operational templates and guidance for ems mass incident deployment potx

6 ‘TEMPLATE 4: Basic Incident Deployment Checklists 4 SECTION I: Mass Care Coordination Toolki Introduction tothe Coordination Planning Toolkit » Residential Medical Facility Evacuation

Operational Templates

and Guidance for EMS

Mass Incident Deployment

June 2012

U.S Fire Administration

Mission Statement

We provide National leadership to foster a solid foundation for

our fire and emergency services stakeholders in prevention,

‘preparedness, and response

Developed forthe US Fire Adminstration (USFA) under Funding Opportunity Number 'DHS-10-USEA-105-000-06 bythe National Emergency Medical Services Management Asocaton

Ths og ws intel ee Ma,

=7}

Acknowledgements

‘The expert review panel for this publiation was composed of senior Emergency Medical Service (EMS) leadership from a broad domain of stakeholders Each contributed time and expertise ro ensure thatthe f- nal publication was useful to local level emergency planners in the EMS Secor Without their guidance and

‘commitment to developing a practical, accurate, and relevant set of tools, this document would not have made it out ofthe planning sages A special thank you goes outro Aarron Reiner, Steve Delahiousey, and

‘Mike MeAdams for preparing and presenting information of key interest during the meeting for this proj-

‘ect Without the input and guidance from cach stakeholder organization and their representatives on the

‘expert review panel, this document would not have come to fruition

inally, Federal partners Rick Patrick and Bill Troup provided background and guidance asthe project pro: [presse from idea to implementation

Expert Review Panel

National EMS Management Association: Project Team

Skip Kirkwood, NEMSMA President/Chief, Wake County EMS

Sean Caflrey, Project Manager/EMS Operations Program Manager, CDPHE

Jim Buell, Editor in Chief and Subject Mater Bxpert/Managing Partner, MTOG LLC

Keith Han, Subject Matter Expert/Senior Partner, MTOG LIC

Bill Stanfield, Subject Matter Expert/Consultant, MTOG LLC

Rosalind Cooper, Editor, Wheat Ridge, Colorado

Jelf Dyae, Meeting Facltato, The Far View Group, LLC

American Ambulance Assocation

Steve Delahousey, Viee President, American Medical Response

Center for Leadership Innovation and Research in EMS

Gary Wingrove, Director of Strategic Affairs, Mayo Medical Transport

International Association of EMS Chiefs

James Robinson, Operations Chef, Denver Health Paramedic Division

National Associaton of Emergency Medical Technicians

‘Don Lundy EMS Dieetoe,Chaleston Coun, South Carolina

International Association of Fie Chiefs

John Sinclair, Fie Chief/Emergency Manager, Kits Valley Fire Rescue

Thtermationgl Association of Fite Fighters

Lon Moore-Merel, Assistant ro the General President

Inerntional Associaton of light Paramedics

“T} Kennedy, Program Manaper/Asstant Vice President, Science Applications international Corporation SAI)

National Association of EMS Physicians

De Kathy Rinnen, Director GEMSS/EMS Fellowship Programs, University of Tesas Southwestern at Dallas

De Brian Schwarte, Exective Lead, Sunnybrook Osler Cemer for Prehospital Care

[National Association of State EMS Officials

Joe Schmider, EMS Director, tae of Fennsylvania

[National Fire Protection Association

Ken Holland, Public Fire Protection Programs

[National Highway Traffic Safety Administration

Gar “Gam” Wijetange Office of Emergency Medical Services

[National Volunteer Fire Council

Ken Knippee, Chair/EMS Rescue Section

Subject Matter Experts

‘Mike MeAdams, Asistant Chief of Operations, Montgomery County Fire Rescue

-Aarton Reiner, National EMS Advisory Commitee, Executive Director, Lakes Region EMS

AlManin, Fie Chie, City of Tuscaloosa, Alabama

USS Fite Administration

‘ill Troup, Project Officer

‘United States Department of Health and Human Services

Jack Beall, Director, National Disaster Medical System

Unite States Department of Homeland Security

Rick Pack Director, Medal Fist Response Coordination, Ofc of Heath ATs

Dr Michael Zanker, MD, Senior Medial Office, Office of Health AEs

SECTION I: Emergency Medical Services Deployment Templates vm

TEMPLATE I: The Emergency Medical Services Emergency Operations Pan 3

‘TEMPLATE 2: Basic Havant Vulnerability Analysis 6

‘TEMPLATE 4: Basic Incident Deployment Checklists 4 SECTION I: Mass Care Coordination Toolki

Introduction tothe Coordination Planning Toolkit »

Residential Medical Facility Evacuation „

‘Weather-Related Disaster Declaration »

SECTION IE: Case Studies in Mass Incident Deployment

(Case I 2010 Bus Crash in Harcord, CT 4

‘Case 2: 2005 F3 Tormado in Marshall County, KY 8 {Case 5: 2010 Veterans Administration Hosptal Eacustion, Lcbanon, BÃ 36 {Case 4 2008 Imperial Sugar Dixie Crystal Plant Fire, ort Wentworth, GA 4p

‘Case : 3006 Woodward Dream Cruise, Berkley, MI st (Case 6: 2010 fronman Triathlon Event, St.George, UT s Case 7: 2004 Democratic National Convention, Boston, MA a Case 8: Annual Creation Music Festival, Mount Union, Pa 60 SECTION 1¥; Policy Guidance for Mass Casualty Contingency Planning at Mass Gathering Events

Relationship of Event Command to Responding Resources a

Expanded Scope/Fimergng Mass Casvaly Incident Management Considerations 68

‘Mass Casualty Incident Planning Checklist 7” Incident Action Plan Safety an Risk Analysis, ICS Forms 2154, 1 SECTION Y: Polic Guidance or Emergency Medical Services Aspects of Mass Shelter and Tecding 75 Emeegency Medial Services Participation in Mass Shelter and Feeding 7s

SECTION VE: Local Mutual A

‘TEMPLATE: Local, Regional, and Sate Mutual Aid a1

‘TEMPLATE: Inter-Local Government Agreement-Mutual Aid 8 ANNEX: Sample Mutual Aid Ageeements

EXAMPLE: Single County Mutual Aid Agreement 89 EXAMPLE: Single State Mutual Aid Compact 93

ANNEX II: Sample Mass Gạthering Event PÏanning To0l$ 5s i

ANNEX IIL: Emergency Management Assistance Compact 1s

ANNEX IV: FEMA National Ambulance Contract

FEMA National Ambulance Contract Operational Considerations Ma ANNEX Intrastate Mutual Aid System 145 ANNEX Vi: National Disaster Medical ystem-Disaster Medical Assistance Teams,

ANNEX VIE References

149

‘The World Bank reported in 2005 that on aggregate the reported numer of natural disasters worldwide has been rapidly increasing, From ewer than TOO in 1975 to moe than 400 in 2008, Terrorism, pandemic surge, and natural disasters have had a major impact on the science of planning for and responding 10 mass fare incidents and remain a significant threat o the homeland, From the attacks of September Ith, 2001, the subsequent use of anthrax as 2 biological weapon, tothe more recent surge concerns following the out break of HIN! influenza, EMS have a real and immediate need fr integration withthe emergency manage- rent proces, and to coordinate effoxts with partners across the spectrum of che eesponse community

