What This Course Covers

You’ve triaged the patients. Now what?

Somebody has to run this scene. Establish command. Build the org chart. Get ambulances flowing. Coordinate with hospitals. Keep 30 moving parts from collapsing into chaos. On your next MCI, that somebody might be you.

This course takes you through the full operational arc of managing a mass casualty incident — from the moment you step out of the truck to the moment the last patient rolls out. It’s built on the Incident Command System, pressure-tested against real-world After-Action Reports from Boston and Las Vegas, and grounded in one of the most progressive MCI plans in North America: the Seattle/King County model.

Lesson 1: What Makes an MCI — It’s not a patient count. It’s a resource-to-demand mismatch. Understanding this changes how you prepare, how you respond, and how you scale.

Lesson 2: Assuming Command — The first 15 minutes set the trajectory for everything that follows. METHANE reports, IC initial actions, ICS-201, and when to expand the structure. Includes downloadable checklists you can print and carry.

Lesson 3: Building the Medical Branch — Triage, Treatment, Transport — the three units that form the medical response. Who does what, where things go, and how King County eliminated the bottlenecks that traditional models create.

Lesson 4: Triage Systems — START, SALT, and the Sick/Not Sick decision. Accuracy data, limitations, and how to choose the right tool. (If you need the deep dive on START/JumpSTART, see our MCI Triage Basics course.)

Lesson 5: Communications and Transport — Multi-channel radio plans, the DMCC role in hospital load-balancing, patient tracking technology, and documentation that scales without delaying care.

Lesson 6: When the Plan Meets Reality — Boston Marathon. Las Vegas Route 91. What the After-Action Reports actually say, what surprised everyone, and the universal principles that apply regardless of your local plan.

Who This Is For

EMTs, PCPs, ACPs — anyone who might find themselves running an MCI or filling a key role in the Medical Branch. Whether you’re a new crew lead who’s never held command or an experienced officer looking to sharpen your operational thinking, this course meets you where you are.

What You’ll Walk Away With

• A working mental model for the first 30 minutes of any MCI
• Understanding of the Medical Branch structure and how to build it in real time
• Practical checklists: IC Initial Actions, ICS-201 Quick Fill, Transfer of Command, Triggers to Expand
• Lessons from real incidents that changed how we think about MCI management
• The confidence to step into command and build the machine while it’s running

Recommended Prerequisite

No prerequisites required. If you want to brush up on triage algorithms first, our Multi-Patient Incident Triage Basics (START/JumpSTART) course covers the foundations.