Plans for medical care must proceed simultaneously along interdisciplinary and intradisciplinary lines. Coordination with fire, rescue, and hazardous materials teams; public health departments; and law enforcement agencies and/or security providers is essential. What law enforcement agency and officials are responsible for precautions against terrorism and the coordinated response to it? What agency and officials are responsible for the jurisdictional disaster or multicasualty incident (MCI) plan? What is the communications path to officials responsible for initiating execution of the plan and what intravenue officials are in the decision tree to trigger the request?
Planning for mass gatherings must also consider the EMS services responsible for responding to 911 calls within the jurisdiction surrounding the venue. The patient transport capacity at which the service becomes saturated and needs to shift into an MCI mode of operation must be known or determined. The extra patient transport capacity afforded by any existing mutual aid agreements with other services should be examined. What potential patient capacities do the surrounding hospitals possess? Limited external medical facilities (e.g., in a rural setting) may force more advanced care to be performed on site, requiring more medical personnel at a higher level of expertise, more supplies, and intravenue facilities. Both the medical and administrative directors of potentially affected EMS and hospital emergency services should be repeatedly updated on medical care plans for the event.
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