‘The barriers identified from the iterature review and interviews with national EMS leadership include + lack of access o emergency preparedness grant funding

+ underrepresentation on local, regional, and State level planning committes: and

+ lack of systematic mandatory incision ofall EMS provider types in State, regional, and local emer: gency plans

In December 2004, New York University’s Center for Catastrophe Preparedness and Response held 3 nation-

a roundiable that included expers from major organizations representing the EMS system as a whole The report from that meeting conchided that

45 pide, sch se deparmens ed hpi bs, commecial a a ambulace servis, sue ht pais ce

‘Hemel ae they oul dung aero aik, WAIb EMSeuend, long nega Melia Tehnksas oad an- lic, repent gh oth f won fist responds hich ab inn rene a fies pst)

"de EMS system ees nb fr pce fis rede nig I EMS pean are ppl fr ec ack,

‘heir ily to pede mail cares emp titi Ý 0 cổ ti be compemiel, Tc il be nine

il rt aoe,

In 2007, the fasttte of Medicine

‘ommendation that stated

is Landmark report Emeyeny Mel Seis athe Closads issued a ee

‘The Dye o Hh aad Hunan Sevies (OHS), the Dg of Home Sey nthe Ss stl loa eager adn se pin pac wth ther ub sey emis a serpin aeons,

Since the time ofthese reports Federal progres to adress these issues has included the creation ofthe Office

of Health Affairs (OH) within the Department of Homeland Security (DHS), the creation of the Emergency Cae Coordination Center (ECC) within HHS, and the creation of the Federal Interagency Committee on [EMS (FICEMS) Preparedness Commute Outputs from these organtzations that have contributed 1 a more elicient and coordinated integration of EMS into preparedness activity are too numerous 0 recount here 1m an effort to inerease the level of preparedness among EMS agencies, the National Emergency Medical Ser-

‘vices Management Association (NEMSMA) approached the DHS and OHA to engage them in a partership

‘that would provide a greater understanding of the shordã]S in EMS emergency preparedness and provide resources to il hose gaps

‘The primary objective of this projet is to understand model policies and practices across a spectrum of disciplines and provider types that will lad to a beter prepared EMS deployment to mass care incidents,

‘While no «comprehensive guidance document, this project should serve a 2 foundation for further devel:

‘opment of EMS specific policies and templates that improve EMS readiness to manage the fll spectrum of hazards that face thelr communities

Mass Care Incidents

‘Mass Care incident s defined forthe purpose of this publication as any event planned or unplanned that sus in the need to provide medical re patients outside oftradlonal hospital stings Broadly, incidents are divided ito planned events pecial events—like a sporting event or poltalprotes) and unplanned inc dents (sue as terrorism, earthquakes, natural disasters, oF weather rlaed triggering mechanisms)

Review of Model Policies and Protocols

‘The Commission on Accreditation of Ambulance Services (CAAS) requires that accredited agencies have some form of policy 10 address moval aid and mass casualty deployment However, in examining several example policies, the focus on tactical definitions of mass casualty incidents, the number and type of per Sonne! needed to manage those incidents, and boilerplate lnguage regarding compliance with the National Incident Management Sytem (NIMS) Further research is needed to determine the elements of a success ful policy that most diecly lead to quality management of mass care and mass casualty incidents, A cross section of policies has been inchided to provide planners with a staring point ro develop heir own agency level policies regarding mass cave and mass incident deployment These policies come from public and pa vate EMS agencies as well a5 Sate ofices of EMS

Document Format

“The document provides guidance inthe form of usable templates and examples For the purpose ofthe doc: uument, che term "semplate” is used both to mean documents that are intended be filed in withthe user’ information, as well a a pattern for accomplishing a specific task (operational vmplae) There are several annexes to the document that describe ey programs that foster EMS integration into the planning and re Sponse proces Those inchide the Emergency Management Assistance Compact (EMAC), FEMA National Ambulance Contract, andthe Interstate Mutual Aid System Finally the references 2nd resources annex docu

‘ments provide an excellent reading list as well as a roadmap tothe scientific foundations of che document Incident Command System

‘Terminology and concepts of Incident Command are used throughout this document, Further information

‘on Incident Command System (ICS) concepts is availabe through courses developed by FEMA including

CS 100, ction 1S fr Open Fist Respnas

TCS-200, Bac NIMS ICS Operon Fit Readers

1CS-300,lnermalie 1S fr Expodig lcd x Operon] Fst Redes

TCS-400, Abuse CS fr Command and Geel Su, CamglesTodens,and MACS

TCS-402, laa Command sem (1S) Overview r Euwene/ Soi Offlis

References

+ Cente for Catastrophe Preparedness and Response NYU “Emergency Medical Services: The Forgotten First Responder-A Report on the Critical Gaps in Organization and Deficits in Resources for America’s Medical Fist Responders” New York: New York University, 2005,

+ Insuinute of Medicine (2006) Emeyny Mail Seve eth Castes Retrieved fom:

hpusew wim edu/Reports/1006/Emergecy-Medical-Services-Atthe-Crossroadsaspx

————————=_— _*

SECTION I: Emergency Medical Services Deployment Templates

‘TEMPLATE 4: The Emergency Medical Services Emergency Operations Plan

“<EMS AGENCY> EOP Overview

‘The cemerpiece of comprehensive emergency management isthe emergency operations plan (EOP) The

‘<EMS AGENCY> FOP will make use of a variety of sources to ensure compliance with Federal, Sate, and local phuning guidance ‘The concepts and guidance within the National Incident Management System (NIMS) will be used and referenced 10 ensure conssteny with Incident Command System (ICS) principles and practices The <EMS AGENCY> will develop an EOP that defines the seape of preparedness and Sci dent management activites needed to acomplah ts assigned missions, The <EMS AGENCY> EOP:

1+ Reconciles requiremenis with other jurisdictions

+ Identifies steps vo address mitigation concerns during response and recovery activites

‘An EOP is flexible enough for use in all emergencies A complete EOP describes the:

+ purpose ofthe plan:

+ assumptions

+ concept of operations (CONOPS)

+ organization and assignment of responsibilities

+ administration and logistics

+ plan development and maintenance; and

+ authorities and references

“The BOP contains annexes and appendices appropriate to the <EMS

AGENCY>'s organization and operations, EOPs identify or designate

Functional area representatives to the Incident Command, Unified

Command (UC), or multiagency coordination entity whenever pos

sible 10 faelltate responsive and collaborative incident management

‘An EOP also defines the scope of preparedness activities necessary 10

rake the FOP more thas a mere paper plan This is because the EOP

defines the requirements to effectively manage response These re

(quirements are used to set training and exercise goals, Training helps

emergency personnel become familiar with thei responsibilities and

Ti te 0b sen w pase agua wi Benue me SE An AE ae

vide a means to validate plans, checklists, and response procedures and evaluate the skils of personnel {In addition, exercise can idemify gaps in expected performance and outcomes that should be addressed through a variety of mechanisms Common mechanisms inchide addtional training, updating or adding

