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MCI Tool for Communication

The military has created a variety of communication templates for ensuring that the proper information is relayed to the receiver. This can be critical for delivering proper supplies and equipment where it is needed, helping allied troops avoid friendly fire, getting patients evacuated from a scene…

Public safety/prehospital medicine has tons of mnemonics as well. Some of those are for charting, but very few are specific for communication. There’s one that stands out for MCI communication. It’s (M)ETHANE. This is useful as a scene-size up/description tool to relay information to the communication center and responding units.

So What Is It Exactly?

  • (M) Declare an MCI. Some versions of this tool omit this step as there’s already and MCI that’s been established, but many times you will arrive and there won’t be any formal declaration that the event is categorized as an MCI. This can be an important step to open up formal MCI protocol for the responding units, or to put responding units in the mindset of treating the event as an MCI. While we should give all patients thorough and appropriate care, MCI events dictate we operate a little faster and don’t perform extraneous treatment.

  • Exact Location. Many times there may be partial information as to the location of the event. This communication provides clear and precise location information. Was that on the northbound or southbound side of the highway? It’s at the highschool, but is it at the gym, football stadium, baseball field, etc.? If called to the airport, is it on runway 02/20, 18/36, etc? Being detailed here saves other responding units time when they don’t have to conduct their own search to get to you.

  • Type: What type of incident is it? Is this a haz-mat incident, bus wreck, plane crash, boat crash, industrial accident? This may help your dispatch center alert any additional authorities that need to be contacted to assist you with managing the scene. Responding units can bring appropriate equipment from their apparatus when they have more information. In a car wreck scene, identifying the number of vehicles and relative damage of each gives responding units an idea of the scope of the wreck. “Three cars, all minor damage” is a big difference from “18 wheeler with heavy rear end damage, second car currently pinned beneath the 18 wheeler.”

  • Hazards: This is one of the most important portions of the communication. Responders need to be aware of any identified and potential hazards on scenes. At night, black power lines are incredibly difficult to see, and a broken power pole may be obscured by another vehicle/apparatus. If responding units are alerted that there are downed power lines, they can keep an eye out for this hazard. Chemical hazards can also be a significant consideration as prevailing winds may force chemicals across the ingress route even though apparatus park “upwind”. Unstable buildings, fire, active shooter/assailant, or other hazards may be present on the scene.

  • Access: The route that responding vehicles need to take to get to the scene. Remember to leave an egress route for ambulances if they have to depart quickly with priority patients. If you need specialized resources closer to the hot zone/center of the scene, leaving space for them may be important instructions during the initial communication. If staging has been established, it may help to instruct responding units to the staging area to keep the scene more organized. As different responding units from different agencies show up, they will typically try to get as close to the incident as possible to reduce walking long distances. This blocks the scene up as the driver walks away from a locked vehicle.

  • Number of patients: How many patients are there? What priority of the patients that are triaged already? This can be important information to determine how many ambulances are necessary. A good rule of thumb is that an ambulance can handle:

  • 1 Red patient, or

  • 2 Yellow patients, or

  • As many Green patients as you can get the crew to accept. If faced with an initial patient count but no idea of priorities, the good rule of thumb is to take the patient count and divide it in half. This will be the number of ambulances to call to the scene initially. This may change, but if the resources are headed your way, it is easier to cancel them than to find out 20 minutes into the scene that you need more. This may change based on your system. More rural systems may not be able to handle patient loads that quickly, and may be more prone to taking more patients per ambulance. Also, rural systems rely on mutual aid agreements more frequently for assistance, so that ambulance you call may be coming from the next jurisdiction with an extended ETA. Flight services also need as early a notification as possible.

  • Emergency Services: What additional resources/departments will be needed? If you have an incident that needs a USAR resource, you need to call for that resource as soon as possible. Some systems will “pre-alert” and dispatch based on the 911 call information, and some systems will wait for the first unit on scene before deciding to dispatch those specialized resources. While each system is different, include this information with your radio traffic. Don’t forget those services that aren’t specifically emergency services. DOT, power utilities, water utilities, gas company, wrecker services and others can be extremely useful. The earlier they are all notified to respond to your scene, the sooner they arrive.

(M)ETHANE is a great tool to help organize that initial radio traffic. One tool that goes along with this is the “tactical breath.” Just before you press the talk button on the radio, take a second and take a deep breath, and exhale it slowly. Taking 5 seconds for yourself to mentally disengage from the excitement of the incident will help you A) sound calmer on the radio, B) think clearly about what you want to say and C) organize your thoughts better to provide the proper information. You’ll sound professional on the radio and won’t be the butt of any jokes later on down the road. This also helps you sound in control of the scene and will instill confidence in those who respond to you that you are managing the scene correctly.

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