordinate the moving of patients to the treatment sector in order of severity
Communicate with other medical branch sectors as needed by
Radio
Wireless phone
Face to face communications
MID-AMERICA REGIONAL COUNCIL 2 JANUARY 2004
APPENDIX D
MCI CHECKLISTS
MARCER REGIONAL MCI PLAN
Provide regular updated progress reports to Medical Sector Leader
Advise “All Clear” to Medical Sector Leader when all patients have been triaged and moved to the
treatment sector
Assess need for decontamination of patients prior to treatment or transport.
MID-AMERICA REGIONAL COUNCIL 3 JANUARY 2004
APPENDIX D
MCI CHECKLISTS
MARCER REGIONAL MCI PLAN
MEDICAL TRANSPORTATION OFFICER
Responsible for arranging appropriate transport vehicles (ambulances, helicopters, buses, vans, etc.) for
those patients that the Treatment Officer has selected for transport.
Assume position as Transportation Officer upon assignment by Medical Sector Leader and identify
yourself by wearing vest
Determine the location for the staging of the transportation of patients
Determine and order any additional resources through Medical Sector Leader, including
Personnel
Ambulances
Helicopters
Buses
Communicate with the appropriate EMCC to determine hospital availability and capacities
Appoint a Medical Staging Officer to control ambulance flow
Designate a person to track all green triaged patients that are or are not transported
Coordinate patient removal to loading zones in order of severity to include moving patients to
helicopter landing zone sector for transport to distant hospitals
Maintain accurate records of patients transported on the tracking boards or sheets
Communicate with other medical branch sectors as needed by
Radio
Wireless phone
Face to face communications
Provide regular updated progress reports to Medical Sector Leader
Advise “All Clear” to Medical Sector Leader when all patients have been transported
MID-AMERICA REGIONAL COUNCIL 4 JANUARY 2004
APPENDIX D
MCI CHECKLISTS
MARCER REGIONAL MCI PLAN
TREATMENT OFFICER
Responsible for sorting patients at the treatment area to establish priorities for treatment and transport,
and for directing coordination with medical professionals mobilized to the scene. The treatment area
should be headed by an individual who routinely functions in pre-hospital EMS, or a previously identified
individual who is designated by position, and participates in pre-hospital mass casualty drills. If at all
possible, this person should be a physician or the highest ALS available. Reports to the Medical Sector
Leader.
Assume position as Treatment Officer upon assignment by Medical Sector Leader and identify
yourself by wearing vest
Determine the location for the field treatment area and notify the Medical Sector Leader
Determine and order any additional resources through Medical Sector Leader, including
Additional personnel, including the need for on-site physician
Mass casualty trailer/van
Construct a formal treatment area to include
Identifiable entrance and exit points by using stakes and barrier tape
Separate red and yellow triaged patients within the treatment area
Develop a pool of medical supplies within the treatment area from mass casualty unit and non-
transporting units
Designate an area for green triaged patients to be collected and treated outside the formal
treatment area
Locate yourself at the entrance point and perform re-triage as needed on patients arriving from the
triage sector
Perform triage on patients arriving into the treatment area without triage tags
Assign and control all personnel in the sector to ensure appropriate treatment for all patients
Move patients through the exit point into the transport sector in order of severity
Communicate with other medical branch sectors as needed by
Radio
Wireless phone
Face to face communications
MID-AMERICA REGIONAL COUNCIL 5 JANUARY 2004
APPENDIX D
MCI CHECKLISTS
MARCER REGIONAL MCI PLAN
Provide regular updated progress reports to Medical Sector Leader
Advise “All Clear” to Medical Sector Leader when all patients have been treated and moved to the
transport sector
MID-AMERICA REGIONAL COUNCIL 6 JANUARY 2004
APPENDIX E
NON ACUTE CARE FACILITIES
MARCER REGIONAL MCI PLAN
NON ACUTE CARE HOSPITAL RESOURCES FOR MCI
ASSISTANCE
The following facilities have indicated that they are willing and able to accept stable
patients transferred from acute care hospitals in the event of a mass casualty incident
FACILITY # OF BEDS ADDRESS 24 HOUR NAME
AVAVILABLE AND NUMBER TO
CONTACT TO
ACTIVATE YOUR
FACILITY AS
PART OF THE
MCI PLAN
Creekwood 8 pre-op stalls 211 NE 54th St Suite Diana Carr (816) 587-
Surgery Center 6 recovery stalls 100 5923 or (816) 853-
2 patient rooms Kansas City MO 8215
64118
Kindred 12 staffed beds 8701 Troost 816-955-2166
Hospital Kansas Kansas City, MO
City 64131
Rainbow Mental 10 staffed beds also 2205 West 36th Roz Underdahl
Health Facility have a gym for Avenue
temporary overflow Kansas City Kansas
Research 40 staffed beds 2323 E. 63rd Street (816) 444-8161
Psychiatric further beds are Kansas City, MO
Center dependent upon 64130
current census at
the time of the
incident
Please note that Standard Operating procedures have not yet been developed as of June
2003.
MID-AMERICA REGIONAL COUNCIL 1 JANUARY 2004
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