NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
APPENDICES
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
APPENDIX A:
GLOSSARY
This glossary includes ICS terminology and other terms.
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GLOSSARY
AGENCY EXECUTIVE OR ADMINISTRATOR – Chief executive officer (or
designee) of the agency or jurisdiction that has responsibility for the incident.
AGENCY REPRESENTATIVE – An individual assigned to an incident from an
assisting or cooperating agency who has been delegated authority to make decisions on
matters affecting the agency’s participation at the incident. Agency Representative report
to the Liaison Officer.
ALLOCATED RESOURCES – Resources dispatched to an incident that have not
checked-in with the Incident Communications Center.
AREA COMMAND – An organization established to: 1) oversee the management of
multiple incidents that are each being handled by an Incident Command System
organization; or 2) to oversee the management of a very large incident that has multiple
Incident Management Teams assigned to it. Area Command has the responsibility to set
overall strategy and priorities, allocate critical resources based on priorities, ensure that
incidents are properly managed, and ensure that objectives are met and strategies
followed.
ASSIGNED RESOURCES – Resources checked in and assigned work tasks on an
incident.
ASSIGNMENTS – Tasks given to resources to perform within a given operational
period, based upon tactical objectives in the Incident Action Plan.
ASSISTANT – Title for subordinates of the Command Staff positions.
ASSISTING AGENCY – An agency directly contributing tactical or service resources
to another agency.
AVAILABLE RESOURCES – Incident-based resources which are ready for
deployment.
BASE - That location at which the primary logistics functions are coordinated and
administered. As differentiated from Staging, resources in Base are not generally ready
for immediate deployment. This element is typically staffed at large scale incidents such
as high-rise fires where non-essential resources are marshaled and essential resources are
staged. Base is a Logistics function.
BRANCH - The organizational level having functional or geographic responsibility for
major segments of incident operations. This functional level falls between SECTION
and DIVISION/GROUP in the Operations Section, and between the SECTION and
UNITS in the Logistics Section.
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BRIEF INITIAL REPORT - The initial status report which includes all of the
information necessary to establish the operations at an incident.
BRIEF PROGRESS REPORT - Periodic information on the status of an incident
designed to keep interested parties informed as to the progress of the incident.
CAMP – A geographical site, within the general incident area, separate from the Base,
equipped and staffed to provide food, water, and sanitary services to incident personnel.
CHIEF - Functional title of the individual in COMMAND of any of the functional
sections of the General Staff: Operations, Plans, Logistics, or Finance/Administration.
CLEAR TEXT – The use of plain language in radio communications.
COMMAND – The act of directing and/or controlling resources by virtue of explicit
legal, agency, or delegated authority. May also refer to the Incident Commander. One of
the Sections that comprise the General Staff
COMMAND POST - A fixed location at which primary COMMAND functions are
executed.
COMMAND STAFF - The collective functions of Safety, Liaison, and Information
which report directly to the Incident Commander. Assistants may be designated as
required.
COMMUNICATIONS UNIT - Functional unit within the Service Branch of the
Logistics Section responsible for the incident communications plan, the installation and
repair of communications equipment, and operation of the incident communications
center.
COMPANY - A ground vehicle providing specified equipment capability and personnel.
COMPENSATIONS/CLAIMS
UNITFunctional
unit
within
the
Finance/Administration Section responsible for financial concerns resulting from
injuries, fatalities, or property damage at an incident.
COMPLEX – Two or more individual incidents located in the same general area which
are assigned to a single Incident Commander or to a Unified Command.
COOPERATING AGENCY – An agency supplying assistance other than direct tactical
or support functions or resources to the incident control effort (e.g. Salvation Army,
Utility Company, etc.).
COORDINATION CENTER – Term used to describe any facility that is used for the
coordination of agency or jurisdictional resources in support of one or more incidents.
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COST UNIT - Functional unit within the Finance/ Administration Section responsible
for tracking costs, analyzing cost data, making cost estimates, and recommending costsaving measures.
COST SHARING AGREEMENTS – Agreements between agencies or jurisdictions to
share designated costs related to incidents. Cost sharing agreements are normally written
but may also be verbal between authorized agency or jurisdictional representatives at the
incident.
CREW - A specific number of personnel not to exceed the recommended span of control
of 5 assembled for an assignment most often used when company assignments are not
available.
DELEGATION OF AUTHORITY – A statement provided to the Incident Commander
by the Agency Executive delegating authority and assigning responsibility.
DEMOBILIZATION UNIT - Functional unit within the Planning Section responsible
for assuring orderly, safe, efficient demobilization of resources committed to an incident.
DEPUTY – A fully qualified individual, usually assigned to General Staff positions or
Branch Directors, who can function in their absence or provide relief for a superior.
DIRECTOR - Functional title of the individual responsible for supervising a Branch.
DISPATCH – The implementation of a Command decision to move a resource or
resources from one place to another.
DISPATCH CENTER – A facility from which resources are directly assigned to an
incident.
DIVISION - That organizational level having responsibility for operations within a
defined geographic area. This functional level falls between BRANCH and CREWS,
TASK FORCES, STRIKE TEAMS, and/or SINGLE RESOURCES. They are identified
by alphabetic characters (A,B,C,D) for horizontal applications and by floor numbers for
vertical application.
DOCUMENTATION UNIT - Functional unit within the Planning Section responsible
for recording/protecting all documents relevant to an incident.
EMERGENCY MANAGEMENT COORDINATOR – The individual that has the
responsibility to coordinate emergency management within each political subdivision.
EMERGENCY OPERATIONS CENTER (EOC) – A pre-designated facility
established by an agency or jurisdiction to coordinate the overall response and provide
support to an emergency.
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EMERGENCY TRAFFIC – A term used to clear designated channels used at an
incident to make way for important radio traffic for a firefighter emergency situation or
an immediate change in tactical operations. NOTE: The term Mayday should not be
used for fire ground communications which could cause confusion with the term used for
aeronautical and nautical emergencies.
EMERGENCY OPERATIONS PLAN – A jurisdictional plan developed and
maintained for responding to appropriate emergencies.
ENGINE COMPANY – A ground vehicle providing specified levels of pumping
capacity, water, hose, and personnel.
FACILITIES UNIT - Functional unit within the support branch of the logistics section
responsible for providing fixed facilities at an incident, including base, feeding areas,
sanitary facilities, and a formal command post.
FINANCE/ADMINISTRATION SECTION - That section of the General Staff directly
responsible to the Incident Commander for all costs and financial considerations of the
incident. This Section is also responsible for legal issues related to the incident.
FIRST RESPONDER – Personnel who have responsibility to initially respond to an
emergency.
FOOD UNIT - Functional unit within the Service Branch of the Logistics Section
responsible for providing meals to personnel involved in an incident.
GENERAL STAFF - The collective Section Chiefs of the OPERATIONS,
PLANNING, LOGISTICS, and FINANCE/ADMINISTRATION Sections.
GROUND SUPPORT UNIT - Functional unit within the Support Branch of the
Logistics Section responsible for fueling/maintaining/repairing vehicles and the
transportation of personnel and supplies at an incident.
GROUP - That organizational level having responsibility for a specific functional
assignment. This functional level falls between BRANCH and CREWS, TASK
FORCES, STRIKE TEAMS, and SINGLE RESOURCES.
INCIDENT ACTION PLAN/S - General control objectives reflecting the overall
incident strategy, and specific action plans for the next operational period. Action plans
identify the problem/s (strategies), the solution/s (tactics), and the tactical operation/s
(who, where & when).
INCIDENT BASE – Incident location where the primary logistical functions are
coordinated and administered. There is only one BASE per incident.
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INCIDENT MANAGEMENT TEAM – The incident commander and appropriate
Command and General Staff personnel assigned to an incident.
INCIDENT OBJECTIVES – Statements of guidance and direction necessary for the
selection of appropriate strategies and tactics. Incident objectives must be based on
realistic expectations, achievable, and measurable.
INCIDENT COMMANDER - That individual responsible for the overall management
of incident activities, specifically responsible for determining incident priorities;
developing goals and objectives; developing and implementing incident action plans;
developing appropriate command structure; resource management; incident scene safety;
liaison with outside agencies; and release of appropriate information to the media.
LEADER - Functional title of any individual in command of a Crew, Task Force, Strike
Team, or functional unit.
LIAISON OFFICER – A member of the Command Staff that serves as a point of
contact for coordinating with assisting or cooperating agencies.
LOBBY CONTROL - A high-rise logistics function responsible to coordinate the
movement of resources between Base and Staging. Also responsible for control of
elevator and air handling systems. Works for the Logistics Section Chief.
LOGISTICS SECTION - That section of the General Staff responsible directly to the
Incident Commander for providing facilities, services, and materials for the incident.
MEDICAL GROUP/BRANCH – An organizational element providing an expandable
system for handling patients at the emergency scene.
MEDICAL UNIT - Functional unit within the Service Branch of the Logistics Function
responsible for developing the Medical Emergency Plan and for providing emergency
medical treatment of on-scene emergency personnel. Responder Rehab is a function of
the Medical Unit.
MULIT-AGENCY INCIDENT – An incident where one or more agencies assist a
jurisdictional agency. May be single or unified command.
MULTI-CASUALTY – An incident where the numbers of casualties and the types of
injuries exceed the resource capability of the responding agency.
MULTIJURISDICTION INCIDENT – An incident requiring action from two or more
agencies that have legal responsibility for mitigation. These incidents should be managed
under a Unified Command System.
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MUTUAL AID AGREEMENT – A written agreement between agencies and/or
jurisdictions in which they agree to assist one another upon request, by furnishing
personnel, equipment, and/or apparatus.
OFFICER - Functional title of any individual responsible for the Command Staff
functions of Safety, Liaison, or Information.
OPERATIONAL PERIOD – The period of time during which a given set of operational
actions, as specified in the Incident Action Plan, are carried out. Operational period may
vary in length but should not be longer than 24 hours.
OPERATIONS SECTION - That section of the General Staff responsible directly to the
Incident Commander for management of all tactical operations at an incident.
PERSONNEL ACCOUNTABILITY – The ability to track the location of personnel
and account for their welfare.
PERSONNEL ACCOUNTABILITY REPORTS (PAR) – Personnel accountability
reports of emergency personnel and companies assigned to an incident.
PLANNING MEETING – A meeting held as needed throughout an incident, generally
prior to the next operational period. The strategies and tactics as well as support and
service needs for the next operational period are planned at these meetings and become
part of the Incident Action Plan.
PLANNING SECTION - That section of the General Staff responsible for the
collection, evaluation, dissemination, and use of information about the development of
the incident and the status of resources.
PROCUREMENT UNIT - Functional unit within the Finance/Administration Section
responsible for financial matters involving vendors.
PUBLIC INFORMATION OFFICER – A member of the Command Staff responsible
for interface with the media or other appropriate agencies requiring information directly
from the incident scene. While they may have assistants, there is only one Information
Officer per incident.
RAPID INTERVENTION CREW (RIC) – A crew or company designated to stand-by
, with necessary tools and equipment, to rescue firefighters should it become necessary.
RESOURCE UNIT - Functional unit within the Planning Section responsible for
recording the status of resources committed to an incident.
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RESPONDER REHABILITATION – Functional unit within the Medical Unit of the
Logistics Section responsible for monitoring, evaluation, and appropriate action with
respect to the medical condition of emergency personnel on the incident scene. Also
known as “REHAB”.
SAFETY OFFICER - Responsible for monitoring and assessing safety hazards or
unsafe situations and developing measures for ensuring personnel safety. The Safety
Officer is a member of the Command Staff and may have Assistants.
SECTION - That organizational level having functional responsibility for primary
segments of
the incident such as: Operations, Planning, Logistics, and
Finance/Administration.
SERVICE BRANCH - A Branch within the Logistics Section responsible for service
activities at an incident, including Communication, Medical, and Food Units..
SINGLE COMMAND - Command structure in which one individual has sole
responsibility for COMMAND functions.
SINGLE RESOURCE - An individual company or crew.
SITUATION UNIT - Functional unit within the Planning Section responsible for the
collection, organization, and analysis of incident information, and for analysis of a
situation as it progresses.
SIZE-UP - The mental evaluation of the various factors at an incident that lead to the
determination of the problems that must be solved.
SPAN OF CONTROL – The supervisory ratio of three to seven individuals (or
companies) with five generally being considered the optimum.
STAGING AREA - That location or locations where personnel and equipment are
pooled and ready for immediate deployment in an incident.
STAGING AREA MANAGER - Responsible for the coordination, support, and
distribution of incoming resources.
STRATEGY - The overall plan that will be used to control the incident. The purpose
towards which all incident activities are directed. Strategic goals are broad definitions of
incident problems. Examples: Rescue, Extinguishment, Salvage, etc. Strategy is
achieved by the completion of tactics.
STAIRWELL SUPPORT - A high-rise logistics function responsible for the movement
of equipment from Base to Staging when utilizing the stairwell.
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STRATEGIC MODE - The mode of attack as specified by the availability of resources
compared to the resource requirements of the incident. I.E.,
Offensive Mode - Aggressive attack due to the fact that available resources
exceed that required by the incident.
Defensive Mode - A protective attack or defense due to the fact that the incident
requires more resources than are available.
STRIKE TEAM - A functional element of up to five (5) units of the same kind and type,
with common communications and a leader.
SUPERVISOR - Functional title of any individual in command of a Division, Group, or
Sector.
SUPPLY UNIT - Functional unit within the Support Branch of the Logistics Section
responsible for ordering equipment/supplies required for incident operations.
SUPPORT BRANCH - A Branch within the Logistics Section responsible for providing
the personnel, equipment, and supplies to support incident operations. Includes Supply,
Facilities, and Ground Support Units.
TACTICS - Specific operations that must be accomplished to achieve the strategy.
Tactics are both specific and measurable.
TASK FORCE – A combination of single resources with common communications and
a leader. May be resources of different types, generally assembled for a specific
assignment.
TECHNICAL SPECIALISTS - Personnel with special skills specifically activated for
those skills. These personnel initially report to the Planning Section but can assigned
anywhere within the Incident Command Organization to meet incident needs.
TIME UNIT - A functional unit within the Finance/Administration Section responsible
for record keeping of time for personnel and hired equipment working at an incident.
TYPE – Refers to the capability of a specific resource, with Type 1 having the greatest
capacity, then Type 2, etc. Typing aids in selecting the best resource for the job.
UNIFIED AREA COMMAND – Unified Area Command is established when incidents
under an Area Command are or become multijurisdictional.
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UNIFIED COMMAND - The organizational method which allows all agencies or
individuals having jurisdictional or legal responsibility for an incident to be involved in
the COMMAND function, by establishing a common set of incident objectives and
strategies.
UNIT - That organizational element having functional responsibility for a specific
incident's planning, logistics, or finance/administration activity.
UNITY OF COMMAND The principle by which each individual in the organization
reports to only one designated person.
WATER TENDER – Any ground vehicle capable of transporting specific amounts of
water.
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
APPENDIX B:
ADOPTING THE
INCIDENT COMMAND SYSTEM
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ADOPTING AN INCIDENT COMMAND SYSTEM
Why Adopt: A Review
The need to provide increased effectiveness in emergency management--coupled with
new laws, regulations and standards, including the NIMS--is resulting in increased use of
Incident Command Systems (ICS's).
Use of the ICS improves safety by providing proper supervision, accountability,
coordinated efforts, and improved communications. Effective incident management also
minimizes "freelancing," and can reduce the department's or jurisdiction's liability, as
well as the financial impact of emergencies on the community.
The NIMS requires that all jurisdictions “institutionalize” the use of ICS as taught by
DHS, including the National Fire Academy (NFA) and Emergency Management Institute
(EMI). They understand that when a jurisdiction makes the decision to adopt the ICS, a
commitment must be made to provide the required resources (money, personnel, and time
to develop, train, and implement) to support the program.
Adoption/Implementation Process
What steps are necessary to ensure a smooth and effective implementation of the ICS?
Here is a suggested process:
1.
First, the chief of department issues a written policy statement on the decision to
adopt the ICS for all incidents--after training has been completed.
2.
The chief selects an ICS Implementation Committee.
3.
The committee identifies departmental needs that the ICS can meet, as well as
present resources.
4.
The committee develops an ICS Standard Operating Guideline (SOG) Manual.
5.
ICS training is implemented--both initial and continuing--according to agreedupon priority order.
6.
Everyday ICS usage by department personnel is constantly monitored, reviewed,
and evaluated to provide ongoing feedback that can lead to revision of the ICS
SOG Manual or training materials/procedures.
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ESTABLISHING AN ICS COMMITTEE
Effectiveness of Committee Approach
The committee approach to ICS adoption and implementation is usually the most
effective method in adopting an ICS.
It's a process that has been used by many departments, and proved highly successful.
Initial Work
First, the chief selects the committee. Membership selection criteria will be discussed
shortly. The chief then meets with the committee and provides a clear description of its
task:




