Level I adult trauma centers (Einstein Medical Center, Hahnemann University Hospital, Thomas Jefferson University Hospital, Penn Presbyterian Medical Center, and Temple University Hospital) within 8 miles and a Level II adult trauma center (Aria Health Torresdale) about 12 miles away. Temple University Hospital and Aria Health Frankford (not a trauma hospital) are the closest medical facilities; both are within 3 miles of the accident site.[1]
In an MCI, the goals for EMS are to triage, treat, and transport the injured as expeditiously as possible within the incident command system. EMS personnel are trained to perform an initial, quick triage of patients in an MCI. According to the PFD's operational procedure, EMS uses the Simple Triage and Rapid Transport method in which patients are evaluated and classified as follows:
- An injured person who is walking and talking is classified as priority 3 or green.
- A person who cannot walk but is breathing normally, is not in shock, and is following commands is classified as priority 2 or yellow.
- A person who cannot walk and has signs of respiratory distress or shock or cannot follow commands is classified as priority 1 or red.[2]
After evaluating the injured, EMS must then get them to the appropriate level of medical care as expeditiously as possible. Traditionally, red patients are transported first, followed by yellow, and then green. Generally, patients classified as red and yellow will require expert care in a Level I or II trauma center.[3] In order for a hospital to respond appropriately to an influx of seriously injured patients, each needing this level of resources, the staff must be drawn from outside the hospital or from the care of other patients.
At the beginning of an MCI, hospitals are notified of the event by a 911 center or other local authority, and each hospital reports how many critical (red and yellow) and minor (green) patients they can reasonably handle.[4]
- ↑ Level I trauma centers provide multidisciplinary treatment and specialized resources for at least 600 major trauma patients a year, perform trauma research, and train surgeons. Level II trauma centers provide similar medical services to at least 350 major trauma patients a year, but they do not perform research and training. Level III trauma centers may care for moderately injured trauma patients. Level III and IV trauma centers have the capacity to stabilize and transfer seriously injured patients to a higher level of trauma care.
- ↑ This is the method detailed in the Philadelphia Fire Department OPS-35 for an MCI response.
- ↑ On arrival at a Level I or II trauma center, each patient classified as red or yellow generally merits activation of the trauma team, which typically consists of at least a trauma surgeon, an anesthesiologist, an emergency physician, a radiology technician, a respiratory technician, and multiple nurses. Additional personnel may include lab or blood bank personnel and various trainees (doctors, nurses, technicians, and students). In addition, the operating room must be prepared and various specialists (such as neurosurgeons and orthopedic surgeons) are notified to prepare for urgent consultation.
- ↑ A number of issues affect each hospital's response, such as the number of operating rooms that can be opened; the number of intensive care, ward, and emergency department beds that are available; and the number of staff that are available. Hospitals may activate their internal disaster response to ensure there are enough appropriate staff to respond to the expected influx of patients. This often means holding staff over at the end of a shift, calling the next shift in early, and calling in "on call" staff and physicians. However, while staff can be held over or called
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