EMS Functions in 

ICS

EMSFICS-Student Manual

1st Edition, 5th Printing-January 2015
EMS Functions in ICS

FEMA/USFA/NFA

EMSFICS-SM

January 2015

1st Edition, 5th Printing
EMS Functions in 

ICS

EMSFICS-Student Manual

1st Edition, 5th Printing-January 2015

All materials in this course may be used and distributed by individual states for the purpose 

of delivering National Fire Academy (NFA) state-sponsored courses. All students must 

submit FEMA Form 119-25-2 (General Admissions Application Short Form) to receive a (DHS) 

FEMA/NFA training certificate. NOTE: Any other use of these materials that does not result in 

the receipt of a (DHS) FEMA/NFA training certificate is prohibited. 
This page intentionally left blank.
EMS FUNCTIONS IN ICS

iii

TABLE OF CONTENTS

PAGE

Table of Contents ............................................................................................................................................ iii

Course Goal..................................................................................................................................................... v

Audience, Scope and Course Purpose ............................................................................................................. v

Schedule .......................................................................................................................................................... vii

Firefighter Code of Ethics............................................................................................................................... ix

List of Acronyms............................................................................................................................................. xi

A Student Guide to End-of-course Evaluations............................................................................................... xv

MODULE 1: ICS OVERVIEW....................................................................................................... SM 1-1

MODULE 2: ICS SPECIFIC TO EMS OVERVIEW ................................................................... SM 2-1

SCENARIO A: MASS CASUALTY INCIDENT — CAR ACCIDENT.......................................... SM SA-1

MODULE 3: ON-SCENE CONSIDERATIONS ........................................................................... SM 3-1

MODULE 4: PREPLANNING........................................................................................................ SM 4-1

MODULE 5: MULTIPATIENT MEDICAL TRANSPORT VEHICLES................................... SM 5-1

SCENARIO B: STRUCTURE FIRE.................................................................................................. SM SB-1

MODULE 6: SPECIAL CONSIDERATIONS IN WILDLAND FIRES ..................................... SM 6-1

SCENARIO C: WILDLAND FIRE .................................................................................................... SM SC-1

MODULE 7: SPECIAL CONSIDERATIONS IN MASS GATHERINGS ................................. SM 7-1

SCENARIO D: MASS GATHERING — PLANNED PROTEST.................................................... SM SD-1

MODULE 8: SPECIAL CONSIDERATIONS IN TACTICAL EMERGENCY 

MEDICAL SUPPORT .............................................................................................. SM 8-1

SCENARIO E: TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY 

ACTIVE SHOOTER ................................................................................................. SM SE-1

MODULE 9: SPECIAL CONSIDERATIONS IN HAZARDOUS MATERIALS 

SITUATIONS............................................................................................................. SM 9-1

SCENARIO F: HAZARDOUS MATERIALS................................................................................... SM SF-1

MODULE 10: SPECIAL CONSIDERATIONS FOR EMS AS INCIDENT COMMANDER .... SM 10-1

SCENARIO G: EVACUATIONS........................................................................................................ SM SG-1

MODULE 11: WRAPPING UP INCIDENTS.................................................................................. SM 11-1

Appendix A: NIMS-approved ICS Forms

Appendix B: Nonapproved ICS Forms
EMS FUNCTIONS IN ICS

iv

Appendix C: Field Operations Guide (ICS 420-1) Excerpt — Multicasualty

Appendix D: NIMS Typed Resource Definitions

Appendix E: Special Events Planning Checklist
EMS FUNCTIONS IN ICS

v

COURSE GOAL

The goal of this course is to ensure Emergency Medical Services (EMS) personnel can make critical decisions 

effectively during an emergency/disaster by employing the appropriate EMS functions in Incident Command System 

(ICS) knowledge, skills, and abilities (KSAs), and decision-making techniques.

AUDIENCE, SCOPE AND COURSE PURPOSE

All National Fire Academy (NFA) resident students must complete ICS-100-level and ICS-200-level training before 

they arrive at the National Emergency Training Center (NETC). While we prefer that students complete the Q0462 

and Q0463 courses available through NFA Online at www.usfa.fema.gov/nfa/nfaonline, we will accept other 

National Incident Management System (NIMS)-compliant equivalent training as provided by state and federal 

agencies. The fire chief’s signature attests that the applicant has completed this required prerequisite training.

The primary audience for this training includes EMS personnel who have duties involving emergency/disaster scene 

management at small- to medium-sized incidents (e.g., front line supervisors, street supervisors and shift 

supervisors).

The scope of this course is to provide students with the opportunity to manage the medical, EMS, components of a 

variety of simulated mass casualty incidents (MCIs) using the NIMS ICS.

The U.S. Fire Administration (USFA) is an organizational component of the Federal Emergency Management 

Agency (FEMA) within the U.S. Department of Homeland Security (DHS). The NFA is USFA’s training delivery 

component.

With the multitude of standardized entry-level NIMS/ICS training available online, in the field, or at the NFA, the 

NFA can better serve its customers with performance-based, scenario-driven training designed to support and 

