Last week, public safety response to an MCI in Fort Worth, Texas, was put fully to the test after a crash involving more than 130 vehicles occurred after a night of freezing rain on I-35W. Reports identified that six people were killed, and dozens injured among the wreckage, which included 18 wheelers as well as some public safety vehicles.
The emergency crews, responding from MedStar, Fort Worth, identified patients who had died on the scene and had to clear all vehicles in and amongst the-mile-long pile-up. Medstar’s Chief Strategic Integration Officer, Matt Zavadsky, MS-HSA, EMT, reported they had transported at least 36 people to the hospital, with patients suffering serious and critical injuries. He also noted that crews continued to find new victims as they went from car to car as well as rounding up victims who had walked off the site to take shelter at a local 7-Eleven. In the final tally, 30 MedStar units responded to the scene, a police-run reunification center was established and the city stood up an emergency operations center.
Incidents such as this are clearly tragic and possibly avoidable, as Zavadsky told news reporters in a segment that was syndicated and traveled the globe; “For many of us, this is a career event, many of us have been in this profession for a very long time, we train for this kind of scenario, but you never really expect it to happen.”
Against the backdrop of this tragic event and the sobering fact that NHTSA reported a statistical projection that an estimated 28,000 would have died in motor vehicle crashes in the first 9 months of 2020, it is worth looking at traffic incident management.
Traffic incident management
Traffic incident management systems (TIMS) offer best practices and guidance for highway-related incidents, including technical guidance, training systems and programs for the fire and emergency services. TIMS also provide information on safe and effective management of emergency incidents that occur on roadways, including fires, collisions, hazardous materials incidents and other incidents that expose emergency responders to the hazards of working on active roadways.
Most jurisdictions – and some states – have TIMS-related workgroups and active engagement is encouraged. Understanding the roles and responsibilities of each agency on the scene of a major traffic incident is useful and helps avoid frustration. Police and fire departments occasionally have conflicts about who has lead responsibility, what actions have priority, where emergency vehicles should be situated, and who has priority for collecting driver and/or patient information. These types of disagreements can become distractions at incidents and impair coordination.
Law enforcement TIMS roles
The primary law enforcement MCI responsibilities include securing the incident scene, supervising scene clearance and conducting accident investigations. Detailed tasks include:
- Assist in incident detection
- Secure the incident scene
- Assist disabled motorists
- Provide emergency medical aid until help arrives
- Direct traffic
- Conduct accident investigations
- Serve as incident commander
- Safeguard personal property
- Supervise scene clearance
Fire and rescue TIMS roles
The primary fire and rescue MCI responsibilities include protecting the incident scene, HAZMAT containment and rescuing victims. Detailed tasks include:
- Protect the incident scene
- Provide traffic control until police or DOT arrival
- Provide emergency medical care
- Provide initial HAZMAT response and containment
- Suppress fire
- Rescue crash victims from wrecked vehicles
- Rescue crash victims from contaminated environments
- Arrange transportation for the injured
- Serve as incident commander
- Assist in incident clearance
EMS TIMS roles
The primary EMS MCI responsibilities are the triage, treatment, and transport of crash victims. Detailed tasks include:
- Provide advanced emergency medical care
- Determine destination and transportation requirements for the injured
- Coordinate evacuation with fire, police and ambulance or air transport
- Serve as incident commander for medical emergencies
- Determine the approximate cause of injuries for the trauma center
- Remove medical waste from the incident scene
In addition to the front-line public safety agencies, state Department of Transportation agencies and towing and recovery companies would also be in the vicinity and on scene. In the aftermath of devastating incidents, coroner and medical examiner services will also deploy. Roles occasionally overlap or merge, which leads to confusion, frustration and occasionally, handcuffs. As with every multi-agency operation, liaison and understanding are key.
MCI media and public information
As with any major incident, after an MCI, the news will travel fast and a clamor of journalists and bystanders, both equipped with high-tech recording equipment, will get the message out before you can. Always be prepared to deploy a spokesperson to the incident. This may well allow an immediate press conference at the scene with a voice from each participating discipline to describe the work they have undertaken.
