Hospital Incident

Command System

Application of
Incident Action Plan and
Forms Improvised
Explosive Device (IED)
This material has been developed for training purposes; do not share, distribute, transmit or reproduce without prior written consent of California Hospital Association This course was
developed by the CHA Hospital Preparedness Program with grant funds provided by the U.S. Department of Health & Human Services Assistant Secretary for Preparedness &
Response Hospital Preparedness Program and awarded by the California Department of Public Health. No part of this course or its materials shall be copied or utilized for monetary
gain.

Objectives
Demonstrate the Incident Action Planning
Process
Demonstrate the use of HICS Forms
Implement the use of the Incident Response
Guides

Scenario Based Implementation

Discuss and rehearse practical implementation
of the Incident Action Planning process utilizing
HICS forms and the Incident Response Guides
Utilize a Table Top learning process

Incident Action Planning

1. Assess the Situation
2. Set the Operational Period
3. Determine Safety Priorities & Establish Incident Objectives
4. Determine Branch/Section Objectives
5. Determine Strategies & Tactics
6. Determine Needed Resources
7. Issue Assignments
8. Implement Actions
9. Reassess & Adjust Plans

Scenario
The Universal Adversary terrorist group has
detonated a vehicle bomb in the parking lot of
the communitys largest public building during
business hours
The building is currently hosting a convention
with a large number attendees at the event
Part of the structure has collapsed, fires are
burning throughout the facility and there is
severe blast and fire damage to the surrounding
buildings
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Scenario
There are a large number of people with
trauma and burn injuries, including children
There are an unknown number of people
trapped in the primary and surrounding
buildings
There are many fatalities

Scenario
Your hospital is the closest Medical Center to
the public building, but has not been damaged
by the blast
Water, power and communications services are
functioning normally in the area
Time: 1400
Weather: Clear, 75 F, Light winds

First Actions
Victims and uninjured begin arriving at the
facility within 15 minutes of the blast
Number of victims expected to arrive: Unknown
Is this an incident?
What are your first actions?
Who is in charge?

Incident Action Planning

Step 1: Assess the Situation
Use HICS form 214: Operational Log
Complete HICS form 201: Incident Briefing
Event History and Current Actions Summary

Begin form 202: Incident Objectives

Weather/environmental implications for period

Which Positions to Activate?

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Immediate Time Period

Position
Incident Commander
Public Information Officer
Liaison Officer
Safety Officer

Operations Section Chief

Medical Care Branch Director
Infrastructure Branch Director
Security Branch Director
Law Enforcement Interface
Unit Leader
HazMat Branch Director
Planning Section Chief
Resources Unit Leader
Situation Unit Leader
Documentation Unit Leader
Logistics Section Chief
Service Branch Director
Support Branch Director
Finance /Administration
Section Chief
Time Unit Leader

Immedi
ate
X
X
X
X

Intermed
iate
X
X
X
X

Exten
ded
X
X
X
X

Recovery

X
X
X
X
X

X
X
X
X
X

X
X
X
X
X

X
X
X
X
X

X
X
X

X
X
X

X
X
X

X
X
X

X
X
X
X

X
X
X

X
X
X

X
X
X

X
X
X
X

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Naming the Incident

The Incident Commander names the
incident
If the incident is a community-based
incident, the appropriate jurisdiction will
name the incident (e.g., county, city, EMS)
The incident name should be documented
on all forms

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Incident Action Planning

Step 2: Set the Operational Period
HICS form 202: Incident Objectives
Operational Period Date/Time

Incident Commander sets the Operational Period

Based on number of simultaneous activities
How quickly the situation is changing
An Operational Period breaks the incident down
into manageable timeframes
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Incident Action Planning

Step 3: Determine Safety Priorities
& Incident Objectives
Identify Command & Control Objectives (these
are the overarching objectives that will last
throughout the whole response)
HICS form 202: Incident Objectives

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Control Objectives
Utilize the Incident Response Guide
Explosives Incident:

Ensure the safety of patients, staff, and

visitors
Initiate and maintain a coordinated response
with law enforcement, public safety,
regulatory officials, hazardous materials
responders, and others
Maintain clinical operations within the
constraints of the response and recovery
phases
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Scenario Update #1
It has been 30 minutes since the explosion
The ED has received 2 critical burn/trauma
patients by private car
20 victims have been triaged
2 immediate
2 delayed
16 minor

