The Incident Command System (ICS): Control and Coordination
of Mass Casualty Events
- The Incident Command System assumes that the first public
safety official (law enforcement, fire, medical) to arrive on
the scene of an emergency becomes the "incident commander"
who takes charge of the scene, assesses the priorities, and requests
additional first responders. When sufficient additional personnel
arrive, the incident command role may be transferred to a command
officer from a law enforcement, fire, or emergency medical unit.
The nature of the emergency often determines which agency
or individual assumes ultimate command of the event. For example,
an incident in which a fire and/or rescue operation is indicated,
and mass casualties are present, will be turned over to fire commanders.
Law Enforcement and Emergency Medical Services then assume a supporting
role. The experience and affiliation of the public safety
official often determines the appropriateness of their assuming
the Incident Commander position.
Communications and Coordination: The Incident Command Vehicle
- The Incident Commander will generally operate from a "command
post" in which he is provided with access to radio communications
on a variety of channels (law enforcement, fire, emergency medical
services, etc.). A Communications Officer (CO) serves to coordinate
these operations and to keep the Incident Commander and Operations
Branch officers apprised of status changes, additional requests,
and contact with Central Communications Centers where additional
resources can be requested (such as helicopter ambulances, ground
ambulances, fird post by supplying live video
and sound of various areas of the disaster or mass casualty incident
to the command post. Incident command staff can then make better
judgments on deployment of resources. Videotaped documentation
of the event is also available for legal and administrative follow-up
after the event.
Scene Safety: Universal Precautions
- All first responders who may have contact with bleeding injured
victims will wear rubber gloves, and may also wear face masks
and goggles to prevent transmission of blood-borne diseases such
as Hepatitis B, and Human Immunodeficiency Virus (HIV) which causes
A.I.D.S. Other safety equipment is used by various responders
to prevent personal injury such as firefighter turn-out gear (heavy
bunker coats, boots, trousers, helmets, eye protection, self-contained
breathing apparatus). "Chocks" (wooden railroad ties)
are used to stabilize vehicles in insecure locations to prevent
injury to victims and rescuers from sliding or movement during
rescue and extrication procedures.
The Victim Advocate: support for friends, relatives, and rescuers
- A Liaison Officer (LO) serves to interface with other non-public
safety groups or individuals required for support such as Victim
Advocate Counselors for relatives and friends of victims, who
may attend the scene or be contacted if a relative is injured
in the event. Rescuers/first responders can also become
"victims" in a mass casualty event, either becoming
injured or ill from effects of their physical exposure to hazardous
materials, or from "post traumatic stress" caused by
exposure to many seriously or fatally injured victims. Much attention
is now given to scene safety education and accident prevention
for first responders. Additionally, victim advocates assist by
counseling first responders following such an event to minimize
the psychological effects of the exposure.