Major incidents are something that nobody really wants to have to deal with, but it’s important that staff who are in a position where they might be a first responder, or even a secondary responder to a major incident understands how to best assess and communicate the incident in a useful and safe way. This is especially true for medical responders as there is a very high chance that they will have an involvement in the majority of major incidents that could occur at an event or venue.
Dependent on the type of event, and your role, how you approach the incident will differ, and there are a variety of models which are intended to keep you safe, and help you coordinate and communicate what is going on and what you need to resolve the situation effectively.
One of those models is METHANE. This is intended to allow you, as potentially the first responder, to identify the incident and succinctly communicate this to your control, or indeed, other emergency services.
METHANE is part of the JESIP emergency principles, and all the services use it. Some may remember SAD CHALETS, which was an earlier version of METHANE, but was replaced by this new model after consultation across all the emergency services to achieve something that would serve inter-agency working more effectively. As mentioned, METHANE is a method of communicating critical info to other services or a control room, and so it is important that everybody is on the same page. Each letter of the acronym relates to a different element of information as follows:
M- MAJOR INCIDENT DECLARED – This is a bit of a duff point, as this point simply asks whether a major incident has actually been declared? In the sense of a on-site event medic, it is unlikely that you would be formally declaring a major incident, but it certainly doesn’t stop you if you think it’s going (or indeed gone) that way. A major incident does unfortunately have differing definitions across the different services, but generally it refers to an incident that will or is likely to have an impact on ‘business as usual’ for your organisation, or indeed multiple services. For instance, if you were providing cover at a boat-race, a competitor craft capsizing may not be a major incident if it’s a simple case of rescuing the crew, but may become one if all of the crew become casualties and require medical attention and transfer to hospital which is likely to put strain on the ambulance service and hospitals as they manage treatment. The intention, and reason, a major incident is declared in statutory services is usually to quickly implement a number of resilience measures. This may well be the case for event or venue too, and it is not uncommon for large venues and organisations to have major incident procedures built into their emergency planning. A declaration of a major incident could for instance see security staff re-positioned onto gates in order to permit access to any other services that need to attend, or may see some medics transition into a ‘triage and treat’ approach in order to try and ensure effective treatment of the injured. You will also often see this acronym as ETHANE, as it is not necessary to declare a major incident to use the process of METHANE effectively. It is quite common to see an ETHANE approach in the fire service for instance.
E-EXACT LOCATION – This needs to be as accurate as possible, and should be the location of the actual incident. Not any RV points, or triage areas that have been established. Consider the use of postcodes, site markers (campsite A etc) or even What 3. Words. However, don’t use anything that might move! Saying “behind the Range Rover in car park A” is all well and good until it’s careful owner decides to move it out of the way when he sees the fire brigade start slinging hoses and tools around!
T- TYPE OF INCIDENT – What is it? Is it a vehicle collision? Has a marquee collapsed? You simply communicate a nice and succinct description of the incident type.
H- HAZARDS – What hazards can you see or indeed suspect? For instance, if you attended a mass-casualty scenario where multiple people had been where stabbed, but the location of the suspect was unknown, then you would identify this as a hazard. You’d also include anything else obvious, like fire, unstable structures, fuel spills or fall risk.
A- ACCESS – What is the best and safest way in? Have you established an RVP which you want responding services to go to rather than come straight to scene? Perhaps access is already tight here, and so you don’t want 12 ambulances stacking on a single country track, potentially blocking further access (Fun Fact: Many ambulance services now designate a ‘parking officer’ at major incidents for this very reason). It’s this section where you would mention it. You may also want to note any ‘red routes’. I.E. Any route any other responders should not travel down due to safety issues. Red Routes are commonly designated by the police where they don’t want a potential suspect to sight responding personnel, but might also relate to a route that should not be travelled due to fire-risk or being downhill of fuel spill.
N – NUMBER OF CASUALTIES – Having performed a very cursory triage, you should report the number of casualties and the severity so their injuries. This will hopefully help with determining onward care, such as pre-alerting local hospitals and arranging sufficient ambulance response. However this is likely to then be complemented by a proper triage process later on when the initial reporting of the incident has occurred. The important factor of this stage is that the volume of injured people is communicated rather than drilling down into the true severity of injury in order to get the right amount of ambulance resource moving towards you.
E – EMERGENCY SERVICES – What services do you require? You should also include what services you already have on Scene. For instance, you may ask for the fire service to assist at a marquee collapse, and report that you have 3 medical first responders on scene already, but will require ambulance assistance to transport the wounded, and deal with the more serious injuries. Agian, bear in mind that METHANE is not a injury triage system, and so you’d likely want to avoid any great detail about extent of injuries for a METHANE update. However, following this, you might then pass a further update with regards to initial patient triage, and in fairness, any ambulance contact handler will likely then lead you down this path anyway.
That concludes our very whistle stop tour of METHANE, hopefully it’s given you a good insight, and if nothing else, an awareness this system exists. You can try it very simply by just using the ETHANE model next time you need to request the emergency services, especially where you may require multiple services. However equally, you’ll understand the reference if you are ever asked for a METHANE assessment in the field. The focus of the model is communication between the various responders to achieve ‘shared situational awareness’ of a incident. Ideally, as other services attend the location, operational commanders will co-locate and each service will also do their own METHANE assessment. This is because a firefighter is likely to recognise other risks and hazards that a paramedic may not recognise, but equally, a paramedic may have a differing view in terms of number of casualties etc. It fosters partnership working to achieve the best application of varied expertise.
As mentioned at the start, this model forms part of the JESIP principles, which essentially govern how inter agency working should occur. JESIP make a wealth of info available for free, so if you want to learn more, you can do so HERE.
MEDIREK offer businesses, venues and events a wide range of support services. This can include on-site medical rescue teams, risk management planning and even fire cover! All of our management staff are accustomed to the JESIP principles, with a wide’ breadth of experience from across various emergency services and risk management/incident command backgrounds.
