Major Incident Planning in Event Medicine: JESIP, METHANE, and Ten Second Triage

Introduction: Why Major Incident Planning Matters for Events

Large-scale events—whether music festivals, sporting tournaments, or public gatherings—carry inherent risks. While most events run smoothly, organisers must be prepared for the rare but critical possibility of a major incident. A well-prepared medical plan doesn’t just save lives—it reassures licensing authorities, emergency services, and attendees that safety is the top priority.



Major incident planning in event medicine relies on structured frameworks such as JESIP, METHANE, and Ten Second Triage, which ensure effective communication, coordinated decision-making, and rapid casualty prioritisation.

What Is a Major Incident?

A major incident is any event that overwhelms normal resources and requires special arrangements from multiple responding agencies. In an event medicine context, this could include:

• A structural collapse, fire, or explosion.
• A crowd surge or crush.
• A mass-casualty incident (MCI) from violence, terrorism, or a serious accident.
• Severe environmental hazards such as extreme weather or chemical exposure.

Preparedness is critical because major incidents demand coordination, speed, and structure.

Discover How JESIP Shapes Major Incident Response

JESIP (Joint Emergency Services Interoperability Principles) is the national framework guiding how police, fire, ambulance, and other responders work together during a major incident. Event medical teams are often the first link in that chain, so understanding JESIP is essential.

The five principles of JESIP are:

1. Co-location – Commanders meet at one location to make joint decisions.
2. Communication – Use clear, plain language and confirm key information.
3. Co-ordination – Agencies work to a shared set of priorities.
4. Joint Understanding of Risk – Agreeing risks before taking action.
5. Shared Situational Awareness – Everyone must have the same picture of what’s happening.

For event medicine, JESIP ensures medical teams align seamlessly with statutory emergency services when responding to a major incident.

Mastering METHANE for Accurate Major Incident Reporting

When a major incident is declared, structured communication is essential. The METHANE mnemonic provides a quick, standardised way to pass vital information:

• M – Major incident declared (yes/no).
• E – Exact location.
• T – Type of incident.
• H – Hazards present or suspected.
• A – Access routes and egress points.
• N – Number and type of casualties.
• E – Emergency services present and required.

Often, the first METHANE report comes from event medical staff, ensuring NHS Ambulance Services and other responders receive a clear, accurate initial picture.

Discover the Role of Ten Second Triage in Mass Casualty Incidents

In mass-casualty situations, speed is everything. The Ten Second Triage tool is designed to categorise patients rapidly, ensuring that those most in need receive help first.

The colour-coded categories are:

• Red (Immediate): Life-threatening but potentially survivable injuries.
• Amber (Urgent/Delayed): Serious injuries needing hospital care but not immediately life-threatening.
• Green (Walking Wounded): Minor injuries—patients who can walk are directed away from the scene.
• Black (Expectant/Deceased): Patients who are dead or whose injuries are incompatible with survival.

Ten Second Triage allows responders to process large numbers of casualties quickly and effectively before advanced clinicians arrive.

Discover the Hidden Risks in Your Event Environment

When planning for major incidents, it’s not just about the number of attendees—the design, location, and activities of your event site directly affect medical planning.

Site Layout and Casualty Flow

Stages, barriers, exits, and crowd control structures can either help or hinder emergency response. Poor layouts may block ambulance access, delay evacuation, or restrict casualty movement. Medical teams should be involved in event planning to ensure clear routes, safe access, and casualty clearing zones.

Environmental Risks

Outdoor events bring environmental challenges. Heatwaves can trigger dehydration and heatstroke, while heavy rain and flooding can disrupt infrastructure and create hazards. Uneven or muddy terrain can make stretcher evacuations difficult. Mitigating environmental risks through planning and contingency measures is essential.

High-Risk Activities

Certain event types naturally present higher medical risks. Motorsports and extreme sports increase the likelihood of trauma. Alcohol-heavy music festivals or late-night events raise risks of intoxication, violence, and crush injuries. These risks should always be factored into the event’s medical risk assessment and provision planning.

Wider Considerations in Major Incident Planning

Alongside JESIP, METHANE, and Ten Second Triage, event medical providers should also consider:

• Casualty Clearing Stations: Dedicated zones for assessment, stabilisation, and transfer.
• Evacuation Routes: Ensuring ambulances and responders can enter and exit efficiently.
• Resource Escalation: Knowing how to call for extra ambulances, air assets, or hospital capacity.
• Controllers and Loggists: Maintaining communication and accurate records during incidents.
• Safeguarding: Accounting for vulnerable groups, including children and disabled attendees.

Discover Why Training and Exercises Build Confidence

Even the best-written major incident plan is ineffective without practice. Regular training ensures staff can act quickly and confidently under pressure. This includes:

• Tabletop exercises with event control and emergency services.
• Live drills to rehearse triage, evacuation, and communications.
• Refresher training on JESIP, METHANE, and triage protocols.

Practical training not only improves team readiness but also strengthens confidence with licensing bodies and safety advisory groups.

Conclusion: Building Resilience Through Major Incident Planning

Major incident planning is an essential part of safe, compliant event management. By adopting structured tools like JESIP, METHANE, and Ten Second Triage, alongside planning for crowd and site-specific risks, organisers can create robust, professional responses to even the most challenging scenarios.

Preparedness doesn’t just protect lives—it reassures stakeholders, builds trust, and ensures your event is remembered for the right reasons.