reinforce other education and program standards.
EMS FUNCTIONS IN ICS

vi

This page intentionally left blank.
EMS FUNCTIONS IN ICS

vii

SCHEDULE

TIME DAY 1 TIME DAY 2

8:00-9:45

Introduction

Module 1: ICS Overview

Activity 1.1: Completing Unit Log

8:00-9:35

Module 7: Special Considerations in 

Mass Gatherings

Scenario D: Mass Gathering —

Planned Protest

9:45-10:00 Break 9:35-9:50 Break

10:00-12:05

Module 2: ICS Specific to EMS 

Overview

Activity 2.1: Resource Typing

Activity 2.2: EMS Task Force

Scenario A: Mass Casualty Incident 

— Car Accident

9:50-11:45

Module 8: Special Considerations in 

Tactical Emergency Medical Support

Scenario E: Tactical Law 

Enforcement — University Active 

Shooter

Module 9: Special Considerations in 

Hazardous Materials Situations

12:05-1:05 Lunch Break 11:45-12:45 Lunch Break

1:05-2:45

Module 3: On-scene Considerations

Module 4: Preplanning

Module 5: Multipatient Medical 

Transport Vehicles

Scenario B: Structure Fire

12:45-2:05

Scenario F: Hazardous Materials

Module 10: Special Considerations for 

EMS as Incident Commander

2:45-3:00 Break 2:05-2:20 Break

3:00-4:20

Module 6: Special Considerations in 

Wildland Fires

Scenario C: Wildland Fire

2:20-3:55

Scenario G: Evacuations

Module 11: Wrapping Up Incidents
EMS FUNCTIONS IN ICS

viii

This page intentionally left blank.
EMS FUNCTIONS IN ICS

ix
EMS FUNCTIONS IN ICS

x
EMS FUNCTIONS IN ICS

xi

LIST OF ACRONYMS

ALS advanced life support

BIR Brief Initial Report

BLS basic life support

CAN Conditions, Actions and Needs report

CC Central City

CCP Casualty Collection Point

CDC Centers for Disease Control and Prevention

CERT Community Emergency Response Team

CISM Critical Incident Stress Management

CPAP continuous positive airway pressure

CSU Columbia State University

DOC Department Operations Center

DOT Department of Transportation

ECC Emergency Communications Center

EMS Emergency Medical Services

EMT emergency medical technician

EOC Emergency Operations Center

ERT Emergency Response Team

ESSD Exercise Simulation System Document

ETA estimated time of arrival

GACC Geographic Area Coordination Center

GSW gunshot wound
EMS FUNCTIONS IN ICS

xii

IAP Incident Action Plan

IC Incident Commander

ICS Incident Command System

IED improvised explosive device

IMT Incident Management Team

KSAs knowledge, skills and abilities

LC Liberty County

LCES Lookouts, Communications, Escape routes and Safety zones

LCFD Liberty County Fire Department

MACS Multiagency Coordination System

MCI mass casualty incident

MSDS Material Safety Data Sheet

NDM naturalistic decision-making

NFPA National Fire Protection Association

NIFC National Interagency Fire Center

NIMS National Incident Management System

NRCC National Response Coordination Center

NWCG National Wildfire Coordinating Group

PG patient generator

PIA Postincident Analysis

PIO Public Information Officer

PPE personal protective equipment

RRCC Regional Response Coordination Center
EMS FUNCTIONS IN ICS

xiii

SCBA self-contained breathing apparatus

SM Student Manual

SOGs standard operating guidelines

SOPs standard operating procedures

TCDs traffic control devices

TEMS Tactical Emergency Medical Support

TF Task Force

UC Unified Command

USFS United States Forest Service
EMS FUNCTIONS IN ICS

xiv

This page intentionally left blank.
EMS FUNCTIONS IN ICS

xv
This page intentionally left blank.
EMS FUNCTIONS IN ICS

MODULE 1:

ICS OVERVIEW

OBJECTIVES

The students will be able to:

1.1 Describe the Incident Command System (ICS) structure.

1.2 Define common ICS terms.

1.3 Differentiate among Groups, Divisions and Branches.

1.4 Identify the leadership titles for ICS organizational elements.

1.5 Describe each of the relevant ICS forms.

1.6 Discuss ICS map symbols.
ICS OVERVIEW

SM 1-2

This page intentionally left blank.
ICS OVERVIEW

SM 1-3

MODULE 1:

ICS OVERVIEW

Slide 1-1

OBJECTIVES

• Describe the Incident Command System 

(ICS) structure.

• Define common ICS terms.

• Differentiate among Groups, Divisions 

and Branches.

• Identify the leadership titles for ICS 

organizational elements.

• Describe each of the relevant ICS forms. 

• Discuss ICS map symbols.

Slide 1-2

I. WHAT IS ICS?

WHAT IS ICS?

• Based on proven incident 

management practices.

• Defines incident response 

organizational concepts and 

structures.

• Consists of procedures for 

managing personnel, 

facilities, equipment and 

communications.

• Used throughout the life 

cycle of an incident.

Slide 1-3

ICS is a 

management 

approach that is:

Standardized

On-scene

All-hazards
ICS OVERVIEW

SM 1-4

A. The Incident Command System (ICS) is an effective method for organizing a 

response. ICS is a standardized, on-scene, all-hazards incident management 

approach.

B. ICS allows responders to adopt an integrated organizational structure that matches 

the complexities and demands of the incidents without being hindered by 

jurisdictional boundaries. ICS allows all involved to know their roles and work 

together without jeopardizing anyone’s voice or authority.

C. The ICS:

1. Is based on proven incident management practices.

2. Defines incident response organizational concepts and structures.

3. Consists of procedures for managing personnel, facilities, equipment and 

communications.

4. Is used throughout the life cycle of an incident (i.e., from threat to 

response to recovery).

BENEFITS OF ICS

Slide 1-4

ICS helps to ensure: 

• The use of common terminology, allowing 

diverse incident management and support 

entities to work together.

• The safety of responders and internal and 

external customers (patients/victims).

• The achievement of response objectives.

• The efficient use of resources.

D. Benefits of ICS.

1. ICS is the result of decades of lessons learned in the organization and 

management of emergency incidents. 

2. ICS has been tested in more than 30 years’ worth of emergency and 

nonemergency applications, by all levels of government and in the private 

sector.
ICS OVERVIEW

SM 1-5

3. ICS helps to ensure:

a. The use of common terminology, allowing diverse incident 

management and support entities to work together.

b. The safety of responders and internal and external customers 

(patients/victims).

c. The achievement of response objectives.

d. The efficient use of resources.

Slide 1-5

HOMELAND SECURITY 

PRESIDENTIAL DIRECTIVE (HSPD-5)

• HSPD-5 calls for National Incident 

Management System (NIMS).

• NIMS: 

– Identifies steps for improved coordination of 

federal, state, local and private-sector 

responses to incidents.

– Describes ways these agencies should 

prepare for such a response.

– Requires the use of ICS.

E. Homeland Security Presidential Directive (HSPD-5).

1. HSPD-5 was issued by President George W. Bush in February 2003 in 

response to the attacks of Sept. 11, 2001. It called for the use of a National 

Incident Management System (NIMS), which identified steps for 

improving the coordination of federal, state, local and private-sector 

responses to incidents, and described the ways these agencies should 

prepare for such a response. 

2. NIMS requires the use of ICS.
ICS OVERVIEW

SM 1-6

Slide 1-6

NIMS AND ICS

Preparedness

Communications 

and Information 

Management

Resource 

Management

Command and 

Management

Ongoing 

Management and 

Maintenance

Incident 

Command 

System

Multiagency 

Coordination 

Systems

Public Information

F. NIMS and ICS.

1. NIMS provides a consistent framework for incident management at all 

jurisdictional levels, regardless of the cause, size and/or complexity of the 

incident. NIMS is not an operational incident management or resource 

allocation plan. NIMS represents a core set of doctrines, concepts, 

principles, terminology and organizational processes that enables 

effective, efficient and collaborative incident management.

2. There are five components of NIMS:

a. Preparedness: Effective emergency management and incident 

response activities begin with a host of preparedness activities 

conducted on an ongoing basis in advance of any potential 

incident. Preparedness involves an integrated combination of 

planning, procedures and protocols, training and exercises, 

personnel qualifications and certification, and equipment 

certification.

b. Communications and Information Management: Emergency 

management and incident response activities rely upon 

communications and information systems that provide a common 

operating picture to all Command and coordination sites. NIMS 

describes the requirements necessary for a standardized framework 

of communications and emphasizes the need for a common 

operating picture. NIMS is based upon the concepts of 

interoperability, reliability, scalability and portability, as well as

upon the resilience and redundancy of communications and 

information systems.
ICS OVERVIEW

SM 1-7

c. Resource Management: Resources (such as personnel, 

equipment, and/or supplies) are needed to support critical incident 

objectives. The flow of resources must be fluid and adaptable to 

the requirements of the incident. NIMS defines standardized 

mechanisms and establishes the resource management process to 

identify requirements; order and acquire; mobilize, track and 

report; recover and demobilize; reimburse; and inventory 

resources.

d. Command and Management: The Command and Management 

component within NIMS is designed to enable effective and 

efficient incident management and coordination by providing 

flexible, standardized incident management structures. The 

structures are based on three key organizational constructs: ICS, 

Multiagency Coordination Systems, and Public Information.

e. Ongoing Management and Maintenance: There are two 

components of Ongoing Management and Maintenance: the 

National Integration Center and Supporting Technologies.