analyze the department's existing command system;
compare it to the ICS (included in the NIMS document);
develop an ICS SOG Manual; and
implement ICS training.
Selection Criteria
Those selected for the committee should know the ICS and be experienced in command,
as well as in training and course development. All department ranks and assignments
should be represented, if possible.
Three to six members are an ideal number. In smaller departments with limited
resources, however, perhaps only two or three individuals may serve on the committee.
The person selected as leader should have--in addition to knowledge and experience--the
respect of the other committee members as well as credibility with the entire department
or jurisdiction.
Human Factors
Human factors may affect the committee. Some committee members may tend to resist
change, while other members may accept change more readily. These differences are to
be expected.
Allowing and encouraging everyone on the committee to voice concerns and to raise
issues about ICS, and then to provide input into its development, can help overcome any
resistance, since members will feel that they are a part of the program. They will develop
"ownership." Be patient with those unfamiliar with the ICS.
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It's important that time be taken to explain the ICS to committee members who have
limited knowledge about it. The way the system works and its benefits must be clearly
explained and understood.
The committee members and the chief alike should keep in mind that adopting the ICS
doesn't happen overnight. It is a process that takes time.
Meetings
Committee meeting schedules must take into consideration the shift schedules of all
members. Meetings should be held at a location that provides logistical support as well
as any required reference material from the department and from other sources, such as
the NFA or the NIMS Integration Center (www.fema.gov/nims).
COMMITTEE IDENTIFICATION OF NEEDS
Resource Levels
The first step the committee takes is an analysis of the department's current resource
levels and resources available through formal mutual aid agreements.
The committee evaluates the personnel available within the department to determine the
number of chief officers, company officers/field supervisors, and firefighters/EMS
providers who can be assigned to perform various functions within the ICS.
The committee reviews available written mutual aid agreements and their impact on ICS
organization at emergency incidents. Determining if liability and cost compensation
agreements exist is critical.
The committee should also determine what is available in terms of staffing of mutual aid
companies, equipment, and types of apparatus that will respond.
Other factors that the committee considers:

SOG's about where or to whom units report.

Who will function as the Incident Command (IC)? It's usually best to pick the
highest ranking chief from the jurisdiction where the incident occurs to serve as
the IC.

How best to use responding staff from other jurisdictions in the ICS organization.
Included in the consideration should be standardization of equipment, as well as
SOG's, terminology, and communications.
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Existing Incident Command Organization
Next, the committee analyzes the existing command organization at incidents. How
does the department currently organize and manage both small and large incidents?
The committee particularly examines the span-of-control of the IC and subcommanders.
IC's in departments not using the ICS tend to be overburdened: too large a span-ofcontrol and too many jobs to do. The ICS offers the ability to maintain a reasonable
span-of-control, no matter what type of incident or the number of resources. Reasonable
span-of-control improves communications, safety, and overall effectiveness. The IC will
then manage subcommanders instead of individual units.
Incident-Scene Duties/Responsibilities
Then, the ICS committee analyzes existing SOG's in terms of incident-scene duties and
responsibilities.
The members review the method used to divide the incident into geographical and
functional areas. They need to determine the responsibilities of chiefs, company officers,
and firefighters.
They evaluate the effectiveness of their initial onscene reports. They also address the
support facilities required for effective incident management, such as Staging, base, and
Command Post (CP).
Comparison of Existing System
Finally, the committee compares the department's existing system to the NIMS ICS. In
so doing, they identify areas to be addressed in the development of ICS procedures for
that department.
DEVELOPING THE STANDARD OPERATING GUIDELINE MANUAL
After completing the analysis and identification of specific needs, the committee is ready
to develop an ICS SOG Manual for its department.
Ideal Developers
Desirable qualifications for manual developers include




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knowledge of ICS;
writing or course development experience;
familiarity with the ICS; and
command experience.
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
The task of actually writing sections of the manual can be accomplished effectively by
two or three members working together. Limiting the number of writers provides
uniformity of wording and format and prevents possible redundancy.
MANUAL FORMAT
These elements should be included in the manual:

An introduction.
Explanation of why the ICS is being adopted and what it will accomplish.
Covered somewhere in the manual should be the fact that in departments with
limited resources, one person may be performing many duties.

An operational section describing the ICS organizational structure, initial
response duties, and the flexibility of the system. Modular expansion, with
incident growth and transfer of command at expanding incidents, also should be
explained in this section.

A description of incident facilities, which includes a description of incident CP
and Staging. If the use of a base facility is anticipated, such as at highrise and
brush incidents, this should be covered as well.

Duties and responsibilities of the IC and the Command Staff. Included in the
Command Staff should be Safety, Liaison, and Public Information Officers.

The General Staff positions of Operations, Planning, Logistics, and
Finance/Administration. All subunits within each section also should be
discussed.

The means to identify the command positions and the incident facilities should
then be covered; typically, this means the use of vests for command officers and
flags or lights for fixed-incident facilities.

General instructions and guidelines for Company Officers/Field Supervisors,
chief officers, and agency representatives at incidents.

