# Multi-casualty incident response plan

A field-facing OCEMS MCI guide to activation, communications, patient reports, destinations, fallback capacity, and documentation.

Official source: 900.00. Effective: January 1, 2026.
Population: All patients. Scope: BLS / ALS / System.
Updated and source-checked: 2026-09-16.
Canonical page: https://www.ocmedic.com/reference/900-00-multi-casualty-incident-mci-response-plan/

Independent OC Medic summary. This page does not replace the complete policy, current system notices, agency requirements, or clinical judgment.

## Policy 900.00 is the health-sector plan, not the entire scene plan

- The Orange County Fire Services Operational Area Annex MCI Plan governs field operational procedures; OCEMS Policy 900.00 governs health-sector coordination, receiving destinations, and documentation.
- Med Com communicates with the assigned base hospital and transporting units; field units do not self-distribute patients from the static capacity table when communications are working.
- The default Patient Care Capacity Inventory is a communications-failure fallback, not live hospital capacity.

## Activation & communications chain

1. The MCI response plan activates when fire service responders announce that the Orange County Fire Services Operational Area Annex MCI Plan is being used for an incident.
2. Fire dispatch notifies Orange County Communications (OCC) with the location, incident type, and estimated victim count.
3. OCC assigns a coordination talkgroup from 6-Bravo through 6-Kilo for Med Com and assigns the base hospital managing the MCI.
4. Med Com maintains the link between the scene and base hospital. The base hospital activates the ReddiNet MCI module, polls potential receiving hospitals, and returns destination assignments through Med Com.
5. OCC notifies the on-call EMS Duty Officer for incidents involving 20 or more victims.

## START categories used by Policy 900.00

- At the MCI scene, START is used to decide which patients require an ALS-level assessment. Follow the complete operational MCI plan for triage procedures.

| Category | Policy 900.00 description |
| --- | --- |
| Immediate - red | Highest priority; rapid assessment and intervention may increase the chance of survival. |
| Delayed - yellow | Second priority; injuries or exposure are less severe or pose no immediate threat to life. |
| Minor - green | Third priority; requires only simple medical care. |
| Expectant - black | Lowest priority; found pulseless and non-breathing. |

## MCI patient report by incident level

- Scene safety, incident type, and the need to move patients can justify a more limited report than the default elements below.
- When providing a later patient update directly to an assigned hospital, state that the MCI patient is already assigned and reference age, sex, and triage-tag number to avoid duplication.

| Level | Approximate victims | Report elements |
| --- | --- | --- |
| Level 1 | 3-10 | Last 3 triage-tag digits; category; specialty need; age; gender; major injuries; vital signs; destination or specialty request; ambulance identifier. |
| Level 2 | 10-30 | Last 3 triage-tag digits; category; destination or specialty request; ambulance identifier; additional information as available. |
| Level 3 | 30 or more | Level 2 report when possible; destination or specialty-center request. |

## Destination & transport rules

- ALS and BLS providers relay the available patient-report elements to Med Com. Med Com receives assignments from the base hospital and returns them to transporting providers.
- Patients meeting specialty criteria are preferentially assigned to specialty centers based on field triage, Med Com/base communications, and specialty-bed availability. In a large event, the base hospital prioritizes who benefits most from limited specialty beds.
- For online medical direction during transport, request that OCC assign the same base hospital managing the MCI.
- A receiving facility may not divert an MCI patient already assigned by the base hospital unless the facility is closed because of an internal disruption under OCEMS Policy 310.96.

## Communications failure & default capacity

- If OCC is in FAILSAFE, Med Com contacts the base hospital normally assigned to units in that area. If the 800 MHz system fails, Med Com uses Med-9, landline, or cellular phone.
- Only when communication cannot be established with OCC or the base hospital by alternate means does Med Com use the default PCCI below to assign destinations.
- The numbers are default MCI capacity without prior notification from Policy 900.00, effective January 1, 2026; they are not a live availability display.
- In the official table, BC marks a burn center and Helo marks a helicopter landing site: Orange County Global and UCI Health - Orange are marked BC; Long Beach Memorial, Mission Hospital - Mission Viejo, Orange County Global, and Rady Children's are marked Helo.

| Trauma center | City | Emergency dept | Red phone | Trauma | Immediate + delayed | Minor |
| --- | --- | --- | --- | --- | --- | --- |
| Long Beach Memorial Hospital | Long Beach | (562) 933-1400 | (562) 933-1406 | 4 | 4 | 4 |
| Mission Hospital - Mission Viejo | Mission Viejo | (949) 365-2202 | (949) 364-1181 | 4 | 4 | 4 |
| Orange County Global Medical Center | Santa Ana | (714) 953-3331 | (714) 835-6465 | 4 | 4 | 4 |
| Rady Children's Hospital Orange County | Orange | (714) 509-9095 | (714) 633-3081 | 4 children | 4 children | 4 children |
| UCI Health - Orange | Orange | (714) 456-5705 | (714) 456-6480 | 4 | 4 | 4 |

