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Multijurisdiction; multiagency
Incident Command System
(ICS)
Expands from nonmajor incident to
major incident in logical manner
Using ICS as standard operating
procedure for small incidents permits
smooth transition in major incident
ICS Terminology
Apparatus Medical direction
Flexible system
Operations
Logistics
Finance/administration
The Command Function
One person coordinates variety of emergency
activities
Cornerstone of ICS structure
Commander responsibilities
Types of Command
Singular command
One individual responsible for operation
Unified command
Large events or as small incident evolves
Specialized organizations identified and
personnel unify to complement command
EMS, fire, police, health department, Red Cross
Application of Unified
Command
ICS Organization
Incident commander (IC) expands (or
contracts) ICS organization based on:
Life safety
Incident stability
Property conservation
If expansion is needed:
Other command staff positions established
Possible Command Staff
Positions
Section Responsibilities
Sections assigned by IC to section
chiefs
Planning
Operations
Logistics
Finance/administration
Primary role
“Make things happen”
Ensure rescuers working toward common goal
Responsibilities
Operations Section
Logistics Section
Supports logistical needs of incident
Local/regional threshold
Examples of Medical ICS
Establishing Command
Group/sector functions or major functional areas
implemented by incident size and scope
Additional responsibilities
Treatment Sector
Works with extrication sector in patient care
As patients delivered, categorized by medical need
Triage function
Increased ability to make difficult triage decisions
In treatment area for secondary triage decisions
Emergency surgery to facilitate extrication
Treatment capabilities
Invasive procedures
Assessment and direction of specific treatments
Disposition of the
Deceased
Depends on scale of incident
Personnel assigned to disposition of deceased
Duties
Work with medical examiner, coroner, law
enforcement to coordinate disposition
Assist in establishment of secure area for morgue
if needed
Monitor personnel for signs of stress
Transportation Sector
Communicates with hospitals, ambulances, and
aeromedical services for patient transport
Responsibilities
Staging Sector
Prevents vehicle congestion and
response delays
Responsibilities
Rehabilitation (Rehab)
Sector
Standard operating procedures in many fire
and EMS agencies and major incident
response plans
Monitors personnel
Ensures proper rest and hydration
Responsibilities
Sector Identification
All emergency responders must know ICS
structure and radio communication
procedure
Evaluate:
Ability to walk
Respiratory effort
Pulses/perfusion
Neurological status
START Triage
Classify patients as:
Urgent
Delayed
Dead or dying
Critical
START Triage
Allows rescuers to:
Identify patients at risk of early death
Advise others of patient's need for
stabilization by tagging with disaster
tags
START Triage System
Insert
Insert
Fig
Fig50-10
50-10
START Triage
Assess ability to walk
Assess pulses/perfusion
Patient priority
Hospital destination
ICS Patient Log
Transportation of
Patients
Method of transportation determined
by triage priority and situation