A glossary and appendix providing standard terminology to be used by the
department and outside agencies, and supplemental material explaining
departmental ICS operations.
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Review of Manual
When the manual is completed, it is sent to selected individuals in training and the field,
those with command experience, and senior members. They are to review the manual for
content, clarity, and possible conflicts with policy. Comments are solicited. Time
schedules should be established for this review. Two weeks usually is sufficient.
Upon receiving the comments, the committee reviews them and makes any necessary
changes to the manual. When the final draft is completed, it is sent to the chief for
review and approval.
Revision of Existing Documents
Once the manual is approved, there may be a need to revise some existing department
documents. These may include the communication procedures--including terminology
and onscene reporting procedures--and some of the present SOG's.
IMPLEMENTING TRAINING
Notification of Personnel
The department then notifies personnel about the implementation of ICS training.
A written statement on policy and procedures from the chief with regard to the adoption
of ICS usually is issued. This statement will motivate interest in the program.
Coordination
Methods of coordination need to be established for scheduling training dates, confirming
class space availability and class size, and documenting the training of personnel. Such
attention to detail minimizes confusion and ensures that training is conducted properly.
In larger departments, it may be beneficial to assign one person to act as a coordinator for
the program within the department.
In smaller departments, all these tasks may be addressed by one individual who may have
to perform more than the coordinator's job. This work may not be as complicated as in a
larger department.
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Criteria for Instructors
Those who conduct the training should have instructional experience as well as a
thorough understanding of ICS and the ability to relate it to everyday life as well as to
answer questions about the system and offer examples of its use. They should have prior
training experience.
Training Priorities
The recommended priority order for training is chief officers, then Company
Officers/Field Supervisors, and finally the firefighters and EMS providers. All personnel,
however, must receive training in their anticipated duties and responsibilities.
The specific level of training is usually based on the available resources in the department
to fill positions within the ICS organizational structure and anticipated ICS roles.
In smaller departments, personnel must be able to perform multiple functions. Company
Officers/Field Supervisors and firefighters/EMS providers may have to perform functions
normally handled by a chief officer in larger departments.
Remember: in the ICS, it is knowledge, not rank, that is important.
Optimal Incident Command System Training
Training should be ongoing, following the initial orientation. There should be additional
classroom training and simulations. Company Officers and/or Field Supervisors should
conduct regular in-station training. Outside exercises should be conducted as well,
involving multiple company drills. This will be the test of classroom training.
Mutual-aid departments and other agencies also should be involved in training activities
whenever possible. That will allow them to become familiar with the ICS and understand
how they fit into the system.
The best training in ICS is the day-to-day use of the system at all incidents. It improves
understanding and fine-tunes the system. It allows for smooth transition from a small to a
large incident when you get the "big one." It makes the use of the ICS routine.
If everyone uses ICS terminology and procedures on a daily basis, confusion and stress at
larger incidents are minimized. In this way, ICS becomes a mind set.
Day-to-day use of the ICS should be monitored. Misunderstandings should be clarified,
revisions made, and additional training instituted, if necessary.
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APPENDIX C:
MODEL INCIDENT COMMAND
SYSTEM STANDARD OPERATING
PROCEDURE
This model Standard Operating Procedure (SOP) is included to provide an example of the elements that
may need to be included in Incident Command System (ICS) SOPs. This procedure cannot replace the
important organizational process of adoption and development of specific procedures to integrate the ICS
with the existing SOPs and tactical evolutions of a specific department.
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INTRODUCTION
The application of sound management principles to any undertaking which requires the
coordination of various resources is paramount to the success of that undertaking. This
concept is applied to our personal and professional lives everyday. We manage our
personal budgets, our own time, and many other aspects of our own lives. Professionally
we also manage our manpower and apparatus, the activities of our working days, our
budget, and our goals and objectives. We do this by applying the basic textbook
management principles of planning, directing, organizing, coordinating, communicating,
delegating, and evaluating.
So should it be with emergency operations. The major difference between routine, dayto-day management and emergency management is the time frames for gaining control of
the situation. Emergency operations still require the management of resources, goals and
objectives, and activities in order to insure a satisfactory outcome. In other words,
emergency operations still require planning, directing, organizing, coordinating,
communicating, delegating, and evaluating. Therefore, the same management process
applied to our routine everyday operations can, and should, be applied to emergency
operations.
This policy & procedure manual clearly spells out the incident scene management
process. It adopts the management principles previously mentioned and, because of its
modular concept, it can be applied to any incident regardless of the type or magnitude of
that incident. As a function specific tool rather than a rank specific one, it is equally
adaptable because anyone can fill any position assuming appropriate training for that
position.
It shall be a matter of departmental policy that all personnel be familiar with this manual
and fully functional in any position which he/she might reasonably be expected to fill.
C-3
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
PURPOSE & SCOPE
The Incident Command System is a management system designed to control personnel,
facilities, equipment, and communications throughout an emergency operation. It is
designed to begin developing from the time an incident occurs until the requirement for
management and operations no longer exists. The structure of the Incident Command
System can be established and expanded depending upon the changing conditions of the
incident. The Incident Command System meets the following operating requirements
necessary of any emergency management process:
• Management capabilities for:
1. Single jurisdiction/single agency involvement.
2. Single jurisdiction/multi-agency involvement.
3. Multi-jurisdiction/multi-agency involvement.
•
Organizational structure adaptable to any emergency or incident to which
fire protection agencies would be expected to respond.
•
Applicable and acceptable to users throughout the country.
•
Readily adaptable to new technology.
•
Ability to expand in a logical manner from an initial attack situation into a
major incident.
•
Basic common elements in organization, terminology, and procedures.
•
Implementation with the least possible disruption to existing systems.
•
Effective in fulfilling all management requirements yet simple enough to
insure low operational maintenance costs.
As such, the system can be utilized for any type or size of emergency ranging from a
minor incident involving only a few units to a major incident involving several agencies.
It is intended to be staffed and operated by qualified personnel from any emergency
services agency and may involve personnel from a variety of agencies.
C-4
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
TABLE OF CONTENTS
Unit
Introduction
Purpose & Scope
Responsibilities of COMMAND
Size-Up
Communications Procedure
Brief Initial Report
Brief Progress Report
Staging
Dividing the Incident
C-5
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
RESPONSIBILITIES OF COMMAND
In order to develop a well orchestrated response to any incident scene, clear lines of
authority, responsibility, and accountability must be defined. To this end the following
policy shall provide direction and authority for the COMMAND function.
I.
II.
Command Procedure
A.
The effective functioning of all units and personnel at any incident
requires clear decisive action on the part of an incident
commander.
B.
This procedure fixes responsibility for the COMMAND function
and its associated duties on one individual at any time during an
incident.
C.
Command procedures are designed to accomplish the following:
Fix the responsibility for COMMAND on a specific
individual.
2.
Strong, direct, and visible COMMAND will be established
as early as possible in the operation.
3.
Establish an effective framework for activities and
responsibilities.
4.
Provide a system for the orderly transfer of COMMAND
to subsequent arriving authorities.
Authority & Responsibility
A.
C-6
1.
COMMAND responsibilities.
1.
Assess incident priorities.
2.
Determine strategic goal/s.
3.
Determine tactical objective/s.
4.
Develop incident action plan.
5.
Develop appropriate organizational structure.
6.
Manage incident resources.
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
B.
III.
7.
Coordinate overall incident activities.
8.
Ensure safety of on-scene personnel.
9.
Coordinate activities of outside agencies.
10.
Authorize release of information to media.
Normal operating procedure.
1.
The 1st arriving company officer, acting officer, or
otherwise senior individual on the 1st arriving unit shall be
responsible for, and shall have the authority to exercise, all
COMMAND functions deemed reasonable and prudent
until such time as they are relieved by proper authority.
2.
The 1st arriving company officer, acting officer, or
otherwise senior individual on the 1st arriving unit shall:
a.
Perform a size-up in accordance with the size-up
standard.
b.
Determine the appropriate strategies and tactics.
c.
Assign tactical objectives as required, including
support.
d.
Transmit the Brief Initial Report in accordance with
the BIR standard.
e.
Determine the need for assistance and request such
assistance as necessary.
Addressing the Command Function.
A.
Passing COMMAND
1.
May only be done by the 1st arriving company officer,
acting officer, or otherwise senior individual on the 1st
arriving unit.
2.
May be done only after all other necessary COMMAND
functions have been completed according to the BIR
format.
C-7
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
B.
3.
Shall be the result of a conscious decision by the company
officer or acting officer that they must necessarily commit
themselves to a tactical objective and, therefore, can not be
in an appropriate position to adequately manage the
incident.
4.
When COMMAND is passed, the next arriving unit must
report to the scene rather than to Level I staging.
Assuming COMMAND
1.
Is the result of a conscious decision by the company officer
or acting officer in the 1st arriving unit that the incident
requires immediate command and control or that there are
sufficient resources available to adequately handle the
necessary tactical objectives. In this situation the Incident
Commander must remain in a position to appropriately
manage the incident.
2.
Must be done by the company officer or acting officer in
the next arriving unit if COMMAND was passed by the 1st
arriving company officer or acting officer.
3.
May be done by the company officer or acting officer in the
1st arriving unit if, after having already passed
COMMAND, decides that assuming COMMAND is now
warranted as a result of changes in the situation.
May be done by higher ranking officers as the incident
dictates.
C.
Considerations for passing/assuming COMMAND
1.
C-8
Size & extent of the incident.
a.
Small or less complex incidents where your
immediate assistance in a tactical operation would
have a positive impact on the outcome might
indicate the need to PASS COMMAND. EX:
Room & contents fire; a limited number of persons
trapped; etc.
b.
Investigating where the status reported is nothing
evident. This constitutes a tactical objective which
might place you in an inappropriate position to
adequately manage the incident should something
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
go wrong.
appropriate.
c.
2.
The magnitude or type of incident may require
immediate command and control of resources. EX:
Significant haz-mat incidents; structure fires
requiring resources beyond the 1st alarm
assignment; many persons trapped or a large scale
evacuation; mass casualty incidents, etc. Assuming
COMMAND would be appropriate.
Availability of relief.
a.
b.
IV.
PASSING COMMAND may be
If senior authority is close at hand, PASSING
COMMAND may be appropriate.
If senior authority will be significantly delayed,
assuming COMMAND may be appropriate.
Transfer of COMMAND
A.
B.
Purpose - Transfer of COMMAND refers to the act of one
individual relieving another individual of authority, responsibility,
and accountability as it pertains to the execution of the function of
COMMAND on any given incident. The progressive chain-ofcommand principle shall be utilized.
1.
Should an incident commander be of a non-officer grade,
they shall be relieved as soon as practical by the 1st
arriving officer.
2.
The 1st officer to assume COMMAND shall retain
COMMAND until formally relieved by a ranking officer.
Ranking officers shall have the discretionary authority to
relieve a subordinate officer of COMMAND. However,
the senior officer present assumes accountability regardless
of whether or not they assume COMMAND.
Transfer of COMMAND Procedure
1.
At all times possible, transfer of COMMAND shall be
done face to face. When a face to face transfer can not be
accomplished, the incoming senior individual may assume
COMMAND immediately, but MUST make every effort to
gain the necessary information as soon as possible.
C-9
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
2.
The individual preparing to assume COMMAND shall, at
an appropriate moment, request a status report from the
Incident Commander.
3.
The Incident Commander shall brief the incoming
individual as to:
a.
The current situation.
b.
Any injuries, loss of life, etc.
c.
All current control efforts and the status of those
efforts.
d.
The anticipated course of the incident.
e.
The location of on scene resources.
f.
Any other information pertinent to the incident.
4.
When the incoming individual is fully prepared to assume
COMMAND, he or she shall then formally relieve the
current incident commander and reassign that individual as
necessary.
All transfers of COMMAND shall be transmitted over
the radio.
"Engine 1 to Dispatch, Chief 2 is Command."
SIZE-UP
The 1st in company officer or acting officer in the 1st arriving unit is faced with the need
to make proper and reasonable decisions under the immediate pressure of the emergency.
A size-up system becomes a vital and necessary tool to have in this situation. This same
system is also necessary for subsequent incident commanders as their need to make
decisions varies with the dynamics of the incident. The following 5-point Size-Up
system shall be utilized when operating at an incident:
1.
FACTS ( Facts that the situation presents)
a. Time of the incident.
b.
Location of the incident.
c. Nature of the incident.
d.
Life hazards.
e. Exposures.
f. Buildings, areas involved.
g.
Weather.
2.
situation)
C-10
PROBABILITIES (Predictions based upon the existing
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
a. Life hazards.
b.
Extent of the incident.
c. Explosion potential.
d.
Collapse potential.
e. Weather changes.
3.
OWN SITUATION (Your resources and capabilities)
a. Personnel & equipment on scene.
b.
Availability of additional resources.
c. Available water supply.
d.
Appropriate strategic mode.
e. Actions already taken.
4.
DECISION (Result of your analysis of items 1, 2, & 3)
a.
Determine strategy.
b.
Evaluate tactical options.
c. Select tactics.
5.
PLAN OF OPERATION
a. Issue tactical assignments.
b.
Coordinate activities.
c. Evaluate results
d.
Alter activities as necessary.
C-11
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
COMMUNICATIONS PROCEDURE
In accordance with the philosophy of the Incident Command System as adopted by the
Fire Department, the value of effective yet simple communications procedures is clearly
recognized. It is further recognized that effective incident scene communications is the
responsibility of COMMAND and goes hand in hand with the sound execution of
COMMAND functions. Dispatch, therefore, should be considered an integral part of the
Incident Commander's resource pool.
The following procedures shall be used for communications on any and all incidents
requiring the response of two (2) or more units, regardless of the type of units:
1.
The first individual addressing the COMMAND function shall do so by
identifying the incident. This procedure is implemented to benefit both
on-scene personnel and Dispatch by clearly separating each incident from
any other incident which may be simultaneously occurring. Addressing
the COMMAND function without identifying that COMMAND is an
inappropriate procedure.
Example A:
Bldg. fire at North Arundel Hospital.
"Lt. 26 is passing/assuming North Arundel Command, or
"Lt. 26 is passing/assuming Hospital Command.
Example B:
Dwelling fire on Milton Ave. - Box 34-1.
"Battalion 1 is assuming Milton Ave. Command.,or
"Capt. 31 is passing/assuming Milton Command.
Example C:
dispatched.
Medical assignment at the School with E-9 & PM-1
"Lt. 9 assuming School Command, or
"Lt. PM-1 passing/assuming School Command."
The terminology for incident identification shall be left to the discretion of the Incident
Commander. However, caution should be exercised so as not to use identifiers which
might not clearly separate one incident from another. The use of the 1st Incident
Commander's last name would be appropriate.
2.
C-12
Internal incident communications may be directed to/from any element on
location in accordance with the appropriate procedures. Face to face
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
communications is always preferable. However, radio communications
directed to/from established functional assignments shall use the
appropriate functional title.
3.
Example 1:
Communications directed to/from the Incident Commander
shall address '(ID) COMMAND', not 'Batt-1', 'Chief-1',
'Lt-26', etc.
Example 2:
Communications directed to/from the individual assigned
responsibility for all activities on the 1st floor of a structure
shall address 'Division-1', not 'Chief-12', Lt-18', 'FF-T- 26',
etc.