‘equipment, incorporating technology, or enhancing existing agreements wath response partners

Adjusting an EOP afier conducting training or exercises or responding to events also makes st practice based, The EOP feiitates response and short-term recovery (oshich se the stage for successful Tong-term_ recovery), Response actions are time-sensitive Some post disster recovery ists, such asthe rebuilding and placement of temporary housing facilites, also must be addressed quickly Advance planning makes performing this ask ease, especially when a changing environment requires midcourse corrections

“<EMS AGENCY> EOP Outline

Basie Plan

+ promulgation docomenvsignatae pages

+ approval and implementation:

+ ongnization and assignment of responsibilities:

+ dieetion, conto, and coordination:

+ disses itlligence:

+ administration, finance, and logistics

+ plan development and maintenance: and

+ authorities and references

+ as shelter and feeding

+ seternarians and animal shelering groups: and

+ volunteer and nongovernmental organizations

‘Support Agencios

+ emily those agencies that have a support role during am emergency

‘TEMPLATE 2: Basic Hazard Vulnerability Analysis,

Hazard Vulnerability Analysis for <INSERT JURISDICTION HERE>

‘<EMS AGENCY>

Introduction

Inser an introduction tothe plan here that contains background and methods used to collect information

fm the hazards present in the local community

Summarize the type of hazards present inthe jurisdiction, Describe the specific hazards found in the com-

‘munity narral and/or manmade, using historical data for nisk assessment

NỔ ———

Potential Hazards for <INSERT JURISDICTION HERE>

‘<INSERT HAZARD TYPE HERE>

Describe the type of hazard in detail, Include ypecific examples of the hazant asi exists in the community Differeniate berween threats and risks in accordance with risk assessment principles,

xtimate the probability of occurrence for this incident type

Some common hazard types are listed below along with definitions

Dam Failure: Dam failure may be caused by flooding, earthquakes, poor construction, lack af maintenance and repair, improper operation, or acts of vandalism or terrorism

Drought: A drought is defined as “a period of abnormally dry weather sufficiently prolonged and severe

‘enough to reduce soil moisture, water and snow levels ta drop below the minimum levels aecesry to sus

‘ain animal, plant and economic systems”

Barthquakes: Earthquakes cause damage by strong ground shaking and by the secondary effects of ground failures and tsunamis The strength of ground shaking generally decreases with the distance from the earthquake source, Shaking can be much higher when earthquake waves are intensified by bedrock and then passthrough softer earth materials such as sediment Ground fires caused by earthquakes include fault rupture, ground cracking landslides, rock fll liqueiction and ypli Faults do not often rupture through to the surice, Unstable ground is mostly at rsk of the other effects Any ofthese ures will a fect structures above of below them,

pldemie: Epidemics are outbreaks of disease that affect, or threaten to affect, a significant portion of a population in a relatively short period of time, Although usually referring to human contagious disease, epidemics can also affect domestic and wild animals and crops Epidemic diseases are usally introduced

no an area fom remote regions and inflict devastation because there is no natural or induced immunity Forest Fees/Wildfires: A forest fte is considered as any uncontrolled busning witha a forested area and

‘wncontroled and hard to extinguish burning in grassland, brush or woodland

Flooding: Groundwater flooding occurs when the water table is high and these is persistent heavy sai,

‘Waer collects in any natural depression when the soil can no longer absorb the water

to many feet pee second, depending lige on slope, material and water coment

Erosion refers tothe gradual removal of sil through wind or water action Erosion may be Induced or in

«eased by faire to use ground covers to protect soil fiom wind or drainage systems to allow good disper salofsiorm water Slopes on waerftont canals be severely undercut by normal water ow, wave action or lange waves produced by storms

Nuclear Incidents: Nuclear incidents result From a release oF radioactive material into the atmosphere from sources such as nuclear power fclices, mlliary installations that house nuclear powered vessels, or nuclear storage facies

Storm: Destructive storms come in several forms: wind, sain, ice, snow, anda combination, Any winter storm cam pack high winds and heavy sain causing widespread damage High winds of short duration, such 35 tornadoes and song gsi fom thunderstorms, ca also be destructive though generally not as widespread Terrorism: Terrorism is defined as the use of force oF vio

lence against persons or property violating the criminal laws

of the United States for purposes of intimidation, coercion,

‘or ransom Terrorists offen use theeats to create fear among

the pubic for the purpose of influencing political process and

generate publicy: Terrorism can be broken down further

{nto chemical, biological, radologial, nuclear, explosive, and

cyber related forms of atack, Mass shooting incidents can

alko bea form of errors based upon motivation and intent

‘Tounami/ High Waves/Sciches: Tsunamis ae sea waves gen Tyee stato new ne sghtel te Wel Wade Ce erated by seismic activity, underwater volcanic eruptions, teraterte rns aac ot September, 2043, meteor impacts, o landslides

Voleanoes/Ash Fall: Volcanic eruptions can cause damage throvgh direct exposuce to eruption materials (lava, et) or by ash fall The probability of ash fall depends on wind direction and the voleanic source of the eruption causing the ash fll, Most ofthe dangers are ro persons in the neat vicinkty of the volcano, (Other dangers, such as miidflows and ash fall, may exist miles downstream and down wind

‘TEMPLATE 3: Incident and Event Plans

All events and incidents <EMS AGENCY> participates in will hve an Event Pan for planned events, an In cident Action Pan (AP) for unplanned evens, or both

vent and Incident Planning Process

Refer tothe chart below fr information on the Command and General staff members’ responsibilities for planning

> Povides overall ice Ob Rave and Say + sablses procedures for indent resource ordering + Esablises procedures for resource activation, mobilization, and employment pee + Approves complete IAP by signature

Commander FR

Reviews hasan sscited withthe incident andl proposed acti ssignments

~ Assists in developing safe acts

‘sits in Wenning strategies

on

ROMERIREEM - Devermines cies 1 achieve command objectives

Determines work sssignments and resource requirements

> Conducts the Planning Meeting

ed Coordinates preparation and documentation ofthe IAP,

+ Ensures that resource ordering procedures are communicated appropriate agency ordering points

/+ Develops transportation system to support operatonal needs

koglstics + Ensures tat the Logistics Seetion ean support the TAP

+ Competes assigned portions ofthe writen IAP

1+ Places orders) for resources Ensures that responders receive operational medical care when needed

Provides cost implications of incident objectives, as required

‘+ asores thatthe TAP is within the nancial limits established by the Incident Com

Sore

+ Evaluates facilities, transportation asets, and other contracted services to determine

‘any special conirace arrangements are needed,

+ Incident objectives should be developed that cover the entire course ofthe incident For complex inc-

‘dens, it may take more than one operational period to accomplish the incident objectives