Agency PIOs can deliver key messages on the incident itself, the type of injuries being encountered, traffic flow and diversion, possible causation if determined, and the strong and solid work of the responders on the scene. In the recent Fort Worth incident, the on-scene press conference was followed up with news stories on the actions of receiving hospitals as well as interviews with those involved.
EOC and ICS
Familiarity and training breed cooperation, and as with all multi-agency operations, regular liaison and exercises, both tabletop and live, always make for an easier operational day. The glue that bonds all operations is the incident command system, which offers an organized approach to incident management and enables providers of all uniforms to speak the same language.
The common terminology, modular organization, integrated communications and the unified command structure inevitably assist in gaining order from chaos. ICS isn’t limited to large and major incidents. Many events inevitably see a group of functional leaders on the scene of a road incident or event co-located around the command board of the battalion commander or EMS supervisor’s vehicle. For major incidents, such as the Fort Worth MCI, a formal, distant, emergency operations center can be stood up to ensure all aspects of not only the response but also the recovery, information, demobilization and after actions are managed.
Ongoing research to improve emergency response road safety
Highway transportation safety research is constantly ongoing to make roadways safer, to protect those who operate on our highways and to identify best practices. Below is a list of projects being carried out in response to a requirement in the FY2020 Consolidated Appropriation Act. This information was forwarded by the NHTSA Office of EMS in conjunction with NASEMSO, and projects have been awarded and are underway:
1. Police pursuit study. This project will provide a resource that will help law enforcement manage high speed vehicular pursuits before they are encountered; endangering life or damaging property and share information on encouraging practices used in managing high-risk vehicular pursuits. Project facilitated through an Inter-Agency Agreement (IAA) with the DOJ COPS Office and was awarded to the Police Executive Research Forum (PERF).
2. Move over crash investigations. NHTSA’s National Center for Statistics and Analysis (NCSA), through the Special Crash Investigations Division, will conduct in-depth studies of both fatal, non-fatal and property damage move over related crashes and develop a report, including noteworthy practices.
3. Evaluation of efficacy of move over laws and influence of technology on driver behavior: Awarded through an IAA, the Federal Highway Administration (FHWA) will conduct a prospective study of move over compliance and strategies, including technologies that increase compliance with the laws.
4. NASA JPL trusted and explainable artificial intelligence for saving lives (TruePAL). Awarded through an IAA to the NASA Jet Propulsion Laboratory, this project will evaluate law enforcement officer and firefighter/EMS behavior in response to technology based explainable AI and trusted autonomy technologies to fuse multiple information sources and produce explainable AI recommendations for supporting first responder operations to improve operator safety both in route and on scene.
5. Move over crash data collection and analysis. Awarded through an IAA to FHWA, the project will use an expert panel approach to study the causes of first responder and other road workers struck-by fatalities, injuries and to the extent possible, near-hit incidents.
6. ITS-JPO equipment loan program: Awarded through an IAA to the Intelligent Transportations Systems Joint Program Office, this project will purchase work-zone and incident response technology and equipment for shared use among the states. States will be required to evaluate the effectiveness of the equipment.
Preparation, planning and exercise
In this week of the polar vortex, where Austin out-froze Alaska, the Fort Worth incident was the largest, but not the only vehicle-related winter weather incident, and statistics tell us it won’t be last. Prior preparation, planning and exercise cannot replicate the raw emotion of responding to a devastating incident, but it can hone the necessary tactics, techniques and procedures to ensure the response goes well. As with every event, communication and understanding are key, and, as has been said many times, the incident itself should not be the first time commanders meet.
Kudos to the responders who managed the Fort Worth incident.
EMS One-Stop With Rob Lawrence: Traffic incident management
MedStar’s Matt Zavadsky and NASEMSO’s Dia Gainor discuss traffic incident management and EMS’s role in multi-agency response after 133 vehicle pileup.
Additional resources for TIMS, MCI management
- National Operations Center of Excellence: Traffic Incident Management
- NHTSA Early Estimate of Motor Vehicle Traffic Fatalities
- Rapid Response: Roadway incidents are a hot zone for EMS
- How to practice the EMS response to an MCI
- Creating an effective tabletop training exercise for pre-planning MCI response