In order to keep incident scene communications to a minimum, the
'Command By Exception' principle should be utilized. This means that
radio traffic directed to immediate supervisors should be limited as much
as practical to:
A.
B.
C.
D.
E.
Announcing the completion of an assigned objective.
Announcing when an assigned objective cannot be met.
Announcing identified safety problems.
Announcing the need for additional resources to accomplish an
assigned objective.
Announcing other emergency or absolutely necessary information.
4.
Units shall not request that Dispatch relay information. Information shall
be communicated unit to unit.
5.
The Incident Commander shall be responsible for cancelling assignments
or placing units available.
C-13
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
BRIEF INITIAL REPORT
A primary role of the 1st arriving Incident Commander is to establish strategy & tactics.
A primary role of the additional responding units is to support the Incident Commander's
strategy & tactics by accomplishing specifically assigned tactical objectives. In order for
this cooperation to work effectively it is important for the support units to have as close
an idea as to what is occurring as does the Incident Commander. Therefore, the Incident
Commander must act as the "TV camera" for the other units. His or her initial report of
the situation must be concise, complete, and accurate.
A Brief Initial Report (BIR) shall be required on any and all incidents involving a
response of multiple units regardless of the types of units. This procedure is particularly
important where one or more units initially report to the scene and all other units stage
away from the scene. The following elements, in the specific order listed, shall be
included in the initial report of any and all incidents when such reports are required.
1.
Unit ID arrived on location.
2.
Location of unit in relation to the overall incident.
3.
Description of situation found.
4.
1st unit's tactical assignment.
5.
Other units' tactical assignment/s.
6.
Request additional assistance if necessary & identify the Level II
staging area.
7.
Address the COMMAND function.
An example can not be provided for every type of situation. However, the ones provided
should serve well to illustrate the appropriateness of the format. The unit assignments
illustrated in these examples should not be interpreted as required tactical objectives, nor
should they be interpreted as necessary unit assignments. Such matters are at the
discretion of the Incident Commander and units not assigned specific tactical objectives
by COMMAND should be staged.
C-14
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
EXAMPLES:
A.
B.
C.
Multiple units responding to a single story dwelling fire.
1.
"E-1 on location."
2.
"Side A of a single story, single family dwelling."
3.
"Nothing showing."
4.
"E-1 is investigating."
5.
(No transmission is necessary at this time because all other units
will stage in accordance with Level I procedures.)
6.
(No transmission is necessary because no help is necessary at this
time.)
7.
"Lt - E-1 is (passing/assuming) COMMAND."
Multiple units responding to a 2-story dwelling fire.
1.
"E-1 on location."
2.
"Side A of a 2 story, single family dwelling."
3.
"Fire showing on the 1st floor, persons trapped on the 2nd floor."
4.
"E-1 is making an interior attack on the fire through side A."
5.
"E-2 advance a line to the 2nd floor, protect the stairs and confine
the fire."
"T-1 do a primary search of the 2nd floor and provide horizontal
ventilation."
"E-3 advance a line to back up E-1 on the 1st floor."
6.
"E-1 to Dispatch, send a 2nd Alarm. Level II staging area will be
(ID location of staging area.)"
7.
"Lt - E-1 is (passing/Assuming) COMMAND."
Two units responding to a medical emergency in a structure.
1.
"A-1 on location."
C-15
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
2. /3./4.
D.
E.
C-16
(No transmission necessary because information is not
pertinent at this time.)
5.
"E-1 to PM-1 bring in a backboard."
6.
(No transmission is necessary because information is not pertinent
at this time.)
7.
"FF/A-1 is assuming (ID) COMMAND.
Multiple units responding to a High-Rise building fire.
1.
"E-1 on location."
2.
"Side 1 of a 10 story high rise."
3.
"Smoke showing from Side A at the 5th floor."
4.
"E-1 is advancing to the 5th floor."
5.
"E-2 support the standpipe/sprinkler system and assume Lobby
Control."
"T-1 support E-1 on the 5th floor."
"E-3 establish Staging on the 3rd floor."
6.
"E-1 to Dispatch, send a 2nd Alarm. Base will be (ID location of
base)"
7.
"Lt - E-1 is passing COMMAND and Assuming Operations."
Multiple units responding to a Rescue Box involving motor vehicles.
1.
"E-1 on location."
2.
"Ritchie Hwy. near Waterford Rd."
3.
"Two vehicles involved."
"One vehicle on fire, persons believed trapped in the other
vehicle."
4.
"E-1 will extinguish the fire."
5.
"Squad-1 handle the extrication in the 2nd car."
"A-1 coordinate with Squad-1 to handle patient care."
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
F.
6.
(No transmission is necessary because no help is necessary at this
time.)
7.
"Lt - E-1 is assuming COMMAND."
Multiple units responding to a Haz-Mat Box involving a motor
transport vehicle.
1.
"E-1 on location."
2.
"I-97 at Severn River."
3.
"One 6000 gallon tank truck overturned and leaking #2 fuel oil."
"Driver is believed trapped in the vehicle."
"Fuel spill is threatening Severn River."
4.
"E-1 will begin diking near the leak."
5.
"Truck-1 handle the extrication of the driver."
"PM-1 coordinate with TRK-1 to handle patient care."
"E-2 assist E-1 with diking."
"E-3 begin skimming operations on Severn River."
6.
"E-1 to Dispatch, send the helicopter for a Medivac."
7.
"Lt - E-1 is assuming (ID) COMMAND."
C-17
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
BRIEF PROGRESS REPORT
A Brief Progress Report (BPR) is essential to any ongoing incident in that it keeps all
concerned parties abreast of a dynamic situation. It is designed to provide information
which:
1.
Allows Dispatch latitude in filling vacant stations.
2.
Updates Duty Chiefs.
3.
Updates the Information Officer.
4.
Permits continuous documentation of an ongoing incident.
A Brief Progress Report (BPR) shall be required on any and all incidents which initially
required a Brief Initial Report (BIR), except as noted in the examples. The 1st BPR shall
be transmitted at approximately 10 minutes after the BIR. Thereafter, BPRs shall be
transmitted at intervals deemed appropriate by the Incident Commander, but in no case
should an interval exceed 30 minutes. The BPR shall consist of the following
information:
1.
Description of the current situation.
2.
Description of current tactical objectives.
3.
Status of resource needs.
4.
Length of time holding units from 1st unit to the last unit.
An example can not be provided for every type of situation. However, the ones provided
should serve well to illustrate the appropriateness of the format.
EXAMPLES:
A.
Multiple units responding to a 2-story dwelling fire.
"E-1 to Dispatch"
C-18
1.
"We are in an offensive mode and bringing the situation under
control."
2.
"Primary search has been completed and an interior attack is
underway."
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
B.
3.
"No need for additional resources is anticipated."
4.
"All units will be committed for about 1 hour."
Two units responding to a medical emergency in a structure.
Under normal conditions no BPR is necessary. However, should the
incident escalate to bigger proportions, BPRs would become appropriate.
C.
Multiple units responding to a High-Rise building fire.
"E-2 to Dispatch"
D.
1.
"Fire is contained on the 5th floor with heat damage on the 6th
floor."
"All occupants have been evacuated with no injuries."
2.
"An interior attack and ventilation on upper floors is underway."
3.
"Two additional alarms will be needed for crew relief and
rotation."
4.
"Units will be committed for approximately 3 hours."
Multiple units responding to a Rescue Box involving motor vehicles.
"E-1 to Dispatch"
1.
"Fire has been extinguished & all victims have been extricated."
2.
(No information is necessary here.)
3.
"No additional resources are required."
4.
"All units except A-1 will come available within 15 minutes."
E.
Multiple units responding to a Haz-Mat Box involving a motor
transport vehicle.
"E-1 to Dispatch"
1.
"Extrication of 1 victim is progressing."
C-19
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
"Diking is underway but some product has gotten into the Severn
River."
"Spill containment will take about 1/2 hour."
C-20
2.
"Diking efforts are underway to limit the exposure to the Severn
River."
"We are going to attempt to transfer the product to another
vehicle."
3.
"Dispatch a unit to handle a landing site for the helicopter."
"Notify DNR and the Department of the Environment."
4.
"All units will be committed for a minimum of 2 hours."
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
STAGING
The purpose of staging is to provide a standard system of resource placement prior to
tactical assignments. Failure to utilize such a system will result in added confusion on
the incident scene and units determining their own tactical assignments. Incident
commanders will lose track of their resources resulting in poorly applied resources;
priorities being overlooked; the inability to oversee personnel safety; and a general lack
of accountability. The following policy addresses two staging requirements; Level I - the
initial response involving multiple units and, Level II - the response of multiple units
beyond the initial response.
I.
Level I Staging - Utilized by all responding units up to and including a
full 1st Alarm assignment regardless of the type of incident.
A.
B.
1st arriving company.
1.
Shall report to the most appropriate position on-scene to
carry out the duties specified in Responsibilities of
COMMAND.
2.
If in a hydrant area, and in lieu of orders to the contrary, the
1st arriving engine company shall proceed to the most
convenient hydrant and lay (or be prepared to lay) the
appropriate size hose line/s should the type of incident
necessitate water.
3.
If in a non-hydrant area, and in lieu of orders to the
contrary, the 1st arriving engine company shall lay (or be
prepared to lay) the appropriate size hose line/s to the
incident scene in such a manner as to allow for the
establishment of a continuous water supply to the incident
should the type of incident necessitate water.
4.
If in a non-hydrant area, and in lieu of orders to the
contrary, the 1st arriving tanker shall hook up and prepare
to pump to any lines laid by the 1st arriving engine should
the type of incident necessitate water.
5.
In lieu of orders to the contrary, the 1st arriving truck
company shall report to the same location as the 1st
arriving company. If an obvious rescue situation exists at
another location, the 1st arriving truck company may
proceed to that location while advising the Incident
Commander of the situation.
All other units.
C-21
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
II.
In lieu of orders to the contrary, all other units shall remain
outside of the incident scene.
2.
In lieu of orders to the contrary, all other units shall
proceed to a convenient location (at a hydrant if available)
approximately one (1) block from the scene. Upon arrival
at this location unit commanders shall transmit "(Unit ID)
is staged (ID the location)." This message will inform the
incident commander that the unit is ready for assignment.
3.
No unit shall commit itself to any operation without having
received orders or approval from COMMAND.
4.
Unit commanders shall not request assignments from
staging. Should a staged unit commander feel that the BIR
indicated a need for their unit and no orders have been
received, they shall repeat the transmission "Unit (ID) is
staged (ID the location)." If the 2nd transmission is not
acknowledged, the unit commander shall report directly to
the Incident Commander by walking to the Command Post.
Level II Staging - Utilized by all responding units beyond the 1st Alarm
assignment.
A.
B.
C-22
1
Level II staging shall utilize an area suitable to park, organize, and
coordinate the anticipated response of additional resources.
1.
COMMAND, upon requesting additional resources, shall
inform Dispatch of the designated location of the Level II
staging area.
2.
The 1st unit commander arriving at the Level II staging
area, and without orders to the contrary, shall assume
Staging Area Manager.
3.
Communications to and from the incident scene and the
Level II staging area shall be directly between
COMMAND/OPERATIONS and the Staging Area
Manager. Requests for assignment of units from staging
shall be directed from COMMAND/OPERATIONS to the
Staging Area Manager. No unit shall take any action
except as directed by the Staging Area Manager.
Duties of the Staging Area Manager
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
1.
Identify location by use of warning lights. All other units
shall turn off all lights.
2.
Log in all responding resources and notify
COMMAND/OPERATIONS of available resources.
3.
Park apparatus in such a manner as to avoid congestion and
facilitate movement.
4.
Dispatch
resources
as
directed
by
COMMAND/OPERATIONS. Directions to resources
should be verbal so as not to tie up radio frequencies.
5.
Maintain a level of resources in staging as directed by
COMMAND.
6.
Coordinate with police to insure access and security of the
staging area.
C-23
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
DIVIDING THE INCIDENT SCENE
For the purpose of coordinating operations, the following procedure shall be used when
geographically dividing an emergency incident.
Structures:
C-24
1.
The exterior walls of any structure shall be designated as Divisions and
shall be identified in order by going clockwise beginning with Division A.
2.
Division A shall be defined as that side containing the street address.
Under unusual circumstances the Incident Commander may designate any
side as Division A. All other sides shall be identified in accordance with
Item #1.
3.
Exposures shall be identified by the side of the involved structure to which
it is exposed. Ex: The exposure facing Division C of an involved
structure would be identified as Exposure C.
4.
The interior floor area of a structure shall be know as a Division and shall
be identified by its floor number. Ex: The 5th floor of a structure would
be identified as Division 5. A single story structure would only have a
Division 1.'
5.
The roof shall be designated Roof Division.'
6.
The basement shall be designated Basement Division.'
7.
Unusual areas such as multiple sub-basements, mezzanines, etc. shall be
designated as Divisions but may be identified at the Incident Commander's
discretion.
8.
Personnel assigned to supervise a geographic area shall be designated as,
and identified by, that geographic area. EX: The supervisor of the 5th
floor of a structure would be identified as Division 5. The supervisor of
the interior of a single story structure would be identified as Division 1.
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
Examples of Dividing a Structural Incident :
Example 1: Sides & Exposures
EXPOSURE C
EXPOSURE
B
D
I
V
I B
S
I
O
N
DIVISION
C
D
I
V
I D
S
I
O
N
DIVISION
A
EXPOSURE
D
FRONT/ADDRESS SIDE
Example 2: Involved High-Rise with an exposure on Side B.
ROOF DIVISION
5 th Flo o r
D I VI SI O N 5
4 th Flo o r
D I VI SI O N 4
3 rd Flo o r
D I VI SI O N 3
2 n d F lo o r
D I VI SI O N 2
1 s t F lo o r
D I VI SI O N 1
E xposu re B
B ASE ME NT DIVISION
Involved Structure
C-25
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
Example 3: Single & Multiple story dwellings.
< S in gle S tory
Divi si on 1
< 2n d Flo or
Divi si on 2
<1 st Fl oo r
Divi si on 1
C-26
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
Open Areas:
1.
Geographic areas necessary to maintain command and control should be
established using natural dividing lines such as roads, creeks, rail road
beds, etc., whenever possible.
2.
These established areas shall be designated as Divisions and shall be
identified alphabetically. EX: A brush fire divided into three (3) separate
areas of control would be designated Division A, Division B, & Division
C.
3.
Personnel assigned to supervise a geographic area shall be designated as,
and identified by, that geographic area. EX: The supervisor of the fire
area designated as Division A would be identified as Division A.
Examples of Open Area Sectoring:
Example 1: Brush Fire
Divi si on A
3 Compan ies
RR >
Divi si on B
3 Compan ies
Divi si on C
Hwy >
5 Compan ies
FIRE ARE A
COMMAND
10 A CRE S
B RUSH
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
Example 2: Haz-Mat Incident
E xposu re s: S cho ol s,
Hospi tal s, E tc.
E xposu re s: Homes ,
Hwy.
A pts.
Divi si on A
Divi si on B
Roadway
Spill
W ind Direct ion
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
APPENDIX D:
CALIFORNIA AMBULANCE STRIKE TEAM/
MEDICAL TASK FORCES GUIDELINES
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
NOTE – THIS IS ONE OF MANY EXAMPLES OF AN AMBULANCE STRIKE
TEAM/MEDICAL TEAM GUIDELINES. THE INCLUSION OF THE
GUIDELINE IN THIS COURSE DOES NOT CONSTITUE ENDORSEMENT OF
THIS PARTICULAR GUIDELINE – IT IS USED IN THIS COURSE AS ONE
EXAMPLE OF THE MANY OTHERS THAT ARE AVAILABLE.
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
AMBULANCE STRIKE TEAM/
MEDICAL TASK FORCES
(AST)
GUIDELINES
.................................................................................................................
EMSA #
215
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
STATE OF CALIFORNIA
AMBULANCE STRIKE TEAM/
Medical Task Forces Guidelines
TABLE OF CONTENTS
CONTENTS
PAGE
Part One – BASIC PLAN
FORWARD
4
INTRODUCTION
5
PURPOSE, SCOPE, AND ASSUMPTIONS
6
CONCEPT OF OPERATIONS
8
Team Structure
8
Ambulance/Medical Personnel Qualifications and Training
9
Strike Team/Medical Task Force Leader Qualifications,
Training,
and Job Responsibilities
10
Equipment Standards/Requirements
12
Communications
14
Part Two – DISASTER OPERATIONS: RESPONSE AND
RECOVERY
16
ORDERING/REQUESTING PROCESS
16
ACTIVATION PROCESS
18
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
RESOURCE MANAGEMENT
19
Enroute
19
At Incident
19
PROTOCOLS – ENROUTE AND AT INCIDENT
20
AT INCIDENT SUPPORT
21
DEMOBILIZATION
22
CONTENTS
PAGE
Part Three – ATTACHMENTS
Attachment A -- Master Mutual Aid Agreement
23
Attachment B -- Inter-Region Cooperative Agreement
For Emergency Medical & Health Disaster
Assistance
28
Attachment C -- Regional/State Medical/Health Resources
31
Attachment D -- RIMS Mission/Request Tasking Form
33
Attachment E -- RIMS Resource Order Form
35
Attachment F – Acronyms
36
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
Part One – BASIC PLAN
FORWARD
The “Strike Team” concept (an organized group of
personnel and equipment as applied to an emergency
response) has been in use for many years in California.
The following Ambulance Strike Team/Medical Task
Force (AST/MTF) guidelines and related disaster
response plan adapt this concept to prehospital care
and transportation, ambulances. The lead agency on
this project is the State Emergency Medical Services
Authority (EMSA) in conjunction with representatives
from the following:

C
alifornia Ambulance Association (CAA)

C
alifornia Fire Chiefs Association (CFCA)

E
mergency Medical Services Administrators Association
of California
(EMSAAC)

F
IRESCOPE

G
overnor’s Office of Emergency Services (OES)
For more information on AST/MTF, contact the
following:
Anne M. Bybee
Disaster Medical Specialist
EMSA
1930 – 9th Street
Sacramento, CA 95814-7034
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
(916) 322-4336 x 407
Neil Honeycutt
Fire and Rescue Branch, FIRESCOPE
OES
P.O. Box 419047-9047
(916) 845-8721
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
INTRODUCTION
The EMSA recognized the need to develop a statewide
“mutual aid” system for private or non-fire based
ambulance disaster response soon after the
organization’s creation over 20 years ago. Ambulances
are an important disaster response partner. Beginning
in the early 1980s, EMSA met with CAA officials and
others to discuss the concept of regional coordination for
ambulance deployment in state-declared emergencies.
CAA responded by designating a volunteer regional
coordinator in each of the six mutual aid regions to work
with local private or non-fire based providers to identify
those ambulance units that would be available for
deployment at EMSA’s request. Although the system
existed in concept, it was implemented in only a few
actual disaster response.
The need to develop a coordinated approach to manage
requests, movement and support of ambulances in a
disaster presented itself in several instances in the
ensuing years although none of these events required
the movement of large numbers of vehicles. The Winter
Floods of 1997, however, significantly renewed
coordination as an issue. Many private sector
ambulances responded from various parts of the
Sacramento Valley to assist in the evacuation needs in
Sutter and Yuba Counties. Although the responding
units provided critically needed services, there was a
lack of overall coordination, and this left some with a
concern that “provider” counties were without sufficient
emergency transport resources to address their routine
day-to-day needs.
In an effort to address the mutual aid coordination
issues demonstrated during the floods and to prepare
for the upcoming El Niño Weather Phenomenon the
following winter, EMSA assembled a group of Local
Emergency Medical Service Agencies (LEMSAs), CAA
and OES in late 1997 to develop an interim solution at
the state level. Over the next year and one-half, the
Statewide Ambulance Agreement Committee met to
draft an Inter-County Disaster Ambulance Response
Agreement. Included in the planning effort was
significant work on the composition of private sector
“ambulance strike teams or medical task forces”.
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
The committee was unable to reach resolution on the
issue because of concerns regarding reimbursement for
private or non-fire based ambulance response and
differing opinions as to whether the agreements should
be statewide, between counties (LEMSAs) or between
LEMSAs and individual private or non-fire based
providers. There also exists a need to designate
standard terminology between fire based and non-fire
based ambulance providers. All parties agreed that for
private ambulance services in mutual aid situations, the
payment aspect should be addressed as part of a larger
discussion of mutual aid that needed to be conducted by
State OES. OES convened a mutual aid sub-committee
as part of the Standardized Emergency Management
System (SEMS) Technical Committee but this group
also did not reach consensus on the need for changes in
state wide mutual aid for all public and private
responders. OES then recommended that a Blue
Ribbon Commission be established under the next
Administration to study the issue but to date that has not
occurred.
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
PURPOSE, SCOPE, AND ASSUMPTIONS
In 2002, EMSA confirmed the need for “Ambulance
Strike Teams or Medical Task Force” (Ambulance Strike
Teams have yet to be defined, typed, and accepted
within the emergency response community) and regional
ambulance deployment as a critical resource for
California disaster planning and preparedness. The
EMSA, together with OES, representatives from CAA,
EMSAAC, FIRESCOPE, and CFCA, has worked to
create these guidelines as a vital part of the State’s
response to disasters, including our Homeland Defense
efforts. This disaster medical response system would
process and provide supplemental ambulances and
personnel to "impacted counties" whose resources are
overwhelmed by an emergency.
Ambulance personnel are an extremely valuable service
delivery resource and participate in large-scale disaster
response: medical triage, on-scene medical care,
transportation to hospitals, shelter medical care, etc.
The following assumptions and historical situations were
considered in guiding this initial planning:
1.
Within the first two to eight hours after a mass casualty or
catastrophic event, the community’s primary field medical
response may be from both the fire based and non-fire based
ambulance and medical first responder entities.
2.
Ambulances have self-dispatched in past events. Selfdispatching of any resources can cause negative
consequences.
3.
An organized response within the SEMS framework and
using the Incident Command System (ICS) is superior to a
unorganized response.
4.
To date, ambulance resources are generally managed under
two different systems:
The OES Fire and Rescue Mutual Aid System coordinates
public sector fire service resources including ambulances.
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
Private sector ambulances are coordinated through the
medical/health mutual aid system (Regional Disaster
Medical/Health Coordinators and EMSA).
5.
To provide the best possible response during a major disaster
in our State, it is imperative to move forward with one unified
system that combines the resources from both the fire based
and non-fire based ambulance providers under OES’ disaster
management process.
6.
Management of single resources becomes cumbersome
whereas the supervision of resources organized in strike
team/task force configuration under the incident command
system is a proven manageable model.
These guidelines focus on system organization (policies
and procedures), communications and logistic support
without addressing in detail the issues related to
reimbursement.
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
CONCEPT OF OPERATIONS
Ambulance
(AST/MTF)
Strike
Teams/Medical
Task
Forces
There will be two possible AST/MTF complements, ordered
as
such:
Type I – Advanced Life Support (ALS)* as defined in Title
22 of the Health and Safety Code:
5 ALS ambulances (an approved vehicle and 2 personnel
each, at least one an ALS provider)
1 Team Leader with Vehicle.
Note: ALS Provider could be either a Paramedic or an
EMT-II.
Type II – Basic Life Support (BLS)* as defined in Title 22 of
the Health and Safety Code:
5 BLS ambulances (an approved vehicle and 2 personnel
each, both at least EMT-Basic certified)
1 Team Leader with Vehicle.
Request for AST/MTF should be requested by Type, Kind,
and quantity (i.e. “one Type-I ALS Ambulance Strike Team”,
or “two Type-I ALS Ambulance Strike Teams and one Type-2
BLS Ambulance Strike Team”).
AST/MTF will be ordered from one or more of the six OES
geographical Regions using the closest forces concept.
Ambulance providers in each Operational Area will meet the
minimum requirements for training and equipment according
to the guidelines set out in this document. Agencies not
meeting these minimum requirements will not participate in
out of Operational Area responses.
At any time and based on current resource levels, a Region or
Operational Area has the ability to provide either AST/MTF
or individual ambulances.
Individual ambulances from
different Operational Areas may be formed into Regional
Ambulance Strike Teams or Medical Task Forces.
(FIRESCOPE Field Operations Guide, page 12-11, dated
2004).
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
AST/MTF will be ordered through the State Operations
Center in accordance with SEMS and coordinated by OES
together with their medical/health and public safety partners.
Note:
The ambulance industry uses the term “type” to describe the
size of the ambulance, the body style of the ambulance, or the
number of patient an ambulance can carry. For clarity, it is
suggested that both terms
(i.e. “Type I – ALS”) be used when ordering to avoid any
confusion.
* Advanced Life Support is indicating a paramedic with full
paramedic scope of practice. Basic Life Support is indicating
EMT-1 Basic Scope of Practice.
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
Ambulance/Medical Personnel Qualifications and Training
Minimum Training Requirements:
ICS 100
Preferred Additional Training and Experience:
ICS 200
Hazmat First Responder Operations Course
Basic MCI Field Operations Course
WMD Awareness Course
1 Year EMS Experience
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
AST/MTF Leader Qualifications, Training, and Job
Responsibilities
Minimum Training Requirements:
ICS 100 and 200
Basic MCI Field Operations Training Course (8 hours) –
Using
Mountain Valley EMS Agency Course Guidelines
Strike Team Leader-Ambulance Course (16 hours)
One year Leadership experience in a related field, as
determined by Provider
Once the AST/MTF concept is fully developed, it is
recommended that “training positions” be created to develop
new leadership personnel. It is also recommended that nonfire based personnel gain practical experience by working
with local fire-based Strike Teams/Task Forces.
Preferred Additional Training and Experience:
ICS 300
Hazmat FRO Course
WMD Awareness Course
3 Years EMS Experience
Duties and Responsibilities
The Strike Team/Task Force (ST/TF) Leader-Ambulance is
responsible for:
1. Assuring the safety and condition of the personnel
and equipment.
2. Coordinating the movement of the personnel and
equipment traveling to and returning from an incident.
3. Supervising the operational deployment of the team at
the incident, as directed by the Division/Group
Supervisor, Operations Section Chief, or Incident
Commander.
4. Maintaining familiarity with personnel and equipment
operations, including assembly, response, and direct
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
actions of the assigned units, keeping the team
accounted for at all times.
5. Contacting appropriate Incident personnel with problems
encountered on the incident, including mechanical,
operational, or logistical issues.
6. Ensuring vehicles have adequate communications
capability (see communications section).
7. Maintaining positive public relations during the incident.
8. Prior to deployment, determining mission duration,
special circumstances, reporting location and contact
information.
9. Ensuring completion and submission of ICS documents
for timekeeping and Demobilization (ICS Form 214).
In summary, the ST/TF Leader-Ambulance must have
the capability and experience to manage, coordinate,
and direct the actions of the ambulance crews at a wide
variety of emergency situations. This includes
maintaining all required records, and ensuring the
logistical needs of all personnel are met during the entire
activation of the team.
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
Equipment Standards/Requirements
Personal 72-hour “GO” Pack for AST/MTF Members:

o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
Pack to contain the following:
Reflective Jacket
Extra Uniform, socks & underwear
Safety Boots
Sunglasses
1-Qt. Water Bottle/Canteen with potable water
Raingear
2 MREs
Toilet Paper
Personal Meds & Medical History Documentation
Toiletries & Other Personal Items as needed
Sunscreen
DEET
Sleeping Bag
Hearing Protection (ear plugs)
Photo I.D. and petty cash
Clothing Appropriate for Climate
Ambulance (Minimum requirements in each category)










Equipment and Supplies to meet minimum scope of practice
(ALS or BLS) as determined by Title 13 and Title 22
Most recently published edition of State Thomas Brothers
Map Book
Communications Equipment (TBD)
Fuel & Supply Purchasing (Credit Cards, Cash)
20 Patient Care Reports (PCRs)
20 Disaster Triage Tags
2 pair Work Gloves
2 Safety Helmet with Dust-Proof Safety Goggles
4 HEPA masks and 4 dust filters
2 Flashlights or Headlamps
ST/TF Leader-Ambulance Vehicle



C-46
Equipment and Supplies to meet minimum
requirements in Title 13 for a CHP Support Vehicle
Most recently published edition of State Thomas
Brothers Map Book
Compass
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES

Fuel and Supply Purchasing (Credit Cards,
Cash)













Communications Equipment capable of
communicating with the team enroute and at the
incident.
Cell Phone, batteries and charger
FIRESCOPE Field Operations Guide (FOG)
Manual
2 Sleeping Bags
36 MREs
Potable Water
50 Triage Tags
2 Helmets
2 pairs Work Gloves
2 Flashlights
ICS Forms & Strike Team Leader Kit
100 Patient Care Reports (PCRs)
Personal Pack with contents as described above
Note: When assembling the team and the vehicles, the ST/TF
Leader - Ambulance will make sure there are extra batteries, bulbs,
chargers, etc. as needed for all equipment.
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
Communications
Communications equipment, protocols, etc. vary within
the State. It is the Operational Area (County)
responsibility to ensure that the minimum
communications equipment described below is available
to ambulances, ambulance/medical personnel and
ST/TF Leaders.
There are three distinct communications needs for
AST/MTF:
1) Communications to the home base
All apparatus/units will be equipped with radios and/or
cell phones with the ability to communicate to their base
from any destination in California. Redundant
capabilities are recommended.
2) Communications in-transit
Units within a strike team must be able to communicate
with each other enroute to the incident. Options may
include CALCORD, cell phones, common radio
frequencies, etc.
3) Communications at the scene
A VHF programmable hand-held radio is better suited for
responding to a disaster. It will provide the ability to
maintain communications outside of the vehicle and stay
in contact with the ST/TF Leader-Ambulance. A mobile
radio is recommended in addition to the hand-held
programmable radio, due to the increase in output
power with a mobile unit.
The ST/TF Leader-Ambulance shall be equipped with a
hand-held programmable radio to communicate with the
appropriate Incident Operations staff at the incident
Ambulances will not communicate directly with receiving
facilities. The Medical Communications Coordinator or
Patient Transportation Group Supervisor will conduct all
communications to and from the hospitals.
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
Future Considerations:
1) It is recommended that the State of California investigate
the possibility of acquiring a VHF frequency or
frequencies for Disaster Medical response use. It is also
recommended that we research the availability of
frequencies that are already licensed that could be redirected for this purpose. Calcord is used for much
more than EMS, OES will not authorize the use of
CALCORD other than its current use (fire, law, EMS,
emergency management, public works, etc.)
2) The State of California should also investigate potential
funding sources to purchase a commonality in
communications that would incorporate all Hospitals,
Emergency responders, Strike Team Leaders, and
Ambulance providers (Fire Based and Non-Fire Based).
3) The State needs a communications system that will
allow Medical, Fire, and Law entities to all communicate
with each other during large-scale responses.
4) The State needs to develop local or regional caches of
radios for use in large-scale emergency responses.
Radios should be field programmable and use nonrechargeable batteries. This will allow for programming
radios accordance with the Incident Communications
Plan.
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
Part Two – DISASTER OPERATIONS: RESPONSE
AND RECOVERY
ORDERING/REQUESTING PROCESS
In advance and in preparation for an incident and response,
the Medical Health Operational Area Coordinators
(MHOACs) in each Operational Area will work with
ambulance providers to identify resources, both personnel and
ambulances stocked with equipment as designated. (The
MHOACS will develop a system by which resources in their
area can be identified immediately when needed.) Regional
coordinators, both from the Fire/Law Mutual Aid system and
the Regional Disaster Medical Health Specialists (RDMHS)
will work with the MHOACs at the time of the request(s) to
assemble team(s) for immediate or planned response. NOTE:
The Law Enforcement, Fire and Rescue, and Medical Health
Operational Area Coordinators need to organize a system that
will work for their Operational Area.
The following describes the State of California ordering
system as described in SEMS. This notification and
request process is utilized as an event escalates:
Field Level
At the time the Incident Commander (usually fire or law)
orders ambulance resources the incident will:



Prepare to receive and deploy the requested resources.
Prepare to logistically support those resources.
The local dispatch center will process all orders through
their normal dispatch channels.
Local Jurisdiction


C-50
The Local Jurisdiction will reasonably deplete its own
resources, including any resources received from
neighboring jurisdictions through “move-up,” “back-up,”
or “cover” agreements.
Once it is determined that outside assistance is needed,
will contact the MHOAC or designee to request
additional ambulance resources. They should be
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES

prepared to give standard Resource Request
information (see RIMS Resource/Mission Tasking
Form).
The local jurisdiction should keep the Operational Area
Coordinators informed of the incident status.
Operational Area






Operational Areas with jurisdictional authority should
establish a Single Point ordering system for ambulance
resources, to facilitate all requests for both fire and nonfire ambulance resources.
When responding to a resource request, the MHOAC
should obtain all available information using the RIMS
Resource/Mission Tasking Form.
Operational Areas will relay all requests to the RDMHC
or RDMHS using the RIMS Resource Form.
Operational Areas will notify the OES Fire and Rescue,
Law Enforcement Coordinators when activating the
Medical/Health mutual aid system.
MHOAC will coordinate the dispatch and tracking of
requested resources within the Op Area (see Form
MACS 420).
Each Operational Area will maintain an Emergency
Resource Directory (ERD) listing ALS and BLS transport
resources and qualified Strike Team/Task Force
Leaders.
Region





The RDMHC/RDMHS will receive resource requests,
utilizing the RIMS Resource/Mission Tasking Form
where possible and practical.
The RDMHC/RDMHS will relay request to the MHOACs
within the Region.
The RDMHS will recommend rendezvous points for
mobilization of their regional AST/MTF.
RDMHC/RDMHS will notify the EMSA Duty Officer.
RDMHC/RDMHS will notify the Regional Fire
Coordinator to coordinate and prevent duplication of
resource requests.
State
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES




C-52
The EMSA representative working at the OES State
Operations Center (SOC) will receive requests from
RDMHCs/RDMHSs, utilizing the RIMS
Resource/Mission Tasking Form where possible and
practical.
RDMHC/RDMHS and the EMSA will relay, as
necessary, requests to other regions.
The EMSA will identify available resources and
coordinate inter-regional response.
The EMSA will work with other members of the OES
SOC to provide additional resources.
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
ACTIVATION PROCESS
Until the AST/MTF concept is fully operational,
ambulance providers should identify and train personnel
to participate on Ambulance Strike Teams and MHOACs
should have resource lists available for disaster
response. This would include equipment/supply caches
according to the guidelines in this document. The
following guidelines are offered:
1. Ambulances/medical personnel will report as quickly as
possible to the location requested. (Do not take time to
gather personal equipment/gear and/or additional
ambulance or support vehicle equipment/gear if these
caches are not already pulled prior to the incident.) This
is defined as Immediate Need.
2. EMSA will provide agency representatives to work with
the fire based Strike Team Leaders in coordinating
teams and getting them to the incident when trained
Strike Team/Task Force leaders are not available.
3. EMSA agency representatives, if requested and
assigned, will respond to the incident and report to the
Liaison Officer assigned to the Incident Command.
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
RESOURCE MANAGEMENT
Enroute
All units will contact the ST/TF Leader-Ambulance by
radio or phone while enroute to the incident. The
decision to travel together will depend on the location of
individual ambulances at the time of dispatch.
At the rendezvous or assembly point, the ST/TF LeaderAmbulance will be responsible for the following:
1) Introducing team members
2) Briefing the team members on current incident
conditions, safety issues and potential assignments.
3) Determining response route, considering time of day,
traffic, food, and fueling stops.
4) Making and communicating travel plan (who leads, who
“brings up the rear”, etc. Identifying a travel radio
frequency for enroute communications.
5) Conducting a checklist assessment of the AST/MTF
readiness and equipment availability.
6) Notifying the jurisdictional dispatch center of status and
ETA to incident.
If an ambulance unit is unable to continue to respond for
any reason (mechanical failure of the ambulance, illness
of team members, etc.) the ST/TF Leader-Ambulance
shall contact their ordering point to advise and request
replacement of the unit.
Each ambulance crew shall maintain responsibility for
their personal equipment, the ambulance, and the
medical equipment/supplies. Any problems should be
reported to the ST/TF Leader-Ambulance. Ambulances
and team members are not considered incident
resources until the team has checked in at the incident.
At The Incident
The AST/MTF shall report to and check in at the
incident.
ST/TF Leader-Ambulance will be responsible for the
following:
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
1)
2)
3)
4)
5)
6)
7)
Initiating and use ICS Form 214 (Unit Log) for the entire
incident.
On arrival providing information, including resource order
and request #, for check-in (ICS form 211).
Receiving Incident Briefing (IAP, Commo Plan and Medical
Plan)
Briefing Team Members on Incident and their assignments.
Reporting for Line Assignment(s) or to a Staging Area as
directed.
Obtaining orientation to hospital locations (local information
and ICS 206)
Determining preferred travel routes and brief team members.
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
PROTOCOLS – ENROUTE AND AT INCIDENT
During a response into another California jurisdiction,
and when requested as part of an ALS ambulance, a
paramedic may utilize the scope of practice for which
s/he is trained and accredited according to the policies
and procedures established by his/her accrediting Local
Emergency Medical Services Agency (LEMSA) (Title
22 of the Health and Safety Code, section 100166).
If the ST/TF Leader-Ambulance provides any medical care
during the incident, they will utilize the scope of practice for
which s/he is trained and accredited according to the policies
and procedures established by his/her accrediting LEMSA.
EMT-Basic personnel functioning as members of an
AST/MTF out of their local jurisdiction are authorized to
perform any skills in the State EMT-Basic scope of
practice (as outlined in Title 22) and any extended scope
of practice skills in which they are trained and authorized
by their home LEMSA.
EMS personnel may not overextend their medical scope
of practice regardless of direction or instructions they
may receive from any authority while participating on an
AST/MTF.
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NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
AT INCIDENT SUPPORT
The AST/MTF reporting to the scene of a disaster or
other incident should not expect support services to be
in place in the early stages of the incident. For this
reason all AST/MTF are expected to be self-sufficient for
up to 72 hours. The location and magnitude of the
disaster will determine the level of support services
available. The ST/TF Leader-Ambulance may have to
utilize commercial services for food, fuel, and supplies
until logistical services are established. Obtaining
replacement medical supplies during the first days of a
disaster may also be difficult. (Operational Area, with
the assistance of the MHOAC, may be able to provide
medical re-supply services.)
The facilities, services, and material at an incident are
typically provided by the Logistics Section. ST/TF
Leader - Ambulance will contact their Division Group
Supervisor for instructions on accessing these services.
The Logistics Section consists of the following units:
1)
2)
3)
4)
5)
6)
Communications Unit
Medical Unit
Food Unit
Supply Unit
Facilities Unit
Ground Support Unit
The ST/TF Leader-Ambulance is expected to attend all
operational shift briefings and keep all personnel on the
team informed on conditions. If the individual units of
the AST/MTF are assigned to single resource functions,
i.e., patient transportation, triage, or treatment, the
ST/TF Leader-Ambulance will make contact with the
personnel at least once during each Operational Period.
If possible, all units in an AST/MTF will stay together
when off-shift unless otherwise directed by the ST/TF
Leader-Ambulance. At minimum, all team members will
remain in constant communications.
Until incident facilities are established each ST/TF
Leader-Ambulance will coordinate with their respective
support services to provide facilities support to the
AST/MTF.
C-57
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
DEMOBILIZATION
The Planning Section is responsible for the preparation
of the Demobilization Plan to ensure that an orderly,
safe, and cost effective movement of personnel and
equipment is accomplished from the incident. The
Logistics Section is responsible for the implementation
of the plan.
Demobilization and release will take place in accordance
with the Incident Demobilization Plan and the ICS Form
221. At no time shall a crew or individual team member
leave without receiving departure instructions from their
ST/TF Leader-Ambulance.
Teams should obtain necessary supplies to assure that
the ambulances leave in a “state of readiness” whenever
possible. If unable to replace lost, used or damaged
equipment, the ST/TF Leader-Ambulance shall notify
their Incident Agency Representative prior to leaving the
incident. The ST/TF Leader-Ambulance will return all
radios and equipment on loan from the incident.
Timekeeping records will be recorded and shall be
submitted to the appropriate personnel at the incident
prior to departure.
All AST/MTF personnel will receive a debriefing from the
ST/TF Leader-Ambulance prior to departure from the
incident.
Vehicles will be inspected for safety by the Ground
Support Unit prior to departure from the Incident. Any
problems will be communicated to both the ST/TF
Leader-Ambulance and OES Agency Representative.
ST/TF Leader-Ambulance will review return travel
procedures with the Strike Team/Task Force.
The Incident will notify MHOACs and RDMHS of
ambulance release time, travel route, and estimated
time of arrival back at home base.
The AST/MTF is still a team upon return, and may be
reactivated at any time.
C-58
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
Part Three – Attachments
Attachment A – MASTER MUTUAL AID AGREEMENT
C-59
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
C-60
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
C-61
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
C-62
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
C-63
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
C-64
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
Attachment B – INTER-REGION COOPERATIVE
AGREEMENT FOR EMERGENCY MEDICAL AND
HEALTH DISASTER ASSISTANCE
CONTRACT #________________
INTER-REGION COOPERATIVE AGREEMENT
FOR EMERGENCY MEDICAL AND HEALTH
DISASTER ASSISTANCE
This Agreement is made and entered into by and between the
signatory Counties of the State Office of Emergency Services
(OES) Mutual Aid Region I and Region VI.
WHEREAS, there exists a great potential for a
medical/health calamity capable of producing mass casualties
that overwhelm local ability to contain and control; and
WHEREAS, in preparation for this threat, the signatories of
this document, singularly and severally, agree to assist any
participating County consistent with the OES Region I and
Region VI Medical Health Mutual Aid Plans and the
Standardized Emergency Management System by providing
such assistance as possible without compromising each
County’s own jurisdiction’s medical/health responsibility; and
WHEREAS, the OES Region I and Region VI Disaster
Medical/Health Coordinators, selected in accordance with the
OES Region I and Region VI Medical Mutual Aid Plan, are
responsible for regional coordination of medical/health mutual
aid within OES Region I and Region VI when so requested by
an affected County of Region I or VI; and
WHEREAS, each County is desirous of providing to the
others a reasonable and reciprocal exchange of emergency
medical and health services where appropriate; and
WHEREAS, this Agreement is made and entered into by and
between the Counties for those agencies within their
C-65
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
respective jurisdictions, both public and private, capable of
providing emergency medical and health support; and
WHEREAS, each County has emergency medical personnel,
equipment, and supplies which can be made available, in the
spirit of cooperation, under this Agreement; and
WHEREAS, each County enters into this Agreement for the
prudent use and reimbursement of emergency medical and
health services including, but not limited to, personnel,
equipment, and supplies utilized in assisting any party
participating in this Agreement.
NOW Therefore, it is agreed as follows:
C-66
1.
The Operational Area Medical/Health Coordinators, the
Health Officers, or authorized designee from the affected
County within OES Region I or Region VI may request
emergency medical health services through the OES Region I
or Region VI Disaster Medical/Health Coordination System in
accordance with the Region Plan and the Standardized
Emergency Management System.
2.
Parties to this Agreement shall be financially responsible for
those emergency medical and health personnel and supplies
which they request. In responding to the request of an
affected County identified in this Agreement or to the region
as a whole, each of the assisting Counties shall provide
emergency medical and health assistance to the extent it is
reasonably available and to meet the needs of the requesting
County.
3.
Financial responsibility of the requesting parties to this
Agreement shall be limited to costs for personnel, supplies,
and equipment confirmed by their request for assistance.
Accurate records and documents related to mutual aid requests
hereunder shall be maintained by both the parties that provide
and request mutual aid assistance.
4.
Release or reassignment of mutual aid, personnel, supplies,
and equipment between the Counties in OES Region I and
Region VI, shall be coordinated through the requesting region.
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
5.
Details as to amounts and types of assistance available,
methods of dispatching same, communications during the
mutual aid event, training programs and procedures, and the
