MCI guides

How to run a mass casualty drill

A drill is where a team finds the gaps before a real incident does. It does not need to be big. A car park, ten volunteers with casualty cards and an hour is enough to learn a lot.

This guide is general information for trained responders. Follow your own service's protocols and local rules, which may differ.

1. Pick one or two things to test

Do not try to test everything. Pick one or two goals, for example "first METHANE inside 5 minutes" or "every patient tagged and tracked to a hospital".

2. Write the scenario

• What happened, where, and at what time.
• How many casualties, and what each one looks like. Write a card for each with injuries and vital signs, so the triage team has real numbers to work with.
• One or two surprises: a hazard that appears later, a hospital that becomes full, a patient who gets worse.

3. Brief the team

Tell everyone it is a drill and how to stop it if a real call comes in. Name the safety officer. Do not give away the scenario.

4. Run it

• First crew arrives, takes command and sends a METHANE report.
• Roles are handed out: incident commander, triage, treatment, transport.
• Casualties are sieved, tagged, treated and sent to hospitals.
• Observers write down times and problems. They do not help.

5. Debrief straight after

Spend 20 minutes on three questions: what went well, what did not, and what we will change. Look at real times: when was the incident declared, when was the first METHANE sent, when did the last patient leave.

6. Fix one thing and drill again

A drill that changes nothing was a waste of a Saturday. Pick the biggest gap, fix it, and test it again next time.

In Incident Commander you can tick "This is a drill" when you start. Everything works as normal, but every screen and alert is marked DRILL and drills are kept out of your real statistics. The timeline gives you the times for the debrief.