METHANE
First on-scene / hospital alert message
- M — Major Incident. Declared / Standby — state clearly.
- E — Exact Location. Grid reference, full address, nearest landmark, RV point.
- T — Type of Incident. Transport, fire, explosion, CBRNe, structural, crowd, shooter.
- H — Hazards. Fire, fuel, electricity, secondary device, structural, weather, hostile.
- A — Access / Egress. Best routes in & out for emergency vehicles; cordon points.
- N — Number of Casualties. Estimated total + breakdown (P1/P2/P3/Dead).
- E — Emergency Services. Present and required: Police, Fire, HEMS, EMS, HART, military.
CSCATTT
Command structure & medical priorities at scene
- C — Command & Control. Bronze / Silver / Gold. Wear tabard. Forward Control Point.
- S — Safety. 1-2-3: Self → Scene → Survivors. PPE. Dynamic risk assessment.
- C — Communication. Send & repeat METHANE. JESIP principles. Log decisions.
- A — Assessment. Scene survey + reassessment every 15 min. Anticipate surge.
- T — Triage. Primary SIEVE (START/JumpSTART). Secondary SORT/SALT. Re-triage.
- T — Treatment. ABC + catastrophic haemorrhage first. CCS Red→Yellow→Green.
- T — Transport. Right patient, right place, right time. Spread the load.
ED — First 30 Minutes
0–5 min
Confirm & Declare
Verify METHANE. Consultant declares Major Incident. Switchboard cascades. Tabards on.
5–15 min
Create Capacity
Empty resus. Zone the ED. Single entry. Open MCI cupboard. Start Master Casualty List.
15–30 min
Receive & Distribute
Senior re-triage at door. Trauma teams allocated. MTP. SITREP every 15 min.
Ref: MIMMS 4th ed · NHS England EPRR · WHO Hospital Emergency Response Checklist.