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This scenario was patched together from a few here at home and from around the community.  My service recently ran a call for nausea that included multiple persons in stacked rooms and handled it well.  But identifying the cause or possible causes of the illness can be difficult when multiple possibilities present themselves.

ICS focuses on being the first in and building from the cold zone forward.  This call would be so much easier if we were donning our Medical Group Supervisor vest and carrying the command kit into the lobby control.

Ah, if only life worked that way.  Most MCIs and Haz Mats evolve quickly and rarely come in reported as what we find.

I added the element of the unknown upstairs to make us think about what ELSE could be happening besides the seemingly straight forward CO poisoning call which, had this been contained to two adjacent rooms, is easy to include in our plan.

Medic 88 responded above us, called for a haz mat response and went off the air.  We got neither a status update on their condition or why they called for the haz mat activation so we must assume the worst: They are compromised.

On the 4th floor we have 3 or 4 patients directly needing our assistance with an unknown number possibly dead, dying or completely oblivious to the situation.  The first instinct is to evacuate the building, but scattering our unknown illness may prove more costly than not, so we need to evacuate to a place of safe refuge.

The enclosed nature of hotel rooms gives us the unique option of being able to stage our evacuation from the rooms to the hallway, establishing a warm zone.  Of course identifying those experiencing symptoms will be difficult so we need a way to identify them easily.  The MCI and triage kits are downstairs in the rig, so we’ll need to improvise.  Advise the persons you have already contacted to put on the hotel white robe (if they’re there) or drape a large white towel over their heads.  Asking them to also bring a clean washcloth to cover their coughs will help contain any airborne illness should it be present.  The 2 masks we carry are on us and we are considered contaminated until proven otherwise.

Now we have our original patients easily identifiable and a method to separate them based on signs and symptoms of illness.

This information now needs to be relayed to the other responding units.  Using clear text is key in this situation.  Identify your unit, establish command, list threats and give your status.  If Medic 88 is unreachable upstairs we must include them as victims until we hear otherwise.

For the time being we should stay on the 4th floor, triaging all the rooms who will answer the door.  Symptoms get a white towel/robe and washcloth, non symptomatic get moved the the other end of the hallway from our rooms.

This is no place to establish a command post or begin to orchestrate the response of additional units.  In most communities the first units on scene will be engine companies with basic gear and SCBA, and until we know what is going on upstairs, they should not enter the 4th or 5th floor.

Haz Mat Specialists can speak in more detail as to how they may approach this situation, but leaving what Medic 88 found unknown, I think makes us think in different ways, determining a solution for each possible situation.

Think about the following changes to the scenario:

Medic 88 reports a faulty pilot light on the water heater common to 403, 405, 503 and 505 and that symptoms clear in the hallway.

Medic 88 reports fumes of unknown origin seen coming from room 505, two patients are down inside that room.

Medic 88 calls a mayday and reports they are trapped on the 5th floor in heavy smoke, no SCBA.

Medic 88 stumbles from the stairway with blisters on their faces and arms, excessive snot from their noses and mouths, begging for help.

A hotel employee approaches you stating the hotel has received a bomb threat.

These are all exotic situations we may never see in out careers, but could actually happen when we are already set up for a different event.  Responding to any of these situations allows us to think ahead, set perimeters and stay back from the nasty stuff, but with dispatch systems keen on getting us out the door ASAP, most times without finishing the coding of the call, a simple code 2 sick call can become a dangerous unknown situation.

Think on your feet, use what is around you to your advantage and don’t forget that in this situation, YOU’RE a victim too.  At least until the heroes in the yellow suits say otherwise.

If you said “Slow down and think this through” you made the right call.

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3 Comments

  1. Harpstergary January 17, 2011 4:11 pm

    excellent scenario…

  2. Harpstergary January 17, 2011 4:11 pm

    excellent scenario…

  3. Pingback: Medics!! | Iron Firemen

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