II. ICS FEATURES

Slide 1-7

ICS FEATURES

• Common Terminology.

• Chain of Command and Unity of 

Command.

• Unified Command.

• Modular Organization.

• Management by Objectives.

• Reliance on an Incident Action Plan (IAP).

• Manageable Span-of-Control. 

A. There are 14 basic features of ICS. We won’t discuss all 14 features in this 

course, but you should have reviewed them already in the ICS 100 course.
ICS OVERVIEW

SM 1-8

Slide 1-8

ICS FEATURES (cont’d)

• Incident Locations and Facilities.

• Comprehensive Resource Management.

• Information and Intelligence Management.

• Integrated Communications.

• Establishment and Transfer of Command.

• Accountability.

• Dispatch/Deployment.
ICS OVERVIEW

SM 1-9

Topic ICS Features

The 14 essential ICS features are listed below

1. Common Terminology: Using Common Terminology helps to define organizational 

functions, incident facilities, resource descriptions, and position titles.

2. Chain of Command and Unity of Command: Chain of Command refers to the orderly 

line of authority within the ranks of the incident management organization. Unity of 

Command means that every individual has a designated supervisor to whom he or she 

reports at the scene of the incident. These principles clarify reporting relationships and 

eliminate the confusion caused by multiple conflicting directives. Incident managers at all 

levels must be able to control the actions of all personnel under their supervision.

3. Unified Command: In incidents involving multiple jurisdictions, a single jurisdiction 

with multiagency involvement, or multiple jurisdictions with multiagency involvement, 

Unified Command allows agencies with different legal, geographic and functional 

authorities and responsibilities to work together effectively without harming individual 

agency authority, responsibility, or accountability.

4. Modular Organization: The Incident Command organizational structure develops in a 

top-down, modular fashion that is based on the size and complexity of the incident, and

the specifics of the hazard environment created by the incident.

5. Management by Objectives: This includes establishing overarching objectives; 

developing and issuing assignments, plans, procedures, and protocols; establishing 

specific, measurable objectives for various incident management functional activities; 

and directing efforts to attain the established objectives.

6. Reliance on an Incident Action Plan: Incident Action Plans (IAPs) provide a coherent 

means of communicating the overall incident objectives in the context of both operational 

and support activities.

7. Manageable Span-of-Control: Span-of-Control is key to effective and efficient incident 

management. Within ICS, the span-of-control of any individual with incident 

management supervisory responsibility should range from three to seven subordinates.

8. Incident Locations and Facilities: Various types of operational locations and support 

facilities are established in the vicinity of an incident to accomplish a variety of purposes.

Typical predesignated facilities include Incident Command Posts (ICPs), Bases, Camps, 

Staging Areas, Mass Casualty Triage Areas, and others as required.

9. Comprehensive Resource Management: Comprehensive Resource Management 

includes processes for categorizing, ordering, dispatching, tracking, and recovering 

resources. It also includes processes for reimbursement for resources, as appropriate.

Resources are defined as personnel, teams, equipment, supplies, and facilities available or 

potentially available for assignment or allocation in support of incident management and 

emergency response activities.
ICS OVERVIEW

SM 1-10

10. Information and Intelligence Management: The incident management organization 

must establish a process for gathering, sharing, and managing incident-related 

information and intelligence.

11. Integrated Communications: Incident communications are facilitated through the 

development and use of a common communications plan and interoperable 

communications processes and architectures. 

12. Establishment and Transfer of Command: The Command function must be clearly 

established from the beginning of an incident. When Command is transferred the process 

must include a briefing that captures all information essential for continuing safe and 

effective operations.

13. Accountability: Effective accountability is essential at all jurisdictional levels and within 

individual functional areas during incident operations. To that end, the following 

principles must be adhered to:

Check-In: All responders, regardless of agency affiliation, must report in to receive an 

assignment in accordance with the procedures established by the Incident Commander.

Incident Action Plan: Response operations must be directed and coordinated as outlined 

in the IAP.

Unity of Command: Each individual involved in incident operations will be assigned to 

only one supervisor.

Span-of-Control: Supervisors must be able to supervise and control their subordinates

adequately, as well as to communicate with and manage all resources under their 

supervision.

Resource Tracking: Supervisors must record and report resource status changes as they 

occur.

14. Dispatch/Deployment: Personnel and equipment should respond only when requested or 

when dispatched by an appropriate authority.
ICS OVERVIEW

SM 1-11

Slide 1-9

USE OF COMMON 

TERMINOLOGY

• Communications should be in plain 

English.

– Don't use radio codes, institution-specific 

codes, or jargon.

• Using common terminology helps to 

define: 

– Organizational functions.

– Incident facilities.

– Resource descriptions.

– Position titles.

B. Use of common terminology.

1. A critical part of an effective multiagency incident management system is 

that all entities be able to communicate with each other effectively. 

2. During an incident, communications should be in plain English or clear 

text. For example, do not use radio codes, institution-specific codes, or 

jargon.

3. ICS establishes common terminology, allowing diverse incident 

management and support entities to work together. Using common 

terminology helps to define:

a. Organizational Functions. Major functions and functional units 

with domestic incident management responsibilities are named and 

defined. Terminology for the organizational elements involved is 

standard and consistent.

b. Incident Facilities. Common terminology is used to designate the 

facilities in the vicinity of the incident area that will be used in the 

course of incident management activities.

c. Resource Descriptions. Major resources — including personnel, 

facilities, and major equipment and supply items — used to 

support incident management activities are given common names 

and are “typed” with respect to their capabilities. This helps avoid 

confusion and enhance interoperability. 
ICS OVERVIEW

SM 1-12

d. Position Titles. At each level within the ICS organization, 

individuals with primary responsibility have distinct titles. Titles 

provide a common standard for all users, and also make it easier to 

fill ICS positions with qualified personnel. ICS titles often do not

correspond to the titles used on a daily basis.

Slide 1-10

ICS ORGANIZATIONAL 

STRUCTURE

• Differs from day-to-day structures and 

positions.

• Unique ICS positions designed to avoid 

confusion during incident response.

• Rank may change during an incident.

C. ICS organizational structure.

1. The ICS organizational structure is unique and easy to understand. There 

is no correlation between the ICS organization and the administrative 

structure of any single agency or jurisdiction. This is deliberate, because 

confusion over different position titles and organizational structures has 

been a significant stumbling block to effective incident management in the 

past. 

2. Thus, someone who serves as a Chief every day may not hold that title 

when deployed under an ICS structure.

Slide 1-11

MODULAR ORGANIZATION

• Develops in top-down, 

modular fashion.

