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Command & Leadership, Mass Casualty Incident

Goodbye tarps, I never loved you

MCIs can be stressful incidents.

During most of our preparation and planning we seem to focus on the basics, the parts of the plan that all come together as needed when a large incident strikes.

Vests, radio communication, incident structure…all these things gel into a well run scene.


Buried in the back of our minds, much like the desire to backboard everyone, is the idea that a colored tarp on the ground is a good idea.  “But Justin, how will be be able to distinguish the red area from the yellow and green?

Well, Sparky, first off, everyone is standing in the green area, so let’s just leave them alone.  Until much, much later.  Send them into a general space out of the way and make a note to call them a bus.

Yellows are just greens who can’t walk, so if they’re 30-2-Can Do and can’t move on their own we’ll get to them later too.


Trick with the tarps is this: They’re small, they can’t be seen from the ground level and when they become covered in patients are impossible to distinguish.  Don’t get me wrong, they work to a point and that point is when treatment begins.  Multiple solutions have been floated in recent decades including colored vests for the treatment team to match the area (Which I like) all the way to glow sticks!

At my assignment we have some recent experience with MCIs and have worked to address what did and did not work.  Instead of a colored rectangle on the ground that no one can see, we initially used our large Mass Casualty Units, giant Pierce Fire Engine chassis with extended roof cabinets, as landmarks for treatment areas.  Trouble is, for a person who doesn’t know the difference between an engine, truck and MCU, they all look the same.  Big yellow trucks parked over someplace they need to go.

So we got some flags.


There no longer remains any question as to where the Immediate Treatment area is.  These flags are out on the airfield in a decent wind and held perfectly well.  Throw a sandbag intended to hold a tiny tarp down and we’re golden.  This set up allows the treatment manager to arrange patients in a circle, or flower shape if you prefer, instead of the initial desire for rescuers to put a rectangle board on a rectangle tarp, forgetting that we need to get to them to treat them.  It allows the area to be seen from hundreds of meters away, from above and are just wide enough that, should you have the misfortune of approaching from upwind or directly downwind, they flap just enough to see the colors clearly.

They set up in about 30 seconds with one person and collapse into a tiny little case.  One person can deploy the entire set very quickly.


We still have our tarps, just like we still carry a backboard, in case we have a smaller incident with only 3-5 patients.  Sure they make bigger tarps with fancy outlines of patients, but are we simply taking something marginally useful and making it bigger instead of identifying a better solution?

I say ditch the tarps, plant the flags and get to work ordering resources instead of finding something to hold a tarp down.

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