Countywide : A Textbook Emergency Plan for All

In the middle of a dead-end street littered with shattered glass and three smashed cars, a team of more than 25 yellow-coated firefighters and paramedics struggled to get several bleeding accident victims to the hospital.

Although the scene was staged, firefighters responding to the simulated crisis said Friday that their work would help save lives. Their unique, streamlined method of providing care to a large number of injured was filmed for an instructional video for emergency response teams and hospitals nationwide.

When an accident produces more casualties than emergency teams can easily handle, “it’s like the fog of war,” Newport Beach Fire Department Capt. Nick Waite said. “You’re overwhelmed. It’s a sensory overload. But (advanced planning and training) makes it so you’ve already got set priorities.”

The video details how Orange County emergency-response teams treat a large number of accident victims in a short time when called to the scene of “multiple-victim incidents,” or MVIs, as firefighters and paramedics call them, said Vickie Cleary, Hoag Hospital nurse and project technical adviser.

Orange County is the only place in the nation that has such a specific plan for dealing with MVIs, Newport Beach Deputy Fire Department Chief Tom Arnold said. The MVI response system is called into effect any time that there are more casualties than the first firefighters or paramedics on the scene can handle.

“Before, we’d have five, six, seven, eight patients and try to handle them the same way as one. . . . Now, patients spend less of their ‘golden hour’ out in the streets, and that gives doctors more time to work their magic,” Arnold said. The “golden hour” refers to the first, crucial hour of treatment, which can mean the difference between life and death for critically injured victims.

When such a plan is not used, a person with a broken arm could be sent to the hospital before a person with more extensive injuries that take longer to treat. “Those kinds of things happen,” Waite said.

On Friday, about a dozen ambulances and fire trucks converged on Graham Street near the Slater Avenue intersection in Huntington Beach, responding to a mock, three-car collision as a professional camera crew adjusted lights and rolled tape.

His face painted with light blue makeup to show blood loss, accident “victim” Terry Egan lay in the street, representing a person who had been thrown from a nearby, overturned Suzuki Samurai. Paramedics checked his pulse and blood pressure, stabilized his vital signs, loaded him onto a stretcher and rushed him into an ambulance, in perfect execution of the MVI-response plan.

The plan coordinates everything, from the way vehicles park when they arrive at the scene to the creation of a chain-of-command. For example, drivers make sure that they leave a path for other emergency vehicles, and ambulances back into the scene to facilitate the loading of victims. The first crew on the scene has authority to direct the rest of the response, according to paramedic Gary Finney.

The plan effectively “handles the gap between day-to-day calls and plane crashes with massive casualties. It was a kind of vacant area for a long time,” said Huntington Beach Capt. Jacques Pelletier. Since its inception, the method has slashed by one-third the time it takes to start a patient on the way to the hospital.

The process has been fine-tuned since its inception more than five years ago and is now especially useful because “an MVI accident occurs several times a day in Orange County, usually from traffic accidents,” Cleary said.

The 20-minute video, produced by Hoag Hospital and the Newport Beach Fire Department, has a $35,000 budget and is being financed with profits that the hospital has made on previous instructional videos, Cleary noted.