The pre-hospital management of mass-casualty incidents is a challenging space for many paramedics, due to the rare nature of these events and the significantly different practices implemented whilst under significant pressure. The concepts of sieve, sort, casualty collection, marshalling, and working in a command and control hierarchy in a major multi-agency incident can be confronting and unfamiliar to many.

In a world of evidence-based practice, mass-casualty triage is one area where the evidence is, incredibly, lacking. The large-scale studies and randomised control trials required to drive evidence-based best practice are incredibly difficult to implement when mass-casualty incidents happen rarely but can happen anywhere, and at any time. Perhaps inevitably, a range of triage algorithms have been developed to provide paramedics with a structured approach to mass-casualty triage, and a range of products are available to provide a means of communicating the triage decision to other clinicians. Amongst all these systems and tools, how can we assess just what is best practice, and what happens when these systems are put to the test in the chaos of a real world major incident?

To explore the concepts of mass-casualty management and introduce the latest evidence base, Ambulance Tasmania Duty Manager Cam Anderson will discuss the results of his study, Mass-casualty triage algorithms: in search of best practice (Anderson, 2016). He will explore how various triage algorithms and tools have been applied at major incidents around the world, and propose a “best practice” approach to mass-casualty triage.

To discuss the real-world experience of mass-casualty incidents, Ambulance Tasmania Regional Manager Craig Downing will discuss real-world decision making in a crisis, from his experiences at several incidents including the Canterbury (NZ) earthquakes and the Christchurch Mosque terrorist attack.

Presented by: Cam Anderson and Craig Downing

MC: Ben Lawson

Recorded Live: 1 April 2021, Latrobe Ambulance Station

Presenter Biographies:

Craig Downing is the current Ambulance Tasmania Regional Manager (NW) and has a tremendous amount of on-road/practical experience as the incident/health commander at several major incidents across multiple ambulance services (including; Canterbury (NZ) earthquakes, bush fires, cyclone (CAT4 Nth QLD) and most recently the Christchurch Mosque Terrorist Attack).

Cam Anderson is an Ambulance Tasmania Duty Manager with a keen interest in mass-casualty and disaster medicine. He has significant experience in major incident management across fire, search and rescue, and ambulance, with diverse experiences in major bushfires, cyclones, floods and mass-casualty incidents. He holds a Master of Disaster and Emergency Response, and is a PhD candidate studying pre-hospital management of pandemics and bioterrorist attacks.

If you have any questions for the presenters, please contact them via email on Cam.anderson@ambulance.tas.gov.au or Craig.downing@ambulance.tas.gov.au