Chapter 40: Incident Management

Introduction

• Disasters and Mass Casualty Incidents

  • Disaster: Overwhelms resources (e.g., 2 critical patients with 1 EMS unit)
  • Mass casualty: Involves 3+ patients or requires mutual aid
  • Examples: Bus/train crashes, earthquakes
  • Requires systematic approach and use of Incident Command System (ICS)

• National Incident Management System (NIMS)

  • Developed by Department of Homeland Security (2004)
  • Comprehensive framework for federal, state, local, private, and non-governmental coordination
  • Focus on flexibility, standardization, and interoperability

NIMS Components

1. Communications and Information Management
   • Essential for assessing info, interoperability, decision communication
2. Resource Management
   • Mechanisms for resource description, tracking, dispatch
3. Command and Coordination
   • Standardizes incident management across all government levels

Incident Command System (ICS)

• Ensures safety, goal achievement, efficient resource use
• Modular organizational structure for all hazards
• Avoids duplication and freelancing
• Span of control: 1 supervisor for 5 subordinates
• Organizational levels: Sections, Branches, Divisions, Groups

Incident Command System Roles

• Command: Incident Commander (overall in charge)
• Finance/Administration: Document expenses, claim management
• Logistics: Manage communications, facilities, supplies
• Operations: Tactical operations management
• Planning: Problem-solving, incident action plan development

Command Staff

• Safety Officer: Monitors scene safety
• Public Information Officer: Communicates with media and public
• Liaison Officer: Coordinates between agencies

EMS Response in ICS

• Preparedness: Written disaster plans, mutual aid agreements
• Scene Size-up: Assess scene safety, resources needed
• Triage and Treatment: Categorize patients using START or JumpSTART systems

Triage Categories

• Immediate (Red): Urgent treatment needed
• Delayed (Yellow): Treatment can be postponed
• Minimal (Green): Minor injuries
• Expectant (Black): Likely to die or dead

HazMat Incidents

• Recognition and Response
  • Use NIMS and ICS to manage scene
  • Recognition through occupancy, senses, containers
• Control Zones: Hot, Warm, Cold
• Decontamination: Remove hazardous substances in Warm Zone
• Protective Equipment Levels (A, B, C, D)

Handling Patients

• Decontamination: Essential before treatment
• Care in Treatment Area: Focus on trauma and exposure after decontamination

Disaster Management

• Difference from Mass Casualty Incidents: Longer duration, broader impact
• Hospital Surge Capacity: Early notification for better resource allocation
• Casualty Collection Area: Used in major disasters like earthquakes

This chapter emphasizes the importance of systematic approaches, such as NIMS and ICS, in managing incident scenes, particularly those involving mass casualties or hazardous materials. Proper preparation, communication, and adherence to protocols are crucial in ensuring efficient incident management and responder safety.