ED estimates 20 victims waiting for triage

EMS reports as many as 200 victims
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Side Note:
Safety Officer Tasks
Assess the Safety issues
What hazards exist and what precautions need
to be taken
Security Needs (e.g., increased surveillance,
secondary device, crowd control)

Complete form 215A Incident Action Plan

Safety Analysis

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Side Note:
Public Information Officer Tasks
Prepare a statement for the media
Prepare a statement for the staff, patients and
visitors (e.g., situation, status, safety
precautions, next update time)
The statements need approval from the
Incident Commander
Coordinate consistent messaging with the
Joint Information Center (JIC)

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Side Note:
Liaison Officer
Who or what entity operates as the county
contact/MHOAC, and how do you contact?
What is the situation on-scene?
Who should be notified of bed status? How?
Who is the source of resources in your local plan?
(e.g., local EMS Department Operations Center, PHD
Department Operations Center, County/City Emergency
Operations Center)
Needs should be determined prior to the incident

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Side Note:
Documenting your Actions
Utilize HICS forms
Form 214 - Operational Log

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Incident Action Planning

Step 4: Determine Branch/Section Objectives
Document on HICS 204 Assignment List
They are based on the Incident Objectives
These are based on what is desired to be
achieved by the Section in that operational
period
Objectives need to be SMART (Simple,
Measurable, Achievable, Realistic, TimeSensitive & Task Oriented)
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Branch/Section Objectives
A common problem during exercises is that
Sections dont develop their objectives
promptly
Report top 3 objectives

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Incident Action Planning

Step 5: Determine Strategies & Tactics

Strategies & tactics are how your Branch/Section
is going to achieve the objectives
What actions do you need to take?
Use your facility response plans and Incident
Response Guides
Record strategies & tactics on form 204
Branch Assignment List

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Incident Action Planning

Step 6: Determine Needed Resources
What units/space needs to be activated?
What personnel resources do you need?
What equipment and/or supplies do you need?
Do you need transport resources?
Document resource activities:

Resources assigned (form 204)

Resource requests (form 213)
Actions taken to utilize and obtain resources (form 214)
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Incident Action Planning

Step 7: Issue Assignments
Who will be assigned to the units?
Fill in the assignments on form 204
Assignment List
Are there other branches that need activated?

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Incident Action Planning

For the first Operational Period the Incident Action Plan should be
done within 30-45 minutes
What makes up the Incident Action Plan?

Form
Form
Form
Form
Form

201 - Incident Briefing

202 - Incident Objectives
203 - Incident Assignments
204 - Branch Assignments
215A - Incident Action Plan Safety Analysis

The Planning Section compiles the forms to create the Incident Action
Plans

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IAP Quick Start

New form
Can be used for small incidents
Or for a rapid start to a large incident and
then expand out on individual HICS forms
Great for smaller pre-planned events

27

IAP Cover Sheet

Can be used for the IAP Quick Start or full
Incident Action Plan forms
Can make different colors if you want to
differentiate Operational Periods

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Incident Action Planning

Step 8: Implement Actions
Put your activities / plans into action
What are some of these activities?

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Scenario Update #2
It is now 1530 1.5 hrs into the incident
You have received 2 additional critical trauma
patients and 1 critical burn patient from EMS
You have received a total of:
6 Immediate (1 now deceased)
5 delayed
40 minor

What are your major concerns?

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Incident Action Planning

Step 9: Reassess & Adjust Plans
Towards the end of the operational period, you will
need to evaluate status
Repeat steps 1-8
Update the forms
Evaluate and/or update your Branch/Section
Objectives
This creates your Incident Action Plan (game plan)
for the next operational period
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Scenario Update #3
It is now 4 hours into the incident
All victims have been transported or have left
the scene
Universal Adversary has claimed responsibility
for the bombing and claims a secondary device
is in place
What issues should be considered?

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How are we doing?

What are things we need to remember to do?
Share information
Recovery / Restoration
After Action Report
Corrective Actions Plan

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Questions?

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HICS Basics Part 2

Application of
Incident Action Plan and Forms
Improvised Explosive Device
developed by the
California Hospital Associations
Hospital Preparedness Program
www.calhospitalprepare.org

This material has been developed for training purposes; do not share, distribute, transmit or reproduce without prior written consent of California Hospital Association
This course was developed by the CHA Hospital Preparedness Program with grant funds provided by the U.S. Department of Health & Human Services Assistant Secretary
for Preparedness & Response Hospital Preparedness Program and awarded by the California Department of Public Health. No part of this course or its materials shall be
copied or utilized for monetary gain.

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