• Is based on incident 

objectives and resource 

requirements.

• Expands and contracts 

flexibly.

• Requires that each element 

have a person in charge.
ICS OVERVIEW

SM 1-13

D. Modular organization. 

The ICS modular organizational structure: 

1. Develops in a top-down, modular fashion based on size and complexity of 

the incident. 

2. Is determined based on the incident objectives and resource requirements; 

only those functions or positions necessary for a particular incident are 

filled. 

3. Expands and contracts in a flexible manner (when needed, separate 

functional elements may be established). 

4. Requires that each element have a person in charge. 

Slide 1-12

CHAIN OF COMMAND

Incident

Commander

Command

Staff

General

Staff Operations

Section Chief Planning

Section Chief

Logistics

Section Chief

Finance/Admin

Section Chief

Branch

Director

Branch

Director

Safety

Officer

Liaison

Officer

Public Information

Officer

Service 

Branch Director

Support

Branch Director

E. Chain of command. 

1. The chain of command is an orderly line of authority within the ranks of 

the incident management organization. The chain of command: 

a. Allows an incident manager to direct and control the actions of all 

personnel under his or her supervision. 

b. Avoids confusion by requiring that orders flow from supervisors. 

2. The chain of command does not prevent personnel from communicating 

directly with each other to ask for or share information. 
ICS OVERVIEW

SM 1-14

3. The features and principles used to manage an incident differ from day-today approaches. Effective incident management relies on a tight command 

and control structure. Although information is exchanged freely through 

the ICS structure, everyone involved must adhere strictly to top-down 

direction.

4. To make ICS work, each of us must commit to following this command 

and control approach.

Slide 1-13

UNITY OF COMMAND

• Under unity of command, individuals:

– Report to only one ICS Supervisor.

– Receive work assignments only from their ICS 

Supervisor.

F. Unity of command.

Under unity of command, individuals:

1. Report to only one ICS Supervisor. 

2. Receive work assignments only from their ICS Supervisor.

Slide 1-14

MANAGEMENT BY 

OBJECTIVES

• Used to ensure that everyone has a clear 

understanding of what needs to be 

accomplished.

• Based on the following priorities:

– Life safety.

– Incident stabilization.

– Property preservation.

G. Management by objectives.
ICS OVERVIEW

SM 1-15

1. Incident objectives are used to ensure that everyone within the ICS 

organization has a clear understanding of what needs to be accomplished.

2. Incident objectives are established based on the following priorities, in 

order:

a. Life safety.

b. Incident stabilization.

c. Property preservation.

Slide 1-15

INCIDENT ACTION PLAN

• Every incident must have an IAP that:

– Specifies the incident objectives.

– States the activities to be completed. 

– Covers a specified timeframe, called an 

operational period. 

– May be oral or written — except for 

hazardous materials incidents, which require 

a written IAP.

H. Incident Action Plan (IAP).

1. Every incident must have an IAP that:

a. Specifies the incident objectives.

b. States the activities to be completed.

c. Covers a specified timeframe, called an operational period.

d. May be oral or written.

- Hazardous materials incidents require written IAPs (CFR 

1910.120).

2. Even the smallest of incidents is managed by incident objectives and 

plans. The IAP can be as simple as the next steps the Incident Commander 

(IC) plans to take. These steps can be communicated orally to the rest of 

the ICS organization.
ICS OVERVIEW

SM 1-16

Slide 1-16

DEVELOPING AN IAP

• May not be an Emergency 

Medical Services (EMS) 

responsibility.

• Five phases for developing 

IAP:

– Understand the situation.

– Establish incident objectives 

and strategy.

– Develop the IAP.

– Prepare and disseminate the 

IAP.

– Execute, evaluate and revise 

IAP.

I. Developing the IAP.

1. A clear, concise IAP is essential to guide the initial management decision 

process and continuing collective planning activities. Developing the IAP 

may not be an Emergency Medical Services (EMS) responsibility; 

sometimes it may be developed by another entity, such as the Planning 

Section.

2. These following five phases should be followed in sequence to ensure a 

comprehensive IAP: 

a. Understand the situation.

b. Establish incident objectives and strategy.

c. Develop the IAP.

d. Prepare and disseminate the IAP.

e. Execute, evaluate and revise the IAP.

3. More information on developing the IAP is available in Appendix B, Tab 

8 — The Planning Process and the IAP of the NIMS document, available 

at http://www.fema.gov/pdf/emergency/nims/NIMS_core.pdf.
ICS OVERVIEW

SM 1-17

Slide 1-17

IAP VERSIONS

• An IAP typically starts out as an oral 

report, which is then transferred to ICS 

Form 201, Incident Briefing and then 

expands to other forms and a formal IAP. 

• IAP must address patient generator (PG).

• Initial Plan.

– Developed quickly.

– May have incomplete situation information.

– Should be communicated easily.

J. IAP versions.

1. An IAP typically starts out as an oral report, which is then transferred to 

ICS Form 201 and then expands to other forms and a formal IAP. It must 

address the patient generator (PG), which may be out of the scope of EMS 

and may be the responsibility of the police department (e.g., active 

shooter) or fire department. (The PG is the hazard, action or situation that 

creates patient volume.)

2. The primary phases of the IAP development process are essentially the 

same for developing the initial IAP, revising the IAP, and developing a 

formal IAP for extended operational periods. 

3. During the initial stages of an incident, the IAP should be a simple plan 

that can be communicated through concise oral briefings. Often, this initial 

IAP must be developed very quickly and with incomplete situation 

information. 

Slide 1-18

IAP VERSIONS (cont’d)

• Revised Plan.

– More detailed.

– More situational information.
ICS OVERVIEW

SM 1-18

4. As the incident evolves, additional lead time, staff and technologies enable 

the development of a more detailed IAP.

Slide 1-19

ELEMENTS OF AN IAP

• Every IAP must address the following:

– What do we want to do?

– Who is responsible?

– How do we communicate with each other?

– What is the procedure if someone is injured?

K. Elements of an IAP.

1. Every IAP must address the following:

a. What do we want to do?

b. Who is responsible?

c. How do we communicate with each other?

d. What is the procedure if someone is injured?

2. The most important thing is having a plan and communicating it.

Slide 1-20

ICS MANAGEMENT: 

SPAN-OF-CONTROL

• ICS span-of-control for 

any supervisor:

– Between three and 

seven subordinates.

– Optimally does not 

exceed five subordinates.

L. ICS management: span-of-control.
ICS OVERVIEW

SM 1-19

1. Another basic ICS feature concerns the supervisory structure of the 

organization. Maintaining adequate span-of-control throughout the ICS 

organization is very important. 

2. Span-of-control pertains to the number of individuals or resources that one 

supervisor can manage effectively during an incident.

3. The type of incident, nature of the task, hazards and safety factors, and 

distances between personnel and resources all influence span-of-control 

considerations. Maintaining an effective span-of-control is particularly 

important in incidents in which safety and accountability are top priorities.

4. Effective span-of-control on incidents may vary from three to seven team 

members, and a ratio of one supervisor to five reporting elements is 

recommended.

