MAJOR INCIDENTAdministrative and Legal Issues 4572 This is defined locally by the facility or facilities involved as ‘any health
incident which requires an extraordinary response from the healthcare
system’.
3 Prior planning is an essential component of major incident management,
utilizing an ‘all hazards’ approach.
(i) This involves adopting a flexible, generic plan that can be adapted
to suit any potential major incident.
(ii) The underlying principle is to do the ‘most good for the most
people’ with the resources available.
(iii) Certain types of incident will require a special response such
as incidents involving chemicals, infectious diseases or large
numbers of children.
4 Each hospital’s local plan should be linked to the regional and state plans for
mass casualty, as well as integrating with the plans of the other emergency
services involved.
(i) A copy of the plan should be available for perusal in all key areas
of the hospital.
5 The principles governing any hospital major incident response are
Command and Control; Safety and Staffing; Communications; Assessment;
Triage; Treat ment; Tra nspor tat ion (CSCAT T T).
(i) Command and Control
(a) this adopts a vertical model, with questions and decisions
passed directly to the clinicians and managers coordinating
the hospital response
(b) an overall impression of the hospital’s activity and
capabilities is thus maintained at all times.
(ii) Safety and Staffing
(a) safety of hospital staff is paramount
(b) protecting clinicians and their working environment from
hazards optimizes the delivery of care.
(iii) Communications
(a) communications frequently break down when overstretched
by a major incident
(b) include the use of radios or runners to carry messages to
maintain maximum flexibility, as an alternative form of
communication to land or mobile telephones.
(iv) Assessment
(a) a major incident is a dynamic evolving situation
(b) continuous, rapid assessment and reassessment of the
situation enable available resources to be most efficiently
matched to demand.