Incident Management and Special Operations

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Comment by Erich M. Weldon on August 23, 2011 at 12:18am

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Comment by Katherine Fuchs on December 14, 2009 at 2:44am

Thank you Alan and Joffry. If I ramble a bit, I apologize. I'm a little tired and I speak for how things work or should work here in NYC. In the end, the objectives are the same no matter where you practice: safety, rapid and accurate triage of patients, rapid movement of critically ill or injured patients from the scene. To accomplish them establishing a Transportation Group, which in our National Incident Management System includes staging, is necessary. I'll guess that this is functionally similar to your "Parking and Casualty Clearing" group.

The first arriving ambulance crew confirms the incident, provides some initial information including a preliminary staging area, best access, the number of patients, if known, and begins triage. Treatment areas are established to address bottlenecking of patients when necessary.

Among other things, the incident type, location, geography, size, occupancy, hazards, access and egress, the number of patients and their triage categories will dictate the number and types of resources requested and responding. Addtional resources need to be assigned to move patients or casualties from point A to point B. Large numbers of resources converging on an incident scene require supervision to manage the safety, span of control and accountability of those resources.

We have many names for levels of supervision and the resources that they oversee based on function or geography, like group and division supervisors: branch directors; section chiefs; area managers; unit leaders. The Incident Commander usually operates on the scene at most of our multiple casualty incidents: structure fires, collapses, multiple vehicle collisions, hazmat, etc; not at a remote location.

In the event of another terror attack, the command function will be performed from a remote location as should the other general staff functions of planning, logistics and finance.

Drills, simulations, large scale exercises, training with peers from other agencies, provide opportunities to develop relationships. Those opportunities familiarize all involved with core competencies and responsibilities dictated by the agencies, City and State. Lately, we've had several interagency exercises. Besides the day to day incidents, we often interact with other agencies at special events like the NYC Marathon, 5 Boro Bike Tour, New Year's Eve and July 4th Celebrations. Planning generates an event action plan for every special event.

Have a good nite, or good morning in your neck of the woods. Be safe.

Kathy

Comment by Alan Payne on December 9, 2009 at 2:55am

Katherine, Gold has the Strategic command, Silver has tactical command and the Bronze officers aare at the operational command, Like Holland the first crew would become Silver until released by a duty officer, the next crews would become, Triage, Parking and Casualty Clearing. The silver officers from Fire, Police & Ambulance work together to carry out the strategic goal set by the Gold officers usually the Chief or representative who REMAIN at Headquarters and do not go to scene, this is to ensure that not only this incident is being dealt with but also that we have a business as normal approach to all of our other calls

Comment by Joffry van Grondelle on December 9, 2009 at 1:50am

Also In The Netherlands we got the ''first ambulance approach'' as triage and initial oordination method at all incidents where EMS is involved, the EMS duty officer will follow soon and take command, the crew of the first ambulance can assist the EMS duty officer in coordinating and staging/triage the incident. This approach suits well since 10 years. All the coordinating persons at the scene wear the colour green in tehir jackets and the first arriving emergency and coordination cars emit a green flashing light so they can be recognized with their coordination role.

Comment by Katherine Fuchs on December 9, 2009 at 12:44am

Alan,

Can you elaborate upon or define what you mean by "gold, silver, and bronze?" Thanks and welcome to the group.

Kathy

Comment by Alan Payne on December 1, 2009 at 1:12am

I think EMS command comes easy to those of us in a 3rd service, with no disrespect to Fire or Police I would not have them command my staff at a large scale incident and neither would I as an ambulance manager want to command there staff. EMS has it's own role and in London we have our own duty managers on the road 24/7 who take command at any large scale incidents, The first ambulance on scene always adopts the role of incident command in the initial stage until relieved.

It is tried and tested and works very well, but that is because all 3 agencies use the same, Gold, silver, bronze approach to incident management.

Comment by Katherine Fuchs on November 8, 2009 at 11:29pm

Joffry,

Welcome to the group.

Kathy

Comment by Joffry van Grondelle on November 7, 2009 at 3:01am

Great to share info with colleagues on this ems topic.
I am a Ambulance RN from the Netherlands.

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