Slide 1-21

PROBLEM:

OUT OF CONTROL

Solution: Add 

Groups, Divisions 

and/or Branches

M. Problem: out of control.

1. On a large, complex incident, the Operations Section may become very 

large. Using the ICS principle of modular organization, the Operations 

Section may add the following elements to manage span-of-control:

a. Groups are used to describe functional areas of operation.

b. Divisions are used to divide an incident geographically. 

2. The use of Divisions would be effective if the incident covered a large or 

isolated area of the campus.

3. The Operations Section Chief may add Branches to supervise Groups and

Divisions and further reduce his or her span-of-control.

4. The person in charge of each Branch is designated as a Director. 
ICS OVERVIEW

SM 1-20

5. Other sections can also expand. For example, the Logistics Section Chief 

may add units and further reduce his or her span-of-control.

III. INCIDENT COMMAND AND COMMAND STAFF

Slide 1-22

INCIDENT MANAGEMENT 

FUNCTIONS

• There are five major management functions:

– Command Staff.

– Operations.

– Planning.

– Logistics.

– Finance/Administration.

A. Incident management functions.

There are five major management functions that form the foundation upon which 

the ICS organization develops. These functions apply whether you are handling a 

routine emergency, organizing for a major nonemergency event, or managing a 

response to a major disaster:

1. Command Staff sets the incident objectives, strategies and priorities and 

has overall responsibility for the incident. Includes IC, Public Information 

Officer (PIO), Safety Officer, and Liaison Officer.

2. Operations conducts operations to reach the incident objectives. 

Establishes the tactics and directs all operational resources. 

3. Planning supports the incident action planning process by tracking 

resources, collecting/analyzing information, and maintaining 

documentation.

4. Logistics provides resources and needed services to support the 

achievement of the incident objectives.

5. Finance and Administration monitors costs related to the incident. 

Provides accounting, procurement, time recording, and cost analyses.
ICS OVERVIEW

SM 1-21

Slide 1-23

INCIDENT COMMANDER

• The most qualified person is designated as 

the Incident Commander (IC).

– Independent of rank.

• IC is the only position in ICS that is always

staffed.

• At an incident, the higher-ranking person will 

either assume command, maintain 

command as is, or transfer command to a 

third party.

B. IC.

1. All incident responses begin by establishing command. 

2. Rank, grade and seniority are not the factors used to select the IC. The IC

is always a highly qualified individual trained to lead the incident 

response. The individual may not be a subject-matter expert (SME), but he 

or she must have qualities to manage or lead the incident.

3. The IC has overall responsibility for managing the incident by objectives, 

planning strategies, and implementing tactics. The IC is the only position 

that is always staffed in ICS applications. 

4. On small incidents and events, one person, the IC, may carry out all of the 

incident management functions (Command, Operations, Planning, 

Logistics, and Finance/Administration). The IC is responsible for all ICS 

management functions until he or she delegates the function.

Slide 1-24

INCIDENT COMMANDER 

(cont’d)

• The IC:

– Provides overall leadership for incident 

response.

– Ensures incident safety. 

– Delegates authority to others.

– Establishes incident objectives.

– Can designate a Deputy Incident Commander.
ICS OVERVIEW

SM 1-22

5. The IC:

a. Provides overall leadership for incident response.

b. Ensures incident safety.

c. Delegates authority to others.

d. Establishes incident objectives.

6. The IC will size up the incident and assess resource needs. If the incident 

is complex and/or long-term, more staff may be needed. In addition, a 

Deputy IC may be assigned. If a Deputy is assigned, he or she must be 

fully qualified to assume the IC’s position.

7. A Deputy IC may be designated to: 

a. Perform specific tasks as requested by the IC.

b. Perform IC function in a relief capacity.

c. Represent an assisting agency that shares jurisdiction.

Slide 1-25

TRANSFER OF COMMAND

• Transfer of command may take place 

when: 

– A more qualified IC arrives and assumes 

command.

– A jurisdiction or agency is legally required to 

take command.

– The incident changes in complexity.

– The current IC needs to rest.

C. Transfer of command.

1. The process of moving the responsibility for incident command from one 

IC to another is called transfer of command. Transfer of command may 

take place when the following occurs:
ICS OVERVIEW

SM 1-23

a. A more qualified IC arrives and assumes Command. For example, 

an Engine Company Officer might act as the initial IC, but would 

relinquish Command to a more qualified IC, such as a Battalion 

Chief, when he or she arrives.

b. A jurisdiction or agency is legally required to take Command. For 

example, the Federal Bureau of Investigation is legally required to 

take the lead for investigations of terrorist incidents.

c. The incident changes in complexity. For example, an incident 

might start on campus but spread into the surrounding community, 

affecting multiple jurisdictions, institutions or agencies.

d. The current IC needs to rest. On long or extended incidents, there 

is normally turnover of personnel to accommodate work/rest 

requirements.

Slide 1-26

TRANSFER OF COMMAND 

(cont’d)

• Always includes a transfer of command 

briefing (oral, written or combination of 

both).

– Can use IAP or ICS Form 201.

• Must convey:

– Conditions.

– Progress.

– Resources.

2. The transfer of command process always includes a transfer of command 

briefing, which may be oral, written or a combination of both.

a. The IAP or ICS Form 201 can be used to convey this status.

b. The Conditions, Progress, Resources status must be conveyed 

during transfer of command. The ICS Form 201 or the IAP can be 

used to convey this status.
ICS OVERVIEW

SM 1-24

Topic Transfer of Command

It should be recognized that transfer of command on an expanding incident is to be expected. It 

does not reflect poorly on the competence of the current IC.

There are five important steps in effectively assuming command of an incident in progress.

Step 1: If at all possible, the incoming IC should personally perform an assessment of the 

incident situation with the current IC.

Step 2: The incoming IC must be briefed adequately. This briefing must be given by the current 

IC, and take place face-to-face, if possible. The briefing must cover the following:

• Incident history (what has happened).

• Priorities and objectives.

• Current plan.

• Resource assignments.

• Incident organization.

• Resources ordered/needed.

• Facilities established.

• Status of communications.

• Any constraints or limitations.

• Incident potential.

• Delegation of authority.

Step 3: After the incident briefing, the incoming IC should determine an appropriate time for 

transfer of command.

Step 4: At the appropriate time, notice of a change in IC should be made to:

• Agency headquarters.

• General Staff members (if designated).

• Command Staff members (if designated).

• All incident personnel.

Step 5: The incoming IC may give the previous IC another assignment on the incident. There are 

several advantages to doing this:

• The initial IC retains first-hand knowledge at the incident site.

• This strategy allows the first IC to observe the progress of the incident and to gain 

experience.
ICS OVERVIEW

SM 1-25

Slide 1-27

COMMAND STAFF AND 

GENERAL STAFF

D. Command Staff and General Staff.

1. The Command Staff provides information, safety and liaison services for 

the entire organization and reports directly to the IC. 

2. The General Staff is assigned functional authority for Operations, 

Planning, Logistics, and Finance/Administration.

Slide 1-28

COMMAND STAFF

• Public Information Officer (PIO).