+The cyclical planning process s designed to take the overall incident objectives and break them down ino tactical assignments foreach operational period, Its important that this iiial overall approach 10

‘esablishing incident objectives establish the course ofthe incident, rather than having incident objec tives only address a single operational period

+ The incident objectives must conform to the legal obligations and management objectives of al affected agencies,

Sound, timely planning provides the foundation for effective inedent management The National inident Management System (NIMS) planning process represents a template for strategic, operation, and tactical planning that inchides all steps an IC snd other members ofthe Command and General Staff should take to

‘develop and disseminate an IAR The planning process may begin with the scheduling of a planned event, the identification of a credible threst, of with the initial response o an actual or impending event The

‘process continues with the implementation of the formalized steps and staffing eequited in developing 3

‘written IAP A cles, concise IAP is essential to guide the inital incident management decision process aud the continwing collective planning activities of cident management teams The planning process should provide the followings

+ curtent information that accurately decrbes snd asses the incident station and resource sats + predictions ofthe probable course of evens:

+ alefmalse legle to ata eric incident objectives and

+ an accuse, realistic A? forthe neat operational period

“The following five primary phases must be followed, sm sequence, to ensue a comprehensive IAP

1 Understand the situation,

Establish incident objectives and strategy

Develop the IAP

Prepare and disseminate the LAP

5 Braluate and revise the plan

Operational Planning Cycle

The IAP must provide clear stategic direction and include a comprehensive listing of the tactical obec lives, resources, reserves, and support required to accomplish each overarching incident objective The

‘comprehensive IAP will sate the sequence of evens ina coordinated way for achieving mulkiple incident objectives However, the IAP is base on the best available information a the time of the planning meeting, Planning meetings should not be delayed in anticipation of future information

During the siti stages of incident management, planners must develop a simple plan that can be comma nicated through concise ora briefings Frequently this plan must be developed very quickly and with in

‘complete situation information, As the incident management effort evolves overtime, additional lead time, staf, information systems, and technologies will enable more detailed planning and cataloging of events and “lessons learned

Meeting, Incident Briefing ICS 204

and Assessment Notification Incident/Threat

The log of the "P” describes the inital response period: Once the incidenc/threat begins, the steps ae No

‘fication, tnial Response and Assessment, cident Briefing (ICS Form 201, and Initial Incident Command and, if necessary, expansion toa Unified Command (UC) Meeting

Atthe top ofthe leg ofthe "P” isthe beginning of che frst operational planning period cycle In this circu lar sequence, te steps ate: Incident Command/1JC Sets the Tncident Objectives, Tactles Meeting, Preparing for the Phasing Meeting, Panning Meeting, IAP Prep and Approval, and Operations Briefing,

[At this point, 2 nev operations period begins The next step is Execute Plan and Assess Progres, after

‘which the cycle begins anew with Incident Command/UC Seis Objectives,

Before each operational period begin, the incident objectives must be assessed and updated as needed Ask the following questions:

+ Isthe neldent sable, oF increasing in size and complexiy?

‘What are the cure incident objectives, strategy, and tacts?

+ Ave here any sey issues?

+ Are the objectives effective? Is change of course needed?

+ How long wil tbe with objectives are completed?

+ What isthe currene satus of esoures? Are resources in good condition? Are there sufcient resources?

Tactics Meetings

‘The purpose of the tactics meeting isto review the tacts developed by the Operations Section Chiet This includes:

+ Determining how the selected strategy will be accomplished in order to achieve the incident objectives

“+ Assigning resources wo implement the tacts

+ _ Identifying methods for monitoring tactics and resources to determine i adjustments are requted (eg different tactics, different resources, or new strategy)

+ The Operations Section Chief Safety Officer, Planning Section Chief, Logistics Section Chief, and Re- sources Unit Leader attend the tactics meeting,

+ The Operations Section Chief leads the tactics meeting, The ICS Form 215, Operational Phang Work: sheet, is used to document the tactics meeting

Determining Tactics

Incident objectives state what is 0 be accomplished in the operational period Make use of the SMART

‘objective development proces:

‘Specific: Is he incident objective wording precise and wnambiguens?

‘M-Measurable: How will achievemenss be measured?

‘A-Aetion Oriented: ssn action verb used to describe the expected accomplishosens?

[Realistic Is the outcome achievable with gve available resources?

“T-Time Sensiive: What i the timefamse i which the activity ito occu?

Strategies establish the general plan or direction for accomplishing the incident objectives

“Tactics specify how the strategies will be executed,

————_— — *

Developing Strategy

‘The Operational Section Chie generates alternative strategies to meet the ince bjecives tha:

+ Are within acceptable safety norms

+ Make sense (is asibl, practical, and suitable

+ Are cos effective

+ Are consistent with sound environmental practices

+ Meet political consierations,

Tactical Direction

+ Tactical direction describes what must be accomplished within the selected strategy or strategies in or- {er to achieve the incident objectives Tactical direction isthe esponsibility ofthe IC or the Operations Section Chef (i that position has been assigned by the IC)

+ The ICor the Operations Section Chef gathers input fiom the Branch Directors and Division and/or Group Supervisors on akernative aces, Jointly developed tactics can ensure understanding and enlance com-

*+ Tactical direction consists of the Fllowing dep:

~ Establish Tactics: Determine the tactics needed to implement the seleced strategy Typically, tac- ties are to be accomplished within an operational period During more complex incidents, cactial urection should be stated in terms of accomplishments that can realistically be achieved within the timeframe curcemly being planned

— Assign Resources: Determine and assign the kind and type of resources appropriate forthe selected

‘actcs Resource assignments will consis of the kind, ype, and numbers af resources valabe and needed to achieve the tactical operations desired forthe operational petiod

— Monitor Performance: Performance monitoring wll determine if the tactics and resources selected

fr the various sratepies ae both valid and adequate,

‘TEMPLATE 4: Basic Incident Deployment Checklists

‘<EMS AGENCY> Basie Deployment Checklists

Incident Action Plan (IAP) Compliance

<EMS AGENCY> incident/event operations must be directed and coordinated as outlined in the JAP, Any deviation must be approved by the Operations Chief and communicated 10 and approved by the I cident Commander (IC), <EMS AGENCY> personnel accountability procedures should be documented wwii the TAP

Unity of Command

In order to prevent accountability beakdowas, each individual operating on behal of <EMS AGENCY>

‘involved in incident management will be assigned to only one supervisor

Span of Control

Supervisors mast beable to adequately supervise, communicate with, manage and contol al personnel lnider thele supervision Span of control may vary between 3 and 7 personnel per supervisor, with a recommended ratio of It 5

Resource Tracking

Supervisors must record resource status changes a8 they occur and report those changes tothe Resources

‘Unit Accountability 1s dependent upon the incident management organization having a standard re source tracking method,

E===

Common Responsibilities

‘The following checklists applicable to all <EMS AGENCY> personne! operating in an Tneident Command system (1C3):

Upon arival at che incident, checkin atone ofthe fllowing designated checkin locations

+ Incident Command Post (IC)

