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 (I.C.V.)

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.

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