Managing a High-Volume Incident with Limited Resources
You are working a busy Friday night shift. At 22:15, a call comes in for a multi-vehicle accident on the highway: a semi-truck has jackknifed and blocked all lanes. The caller reports at least three cars involved, multiple people injured, and one car on fire. You dispatch fire and EMS. Within 3 minutes, you receive four more calls:
- A woman reports her husband is having chest pain and difficulty breathing.
- A store clerk reports a man with a gun in the store.
- A teenager reports a party next door is too loud.
- A driver reports a reckless driver on the highway, going the wrong way.
Your available units: two police units, one fire engine (already en route to the accident), and two ambulances (one en route to the accident, one available). The wrong-way driver is on the same highway, heading toward the accident scene. You have a supervisor available by radio.
1. Prioritize the four new calls and explain how you allocate your limited resources. Consider the interplay between the calls and the ongoing accident.
Read the worked answer
Priority order:
- Wrong-way driver – Immediate life threat to multiple people, and heading toward the accident scene where responders are working. This is the highest priority because it can cause another mass-casualty event and endanger responders. Dispatch one police unit to intercept and warn the accident scene. Use the supervisor to coordinate.
- Man with a gun in a store – Active threat with potential for mass shooting. Dispatch the second police unit immediately. If possible, request mutual aid or additional units from neighboring areas. The wrong-way driver and the gunman are both active threats; the wrong-way driver is prioritized because it directly affects the ongoing accident response and has a known location and direction.
- Chest pain – Medical emergency, but the available ambulance can be dispatched. However, the wrong-way driver may require the ambulance to divert if there is another collision. Dispatch the available ambulance to the chest pain call, but advise them to be cautious of the wrong-way driver. If the wrong-way driver causes a crash, you may need to reassign.
- Loud party – Low priority, no immediate danger. Handle by phone or queue for later.
Resource allocation: One police unit to wrong-way driver, one to gunman. Ambulance to chest pain. Fire engine continues to accident. Supervisor coordinates and requests additional resources. The accident already has fire and one ambulance; if more injuries are reported, request additional EMS. The key is to prevent the wrong-way driver from reaching the accident scene and to address the active gunman.
2. The wrong-way driver call is updated: the driver has caused a head-on collision with another vehicle, and the accident is now at mile marker 45, which is 2 miles from the original accident scene. You have no units left to send. What do you do?
Read the worked answer
Actions:
- Immediately notify the units at the original accident scene of the new collision at mile marker 45 and the wrong-way driver. They need to be aware of the danger and may be able to assist if they have resources.
- Request additional resources: Contact the supervisor to request mutual aid from neighboring agencies, including police, fire, and EMS. This is now a second mass-casualty incident.
- Reassign if possible: The police unit that was sent to the wrong-way driver should now be at the new collision scene. If the gunman situation is contained or if the unit can be released, reassign. But the gunman is still an active threat; do not pull that unit unless the gunman is under control.
- Use the available ambulance: The ambulance en route to the chest pain call may need to be diverted to the new collision if there are critical patients. However, the chest pain patient also needs care. Triage: if the new collision has multiple critical patients, divert the ambulance and request another for the chest pain. If the chest pain is stable, divert.
- Coordinate with fire: The fire engine at the original accident may be able to send a crew to the new scene if they have contained the fire. But they are still handling the original accident. Request additional fire units via mutual aid.
- Keep the supervisor informed and document all actions.
Key: The wrong-way driver has created a second emergency. You must escalate to mutual aid and make tough triage decisions. Do not leave the gunman call unanswered, but if the new collision has more immediate life threats, you may need to reassign the police unit from the gunman if the gunman is not actively shooting. Use the supervisor to make that call.