+ Ba

+ Staging Areas and

+Other are designated by the Incident Command

Note: f instructed to report directly 10a tactical assignment, checkin with the Divison Group Super- visor othe Operations Section Chief in charge of the area of operations

Receive briefing from immediate supervisor and document briefing on a Unit Log (ICS Form 214)

-Acqize work materials

Abide by organizational code of ethics, policies, procedures, and applicable labor agreements

Parucipate in Incident Management Team (IMT) meeungs and briefings 2s appropriate

Ensure compliance with all safety practices and procedures Report unsafe conditions to the Safety Officer $0),

Supervisors: Maintain accountability for assigned personnel with regard to exact location), personal safety, and welfare arallrimes, especially when working in or around incident operations

Supervisors: Organize and brief subordinates

‘Know the assigned communication methods and procedures for the Area of Responsibility (AOR) and

‘ens that communications equipment i operating propedy

‘Use plain language and ICS terminology (no codes) in all radio communications

Complete forms, reports, and ICS Form 214 thatare required ofthe assigned position and ensuee proper disposition of incident dacumentation a directed by the Documentation Unit

Ensure all equipment is operational prior to each work period

Report any signs/symproms of extended incident sess, injury, fatigue, or illness to a supervisor

Brief shift replacement about ongoing operations when relieved at operational periods or during rotton Respond to demobilization orders and bref subordinates regarding demobilization,

Prepare personal belongings for demobilization,

Complete demobilization check-out process before being released from the incident ineluding the re-

‘urn ofall equipraent

‘Upon demobilization, eport estimated time of arsval (ETA) vo home agency

Participate im afier-sction activities as directed,

Leadership Responsibilities

In National Incident Management System (NIMS) ICS, a mumber ofthe leadership responsibilities are com:

‘mon w all anetions within the ICS organization Common responsibilities of Unit Leaders are listed belo

‘Medical Branch Director: The Medical Branch Director is responsible for the implementation of the IAP

‘within the Branch This includes the direction and execution of branch planning for the asignment of r- sources within the Branch, ‘The Branch Direcior reports to the Operations Section Chief and supervises the

‘Triage, Treatment, and Patient Transportation Group Supervisors as well s the Medical Supply Coordinator

‘The Medical Branch establishes command and controls the activities within the Medical Area in order a- sure the best possible emergency medical care to patients during a mulicasuaty incident

Review Common Responsibilities,

Review Group/Dinision Assignments fr effectiveness of cusrent operations and modify as needed, Provide input to Operations Section Chief for the IAP

Supervise Branch activities

Report to Operations Section Chief on Branch activities,

(Coordinate with the agency's Medical Director, if salable

Request law enforcement/Medical Examiner involvement as needed,

Collect, review, and compile casualty information

Recommend additional personnel and resources sufficient 19 handle the magnitude of the incident Devermine amounc and types of additional medical resources and supplies needed 10 handle the mage tude ofthe incident (medical caches, backboard, liters, cot),

|G Establish communications and coordination with Patient Transportation Group Supervisor,

|G Ensure activation of hospital alest system, local EMS/bealth agencies,

|B Direct and/or sypervise on scene personnel from agencies such as Medical Examiners Ofice, Red Cross, law enforcement, private ambulance companies, county health agencies, and hospital volunteers

Ensure proper security eafic control, and access fr the area

Direct medically trained personnel in coordination with the appropriate Treatment Group Supervisor Mamata ICS Form 11

"Triage Group Supervisor: The Triage Group Supervisor reports to the Medical Branch Director and super- vises Triage Personnel/Litter Bearers and the Morgue Unit Leader, The Triage Group Supervisor assumes re sponsibility for providing triage management and movement of patients from the wage area When triage has been completed, the Group Supervisor may be reassigned as needed

Review Common Responsibilities,

Review Group Supervisor Responsible

Develop organization sufficient to handle assignment

Inform Medical Branch Director of resource needs,

Implement eriage proces

Coordinate movement of patients from the Tage Area (incident site) tothe appropriate Teatment Aa, Give periodic status reports to Medical Branch Director

‘Matnrain security and control ofthe Triage Area

Estblish Morgue with Medical Examiner personnel when possible

siblish aea for contaminated casualties if necessary

‘Treatment Group Supervisor: The Treatment Group Supervisor reports tothe Medial Branch Direcior and supervises the Treatment Unit Leaders and the Trestmnent Dispatch Unit Leader The Treatment Group Si- pervisor assumes responsibility for ueatment, preparation for uausport, and coordination of patent teat

‘ment in the Teatment Areas and direcs movement of patients to loading location)

Review Common Responsibilities,

‘Review Unit Leader Responsibilities

Develop organization sufcient to handle assignment

Direct and supervise Treatment Dispatch, Immediate (Red) Delayed (Yellow), Minor (Green), Comarni- pated (Blue) Treatment Areas

Coordinate movement of patients fom THage Area to Treatment Areas with Teage Unit Leader

Request sufficient medical caches and supplies as necessary

oo

Establish communications and coordination with Patient Transportation Group,

Ensure continual triage of patients throughout Treatment Areas

|B Direct movement of patents to ambulance loading area

Give periodic status reports to Medical Branch Director

Patient Transportation Group Supervisor: Transportation Group Supervisor ports to the Medical Branch Director and supervises the Medical Communications Coordinator and Air and Ground Ambulance Coor inators This Supervisor is responsible for the coordination of patent transportation and maintenance of records relating 0 patient identification, injuries, mode of off incident transportation, and destination Review Common Responstilces

| Establish communications with hospital),

Designate ambulance staging areas()

Direct che transportation of patients as determined by Treatment Group Supervisor or Unit Leaders

1 Assure thar patien information and destination is recorded

Establish communications with Ambulance Coordinators

Request additional ambulances, a required

Notify Ambulance Coordinatons) of ambulance requests

| Cooninate requests for air ambulance ransportation through the Air Operations Director

Establish sic ambulance landing zone with the Medical Branch Director and Air Operations Director G1 Maintsin CS Form Đá

SECTION II: Mass Care Coordination Toolkit

Introduction to the Coordination Planning Toolkit

This collection of operational templates is intended to assist Emer

gency Medical Services (EMS) personnel in planning fer, responding

fo, and recovering from a representative assortment of scenarios that,

could impact their operations An emphasis is placed on coordina

ing effectively with other agencies that may also be involved in the

response This toolkit is intended a8 a starting point, is not compre

Ibensive, and must be adjusted for geographical, logistical, and politcal,

considerations

reestablished matual aid agreement are considered essential for ef AMBulnnes ar stages andrendy Nap fective response 10 and recovery from EMS incidents The following "isntes#s hunean sporoctes scenarios will be used to illustrate various planning, respons, and re

covery situations:

+ local high schoo football game

‘+ residential medica fiility evacuation;

+ county fi

+ large, participatory sporting event (marathon ironman, ete);

+ weatherselsted disaster declaration:

+ lange college sporting event

+ pola assembly

+ ato racing/competition: and

+ cancer walk

+ requesting agency, point of contact, and contact information for follow-up;

