1. CONFIRM SCENE SAFETY: Verify that the immediate threat has been neutralized before entering the area. Do not enter unstable structures, active hazard zones, or areas with unmitigated threat. The medical mission is always secondary to scene safety.
2. ACTIVATE THE SYSTEM AND RETRIEVE BAGS: Dispatch personnel to retrieve all three duffel bags from their pre-staged zone locations. Deploy bags to a designated Casualty Collection Point or to their assigned zone coverage areas simultaneously to maximize response coverage.
3. ESTABLISH THE CASUALTY COLLECTION POINT: Designate a large, secure, and accessible area that is upwind and uphill from any hazard. Announce the location clearly to all responders and casualties to consolidate treatment efforts.
4. CONDUCT RAPID TRIAGE USING SORT: Perform an initial sweep of all casualties using the SORT protocol before beginning sustained treatment. Assess each casualty for four indicators in sequence: Still (motionless or unresponsive), Obeys Commands (conscious and neurologically present), Respiratory Distress (labored or absent breathing), and Tourniquet Needed (severe extremity hemorrhage). Identify the most critical casualties first.
5. CONTROL MASSIVE HEMORRHAGE IMMEDIATELY: Apply the single tourniquet to eligible limb wounds involving amputation, mangled limb, or arterial bleed uncontrollable by direct pressure. Pack all other significant hemorrhage using Blood Stopper Trauma Dressings with maximal focused direct pressure. Use Multi-Trauma Dressings for large wounds, eviscerations, or to reinforce existing dressings.
6. MANAGE AIRWAYS FOR TRAINED PERSONNEL ONLY: If you are trained and certified, use the Berman Airway Kit to maintain an open airway on unconscious patients with no gag reflex. Do not attempt this procedure without prior qualification, as improper application can cause severe injury or death.
7. DRESS WOUNDS, SPLINT FRACTURES, AND TREAT BURNS: Apply appropriate dressings to major wounds using gauze pads, butterfly bandages, and adhesive dressings scaled to wound severity. Immobilize suspected fractures using splint kits and triangular bandages. Apply burn care kits after initial water cooling for localized minor to moderate thermal burns. Apply cervical collars only if you are trained in correct sizing and application.
8. COVER ALL SIGNIFICANT TRAUMA PATIENTS: Wrap every significant trauma casualty in a Mayday Solar Blanket or Paramedic Blanket regardless of ambient temperature. This protocol prevents hypothermia and treats for shock. The silver side of the solar blanket reflects body heat back to the patient.
9. DON NITRILE GLOVES FOR EVERY PATIENT INTERACTION: Put on nitrile gloves before contact with any casualty and replace them between patients. Replace immediately if a glove tears. Body Substance Isolation is mandatory at all times during care to prevent disease transmission.
10. DELEGATE BASIC TASKS TO EXPAND TREATMENT CAPACITY: Assign uninjured or minimally injured bystanders to hold direct pressure on dressings, support splints, or provide comfort to other casualties. This multiplies your effective treatment capacity while trained responders manage critical interventions.
11. DOCUMENT ALL INTERVENTIONS WITH TIME STAMPS: Record every significant intervention as it is performed, including the time of tourniquet application, airway placement, and patient condition changes. Accurate documentation is critical for EMS handover and continuity of care.
12. EXECUTE HANDOVER TO EMS ON ARRIVAL: Provide arriving EMS personnel with a clear, structured handover report covering the number of casualties, triage findings, interventions performed, times of application, and current patient status. Transfer documentation with each patient.
