9/10/2012. Chapter 62. Learning Objectives. Learning Objectives (Cont d) EMS Operations Command and Control

Transcription

1 Chapter 62 EMS Operations Command and Control 1 Learning Objectives Explain the need for an incident management system and an incident command system in managing EMS incidents Compare command procedures used at small-, medium-, and large-scale medical incidents Define the term multiple-casualty incident 2 Explain the local and regional threshold for establishing command and the implementation of the incident management system, including the threshold multiple-casualty incident declaration Define the term disaster management 3 1

2 Describe the functional components of the incident management system in terms of command, finance, logistics, operations, and planning Describe the role of the paramedic and EMS system in planning for multiplecasualty incidents and disasters 4 Describe the role of table-top exercises and small and large drills in preparation for multiple-casualty incidents List the physical and psychological signs of critical incident stress Describe the role of critical incident stress management sessions in multiple-casualty incidents 5 Describe the role of command Compare singular and unified command and describe when each is most applicable Describe methods and the rationale for identifying specific functions and leaders for these functions in an incident command system 6 2

3 Describe the role of command posts and emergency operations centers in multiplecasualty incidents and disaster management Describe the need for and procedures for transfer of command 7 Describe the essential elements of scene size-up when arriving at a potential multiple-casualty incident Describe modifications of telecommunications procedures during a multiple-casualty incident 8 List and describe the functions of groups and leaders in an incident command system pertaining to EMS incidents: Safety Logistics Rehabilitation Staging Treatment Triage Transportation 9 3

4 List and describe the functions of groups and leaders in an incident command system pertaining to EMS incidents: Extrication or rescue Disposition of deceased (morgue) Communications Describe the role of the physician at multiple-casualty incidents 10 Describe the need for and techniques used in tracking patients during multiplecasualty incidents Describe techniques used to allocate patients to hospitals and track them 11 List and describe essential equipment to provide logistical support to multiplecasualty incident operations, including airway, respiratory, and hemorrhage control; burn management; and patient immobilization Define and describe the principles of triage 12 4

5 Given a list of 20 patients with various multiple injuries, determine an appropriate triage priority with 90% accuracy Define primary triage and secondary triage Describe when primary and secondary triage techniques should be implemented 13 Describe the START method of initial triage Given color-coded tags and numeric priorities, assign the following terms to each: immediate, delayed, hold, deceased 14 Introduction Command and control Formalizes crucial process Maintains span of control Creates single incident commander Must have command and control for large incidents 15 5

6 Introduction (Cont d) Systems provide guidance and structure Incident command system (ICS) National Incident Management System (NIMS) Terminology varies between systems Both are flexible and adaptable Incidents increase and decrease in size Local, state, tribal, and federal governments required to use NIMS NIMS provides common language and terminology 16 Introduction (Cont d) Plan should include: Mitigation Preparedness Response Recovery 17 Introduction (Cont d) Critical components Uniform, consistent set of rules Common language Common approach Incident divided by geography or function Officers titled by their area or function 18 6

7 Introduction (Cont d) Major functional areas Command Finance Logistics Operations Planning Safety Not all always required 19 Introduction (Cont d) Standard operating procedures Each agency should have its own Helps everyone know their role Should be trained in them before incident Preplanning Large-scale events are infrequent Ongoing training maintains readiness 20 Introduction (Cont d) Physical, mental health of responders Often overlooked and mismanaged Large-scale events have profound impact on responders 21 7

8 Basic Elements of Incident Command System CFLOPS Command Finance Logistics Operations Planning Safety 22 Basic Elements of Incident Command System (Cont d) 23 Basic Elements of Incident Command System (Cont d) Command Incident commander is boss Ultimate responsibility for incident All incidents have someone in charge Singular command Unified command 24 8

9 Basic Elements of Incident Command System (Cont d) Finance Seldom used Accounting and monitoring of expenses Important for reimbursement Logistics Support function 25 Basic Elements of Incident Command System (Cont d) Operations Carries out tactical objectives of IC Directs front-end operations Participates in planning Modifies action plan Accounts for personnel 26 Basic Elements of Incident Command System (Cont d) Planning Staff function at large incidents Provides IC with past, present, and future information Maintains resource and status reports Safety Sole function is prevention of unsafe actions 27 9

10 Basic Elements of Incident Command System (Cont d) Additional components Large incidents Public information officer (PIO) Liaison 28 Basic Elements of Incident Command System (Cont d) 29 Role of Incident Commander Incident command is a role, not a person Requires quiet, safe workspace Provides visibility of incident, workers Larger incident, move to emergency operations center 30 10

11 Role of Incident Commander (Cont d) Role of IC Initial scene size-up Closed incident (stable incident) Open incident (unstable incident) Expanding or likely to expand Possible additional patients, hazards, damages 31 Role of Incident Commander (Cont d) Role of IC Incident priorities Life safety Incident stability Property conservation Request additional help sooner than later Avoid excessive radio transmissions Assign sectors 32 Role of Incident Commander (Cont d) Triage Conducts thorough assessment of scene Identifies patients Categorizes by severity Extrication and rescue Performed first on those triaged as most severe Coordinates extrication and rescue Determines need for specialized equipment 33 11

12 Role of Incident Commander (Cont d) Treatment Coordinates treatment of patients Ensures patients delivered top transport area Transportation Coordinates movement of patients to medical facilities Tracks destination of patients 34 Role of Incident Commander (Cont d) Staging Manages area for arriving apparatus Tracks arrival and departure of units Rehabilitation Manages rehabilitation area Workers hydrated, nourished, medically monitored 35 Role of Incident Commander (Cont d) Safety Empowered to stop unsafe acts Empowered to institute safety practices Logistics Provides needed equipment, material, supplies 36 12

13 Principles and Techniques of Triage Primary triage Used at large-scale incidents Separates most critical from others Secondary triage Identifies most critical of remaining from others Determines order of treatment 37 Principles and Techniques of Triage (Cont d) START triage Widely accepted triage method Quickly differentiates critical patients from others Uses airway, respiration, pulse, and mentation Patients identified by colors Tags must meet criteria 38 Principles and Techniques of Triage (Cont d) 39 13

14 Chapter Summary Basic elements of ICS include command, finance, logistics, operations, planning, and safety Incident commander s role includes triage, treatment, transportation, staging, rehabilitation, safety, and logistics Critical components to ICS include uniform, consistent set of rules and common language 40 Chapter Summary (Cont d) Most important component to ICS is communications Incident commander is responsible for and delegates creation of action plan and manages event at the highest level by establishing strategic objectives and tactical priorities 41 Chapter Summary (Cont d) Finance officer is responsible for providing accurate accounting and monitoring of all costs associated with the incident Planning officer supports the operation by providing incident commander with past, present, and future information about the incident 42 14

15 Chapter Summary (Cont d) Incident commander places the responsibility and accountability of achieving tactical objectives with the sector officer Logistics officer is responsible for providing required equipment, material, and supplies to the scene of the incident 43 Chapter Summary (Cont d) Triage officer is responsible for conducting a thorough assessment of the scene, identifying all injured and ill patients, and categorizing them by severity Treatment officer is responsible for coordinating the treatment of all injured and ill patients and ensuring that each patient is delivered to the transport area 44 Chapter Summary (Cont d) Movement of patients to medical facilities is the responsibility of the transportation officer Staging area and staging officer should be identified; track the arrival and departure of units in the staging area 45 15

16 Questions? 46 16