‘+ financial compensation information, sF applicable;

‘+ location of event() including intended staging location of ambulance and crew, ingress and egress routes fom fed

+ contact information for the teams athletic trainer/spors medicine personnel if applicable:

+ contact information for any security oF event personnel involved: and

+ anticipated /historieal attendance mumbers, issues

‘When this information has been obtained, avery brie risk assessment should be performed (Fone has not aleealy been done for this type of event) Contact should be made with any other involved medical person nel to coordinate operations

+ Athlelctalnes

~Alesc trainers may be able to assist with injured players

= Ailecc trainers may be trained in canfiopalmonary resuscitation (CPR)/automated external def Drillator (AED) and are likely to be fist on scene ia player collapses

~ Canasisc with removing proc equipment, such as helmets

+ Sports medicine staff

— Sports mecine staff will be able oasis with injured payers

~ Sports medicine staff should be tained CPR/AED aud are likely ro arcve before EMS

+ Secunty sat

~ Security staff may have CPR/AED training and should know where AEDs are located at the event Security staff will be helpful in locating or moving ilo injured spectators

= Security staff will ako beable to help in guiding addtional medical resources to the incident

‘+ Fire department or EMS ageney (if diferent ftom your oven) that has jurisdiction over the location of the event,

= your agency does not have jurisdiction, the agency with jurisdiction may choose to respond and assume control of any incident that oocurs,

Additional Resources:

+ Nasional Athletic Trainers’ Association

+ Your Sates Athletic Trainers’ Association

=

+ American Medical Society for Sports Medicine

+ American Collegeof Sports Medicine

+ National Academy of Sports Medicine

+ American Orthopedic Society for Sports Medicine

+ American Medical Athlete Asociation

+ County medial association

+ Local woluneee groups

Forms:

+ When coordinating planning with other agencies, an ICS Form 201 (Ineident Briefing) should be uficlen, + FICS forms are going to address other disciplines such as security or logistics, add an ICS Form 206 (Medical Plan}

Respond

Responding to an emergency at any spectator sport will become a high-visblty event Inevitably, photos and video ofthe responding personnel will be available on che internet within minutes ofthe incident oc curving A Public Information Office (P10) should be appointed,

an event oceus in the stands, parking lot, or ether areas, security and other event personnel might not be aware of the emergency This is where the EMS planning related ta collection of contact information will

‘become useful, Communication personnel can use the contact information to notify event staff a well 35 direct thein to acquire an AED or other equipment applicable

For incidents involving multiple agencies, «copy ofthe completed ICS Form 201 can help to orient the Enc dene Commander (IC) tothe rea and resources available Additional ICS forms may be used inthe Inident

‘Action Plan (IAP) based on the type and scope of incident

1 che incident involves numerous unis oF lasts several hours, demobilization procedures should be ft Jovsed and recorded on ICS Form 221 (Demobilizaion) 10 ensure that mutual ad and other resources ace properly accounted for and exurned to service,

Residential Medical Facility Evacuation

Prepare

Preparations for evacuation ofa residential mediealfailty such as a

rnusing home or senior-ciizen center should be taken very seriously

Any large evacuation of a vulnerable population such a8 this is likely

to resule in some injuries or exacerbated illness Responders are at

increased risk of injures due wo repeiive iting ina high-stess stu

ation, Residents are at risk of being injured during moves, The extra

detivity and stress ofan evacuation may resul in respiratory, cardia

vascular, of other medical complications

[A risk assessment should be performed for your community to dete~ ambulances awa cals ding an vac tine which Fc are at highest isk for evacuation, This wenld in- tn ofpatent win special nes

clude failites vulnerable to wilde, earthquake, flooding aud other

weather related threats A majority of planning resources should be devoted to these Facilities, although evacuation due to fre or uty aire can occur anywhere

Evacuation planning should be conducted in coordination with numerous agencies and individuals

+ Decisionmakers from the involved facility:

= Background information such as average census, location ofthe most vulnerable residents, et

= Information on what type of evacuation equipment might be availble, sich as stair chairs and

‘evacuation mattresses and where ii stored or obtained in an emergency

— Responsible for securing receiving facies fr esidems during a precationary evacuation,

Responsible for providing tallng to thelr saffon the evacuation procedures

~ Copies ofthe faclity oor plan outining exits and locations of emergency equipment

+ Fire department and police department

~ Fire depatement may provide addtional personnel even if no iminediatehfe-ehreats exist

~ Police department may asst with controlling trafic or provide additional personnel,

+ Bmergeney management

Will likely provide the information that triggers decisionmakers at the involved facility to begin & precautionary evacuation,

~ In some situations, ofcias may order a mandatory evaeuation,

+ Public heals department

— May be able oasis in coordination process

~ May have access ro medical assets such as Medical Resorve Corps or Metropolitan Medical Response System,

K=ẶằẮ::

+ Decisionmakers from facilities cha might be asked to receive residents fram the evacuated fei

May have special restrictions oF instructions for receiving residents

+ Mutual a partners

Verify that your mutual ad pastners will honor a request or si if involes a precautionary evacn ation, with no immediate emergency

+ Area EMS agencies,

~ Determine type and umber of resources that are likely 1 be available fom each agency:

— Estimate ime to respond based on location of base of operations

+ Amerian Red Cros

May be involved in coordinating sheltering in the cate of an emergency evacuation or ifinsufficent receiving facilities can be identified for the evacuees

+ Sahation Army:

May be Involved in providing food or other assistance to temporary shelters

+ National Guard, Medical Reserve Corps, National Disster Medical System, Metropolitan Medical Re sponse System,

= These assets are unlikely tobe helpful due to time needed to respond but may be useful if advance

‘warning of am evacuation available,

Additional Resources:

+ National Fire Proection Assocation Emergency Evacuation Planning Guide for People with Disabilities” + National Disaster Medial Sytem personnel have extensive experience setting up temporary medical facies + Department of Health and Human Services website isan excellent source of information pertaining to facility evacuations

An ICS Form 201 could be used to document planning fora facility evacuation, oF a custom operations template might be used, An ICS Form 21Sa (Incident Action Plan Safety and Risk Analysis) could be used to document specific hazards within the building such as hazardous chemicals or bulk oxygen storage,

Respond

‘When requested 0 respond toa residential medical facity evacuation, iis important 0 clearly define roles and responsibilities Typically faity staf are responsible for all activities within the facility suchas obtain ing admission forthe residents at another fcihey and determining which patients should be transported it,

Similarly, the EMS service with jurisdiction in the area typically 8 responsible for residents once they exit the facility, This includes organizing the loading of buses, ambulances, and other forms of transportation, However, in a precutionary evacvation situation, facility staff may take on responsibility for organizing all wanspors if they have sufficient staff and resources Regardless of how the incident s organized, EMS personnel must work very closely with feiliy staff ta ensure that each resident is transported safely 1 the appropriate destination

