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(EMT book CH.40) Emergency Incident Management Overview

May 6, 2025

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

Objectives

  • Understand the National Incident Management System (NIMS) and the Incident Command System (ICS).
  • Learn roles and responsibilities within the command and general staff.
  • Recognize the importance of ICS in hazardous materials (hazmat) incidents.
  • Establish EMS branch operations, control zones, personal protective equipment, and triage methods for mass casualty incidents (MCIs).

Key Concepts

Mass Casualty Incidents (MCIs)

  • Defined as any incident with three or more patients or that overwhelms current resources.
  • Multi-aid response: Agreement between neighboring EMS systems to provide assistance.
  • ICS allows for the efficient management of MCIs by maximizing available resources.

National Incident Management System (NIMS)

  • Developed by the Secretary of Homeland Security in 2004.
  • Provides a framework for coordination among federal, state, and local governments, and private sectors.
  • Key components: ICS, multi-agency coordination systems, and public information systems.

Incident Command System (ICS)

  • Ensures responder and public safety, efficient resource use, and communication.
  • Uses common terminology and clear communication.
  • Limits the span of control for effectiveness.
  • Organizational levels include sections (command, finance, logistics, operations, planning) and command staff (public information officer, safety officer, liaison officer).

ICS Roles and Responsibilities

  • Incident Commander (IC): Oversees the entire incident.
    • Can transfer command to someone with more expertise if needed.
    • Demobilization procedures should be established as incidents de-escalate.
  • Finance: Manages expenditures for reimbursement.
  • Logistics: Manages resource distribution, including supplies and facilities.
  • Operations: Manages tactical operations and supervises personnel on site.
  • Planning: Develops incident action plans and solves arising problems.
  • Command Staff: Includes safety officer, public information officer, and liaison officer.

Communications and Information Management

  • Communication is crucial in major incidents.
  • Integrated communication systems recommended for accountability and efficiency.

EMS Response

  • Preparedness: Involves pre-incident planning and training.
  • Scene Size-up: Driven by questions "What do I have?", "What do I need?", and "What do I need to do?"
  • Command Establishment: By senior officials, ensuring coordination and resource effectiveness.

Medical Branch Operations

  • Triage Supervisor: Manages patient prioritization.
  • Treatment Supervisor: Sets up treatment areas and secondary triage.
  • Transportation Supervisor: Coordinates patient transport to hospitals.
  • Staging Officer: Manages vehicle entry and staging away from the scene.

Triage

  • Primary Triage: Initial assessment at scene using triage tags.
  • Secondary Triage: Reassessment in treatment areas.
  • Triage Categories: Immediate (Red), Delayed (Yellow), Minor (Green), Expectant (Black), and possible additional (Orange).

Disaster Management

  • Natural disasters can extend response duration from days to weeks.
  • Only elected officials can declare a disaster.

Hazardous Materials (Hazmat)

  • Approach scenes cautiously for potential hazmat risks.
  • Hazmat Recognition: Visual and auditory cues, type of containers, and DOT marking systems.

Control Zones

  • Hot Zone: Most contaminated; requires decontamination upon exit.
  • Warm Zone: Transition area with decontamination setup.
  • Cold Zone: Safe operations area without special protective gear.

Personal Protective Equipment (PPE)

  • Levels A-D based on hazard severity.
  • Level A: Highest protection with full-body encapsulation.
  • Level D: Minimal protection as a general work uniform.

Care at Hazmat Incidents

  • Focus on simple assessment and essential care.
  • Major risks include respiratory and airway issues.

Conclusion

  • Incident Command System is vital for managing large-scale emergencies efficiently.
  • Proper triage and communication can significantly affect outcomes in MCIs and disasters.

Review Questions

  • What is the purpose of the incident command system?
  • Upon arriving at an ICS scene, what should be your expectation regarding assignment?
  • How does a disaster differ from an MCI?
  • Where is the decontamination area set up in relation to control zones?

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