names of persons authorized to send and receive such
requests, together with lists of equipment and personnel which
may be utilized, shall be developed by the Health Officers of
each County. Such details shall be provided to the signatories
of this document.
6.
The requesting County is the controlling authority for use of
emergency medical and health within its jurisdiction. In those
instances where the assisting operational area providers arrive
on scene before the jurisdictional area, the assisting personnel
will take the necessary action dictated by the situation.
7.
Within one hundred eighty days (180) following its provision
of services and supplies for a disaster or calamity, an assisting
County shall present its billing and a precise accounting of its
costs for the incident to the requesting County. The
requesting County shall pay this billing within ninety (90)
days of its receipt unless other arrangements are made
between the assisting and requesting Counties.
8.
Any party to this Agreement may terminate its participation in
this Agreement upon ninety (90) days advance written notice
to the other parties.
9.
The requesting County agrees to indemnify and hold harmless
the assisting County and their authorized agents, officers,
volunteers and employees against any and all claims or
actions arising from the requesting County’s negligent acts or
omissions and for any costs or expenses incurred by the
assisting County or requesting County on account of any
claim thereof. The assisting County agrees to indemnify and
hold harmless the requesting County and their authorized
agents, officers, volunteers and employees against any and all
claims or actions arising from the assisting County’s negligent
acts or omissions on account of any claim thereof.
10.
The body of this Agreement expresses all understandings of
the parties concerning all matters covered and shall constitute
the total Agreement, whether by written or verbal
understanding of the parties, their officers, agents or
employees.
C-67
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
No change or revision shall be valid unless made in the form
of a written amendment to this Agreement which is formally
approved and executed by all the participating parties.
11.
This Agreement shall in no way affect or have any bearing on
any preexisting mutual aid contracts between any of the
Counties for fire and rescue services. To the extent an
inconsistency exists between such contract and this
Agreement, the former shall control and prevail.
12.
This Agreement does not relieve any of the Counties from the
necessity and obligation of using its own resources for
furnishing emergency medical and rescue services within any
part of its own jurisdiction. An assisting County’s response to
a request for assistance will be dependent upon the existing
emergency conditions with its own jurisdiction and the status
of its resources.
13.
This Agreement shall not be construed as, or deemed to be an
agreement for the benefit of anyone not a party hereto, and
anyone who is not a party hereto shall not have a right of
action hereunder for any cause whatsoever.
14.
Notices hereunder shall be sent by first class mail, return
receipt requested, to the Operational Area Disaster Medical
Health Coordinator who represents the various signatory
agencies.
IN WITNESS WHEREOF, the Board of Supervisors of each
County has caused this Agreement to be subscribed on their
behalf by their respective duly authorized officers, on the day,
month, and year noted.
C-68
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
Attachment C – REGIONAL RESOURCES
A. AST/MTF Organization Committee
The following table shows members involved in designing the AST/MTF guidelines in the State of California.
AMBULANCE STRIKE TEAM
LAST
NAME
FIRST
ORGANIZATION
Bybee
Anne
State EMSA - Lead
Agency
Petrick
Doug
CAA
EMSAAC
(916)
563-0600
(800)
913-9142
(805)
688-6550
(925)
258-4599
(916)
735-0154
(925)
646-4690
(714)
986-3930
(559)
445-3387
(661)
322-8741
(323)
838-2212
(925)
454-2301
(323)
890-7500
/7545
(209)
529-5085
EMSAAC
(530)
Ridenour
James
CAA
Eaglesham
John
Lee
Darrell
CAA
CA Fire Chiefs
Assn
Nevins
David
CAA
Center
Barbara
EMSAAC
Ranger
Brian
CAA
Jones
David
EMSAAC
McGinnis
Tom
Metro
Mike
Bramell
Tom
CAA
CA Fire Chiefs
Assn
CA Fire Chiefs
Assn
Gunter
Carol
EMSAAC
Buchanan
Masterman
Doug
Larry
OFFICE
PHONE
916-3224336
FAX
E-MAIL
916-3234898
abybee@emsa.ca.gov
Doug_Petrick@amr-ems.com
(209)
527-4582
james_ridenous@amr-emsa.com
john_eaglesham@amr-ems.com
dlee@mofd.org
(916)
735-0161
(925)
646-4379
(714)
792-3650
(559)
445-3205
(661)
334-1541
323-8690311
(925)
454-2367
davnevins@aol.com
bcenter@hsd.co.contra-costa.ca.us
BrianRanger@emergencyambulance.com
djones@fresno.ca.gov
mcginnist@hallamb.com
mmetro@lacofd.org
tbramell@lpfire.org
cgunter@dhs.co.la.ca.us
(209)
529-1496
(530)
dbuchanan@mvemsa.com
lmasterman@norcalems.org
C-69
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
229-3979
Marquis
Jim
OES Fire &
Rescue Branch
Honeycutt
Neil
OES; FIRESCOPE
Madison
Steve
CAA
Osur
C-70
Michael
EMSAAC
(916)
996-5212
(916)
231-0290
(209)
522-0500
(909)
358-5029
229-3984
jim_marquis@oes.ca.gov
(916)
364-2810
neil_honeycutt@oes.ca.gov
smadison@pjflaw.com
(909)
358-5160
mosur@co.riverside.ca.us
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
B. Regional and State Medical/Health Resources
Region
Region I
RDMHC
Carol Gunter
Los Angeles Dept. of Health
5555 Ferguson Dr., Suite 220
Commerce, CA 90022
(323) 890-7500 /7545
FAX: (323) 890-8732
cgunter@dhs.co.la.ca.us
P. Michael Freeman
Los Angeles County Fire Dept.
1320 North Eastern Avenue
Los Angeles, CA 90063-3294
(323) 881-2401
Fax: 323-265-9948
After Hours: (323) 881-2455
pfreeman@fire.co.la.ca.us
William Walker, M.D.
Contra Costa County HSD
20 Allen Street
Martinez, CA 94553-3191
(925) 370-5003
FAX: (925) 370-5099
After Hours: (925) 646-2441
wwalker@hsd.co.contra-costa.ca.us
Barbara Center
1340 Arnold Dr. #126
Martinez, CA 94553
(925) 646-4690
FAX: (925) 646-4379
After Hours: (925) 646-2441
bcenter@hsd.co.contracosta.ca.us
Wayne Mitchell
CDF-Northern Region
135 Ridgeway Avenue
Santa Rosa, CA 94501
(707) 576-2900
Fax: (707) 576-2574
After Hours: (707) 967-4206
wayne.mitchell@fire.ca.gov
Larry Masterman
43 Hilltop Drive
Redding, CA 96003-2807
(530) 229-3979
FAX: (530) 229-3984
After Hours: (530) 247-4409
pct@snowcrest.net
Alan Stovall
CDF – Northern Region
6105 Airport Road
Redding, CA 96002
(530) 224-2445
Fax: (530) 224-2496
After Hours: (530) 224-2466
alan.stovall@fire.ca.gov
Randy Linthicum
San Joaquin County EMS Agency
P.O. Box 1020
Stockton, CA 95201
(209) 468-6724
FAX: (209) 468-6725
After Hours: (209) 983-7907
rlinthicum@co.san-joaquin.ca.us
William “Hank” Weston
Grass Valley Fire Department
125 East Main Street
Grass Valley, CA 95945
(530) 274-4370
Fax: (530) 274-4374
After Hours: (530) 273-3222
fire@cityof.grass-valley.ca.gov
Region III
Region IV
OES Reg. FIRE Coordinators
Jim Eads
Los Angeles County EMS Agency
5555 Ferguson Drive Ste 220
Commerce, CA 90022
(323) 890-7519
FAX: (323) 869-8065
After Hours: (818) 751-1332
jeads@dhs.co.la.ca.us
After Hours: (323) 887-5381
Region II
RDMHS
Richard Buys, M.D.
San Joaquin County
PO Box 1020
Stockton, CA 95201
(209) 468-6818
FAX: (209) 468-6725
After Hours: (209)468-7052
richnb@softcom.net
C-71
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
Region V
David Hadden, M.D.
Fresno/Kings/Madera EMS Agency
P.O. Box 11867
Fresno, CA 93775
Business (559) 445-3387
FAX: (559) 445-3205
After Hours: (559)456-7838 (Ask for
EMS Agency On-Call)
DAVIDHADDEN@FRESNO.CA.GOV
Randy Linthicum
San Joaquin County EMS Agency
P.O. Box 1020
Stockton, CA 95201
(209) 468-6724
FAX: (209) 468-6725
After Hours: (209) 983-7907
rlinthicum@co.san-joaquin.ca.us
Tim Turner
CDF – Southern Region
1234 E. Shaw Avenue
Fresno, CA 93710-7899
(559) 222-3714
Fax: (559) 222-3409
After Hours: (559) 292-5271
tim.turner@fire.ca.gov
Region VI
Thomas Prendergast, Jr., M.D.
San Bernardino County
351 N. Mountain View Ave.
San Bernardino, CA 92415
(909) 387-6219
FAX: (909) 387-6228
After Hours: (909)356-3805
tprendergast@dph.sbcounty.gov
Stuart Long
515 N. Arrowhead Avenue
San Bernardino, CA 92415-0061
(909) 388-5832
FAX: (909) 388-5825
After Hours: (909)356-3805
slong@dph.sbcounty.gov
Fred H. Batchelor
CDF – Southern Region
2524 Mulberry Street
Riverside, CA 92501
(909) 782-4240
Fax: (909) 782-4900
After Hours: (909) 320-6179
fred.batchelor@fire.ca.gov
State
EMSA
1930 – 9th Street
Sacramento, CA 95814
Duty Officer Pager: (916) 535-3522
FAX: (916) 323-4898
C-72
OES Headquarters
3650 Schriever Avenue
Rancho Cordova, CA 95741
24 Hour: (916) 845-8911
Fax: (916) 845-8910
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
Attachment D – RIMS Mission/Request Tasking Form
RIMS -- Mission/Request Tasking Form
1. Request Date/Time:
2. Operational Area (county):
3. Related Event or Disaster (if any):
4. Related Incident Name:
5. Mission Type:
6. Desired Arrival Date/Time:
7. Threat:
8. Situation
9. Requested Mission:
10. Incident/Project Order Number:
11. AFRCC Incident Number:
12. AFRCC Mission Number:
Detailed Resource List:
Request
#
Type Resource:
Remarks
b.
Q
ua
nti
ty
c.
12a.
13a.
b.
c.
d.
14a.
b.
c.
d.
15a.
b.
c.
d.
16a.
b.
c.
d.
d.
C-73
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
17a.
b.
c.
d.
18. Requesting Agency:
19. Service/Support Supplier:
a. Name:
b. Position:
a. Fuel:
b. Meals:
c. Agency:
d. Phone #:
c. Water:
d. Maintenance:
e. Fax #:
f. Alt#:
e. Lodging:
f. Misc.:
20. Reporting Location
21. Forwarding Agency:
a. Address:
b. Map Ref.:
c. Lat/Long:
a. Name:
b. Position:
c. Agency:
d. Phone #:
22. OES Coordinator:
24. Special Instructions: (?Duration:
)
Revised: October 1, 2002
C-74
e. Fax #:
f. Alt#:
23. Responding Agency:
25. Responsible OES Branch/Region:
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
Attachment E – RIMS Resource Order Form
Resource Order Form
RESOURCE ORDER
INITIAL
DATE/TIME
5. DESCRIPTIVE LOCATIOIN/RESPONSE AREA
2. INCIDENT/PROJECT NAME
6. SEC.
TWN
3. INCIDENT/PROJECT ORDER NUMBER
RNG
BASE MDM
4. OFFICE REFERENCE NUMBER
8. INCIDENT BASE/PHONE NUMBER
9. JURSIDICTION / AGENCY
10. ORDERING OFFICE
11. AIRCRAFT INFORMATION
BEARING
12. Request #
Order
Date/Time
LAT.
DISTANCE
From/To
QTY
BASE OR OMNI
LONG.
AIR CONTACT
RESOURCE REQUESTED
FREQUENCY
Needed
Date/time
Deliver To:
GROUND CONTACT
From/ To
Time
FREQUENCY
Agency ID
RELOAD BASE
RESOURCE ASSIGNED
OTHER AIRCRAFT/HAZARDS
ETD/ETA
RELEASED
└
└
└
└
└
└
└
TIME/ET
└
└
└
└
└
└
└
C-75
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
└
└
└
└
└
└
13.
Request #
ORDER RELAYED
Date
Time
ACTION TAKEN
To / From
MACS FORM 420
C-76
Request #
Date
ORDER RELAYED
Time
To / From
ACTION TAKEN
└
└
└
└
└
└
INCIDENT COMMAND SYSTEM
Attachment F - ACRONYMS
ALS
care)
AST/MTF
BLS
CAA
CHP
MMA
EMS
EMSA
EMSAAC
EMT-B
EMT-II
EMT-P
FOG
duties/responsibilities)
FRO
GPS
HAZMAT
HO
ICS
LEMSA
MCI
MHOAC
MRE
MST
Advanced Life Support
(indicates EMT-Paramedic or EMT-II level of
Ambulance Strike Team/Medical Task Force
Basic Life Support
(indicates EMT-Basic level of care)
California Ambulance Association
California Highway Patrol
Master Mutual Aid
Emergency Medical Services
Emergency Medical Services Authority
Emergency Medical Services Administrators
Association of California
Emergency Medical Technician – Basic
Emergency Medical Technician – II
(intermediate ALS provider)
Emergency Medical Technician – Paramedic
Field Operations Guide
(Incident Command System Guide to functions,
reporting structure, and specific
Field Response Operations
Geo Positioning System
(satellite tracking system)
Hazardous Materials
Health Officer
Incident Command System
Local Emergency Medical Services Agency
Mass Casualty Incident
Medical Health Operational Area Coordinator
(County level representative)
Meals Ready to Eat
Management Support Team
(provides Command & Control as well as
logistical
support to the teams/missions under its
authority)
OES
Op Area
PCR
RDMHC
RDMHS
RIMS
(Governor’s) Office of Emergency Services
Operational Area (County)
Patient Care Report
Regional Disaster Medical Health Coordinator
Regional Disaster Medical Health Specialist
Response Information Management System
C-77
NIMS--INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
SEMS
(created by OES for information dissemination)
Standardized Emergency Management System
(the organizational structure for
requesting/supplying
ST/TF Leader-Ambulance
VHF
C-78
disaster resources within California)
Strike Team/Task Force Leader-Ambulance
Very High Frequency
NIMS-INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
APPENDIX D:
FIELD OPERATIONS GUIDE
D-1
NIMS-INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES
D-2