Chapter 40: Incident Management - Emergency Care and Transportation of the Sick and Injured 12th Edition

Learning Objectives

• Understand and apply the National Incident Management System (NIMS).
• Describe the command and general staff roles.
• Implement the Incident Command System (ICS) in Hazmat incidents.
• Set up EMS branch operations, control zones, PPE, and triage methods.

Mass Casualty Incidents (MCI)

• Definition: Calls involving three or more patients; situations with significant demands on resources.
• Multi-Aid Response: Agreement between EMS systems for resource sharing.
• Use of ICS: Enables efficient resource use and coordination.

National Incident Management System (NIMS)

• Origin: Implemented by Homeland Security in 2004.
• Purpose: Coordinate emergency responses across federal, state, local, private sectors, and NGOs.
• Features:
  • Standardization in terminology and resources.
  • Interoperability for communication across agencies.

Incident Command System (ICS)

• Purpose: Ensures safety, manages incident goals, and optimizes resource use.
• Components:
  • Command: Leadership and oversight.
  • Finance: Tracks all expenditures.
  • Logistics: Manages communications, facilities, supplies.
  • Operations: Tactical operations management.
  • Planning: Analyzes data, develops action plans.

Command Staff Roles

• Public Information Officer (PIO): Manages communications with the media.
• Safety Officer: Identifies and mitigates hazards.
• Liaison Officer: Coordinates between different agencies.

EMS Response in ICS

• Preparedness: Pre-incident planning and training.
• Scene Size-Up: Initial assessment upon arrival.
• Command Establishment: Notification to responders, resource requests.

Communications

• Method: Prefer face-to-face to reduce radio traffic.
• Backup: Reliable and tested communication equipment.

Medical Branch of ICS

• Roles:
  • Triage Supervisor: Manages patient prioritization.
  • Treatment Supervisor: Sets up treatment areas by priority.
  • Transportation Supervisor: Coordinates patient distribution to hospitals.

Triage Methods

• Primary Triage: Initial assessment in the field.
• Triage Categories:
  • Immediate (Red): Urgent treatment needed.
  • Delayed (Yellow): Serious but not life-threatening.
  • Minor (Green): Walking wounded.
  • Expectant (Black): Unlikely to survive.

Disaster Management

• Disaster Definition: Widespread event with potential large-scale impact.
• Roles: Respond when requested, report to incident command.

Hazardous Materials (Hazmat)

• Initial Response:
  • Assess situation before action.
  • Follow OSHA guidelines (Hazwoper standard).

Hazmat Scene Operations

• Control Zones:
  • Hot Zone: Immediate area of release.
  • Warm Zone: Transition area, decontamination setup.
  • Cold Zone: Safe area, no special PPE required.

Classification of Hazmat Materials

• NFPA 704 Standard: Classifies materials by health, fire, chemical, and special hazards.
• Toxicity Levels: Range from 0 (little risk) to 4 (life-threatening).

Protective Equipment Levels

• Level A: Full encapsulated protection.
• Level B & C: Non-permeable clothing, varying degrees of respiratory protection.
• Level D: Basic work uniform.

Care for Patients at Hazmat Incidents

• Assessment: Simple assessment, essential care before decontamination.
• Focus: Supportive care and transport for toxic substance exposure.

Conclusion: Understanding incident management, particularly through ICS and NIMS, is crucial for effective emergency medical response. Familiarity with triage procedures and Hazmat protocols ensures preparedness for mass casualty and disaster scenarios.