Mass-Casualty Incident Declaration with START/JumpSTART Triage

Overview#

A watch-commander needs to promote a routine incident to a Major Incident or Mass-Casualty Incident in one tap, allocate scene roles, and watch START/JumpSTART triage results and METHANE updates flow into a single MCI record while neighbouring agencies receive structured CAP and SitRep messages without manual fanout.

The MCI Declaration and Triage module turns any active command-board incident into a declared MCI, allocates Bronze Commander, Triage Officer, and Loading Officer roles, drives START (adult) and JumpSTART (paediatric) sieves on responder mobile, transmits a structured METHANE report, and broadcasts EDXL-CAP 1.2 alerts to neighbouring agencies. The MCI itself stays a single canonical incident with N child patient encounters linked through incident correlations.

Last Reviewed: 2026-05-05 Last Updated: 2026-05-05

Key Features#

One-Tap MCI Promotion: A watch-commander promotes any active command-board incident to a declared Major Incident or MCI without recreating the case, preserving the original incident identity and timeline.
Scene Role Allocation: Bronze Commander, Triage Officer, and Loading Officer roles are assigned directly on the incident, so each responder knows their scene function and the command picture reflects who is doing what.
START and JumpSTART Triage on Mobile: Field responders run the open START algorithm for adults and the JumpSTART algorithm for paediatric casualties on the responder mobile, and each sieve result becomes a structured triage record.
Structured METHANE Reporting: The first-on-scene report is captured against the MCI as a structured METHANE payload (Major incident, Exact location, Type, Hazards, Access, Number of casualties, Emergency services required) rather than as free text.
Inter-Agency CAP Broadcast: Neighbouring agencies receive EDXL-CAP 1.2 alerts on declaration and on significant changes, removing the need for manual phone-tree fanout.
One MCI, N Patient Encounters: The MCI remains a single canonical incident and each casualty is held as a child patient incident linked through incident correlations, so the operational picture stays coherent.
Unified MCI Timeline: MCI declaration, role assignments, triage results, METHANE updates, mutual-aid resource requests, and CAP broadcasts appear in one chronological view for command and post-incident review.
Watch-Commander MCI Dashboard: A dedicated PSAP overview surfaces declared MCIs, current casualty counts by triage category, role assignments, and outstanding mutual-aid requests at a glance.

Use Cases#

Multi-Vehicle Road Traffic Collision: A two-vehicle RTC escalates as additional casualties are confirmed; the watch-commander promotes it to MCI in one tap and START triage drives transport priority.
Public Event Medical Surge: A crowd event produces a sudden cluster of casualties; declaring an MCI activates scene roles and triggers CAP notification to neighbouring services.
Paediatric-Heavy Incident: An incident at a school or youth event drives the responder mobile into JumpSTART for paediatric casualties while adults continue under START in parallel.
Industrial or Hazmat Scene: METHANE captures hazards and access constraints in a structured form, and CAP messages carry the hazard context to partner agencies automatically.
Cross-Border Mutual Aid: Neighbouring services receive a CAP alert and a SitRep update so they can pre-position resources without waiting for a phone call.
Post-Incident Review: A single MCI record with linked patient encounters and a unified timeline supports debriefs, audits, and learning reviews.

Integration#

Command Board and Incident Records: MCI promotion happens against the existing incident object, keeping continuity with prior dispatch, resource, and timeline data.
Responder Mobile Field Screens: Existing MCI activation and triage screens on the responder mobile are the primary capture surface for role assignments, START / JumpSTART sieves, and METHANE updates.
PSAP Watch-Commander View: A dedicated MCI dashboard surfaces the live state of declared MCIs alongside other active incidents in the same operational picture.
EPCR and Patient Encounter Records: Each casualty is held as a child patient incident and exposed as an HL7 FHIR R4 Encounter and Observation bundle for downstream clinical systems.
EDXL Publisher: A CAP 1.2 publisher and SitRep generator emit structured messages to neighbouring agencies on declaration and on significant state change.
Event Stream: CloudEvents are emitted for argus.mci.declared, argus.triage.completed, and argus.methane.transmitted so downstream consumers can react without polling.
Incident Correlations: The MCI and its child patient incidents are linked through incident correlation rows so the unified timeline can reconstruct the full picture.

Open Standards#

EDXL-CAP 1.2: declared MCIs and significant updates are broadcast as Common Alerting Protocol messages for inter-agency consumption.
EDXL-SitRep 1.0: situation report updates for the MCI are produced in the open SitRep exchange format.
EDXL-DE 2.0: outbound MCI messages travel inside the EDXL Distribution Element envelope to support routing and acknowledgement.
ISO 22320: incident command, role allocation, and information handling on the MCI follow the ISO 22320 incident command requirements.
START / JumpSTART: adult and paediatric mass-casualty triage use the openly published START and JumpSTART sieve algorithms.
METHANE: the first-on-scene report follows the UK NARU METHANE structure for major incident reporting.
CloudEvents 1.0: MCI lifecycle events (argus.mci.declared, argus.triage.completed, argus.methane.transmitted) are emitted in the CloudEvents envelope.
HL7 FHIR R4: each casualty is exposed as a FHIR Encounter with associated Observation resources for clinical interoperability.
HTTPS / TLS: all MCI message exchange uses the standard secure web transport baseline.
JSON: MCI, triage, METHANE, and correlation payloads remain easy to exchange across command, mobile, and partner systems using a common structured format.