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Incident Management Toolkit (IMT) - METHANE

Description

Emergency services widely use the METHANE acronym to build a report for alerting others about a major incident. The METHANE format is taught widely, and may seem easy to remember, but in a crisis is often difficult to recall at the very time that it is needed the most. The risk is therefore that the METHANE message is never sent, with subsequent delay in an appropriately-scaled emergency response. Prometheus IMT METHANE aims to be an intuitive, simple, quick and reliable way of building a METHANE message in a major incident situation, or an ETHANE message in a complex incident (i.e. a lower tier of incident where the essential components of the message are still very useful).

Prometheus IMT METHANE has been designed and developed by highly experienced emergency responders who still struggle to have the right fluency with the METHANE message when under extreme pressure. This is a tool designed to meet our needs. We believe others out there share those needs. Please let us know how we can make it better.

Background to IMT

Major incidents and ‘complex incidents’ are potentially chaotic and our clinical team felt we should develop an Incident Management Toolkit – a family of apps – using the features of the smart phone to help the person trying to manage it, whether they’re medical or not.

I know that it‘s very easy to be ‘maxed out’ or at the limit of your ‘bandwidth’ in these incidents so any app has to be uncluttered, logical, completely intuitive, and simple.  If you need to navigate through multiple layers of screens to get into it, it’s just not going to be of use at all.  Also, any app like this needs to work when you have no data or phone signal, at least in some useful way, because that’s likely to be the case in a real-world incident.

This is our first go at creating an app and it’s taken much longer and involved a lot more work than we had expected.  It would be easy to make a complicated version, but distilling it down to something really useful took a lot more work.

Background to this particular app

The first idea for an app to go into our toolkit was METHANE. Used for many years in Advanced Life Support Group's Major Incident Medical Management and Support (MIMMS) and adopted in the UK across all the emergency services as part of the Joint Emergency Services Interoperability Principles (JESIP), METHANE is the mnemonic for remembering the key information which should be conveyed immediately as part of declaring a Major Incident (actual or ‘standby’).  

METHANE stands for: 

  • Major Incident Declared, 
  • Exact location, 
  • Type of incident, 
  • Hazards, 
  • Access, 
  • Number and type of casualties, and 
  • Emergency services present and required. 

We use METHANE during training courses and on exercises and it seems simple enough to remember.  Put yourself in a realistic, pressurised exercise and it can be easy to lose fluency with METHANE and it’s not always simple collating the right information quickly and in a structured way.  From my own experience, I’ve scrawled my METHANE messages on my hand, a note book, a scrap of paper and they end up barely legible even to me.  So having something to organise this ought to be a good thing.

Fortunately major incidents are infrequent so we don’t often get to use METHANE for real.  It can be used more regularly as an ETHANE message for incidents which are complex, even if not meeting the definition of a Major Incident.  If you’re first on scene at, for example, a six-person RTC, sending an ETHANE message has real value in organising resources.  This app had to be designed to allow an ETHANE message to be created just as easily as a METHANE report.

Another feature of app is that you should be able to use all or part of it as you wish, without compromising the flow of what you’re doing.  For example, whilst testing it, I regularly use it to confirm just the ‘E’, the exact location, presented as a standard UK Grid Reference or latitude and longitude (depending on your preferences).  I used it in Nepal following the 2015 earthquake as a tool to help log locations of note during medical recces. 

This is our first app, and I know there are many ways to make it better.  Have you ever noticed that sometimes you have a really good app that the developers insist on upgrading with ever-increasing complexity, to the point where it loses utility as you struggle to cope with new options, layers and features? Our plan is to listen to your feedback, to shape and evolve this app for emergency service responders, but without ever making it so complex that you no longer find it of use.  Please let us know how we can make it better, and we’ll do our best to do so.

Building a scenario

I’ll run through an imaginary scenario, going through each screen to try to explain what we’ve done and why and how to get the best out of it. If you’re like me, you’ll probably learn best by playing with it and running through various real or made-up scenarios and testing its functionality. Let us know which bits work and which don’t. 

The overall aim is to build a METHANE message which can then be read off your phone as you send the information verbally on your radio (you do have the option to email it, though this isn’t how you’d conventionally declare a Major Incident in the first instance).

At its most elemental, you have no time, no signal, no bandwidth, just the open app in front of you: it is now just an unpopulated METHANE ‘crib sheet’ for you to work through as you speak, providing the mental triggers as you produce the message ad hoc.  Not the best way of doing it maybe, but this is the real world, so the option is there.

