ems command what we imagine is order is merely the prevailing form of chaos. kerry thornley,...
TRANSCRIPT
EMS COMMAND
What we imagine is order is merely the prevailing form of
chaos.
Kerry Thornley, Principia Discordia, 5th edition
PROCEDURE At all medical incidents where Command has been
established, the Incident Commander will implement the necessary components of the EMS Command structure to ensure firefighter and public safety.
Additionally, he/she will effectively mitigate the incident while maintaining strict accountability for all patients and their personal belongings.
EMS COMMAND IMPLEMENTATION
Implement EMS Command early. Develop the system in a logical order. Provide tactical objectives to subordinate
positions when you assign them. Determine if your incident requires the
expanded EMS ICS structure to manage it. Think about geography (Scene set-up). Use visual indicators to assist responders and
the public.
TERMINOLOGY Mass-Casualty Incident – Any incident with
multiple patients that will significantly impact local resources including area hospitals.
1st Alarm Medical – Through our established Automatic Aid Agreement, a 1st Alarm Medical will result in the response of 2 Engines, 2 Rescues, and 1 Command Officer. (No such thing as a 2nd Alarm Medical)
EM’s System – The Medical Communications Officer will activate the EM’s system through Summit Regional. This system will indicate the availability and status of all regional facilities. (Flagstaff, Phoenix, Tucson, etc….)
ROLES AND RESPONSIBILITIES
COMMAND
Command : Establishes an effective command structure. Manages Communications. Utilize EMS Command tools to assist in this
process. EMS Tactical Worksheet Command Checklist
MEDICAL
Medical : Reports to Command . Organizes incoming resources to mitigate large
EMS incidents.
Medical Branch Director Checklist
TRIAGE Triage :
Reports to Medical/Command. Recon incident area. Is responsible for sorting and prioritizing all
casualties.
Triage Unit Leader Checklist
EXAMPLE:“Medical , Triage Team 1 triaged 15
patients, 7-Immediate, 7-Delayed, and 1-Dead or Dying”
Triage Team
Medical Branch
Incident Command
Triage Team, reports findings up the Chain of Command
TREATMENTTREATMENT
TreatmentTreatment : : Reports to Medical/CommandReports to Medical/Command
Responsible for prioritizing casualties and Responsible for prioritizing casualties and treating the injured.treating the injured.
Treatment Unit Leader Checklist
TREATMENT OFFICER
• SUPERVISES TREATMENT AREA.
• REPORTS TO MEDICAL /
COMMAND
• TEAM SETS UP TREATMENT
AREA
• UTILIZE VISUAL CUES TO
DESIGNATE THE AREAS
Min
or
Tre
at
Are
a
Del a
yed T
reat
Are
a
Imm
edia
te T
reat
Are
a
Treatment Entry Point
•Treatment Teams are responsible for re-evaluating and stabilizing patients brought by each assigned “litter bearers.”
TREATMENT OFFICER / TEAMS
TRANSPORTATION
Transportation
Organizes and coordinates the transportation of all casualties.
Transportation Unit Leader Checklist Transportation Record
TRANSPORTATION OFFICER
• Remains around the designated treatment area and works with the Treatment Officer on transport priorities.
• Assigns patients to transport units.
• Removes last tag and puts it into the “Hospital Can”
• Reports to Medical / Command.
RESCUE Rescue/Extrication:
Reports to Medical/Command Removes trapped victims and provides for their
movement to triage/treatment area(s) (whichever is most appropriate.)
Rescue Group Checklist
MEDS COMM
Medical Communications (MEDS COMM)
Reports to Medical/Command Maintains communications with area hospitals
(EMSCOM) and dispatch to facilitate transportation of victims to the appropriate facilities.
MEDS COMM Checklist
MEDICAL COMMUNICATIONS Medical Communications Officer maintains
communication with area hospitals via EMSCOM.
Receiving hospitals availability in terms of #’s of Immediate/Delayed/Minor pt’s they can take.
Report to receiving facilities the pt. triage level, transport unit #, and ETA.
If requested by Medical Branch, implement the EM’s system .
MEDICAL STAGING Medical Staging :
Reports to Transportation/Medical Establishes, organizes and maintains an area for
incoming medical resources.
Medical Staging Checklist
MORGUE Morgue:
Report to Medical/Command. Collect, protect, and identify deceased victims.
Morgue Manager Checklist
MORGUE MANAGER Mission-Collect,
Protect, and Identify bodies
Establish morgue area
Utilize Law Enforcement/Coroner for assistance
Use litter bearers for moving of dead
Morgue
MEDICAL SUPPLY Not included in the EMS Command Kits. Treatment Officer assigns team to rob
equipment off of every truck. Or, have trucks bring all equipment to
treatment area prior to being assigned to a task.
As the MCI develops, other actions may need to be taken to facilitate equipment. (Department Stock).
EXAMPLE
The following is an example of a typical MCI and the associated command structure.
The ICS StructureIC
MEDS COM
Triage Group Treatment Group Transportation Group
Triage Teams
Litter bearers
Immediate Manager
Delayed Manager
Minor Manager
Medical Staging
Medical Supply
Rescue Group
Morgue
Extrication Teams
Ground Ambulance Manager
Air Ambulance Manager
The ICS StructureIC
Medical Branch
PIO Safety
Divisions GroupsMEDS COM
Triage Group Treatment Group Transportation Group
Triage Teams
Litter bearers
Immediate Manager
Delayed Manager
Minor Manager
Medical Staging
Medical Supply
Rescue Group
Morgue
Extrication Teams
Hazmat Branch Fire Branch
Ground AmbulanceManager
Air Ambulance Manager
The ICS StructureIC
Operations
Medical Branch
PIO Safety
Divisions GroupsMEDS COM
Triage Group Treatment Group Transportation Group
Triage Teams
Litter bearers
Immediate Manager
Delayed Manager
Minor Manager
Medical Staging
Medical Supply
Rescue Group
Morgue
Extrication Teams
Fire BranchHazmat Branch
Planning Logistics Admin/Finance
Ground Ambulance Manager
Air AmbulanceManager
Min
or
Tre
at
Del a
yed T
reat
Imm
edia
te
Tre
at
Treatment Entry Point
Medical StagingTriage Area