## Default emergency receiving-center capacity

- Use this second half of the PCCI only under the communications-failure condition described above.

| Emergency receiving center | City | Emergency dept | Red phone | Immediate + delayed | Minor |
| --- | --- | --- | --- | --- | --- |
| Anaheim Global Medical Center | Anaheim | (714) 563-6220 | (714) 956-5641 | 1 | 5 |
| Anaheim Regional Medical Center | Anaheim | (714) 999-6111 | (714) 991-1251 | 1 | 5 |
| Foothill Regional Medical Center | Tustin | (714) 619-7736 | (657) 267-0700 | 1 | 2 |
| Garden Grove Hospital | Garden Grove | (714) 741-2724 | (714) 537-3810 | 2 | 5 |
| Hoag Hospital - Irvine | Irvine | (949) 517-3010 | (949) 450-0188 | 1 | 4 |
| Hoag Hospital - Newport Beach | Newport Beach | (949) 764-8376 | (949) 642-9001 | 2 | 4 |
| Huntington Beach Hospital | Huntington Beach | (714) 843-5011 | (714) 842-4543 | 1 | 3 |
| Kaiser Permanente Medical Center - Anaheim | Anaheim | (714) 644-2800 | (714) 644-2862 | 2 | 4 |
| Kaiser Permanente Medical Center - Irvine | Irvine | (949) 932-2800 | (949) 932-2656 | 1 | 3 |
| La Palma Intercommunity Hospital | La Palma | (714) 670-6133 | (714) 521-5760 | 2 | 2 |
| Mission Hospital - Laguna Beach | Laguna Beach | (949) 499-1311 | (949) 433-8056 | 1 | 3 |
| Orange Coast Memorial Medical Center | Fountain Valley | (714) 378-7535 | (714) 378-7666 | 2 | 4 |
| Saddleback Memorial Medical Center | Laguna Hills | (949) 452-3569 | (949) 837-1430 | 2 | 5 |
| South Coast Global Medical Center | Santa Ana | (714) 754-5550 | (714) 754-5551 | 2 | 4 |
| Saint Joseph Hospital | Orange | (714) 771-8002 | (714) 639-6900 | 2 | 4 |
| Saint Jude Medical Center | Fullerton | (714) 992-3965 | (714) 446-5311 | 2 | 4 |
| UCI Health - Fountain Valley | Fountain Valley | (714) 966-8105 | (714) 979-3787 | 4 | 6 |
| UCI Health - Irvine | Irvine | (657) 579-2424 | (657) 579-2454 | 2 | 4 |
| UCI Health - Los Alamitos | Los Alamitos | (562) 598-2411 | (562) 799-3588 | 2 | 6 |
| UCI Health - Placentia Linda | Placentia | (714) 524-4827 | (714) 993-5252 | 2 | 4 |
| West Anaheim Medical Center | Anaheim | (714) 229-4088 | (714) 826-8271 | 1 | 4 |

## Documentation & closeout

- Complete patient-care reports while en route or at receiving centers while agency personnel remain available. When they are no longer available, use triage tags with ambulance run sheets.
- For every MCI patient, check the MCI box on the ePCR. Keep the triage tag with the patient; the receiving hospital retains it as part of the medical record.
- Med Com notifies the base hospital when the scene is clear. The base hospital closes the incident through ReddiNet after all victims have left the scene, and involved hospitals complete required casualty-received data.

- [Open MCI Worksheet Attachment 1 - Base Hospital](/reference/900-00-mci-worksheet-attachment-1-mass-casualty-incident-response-plan-bh/)
- [Open MCI Worksheet Attachment 2 - Med Com](/reference/900-00-mci-worksheet-attachment-2-mass-casualty-incident-response-plan-med-com/)
- [Open the Orange County Fire Chiefs Association MCI Plan](/reference/orange-county-fire-chiefs-association-mci-plan-2019/)

## Official OCEMS sources

- [900.00 - Multi-Casualty Incident Response Plan](https://www.ochealthinfo.com/sites/healthcare/files/2026-01/900.00%20MCI%20%2812-30-2025%29.pdf)
- [OCFCA MCI Plan - Orange County Fire Chiefs Association MCI Plan 2019](https://www.ochealthinfo.com/sites/healthcare/files/2023-04/OC%20Fire%20Chiefs%20Assoc.MCI%20Plan.2019%20%28attachment%20to%20900.00%29.pdf)

[OCEMS notices and system updates](https://www.ochealthinfo.com/providers-partners/emergency-medical-services)