TOPOFF 4: Medical Responder Guide


Medical Care Point Exercise Responder Participant Guide Version 10/5

  • University of Portland (U of P) Chiles Center
  • This guide is distributed to the planning contacts of key participating organizations, the Volunteer Coordinator, and Controllers and Evaluators. Participating Organization contacts may distribute the plan to their participating responders.
  • For Official Use Only
  • October 17 2007


The Medical Care Point (MCP) Exercise is a component of the TOPOFF (“T4”) full-scale exercise (FSE) in the Oregon venue. An MCP is a temporary medical treatment facility to relieve overextended hospital emergency rooms and emergency clinics.

This Participant Guide contains excerpts from the Exercise Control Plan that are relevant to Responder Participants. It was drafted by James Spitzer, Emergency Preparedness Manager for the Multnomah County Health Department, in consultation with planners from other participating organizations.

MCP Exercise Objectives

Pre-MCP exercise objective. This exercise MCP has been artificially arranged by planners and leaders of participating organizations. Therefore on October 16th , TOPOFF response organization(s) should create a foundation for this MCP that meets objective 1:

1. Plan MCP Relationships. Define proper ICS relationships for unity of command, coordination, and resource ordering of MCPs to related response organizations, e.g. to ‘protected’ hospital(s); to superior IC/UC (if any); and any direct relationship to jurisdictional and discipline operation center(s). They should also set expectation and plans for MCP leadership to transition from Fire Services to public health/hospitals.
MCP exercise objectives. During the MCP exercise, the objectives for leaders at the MCP are:

2. Apply Plans. Apply/adapt Public Health MCP plan, Portland Fire Bureau MCP training, and the governing IC/UC’s Incident Action Plan.

3. Apply ICS. Apply ICS criteria to assemble resources from a number of different organizations and disciplines into a cohesive, well led, and coordinated MCP. Unity of command, span of control, communications, and execution of all or this MCP’s share of SMART objectives are particularly important.

4. Production. Adjust the organization and MCP processes to gain the highest throughput consistent with the demands imposed by triage priorities and relationship with supported hospital(s).

5. Relationships with Superior, Host, and Supported Organizations. Establish the situation/status sharing and inventory/supply/support process relationships with the MCPs superior response organization, the supported hospital, and with ordering point(s).

6. Transfer of Leadership. To the extent that this was not done and agreed upon previously (see #1), complete a realistic agreement and plan to transfer leadership/resources from Fire Service to public health and/or hospitals. Actual transfer of leadership is not expected to be executed during the 2 hour exercise.


Player Communications. Players will use routine, in-place agency communication systems with additional communication assets made available as player actions as the exercise progresses. The need to maintain capability for a real-world response may preclude the use of certain communication channels or systems that would usually be available for an actual emergency incident. In no instance will exercise communication interfere with real emergency communications.

Exercise Props

Fire apparatus and the Disaster Medical Assistance Teams will come with equipment and supplies intended for patient care during disaster operations. Digital clocks will allow Patients and Responders to record time-stamp data for later operations research analysis. Controller provided signs will display letter designations for MCP stages. Patients will not be prepared with applied ‘wounds.’ Symptom cards will give patients the information needed to act-out symptoms and complaints.

How to Declare a Real-World Emergency

Anyone who needs to declare a Real-World Emergency (something that is NOT part of the Exercise Emergencies that you are enacting) should shout: “I HAVE A REAL-WORLD EMERGENCY!

Then state:
• the kind of emergency,
• where it is, and
• what assistance is needed.

Appropriate exercise staff, participants, or requested emergency services suspend exercise operations to deal with the emergency within the scope of their training and


Anyone NOT needed for the Real-World Emergency continues the MCP exercise unless the lead Exercise Controller announces that exercise play is suspended or cancelled in order to facilitate real-world response operations.

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