Additonal complexities will be invohed in an emergency evacuation An emergency evacuation will likely

be very personel intensive and physically demanding, especially in 2 facility with no or limited elevator availabilty Evacuations involving stairways are expectlly demanding and will require more personnel than evacuations aa single-level faci

A facility evacuation will Iikely attract the attention of media andl will involve concerned family members, Therefore, appointing PIO is important

Am incident such as this will kely require ICS Forms 202 (Incident Objective), 203 (Organization Assign

‘meat Lis), 204 (Assignment Lis), 205 (Incident Radio Communications Plan), and 206 (Medical Plan) as part ofthe IAP

Recover

Recovery fom a fcity evacuation may take many days It is important for reimbursement purposes that EMS personnel kep excellent recards of every transport they provide and any costs associated with the inc dent, Transportation must be arranged for each resident back tothe facility if the building is determined to

be safe 1a occupy If he facily suffered suficlent damage, the resents may need to be relocated to more permanent fclities while awaiting repair of their home

For protracted or complex evens, ICS Form 221 may be warranted,

===

County Fair

Prepare

Planning fora county fair or similar outdoor event should begin well in advance and will require planners

to decide ifthe event will require Bxed aid stations, Fixed aid stations may be used to provide simple first aid supplies such as band aids, over the counter medications, and hydration drinks It is important that 4d sation personnel have protocols approved by their medical director that provide guidance on how to bhandle nontransportstuations that offen occur with aid stations

A simple risk assessment should be performed (not already performed for this type of event) to determine the likely emergencies responders will encounter,

Preparing fa local, mediuan-visbty event such a8 county fie wll requee collecting information such as + requesting agency, point of contact, contact information for Follow-up information

+ financial compensation information if applicable:

+ location of event() including intended staging location of ambulance and crew, ingress and egress

+ contact information for any security or event personnel involved: and

+ amiipated /isworical atendance numbers, sues

‘When tis information has been obralned, avery brief rik assessment shouldbe performed (Fone has not already been dane for this typeof event)

+ Decisionmakers from the even organizer,

Background information such a average atedance, high-risk areas, et

~ Responsible for providing training to their stafTon che emergency procedures

Aap or diagram showing how the event will be lid ou, inchading exts and any obstacle to 3 cessor egress

~ Coordinate locaton of ai stations

+ Fire department and police department

~ Fire department may be needed for extrication or rescue stations

~ Fire inspectors wil be tole in ensuring safe conditions for the event participants

+ Bvent security personne

~ Provide asitance lating 9-14 calles atthe event

— May have accesso AEDs

— Provide asitance directing other emergency crews into the event daring a emergency

+ BMS service with jrisiction if ifferem

Ensure thar EMS personnel know how co contact dhe veterinarian in an emergency

~ Injured animals may threaten the safety oF EMS personnel as wells spectators

+ Mota id parines

"`1"

~ Coordinate ingress and egress routs shoulda mutual aid response become necessary

+ Department of Public Health

—_ May be able 1 assist in providing staf or id stations

~ Will be ivolved in ensuring food safety and sanitation atthe event

The following information sources may be helpful during planning for these events:

+ American Veterinary Medical Associaton

+ Department of Public Health-Food Safety

[Ata minimum, CS Forms 201 and 206 should be inchided inthe IAP

Respond

vents such as these can produce broad range of injures, fom dehydration to animal bites Use extreme

‘caution when operating near livestock or other animals Sirens may provoke panie in some animals and en- danger personnel and parleipants Fairs are often spread out over a large area and may necessitate coord tation with event personnel to ensure ambulances are parked as close as possible othe patient Tn addition, ough oF muuldy ground may necessitate alternative patient movement techniques

‘Mass casualty situations occuring at events such as these can usally be handled with conventional pro: cedures, using additional caution around livestock As with all mass easualy events, media avention and concerned family members will ikly be present Therefore, a PIO should be appoined,

Recover

Recovery from a mas casualty situation at an event such a cis may necessitate extensive cleaning of equip sent soled with dit of mud Other unique secovery steps ae unlike

=== ae

‘Marathon or Similar Running Events

Road races such as marathons, half marathons, and shorter events often occur over avery large road course, Although fixed ai stations may be required, means of responding 0 incidents on the couse are also neces sary Caution must be exercised during response to avoid injury to participants or spectators while tempt ing to respond alongside the runners or attempting ta cross closed course

Please note chat runners in 2 crowd may not notice an ambulance attempting to cross che course due to the

‘other runners in front of them blocking their vision and the loud background noises from cheering specta tors blocking their ability to hear warning devices,

A simple risk assessment should be performed if not aleeady performed for this type of event) to determine the likely emergencies responders will encounter

Prepare

+ vent sponsor:

Determine exact route of course, including road closures and potential emergency crossing points Determine expected attendance for both participants and spectators, (Participants are much more likely than spectators to request assistance during the event)

Determine mimber and capabilities of medical aid stations for the event EMS personnel may oF

‘may not be involved in staffing/operating the ai stations

~ Determine the number and type of EMS resources needed,

Determine number and qualifications of aid station personnel needed

+ Lave enforcement

— Coordinate ambulance ingress and egress routes to ensure timely responses and participant and spectator safety

Frequent requestors of medical aid on behalf of spectators or participants, Officers should be pro-

‘vided instructions on what information dispatch requires in onde ta determine the patient's priority + Aid station staff (different ageney providing:

~ Coordinate ambulance ingress and egress

Discuss parameters by which patients will be treated a the aid station, and who wil be transported toa hospital,

Diseuss how to handle moving participants from the course tothe ad station,

= Determine whether EMS will be responsible for providing any supplies tothe aid salon

+ Representative fom local hospitals

= Provide tnformation to local hospitals so they can make informed staffing decisions forthe day of the re

+ Murua aid parmers,loeal EMS agencies:

Aempt 10 determine how many aldtional resources mual ad partners and local EMS agencies may be abe to send in case of 2 mass care incident

= Make sure moval aid partners are awate of the race and how it will affec taffic/oad closures Events such as these often cross multiple jurisdictions, event planning should incorporate represen- tatives fiom each jurisdiction, and Unified Command (UC) will likly be necessary

‘Additional Resources:

‘American Medical Athletic Assocation,

+ American Road Race Medical Society

+ National Atlee Trainer’ Associaton

+ Your Sate Athletic Trainer’ Assaciation

+ American Medical Society for Sports Medicine

+ American Collegeof Sports Medicine

+ National Academy of Sports Medicine

+ American Onhopedic Scie fr Sports Medicine

+ American Medical Athletic Associaton

+ Conny/tocal medical society

+ Local volunteer groups

IS Forms 201, 202, 203, 205, 206, and 214 (Unit Log) may all be necessary during planning oF response for this type of event An alternative patent contact form may be considered for some units/situatons, Respond

Units responding 10 this type of event may be requested 10 stage a short distance away from the patent while event personnel package and move the patient to the waiting ambulance by stretcher or specialty golF-cart style vehicles Ie is erica that all ambulances responding to an event such as ths are provided

‘with SOPs puiding whether ar aot they are permited to transport patients tothe medical aid station,

