What should you do if there are multiple casualties needing first aid assistance?
Coming across a situation where there are multiple casualties is a daunting prospect for most of us. Having a well rehearsed and thought out process in mind will help you from the start.
Assess casualties in terms of the severity of their injuries using a colour code system:
RED – critical and immediate aid required to save their lives
AMBER – Serious injuries. May become RED casualties very quickly.
GREEN – Walking Wounded. Minor injuries and potential helpers!
(BLACK is also used by the Emergency Services for casualties who are already dead or dying)
Our basic first aid training should come into play:
- Assess for danger – don’t proceed until you know it is safe to do so. Use all your senses – look, listen, smell, taste to assess the situation. Don’t become another casualty!
- Assess for cross contamination – put your surgical gloves on if you have access to a first aid kit. This will protect you as well as all the casualties you come into contact with – and helps prevent cross contamination between casualties you deal with.
- Quickly scan the scene and seek out the quiet casualties (RED casualties) for treatment first – Airway? Breathing? Circulation – deal with major bleeds. Recovery position. Seek out a bystander or ‘walking wounded’ (GREEN casualty) or uninjured person and get them to keep an eye on the quiet casualty. Give the walking wounded person some first aid kit to treat any wounds they may have.
- Seek out the severely wounded casualties next. (AMBER casualties). Treat and move on to the other amber casualties. Amber casualties will probably be the loudest or most distressed casualties. Again, get a Green casualty or bystander to help monitor and reassure them after you’ve dealt with their injuries. Stress that they should let you know if their condition changes.
- Return to red and amber casualties regularly.
- Ensure GREEN casualties are cared for with reassurance and first aid materials as required.
- Get others to help you – monitoring casualties, giving out first aid materials, keeping them in a correct casualty position according to their injuries or moving them to a safe place. Thank and praise people that help.
- When the Emergency Services arrive, brief them on what you’ve done.
Other things to consider:
- In a road traffic accident, many folk will have a first aid kits in their car. Ask someone to get you some gloves out of a kit while you start your assessment of the situation. You can also ask them to get any first aid kits out of cars.
- In major transport hubs, there are often emergency first aid kits mounted on a wall, usually near a defibrillator.
- It is a good idea to check vehicles or buildings for other casualties. Ask “how many people were in this car? Is there anyone still in the building?” Don’t try and remove people from cars if you’re not trained to do so and go into unsafe buildings.
- If someone has a compromised airway and is slumped in a vehicle, get someone to sit in the back seat and hold their head up to give them a clear airway. They will need to stay there until Emergency Services arrive and take over.
- Other first aid trained people will offer to help. You can then divide up the scene into zones and each circulate in that zone. Alternatively, you can get them to concentrate on a particular RED or AMBER casualty that might need more monitoring and help.
- Bus and truck drivers are also first aid trained as part of their CPC Driver requirements.
- Other folk will offer to help that are not first aid trained. If appropriate, get them to sit with and reassure casualties and alert you if the casualty’s condition changes.
- Keep calm and carry on – don’t run yourself ragged. Use the help that is offered. Do your best to the level of first aid that you’re trained to do.
After the incident – take care of yourself
Afterwards, make sure you put some time aside for yourself to recover emotionally. Talk to someone about what happened and avoid getting stressed and anxious about it. It is normal for first aiders to feel they didn’t or couldn’t do enough to help in a multiple casualty incident. Often just talking through the incident will help you clear your head. If feelings persist or return, seek some professional help.
On our courses, we always encourage folk to have a ‘first aid buddy’ with whom they can talk to about their first aid response, whether it is one casualty or ten. All the Emergency Services will have a debrief after incidents – first aiders need a mechanism to do this too.
Multiple casualties in a terrorist or deliberate attack:
Terrorist or deliberate attacks are a different scenario to deal with. Do not rush in to a situation where you are very likely to become the next casualty. Read our specific blog on what to do in the case of a terror or other deliberate attack.
“Be prepared not scared” is the motto of CitizenAID.
CitizenAID is a UK organisation set up by a team of senior military and civilian medics in 2017. The aim of the scheme is to help people learn lifesaving skills in case they are caught up in a terror or other deliberate attack. Their website is full of useful information, quick tips – life saving tips! CitizenAID has produced an app that gives a step-by-step system that enables the right decisions in the right order to save lives in the event of a deliberate act of terrorism or aggression. The app is free to download.
Learn how to plan your workplace response in a Major Incident
The First Aid Training Co-operative has developed two new courses to add to our growing list of professional training. Major incident training will give a summary of the kinds of actions staff should be considering now, before in incident happens. Incidents may be a major infrastructure failure, terror attack or multiple vehicle collision or anything that has an immediate and crucial impact on your workplace or community.
Introduction to Major Incident Management . This 3 hour course gives an overview of how to manage and major incident in a large or high profile organisation. This course is theory based but practical opportunities will be used to demonstrate basic first aid and life saving trauma management.
Major Incident Management Training . This one day course includes basic first aid training for trauma incidents, as well as a triage scenario to give the staff team practical experience in trauma first aid and major incident management. The debriefing of this simulated incident will highlight vital lessons for the safety of your staff in the event of a real incident.
Crucially, this package also includes a pre-course site visit, usually the day before your course, to discuss your specific needs for the training and develop or review your emergency plans for the business premises and its operations.
Managing catastrophic bleeding. This 3 hour practical course covers assessing major bleeds and injuries and the use of haemostatic bandages and techniques to stop bleeding fast. The practical session includes prosthetic models with bleeding effects so learners get to manage haemorrhage in almost real time.