• Safety Officer.

• Liaison Officer.

E. Command Staff.

1. Depending upon the size and type of incident or event, the IC may 

designate personnel to provide information, safety and liaison services. 

2. The PIO serves as the conduit for information to internal and external 

stakeholders. 
ICS OVERVIEW

SM 1-26

3. The Safety Officer monitors safety conditions and develops measures for 

assuring the safety of all response personnel. The Safety Officer conducts 

risk analyses and implements safety measures. He or she also has the 

authority to stop any unsafe activity that is observed. 

4. The Liaison Officer serves as the primary contact for supporting agencies 

assisting at an incident. The Liaison Officer facilitates coordination with 

the Emergency Operations Center, adjacent jurisdictions, and 

nongovernmental agencies.

IV. GENERAL STAFF

Slide 1-29

GENERAL STAFF

A. General Staff.

1. As the incident grows, the IC first establishes the Operations Section. The 

remaining sections are established as needed to support the operations. 

Not all sections need to be activated for every incident. 

2. The Operations Section performs response and tactical actions to achieve 

the incident objectives. 

Some examples: 

a. Medical aid to victims.

b. Search and rescue.

c. Firefighting.

d. Traffic control.

e. Investigations.
ICS OVERVIEW

SM 1-27

f. Victim/Family reunification.

g. Damage assessment.

Slide 1-30

PLANNING SECTION

• The major activities of the Planning 

Section may include:

– Collecting, evaluating and displaying incident 

intelligence and information.

– Preparing and documenting IAPs.

– Tracking resources assigned to the incident.

– Maintaining incident documentation. 

– Developing plans for demobilization.

B. Planning Section.

The major activities of the Planning Section may include:

1. Collecting, evaluating and displaying incident intelligence and 

information.

2. Preparing and documenting IAPs.

3. Tracking resources assigned to the incident.

4. Maintaining incident documentation.

5. Developing plans for demobilization.

Slide 1-31

LOGISTICS SECTION

• The Logistics Section is 

responsible for all of 

the services and 

support needs, 

including:

– Ordering, obtaining, 

maintaining and 

accounting for essential 

personnel, equipment 

and supplies. 
ICS OVERVIEW

SM 1-28

C. Logistics Section.

The Logistics Section is responsible for all of the services and support needs, 

including:

1. Ordering, obtaining, maintaining and accounting for essential personnel, 

equipment and supplies.

Slide 1-32

LOGISTICS SECTION (cont’d)

– Providing incident 

communications. 

– Setting up food 

services for 

responders. 

– Setting up and 

maintaining incident 

facilities. 

2. Providing incident communications.

3. Setting up food services for responders.

4. Setting up and maintaining incident facilities.

Slide 1-33

FINANCE/ADMINISTRATION 

SECTION

• The Finance/Administration Section is 

responsible for:

– Contract negotiation and monitoring.

– Timekeeping.

– Cost analysis. 

– Compensation for injury or damage to property.

– Documentation for reimbursement — i.e., under

Memorandums of Understanding (MOUs).

D. Finance/Administration Section.
ICS OVERVIEW

SM 1-29

The Finance/Administration Section is set up for any incident that requires 

incident-specific financial management. The Finance/Administration Section is 

responsible for:

1. Contract negotiation and monitoring.

2. Timekeeping.

3. Cost analysis.

4. Compensation for injury or damage to property.

5. Documentation for reimbursement — i.e., under Memorandums of 

Understanding (MOUs).

Slide 1-34

SECTION CHIEFS AND 

DEPUTIES

• Each Section Chief may have one or more 

Deputies, if necessary.

• The Deputy: 

– May assume responsibility for a specific portion 

of the primary position, work as relief, or be 

assigned other tasks. 

– Must be as qualified as the Section Chief. 

E. Section Chiefs and Deputies.

1. As mentioned previously, the person in charge of each section is 

designated as a Chief. Section Chiefs have the ability to expand their 

Sections to meet the needs of the situation.

2. Each of the Section Chiefs may have one or more Deputies, if necessary. 

The Deputy:

a. May assume responsibility for a specific portion of the primary 

position, work as relief, or be assigned other tasks.

b. Must be as qualified as the Section Chief.
ICS OVERVIEW

SM 1-30

V. UNIFIED COMMAND 

Slide 1-35

UNIFIED COMMAND

• Unified Command:

– Applies ICS in incidents involving multiple 

jurisdictions or agencies. 

– Enables agencies with different legal, 

geographic and functional responsibilities to 

coordinate, plan and interact effectively. 

A. Unified Command.

1. As the incident expands across multiple jurisdictions and begins to involve 

multiple agencies, the management of the incident moves to a Unified 

Command. Incidents have multiple stakeholders with different statutory 

requirements to work through the incident.

2. Unified Command applies ICS in incidents involving multiple 

jurisdictions or agencies and enables agencies with different legal, 

geographic and functional responsibilities to coordinate, plan and interact 

effectively. 

Slide 1-36

• The ICs within the Unified Command make 

joint decisions and speak as one voice. 

• Unity of command is maintained. Each 

responder reports to a single supervisor 

within his or her area of expertise. 

UNIFIED COMMAND (cont’d)

3. The ICs within the Unified Command make joint decisions and speak as 

one voice. Any differences are worked out within the Unified Command.
ICS OVERVIEW

SM 1-31

4. Unity of command is maintained. Each responder reports to a single 

supervisor within his or her area of expertise. Consider the case of an 

incident involving a shooter on a university campus. Within a Unified 

Command, the police would not tell the firefighters how to do their job, 

nor would the police tell school personnel how to manage parent-student 

reunification.

Slide 1-37

BENEFITS OF UNIFIED 

COMMAND

• A single integrated incident organization.

• Collocated (shared) facilities.

• Single:

– Planning process.

– IAP.

• One set of incident objectives.

• Coordinated process for resource ordering.

B. Benefits of Unified Command.

1. Unified Command benefits include:

a. A single integrated incident organization: As a team effort, 

Unified Command overcomes much of the inefficiency and 

duplication of effort that can occur when agencies from different 

functional and geographic jurisdictions, or agencies at different 

levels of government, operate without a common system or 

organizational framework.

b. Collocated (shared) facilities: In a Unified Command incident, 

facilities are collocated or shared. There is one single Incident 

Command Post (ICP).

c. One set of incident objectives, single planning process and 

IAP: Unified Command uses one set of incident objectives and a 

single planning process, and produces one IAP. The planning 

process for Unified Command is similar to the process used on 

single jurisdiction incidents.

d. Coordinated process for resource ordering: The ICs within the 

Unified Command work together to establish resource ordering 

procedures that allow for:
ICS OVERVIEW

SM 1-32

- Deployment of scarce resources to meet high-priority

objectives.

- Potential cost savings through agreements on cost-sharing 

for essential services.

2. ICs within the Unified Command must concur on the selection of the 

General Staff Section Chiefs. The Operations Section Chief must have full 

authority to implement the tactics within the IAP. 