=

‘Weather-Related Disaster Declaration

Disaster declarations caused by weather evens such as Iueicanes, looding, omados, or snose and ice storms requite a few unique planning considerations Weather events frequently aflet your rmutyal aid partners in che same way that your jurisdiction is being affected Therefore, mual aid assets that might be 2allable during a mass casualty station may no longer be avaiable or may not be able to respond spe tific areas due to road conaitons This requires EMS services 10 ensure they have sufficient surge capacity

te deal wich likely occurrences in their area of operation,

Prepositioning of supplies, personnel, and other resources may be necessary (0 avoid response interruptions

to areas that may be cutoff by rising floodwaters, deep snows, or other weather-related barvers Careful coordination between adjacent municipalities wal help to ensure resources are used ficiently

Am indepth risk assessments critical to planning for these types of events This risk assessment will require

‘coordination with area Emergency Management officials,

Prepare

Planning for such an extensive event may require coordination with:

+ Emergency Management oils

= Condit 0 poitica leaders

~ Coordinate professional risk assessment

= Exablish an Emergency Operations Center (BOC) during the event

+ Fire department and law enforeement agencies with jurisdiction,

~ EMS ambulances may be stationed at fire stations or police stations to ald in coordination and peo- wide for ere sey

+ Volunteer onganizations such as American Red Cross, Salvation Army, et;

Feeding and shekesing of displaced residents likely to be accomplished by one ofthese so groups

~ BMS crews are often approached about how to find these shelters so they must have current contact lnformaton and location ofeach sheke

+ Any groups or facies establishing sheer

+ National Guard

~ May bea resource for disasters declared in advance ofan approaching stom

May be able provide assistance responding to requests in areas nt accessible by ambulance

+ Animal sheer volunees,

~ Shelter fr pts is important for che peace of mind of displaced residents

+ Public Health Department,

May be able provide information on vulnerable populations

= May be able w provide acces to additional medical personnel via Medical Reserve Corps or other

+ Emergency Management Assistance Compact (EMAC), (See Annex I for sdötional information)

I fciliy evacuations oF other medical ansportation issues exceed the capabilites of State resoure

2, State officials will use EMAC agreement to request addtional resources from other States

+ Offroad vehicle clubs

With careful management, volunteers with offroad capable vehicles may be useful for assisting in transporting emergency personnel to scenes inaccessible to conventional response vehicle,

Volunteers may be able to asist emergency responders that become tuck in snow oF mud

Volunteers may be able to move equipment or personnel from ste 1st

+ Public Works Department

~ Public works personnel and equipment wil be erica during and after weather elated evens Snow or debris removal, sandbagging operations wafic barricades and signage for evacuations, ee

CS Forms 201,202, 214 and 215a may be used during planning for such an incident

Respond

During a weather-related disaster declaration, typical responses become more difficult and time consuming

Thezelore, prioritization of requests becomes critical Ics important that publi sity answering points be capable of providing medial instructions to callers

mass casualty situation during a weather-related disaster willbe very challenging forthe fst EMS unit on Scene Depending on road conditions, ingle EMS unit may need to care for many patients for a significant period of time while waiting addtional units As with all MCIs, media atention and concerned family

‘members are very likely, Therefore, a PIO should be appointed

Recover

Recovery ftom an event such as this depends primarily on the damage caused Recovery may be as simple asnormalclesning and restocking of unis, ort may take months or years fora community to flly recover

‘when critialingfastracture is damaged or destroyed

Careful tacking of expenses is necessary for an EMS agency to have any possibility of receiving disaster as sistance fonds

E===-::

Large College Sporting Event

Large college sporting events ate similar wo smaller sporting events, with an added layer of complexity and visibility Mose ofthe same considerations apply, with 2 few additions

Prepare

Preparing fora large college sporting event such as «football or basketball game begins with collecting in formation such as

+ requesting agency, point of conet, and contact information for fllow yp

+ ˆ financial compensation information if applicable

+ location of event() including intended staging location of ambulance and crew, ingress and egress routes fom event;

+ contact information for the rams ablete ualnersports medicine personne!

+ contact information for any security or event personnel involved and

+ amiipated historical atendance numbers, sues

Wben this information has been obtained, risk assessment shouldbe performed (if one has not already

‘been done for this type oF event) Contact should be made with any other involved medical personnel 10

‘coordinate operations

+ Atle tains

Athletic wanes may be abet assis with injured players

~ Athleic walners may be trained in CPR/AED and ar ikely to be frst on scene ia payer collapses +Sports medicine sft

~ Spots medicine sa wil be able oasis with injured payers

~ Sports medicine staff shouldbe tained in CPR/AED andar hch so arive before EMS

+ Security staff

Security staff may have CPR/AED atning and should know where AEDS ae located atthe even Security safTwill be helpfl in lacating oF moving ilo injuted spectators

~ Security staff will abo beable to help in guiding addtional medical resources to the incident

+ Fire depantment or EMS agency (if diferent from your own) that has jurisdiction over the locaton of the even,

= If your agency does not have jurisdiction, the agency with jurisdiction may choose o respond and assume contro of any incident that occurs,

ann Arbor University Park norte columbus

Las Angeles athens Pasadena Baton Rouge

nveseo Fee at Mle High

Sun Ute Stacia

Ralph Wison stadium

ar Dolphins Buta ie carlin Panthers

ast Rutherford ington Kansas city Sacksonile Denver

‘+ National Athlete Trainess' Association

+ Your Sates Athletic Trainers’ Association

+ American Medical Society for Sports Medicine

+ American College of Sports Medicine

+ National Academy of Sports Medicine

+ American Orthopedic Society for Sports Medicine

+ American Medial Atletic Association,

+ Local volunteer groups and county/local medical society

Forms

4+ ICS Forms 202, 204, 205, and 206 will likely be needed during planning for an event suc as hức

‘+ ICS Forms 207 (Incident Organization Chari) and 214 may be required as wel

===

Respond,

Responding to an emergency at any spectator sport will become a high-visblty event Inevitably, photos and video ofthe responding personnel will be available on che internet within minutes ofthe incident oc cung, I'am event occurs in the stands, parking lo, or other areas, secuity and otber event personnel

‘might not be aware of dhe emergency Thiss where the EMS planning related to celletion af contact infor

‘mation will Become useful, Communication personnel can we the contact information to notify event staff

as wells dizect them to acquire an AED or other equipment if spliable,

issues arose during the response or patent treatment that have arated the tention of conventional or So:

‘al media, PIO needs to be appointed forthe incident and active management ofthe situation should beg, Recover

Recover from this type of event should nor be overly complex Recovery will likely be limited 10 cleaning and restocking equipment according 10 SOPS In instances involving emotionally charged stations, such a8

‘unsuccessful resuscitation ofa chil, debriefing or ISM may be indicted

1 the incident involved numerous units oF lasted several hours, demobilization procedures should be fa Jowted and recorded on ICS Form 221 to ensue that mutual aid and other resources are properly accounted for an rewired to service