  • M

    Let’s assume we’re going to build the report quickly and in sequence (you can do it as piecemeal as you like and in whatever order you choose).

    First, hit ‘M’ then choose whether it’s a ‘Major Incident Declared’, or ‘Major Incident Standby’, or not a major incident (such as when you’re using it to make an ETHANE message).  The time defaults to ‘now’ but you do have the option of setting it retrospectively if you’re a bit behind the curve. You can set the time in the future, though I’d seriously worry if you’re writing your METHANE report ahead of the incident occurring.v

  • E

    Next is ‘E’ for Exact Location.  This plots your position and, with the right signal, will show your position on a map (using your device’s own mapping system).  If you have no phone/data signal, it should still give you your grid reference or latitude/longitude as with the iPhone, for example, the GPS chip is independent and will work even in airplane mode (techies, you might correct me on the detail but it does still give the correct position in airplane mode/no signal which is the key issue for me).

    In most cases, I would just hit Grid Ref to populate that field and move on, but you can do other things.  You can free text if you like.  I think free-texting anything in a Major Incident during the immediate phase is unlikely to happen but we’ve put to option there for you anyway.  Better, I think, is that by touching and holding a finger on the screen a little ‘target sight’ comes up which you can label as your location; the incident location (you might not be physically in the middle of the incident when you write your METHANE so it could be different to your own location); HLS (helicopter landing site); rendezvous point; or access point.  The little target can be moved around the map to where you want it to be if you’ve got fingers like mine and initially put it in the wrong place.

  • T

    Next is ‘T’ Type of Incident. Listing all the possible types of major incident would be virtually impossible. Listing the more common ones also produces a very long list. We tried to group incidents into broad categories so that finding them quickly should be just a two-tap procedure. For example, tap Transportation and you then have a list of options relating to Transportation, whether it be RTC or rail crash, etc. We have also allowed different paths into the same incident so, for example, a Maritime Transport incident (e.g. ferry crash) can be accessed through Transportation or Water. Again there is the option to free-text, and in Settings you can add your own specific incidents (space craft crashes, marshmallows raining from the sky, etc.) and re-order them into those you are most likely to attend in your role. So for me, I have transportation at the top but if you do event medical cover, Crowd incidents might be up there.

  • H

    Having finished with ‘T’ we’re on to the ‘H’ hazards. We have tried to list reasonably common hazards and present them in a context-sensitive way depending on the type of incident you’ve selected so you don’t have to waste time searching for what you’re likely to need. In Settings you can define your own hazards and order them as you wish and there’s still the option of free-texting.

  • A

    After Hazards, it’s on to ‘A’ Access which goes back to the map screen. This is always hard to describe without free-text so you might choose not to populate this field or perhaps just record the RVP in the same way as you can on the Exact Location page

  • N

    ‘N’ the Number and Severity of casualties page gives you the option to free text the number of casualties first. This was left as free text because you might be specific e.g. 17, or you might want to write ‘approx. 100’.

    Below that we have four casualty types including fatalities, paediatric casualties, persons trapped, and chemical casualties. Each of these is 0 as default and the first tap of the ‘+’ changes it to multiple as you may not have time or information to put in a specific number. Keep tapping ‘+’ and the number goes into specifics. You can free-text in here too if you wish, which may be easier than multiple taps of the ‘+’ button if there are large numbers.

  • E

    Finally we have the second ‘E’ of METHANE, standing for Emergency Services present and required. Initially services are shown as ‘not required’ but you can show them required and/or present as the situation demands. Again, the first tap of the ‘+’ button takes the field straight to ‘multiple’ if you don’t have time or want to be specific.

    In Settings, you can re-order the services to be relevant to you e.g. if you’re a police officer you may want all the police options up at the top. You can also add your own type of ‘service’ as there are so many different names for teams and resources in different areas. The aim here is to make the list pertinent to the job you do on a day to day basis in your own region.

Summary

The Prometheus IMT METHANE app is our first app.  We’ve put a lot of work into it to try to make it functional, easy and quick to use.  We’re keen to get it right so please play with it and let us know what you think.  If reception is favourable, we’ll put more into the Toolkit…
Malcolm Russell

Links: 

Tech support: METHANE Support — Junction Seven
JESIP: http://www.jesip.org.uk
MIMMS: http://www.alsg.org/uk/MIMMS 
Download app for your IPhone here: METHANE app
Download app for your Android here: METHANE app