Slide 1-38

UNIFIED COMMAND: 

COMMAND STAFF

Example: Unified Command at a Higher Education 

Institution.

C. Unified Command: Command Staff.

Unified Command results in a single integrated organization. The combined 

approach ensures that the responders will speak with one voice.

VI. POSITION TITLES 

Slide 1-39

USE OF POSITION TITLES

• Using ICS position titles:

– Provides a common standard for performance 

expectations.

– Helps to ensure that qualified individuals fill 

positions.

– Standardizes communication.

– Describes the responsibilities of the position.
ICS OVERVIEW

SM 1-33

A. Use of position titles. 

Using specific ICS position titles:

1. Provides a common standard for performance expectations.

2. Helps ensure that qualified individuals fill positions.

3. Standardizes communication.

4. Describes the responsibilities of the position.

Slide 1-40

ICS SUPERVISORY POSITION 

TITLES

Organizational Level Title Support Position

Incident Command Incident Commander Deputy

Command Staff Officer Assistant

General Staff (Section) Chief Deputy

Branch Director Deputy

Division/Group Supervisor N/A

Unit Leader Manager

Strike Team/Task Force Leader Single Resource Boss

B. ICS supervisory position titles.

1. Chief — The ICS title for individuals responsible for functional sections: 

Operations, Planning, Logistics, Finance/Administration, Intelligence (if 

established as a separate section).

2. Director — The ICS title for individuals responsible for command of a 

Branch.

3. Supervisor — The ICS title for individuals responsible for command of a 

Division or a Group.

4. Leader — The ICS title for individuals responsible for a Task Force, 

Strike Team or Unit.

5. Officer — Within the ICS, includes the Command Staff positions of 

Safety, Liaison and Public Information.
ICS OVERVIEW

SM 1-34

VII. ICS INCIDENT FACILITIES AND MAP SYMBOLS

Slide 1-41

ICS MAP SYMBOLS

ICS provides common 

symbology for 

indicating incident 

facilities on maps.

A. ICS map symbols.

Slide 1-42

INCIDENT COMMAND POST

• Location from which the IC 

oversees all incident operations. 

• May change locations during 

event. 

• May be located in a vehicle, trailer, 

tent or building. 

• Positioned outside present/ 

potential hazard zones, but close 

enough to the incident to maintain 

Command.

• Should be clearly marked. 

Symbol

B. ICP.

1. Location from which the IC oversees all incident operations.

2. May change locations during the event.

3. May be located in a vehicle, trailer, tent or building.

4. Should be positioned outside the present hazard zone and potential hazard 

zones, but close enough to the incident to maintain Command.

5. Should be clearly marked (e.g., with green light).
ICS OVERVIEW

SM 1-35

STAGING AREA

• Temporary locations where 

available personnel and 

equipment are kept while 

•

waiting for tactical 

assignments.

– May be more than one Staging 

Area at an incident.

Located close enough to 

incident for timely response, but 

S

Symbol

far enough away to be out of 

immediate impact zone. Slide 1-43

C. Staging Area.

1. Temporary locations where personnel and equipment are kept while 

waiting for tactical assignments (there may be more than one Staging Area 

at an incident). 

2. Should be located close enough to the incident for a timely response, but 

far enough away to be out of the immediate impact zone. 

BASE

•

•

Location from which primary 

logistics and administrative 

functions are coordinated and 

administered. 

Only one Base per incident, 

•

•

designated by incident name.

May be collocated with Incident 

Command Post (ICP). 

Established and managed by 

B

Symbol

Logistics Section. 

Slide 1-44

D. Base.

1. Location from which primary logistics and administrative functions are 

coordinated and administered. 

2. Only one Base per incident, designated by the incident name. 

3. May be collocated with the ICP. 
ICS OVERVIEW

SM 1-36

4. Is established and managed by the Logistics Section. 

CAMPS

• Places where resources 

may be kept to support 

incident operations (if Base 

is not accessible). 

• Multiple Camps may be 

used, but not all incidents 

will have Camps. C

Symbol

Slide 1-45

E. Camps.

1. These are the places where resources may be kept to support incident 

operations if a Base is not accessible to all resources. 

2. Multiple Camps may be used, but not all incidents will have Camps.

•

CAMPS (cont’d)

Temporary locations within 

general incident area —

equipped and staffed to 

provide food, water, 

•

sleeping areas and sanitary 

services. 

Designated by geographic 

location or number. 

C

Symbol

Slide 1-46

3. They are temporary locations within the general incident area that are 

equipped and staffed to provide food, water, sleeping areas and sanitary 

services.

4. They are designated by geographic location or number. 
ICS OVERVIEW

SM 1-37

Slide 1-47

HELIBASE/HELISPOTS

• Helibase

– Location from which 

helicopter-centered air 

operations are conducted. 

– Used on a longer-term basis 

and include such services as 

fueling and maintenance. 

H

H-1

F. Helibase/Helispots.

1. A Helibase is the location from which helicopter-centered air operations 

are conducted. Helibases are generally used on a longer-term basis and 

include such services as fueling and maintenance.

Slide 1-48

• Helispots

– Temporary locations at 

incident, where helicopters 

can safely land and take off. 

– Multiple Helispots may be 

used.

H

H-1

HELIBASE/HELISPOTS 

(cont’d)

2. Helispots are more temporary locations at the incident, where helicopters 

can safely land and take off. Multiple Helispots may be used in an 

incident.
ICS OVERVIEW

SM 1-38

Slide 1-49

SUMMARY OF INCIDENT 

FACILITIES

G. Summary of incident facilities.
ICS OVERVIEW

SM 1-39

VIII. ICS FORMS

Slide 1-50

ICS FORM 201, 

INCIDENT BRIEFING

• Purpose. 

– Provides basic incident information, allocated 

resources.

– Permanent record of initial incident response.

• Preparation.

– Field Command.

A. ICS Form 201, Incident Briefing.

1. Purpose:

a. It provides basic information regarding the incident situation and 

the resources allocated to the incident.

b. It also serves as a permanent record of the initial response to the 

incident.

2. Preparation: It is prepared by Field Command. 

Slide 1-51

ICS FORM 202, 

INCIDENT OBJECTIVES

• Purpose. 

– Describe basic incident strategy, controls 

objectives, and provides weather information 

and safety considerations for use during next 

operational period.

• Preparation.

– By Planning Section Chief.

B. ICS Form 202, Incident Objectives.
ICS OVERVIEW

SM 1-40

1. Purpose: It describes the basic incident strategy, controls objectives, and 

provides weather information and safety considerations for use during the 

next operational period.

2. Preparation: It is prepared by the Planning Section Chief.

Slide 1-52

ICS FORM 203, 

ORGANIZATION ASSIGNMENT LIST

• Purpose. 

– Provides ICS personnel with information on 

units currently activated and names of 

personnel staffing each position/unit.

• Preparation.

– By Resources Unit under direction of Planning 

Section Chief.

C. ICS Form 203, Organization Assignment List.

1. Purpose: It provides ICS personnel with information on the units that are 

currently activated and the names of personnel staffing each position/unit. 

