Mass Casualty Incident Management: Part 11

Incorporating lessons for the first due crew


In September 1994, a small aircraft crashed into an elementary school in New Fairfield, CT, causing an explosion and fire that injured 15 students and drew emergency resources from many surrounding communities. EMTs and paramedics had to work around hazards, including spilled fuel and plane wreckage, in order to triage, treat and transport injured children and adults. While it attracted the amount of attention you might expect from such an incident, fortunately it was only a training exercise. Such an incident requires career and volunteer agencies from different branches of emergency services to work together to care for more sick and injured patients than any one agency is capable of individually.

Only weeks later, at 3:50 p.m. on November 8, planning and preparation became reality. Three buses packed with middle school children on their way home collided in a chain reaction crash. The majority of the patients were terrified children with lacerations, and neck and back injuries. Several adults (including one pregnant bus driver) complained of more serious injuries, including chest pain and shortness of breath. These 111 victims provided a real-life challenge for the New Fairfield Volunteer Fire Department and surrounding agencies.

Within moments, Fire Chief Peter Benzinger took over as incident commander and called for emergency resources from neighboring communities to assist, following the protocol of the regional mass casualty incident training the agencies had recently worked on together. As the first arriving paramedics began triage inside the buses, I was assigned to establish the treatment area and began to assemble resources to assist with the extrication of students.

Shortly after police, fire and EMS were dispatched, the school system began notifying parents about the incident via telephone call-back. This resulted in the sudden arrival of almost as many parents as patients, many of whom pushed past emergency providers just as the fire department was beginning to coordinate the scene and account for the injured children.

Thirty-six patients of various priorities were transported by individual ambulances. The remaining 75 patients (all lowest priority) assembled on additional school buses for transport to the local emergency department. Closely coordinated by the transport officer, this enabled responders to provide a secure location, well away from the emergency scene, where parents could pick up their children and, should they wish, seek additional medical evaluation.

This is the kind of incident that can be encountered by any agency, in any town across North America. “I was very proud of how it went,” says Benzinger in a recent interview. At the time only in his third year as chief, Benzinger had pushed hard for integration of the incident command system and close operations with mutual aid agencies. “I’m glad the training paid off.”

So what lessons from our MCI series can be seen in this commonly uncommon mass casualty incident?

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