Multi-casualty incident response plan

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.

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.

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.

Default emergency receiving-center capacity

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

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.