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EMS News in Focus
by Arthur Hsieh

3 things yesterday's 2 MCIs can teach medics

The New York building explosions, followed by a Texas driver who plowed through a crowd are good reminders to always be prepared

By Arthur Hsieh

Wednesday morning, a gas leak triggered an explosion that flattened two NYC apartment buildings, killing at least seven people and injuring more than 60. Then just after midnight, a suspected drunk driver fleeing police crashed through barricades at a Texas festival and plowed into a crowd, killing two and injuring 23.

Having two high-profile EMS incidents occur within a few hours of each other serves as a somber reminder of being able to respond effectively when the community needs our services the most.

Here are three lessons from these incidents.

1. MCI management is an interdisciplinary game. EMS, fire, law enforcement, public works, utility companies, and other agencies have to pull together to mitigate a mass casualty event. Each agency has its part to play.

In the initial phase, public safety agencies have to aggressively rescue victims, protect others from harm and minimize the extent of the incident. Over time, other public agencies stabilize the effects of the disaster, seek to find the cause of the event, determine wrongdoing, and figure out what could be done to prevent the incident from happening again. 

2. MCI drills are crucial. They can be tedious. But rehearsing the plan, practicing the techniques, and analyzing outcomes add up to be mentally prepared for when the ‘big one’ hits. Try to keep that in mind the next time you are going through yet another tabletop exercise.

3. The risk of injury to rescuers is high. While I don’t have any evidence to support my assertion, I believe that the adrenalin flow created by the stress taxes our bodies. Poor body mechanics and extended cardiovascular workload, not to mention the hazards associated with the actual incident itself, may make us take unnecessary risks.

Keep a cool head in these situations. The person you save might very well be yourself.

About the author

EMS1 Editorial Advisor Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. Since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook author, has presented at conferences nationwide, and continues to provide patient care at an EMS service in Northern California. Contact Art at
The comments below are member-generated and do not necessarily reflect the opinions of or its staff. If you cannot see comments, try disabling privacy and ad blocking plugins in your browser. All comments must comply with our Member Commenting Policy.
Thursday, March 13, 2014 6:45:28 PM Well said; this shows how an event can quickly become an incident, like the Boston Marathon bombing. Preparedness and Vigilance!
William Bill Hathaway William Bill Hathaway Friday, March 14, 2014 5:17:20 AM You never know where the next event will occur. Prior preparation is the only key to success.
William Bill Hathaway William Bill Hathaway Friday, March 14, 2014 5:17:47 AM You never know where the next event will occur. Prior preparation is the major key to success.
Triage Lights Triage Lights Friday, March 14, 2014 3:43:36 PM Be best prepared for night time MCI triage by using triagelights .
Scott Anderson Scott Anderson Saturday, March 15, 2014 10:23:31 AM Very well said Art. I am very proud of how my department handled the incident that night.
Zanther Stone Zanther Stone Sunday, March 16, 2014 12:10:55 PM Kind of misleading article. It implied actual lessons specifically from those two incidents that might help us make decisions on our next MCI, but instead those two MCI's could have been any random MCIs. The "lessons" were the vaguest ever. Stuff people always say about MCIs in general. The stuff everyone knows already if they're reading this magazine. We need more substance!!

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