It is also used to complete the ICS Form 207, Incident Organization Chart, 

which is posted on the ICP display.

2. Preparation: The list is prepared and maintained by the Resources Unit 

under the direction of the Planning Section Chief.

Slide 1-53

ICS FORM 204, 

ASSIGNMENT LIST

• Purpose. 

– Inform Operations Section personnel of 

incident assignments.

• Preparation.

– By Resources Unit using guidance from ICS 

Form 202, Incident Objectives, ICS Form 215, 

Operational Planning Worksheet, and 

Operations Section Chief.

D. ICS Form 204, Assignment List.
ICS OVERVIEW

SM 1-41

1. Purpose: It is used to inform Operations Section personnel of incident 

assignments. Once the assignments are agreed to by the IC and General 

Staff, the assignment information is given to the appropriate units and 

Divisions via the Communications Center.

2. Preparation: The Assignment List normally is prepared by the Resources 

Unit using guidance from ICS Form 202, Incident Objectives, ICS Form 

215, Operational Planning Worksheet, and Operations Section Chief. The 

Assignment List must be approved by the Planning Section Chief. When 

approved, it is attached to the incident objectives as part of the IAP.

Slide 1-54

ICS FORM 206, 

MEDICAL PLAN

• Purpose. 

– Provides information on incident medical aid 

stations, transportation services, hospitals, and 

medical emergency procedures.

• Preparation.

– Prepared by the Medical Unit Leader and 

reviewed by the Safety Officer.

E. ICS Form 206, Medical Plan.

1. Purpose: It provides information on incident medical aid stations, 

transportation services, hospitals, and medical emergency procedures.

2. Preparation: It is prepared by the Medical Unit Leader and reviewed by 

the Safety Officer.

Slide 1-55

ICS FORM 211, 

CHECK-IN LIST

• Purpose. 

– Recording arrival times of all overhead 

personnel and equipment at the incident.

– Recording initial location of personnel and 

equipment.

– Supporting demobilization by recording the 

home base, method of travel, etc. on all checkins.
ICS OVERVIEW

SM 1-42

F. ICS Form 211, Check-in List.

1. Purpose: 

a. It is used for recording arrival times of all overhead personnel and 

equipment at the incident. 

b. It is used for recording the initial location of personnel and 

equipment, thereby allowing for subsequent assignment.

c. It is used for supporting demobilization by recording the home 

base, method of travel, etc. on all check-ins.

Slide 1-56

• Preparation.

– Managers at Staging Areas, Base, Camps, 

Helibases, ICP and Communications Center 

record information and give it to the Resources 

Unit.

– Check-in at the ICP is done by a recorder in the 

Resources Unit.

ICS FORM 211, 

CHECK-IN LIST (cont’d)

2. Preparation: It is prepared by managers at Staging Areas, Base, Camps, 

Helibases, ICP, and the Communications Center; they record information 

and then give it to the Resources Unit. Check-in at the ICP is done by a 

recorder in the Resources Unit.

Slide 1-57

ICS FORM 214, 

UNIT LOG

• Purpose. 

– Record of unit activities.

– Basic reference from which to extract 

information for inclusion in any after-action 

report.

• Preparation.

– Initiated and maintained by Command and 

General Staff members, Field Command, and 

Unit Leaders.
ICS OVERVIEW

SM 1-43

G. ICS Form 214, Unit Log.

1. Purpose: It provides a record of unit activities. It can also serve as a basic 

reference from which to extract information for inclusion in any afteraction report.

2. Preparation: It is initiated and maintained by Command and General 

Staff members, Field Command, and Unit Leaders.
ICS OVERVIEW

SM 1-44

This page intentionally left blank.
ICS OVERVIEW

SM 1-45

Activity 1.1

Completing Unit Log

Purpose

The purpose of this activity is for you to become familiar with the use of ICS Form 214, Unit 

Log.

Directions

1. You will complete ICS Form 214, Unit Log as you complete the scenarios and various 

other activities during the course.

2. Hand in your completed form at the end of each day. 
ICS OVERVIEW

SM 1-46

This page intentionally left blank.
ICS OVERVIEW

SM 1-47

Activity 1.1 (cont’d)

Completing Unit Log

ICS Form 214, Unit Log Day 1

UNIT LOG 1. Incident Name 2. Date Prepared 3. Time Prepared

4. Unit Name/Designators 5. Unit Leader (Name and Position) 6. Operational Period

7. Personnel Roster Assigned

Name ICS Position Home Base

8. Activity Log

Time Major Events

9. Prepared by (Name and Position)
ICS OVERVIEW

SM 1-48

This page intentionally left blank.
ICS OVERVIEW

SM 1-49

Activity 1.1 (cont’d)

Completing Unit Log

ICS Form 214, Unit Log Day 1

UNIT LOG 1. Incident Name 2. Date Prepared 3. Time Prepared

4. Unit Name/Designators 5. Unit Leader (Name and Position) 6. Operational Period

7. Personnel Roster Assigned

Name ICS Position Home Base

8. Activity Log

Time Major Events

9. Prepared by (Name and Position)
ICS OVERVIEW

SM 1-50

This page intentionally left blank.
ICS OVERVIEW

SM 1-51

Activity 1.1 (cont’d)

Completing Unit Log

ICS Form 214, Unit Log Day 2

UNIT LOG 1. Incident Name 2. Date Prepared 3. Time Prepared

4. Unit Name/Designators 5. Unit Leader (Name and Position) 6. Operational Period

7. Personnel Roster Assigned

Name ICS Position Home Base

8. Activity Log

Time Major Events

9. Prepared by (Name and Position)
ICS OVERVIEW

SM 1-52

This page intentionally left blank.
ICS OVERVIEW

SM 1-53

Activity 1.1 (cont’d)

Completing Unit Log

ICS Form 214, Unit Log Day 2

UNIT LOG 1. Incident Name 2. Date Prepared 3. Time Prepared

4. Unit Name/Designators 5. Unit Leader (Name and Position) 6. Operational Period

7. Personnel Roster Assigned

Name ICS Position Home Base

8. Activity Log

Time Major Events

9. Prepared by (Name and Position)
ICS OVERVIEW

SM 1-54

This page intentionally left blank.
ICS OVERVIEW

SM 1-55

IX. SUMMARY

Slide 1-59

SUMMARY

• Describe the ICS structure.

• Define common ICS terms.

• Differentiate among Groups, Divisions and 

Branches.

• Identify the leadership titles for ICS 

organizational elements.

• Describe each of the relevant ICS forms. 

• Discuss ICS map symbols.
This page intentionally left blank.
EMS FUNCTIONS IN ICS

MODULE 2:

ICS SPECIFIC TO EMS OVERVIEW

OBJECTIVES

The students will be able to:

2.1 Identify common Incident Command System (ICS) terminology specific to Emergency Medical Services 

(EMS).

2.2 Describe the basic structure of the medical component within an ICS structure.

2.3 Describe methods for incorporating Medical Branch organization into ICS structure.

2.4 Describe resource typing.

2.5 Describe Ambulance Strike Teams.

2.6 Define EMS Task Force.

2.7 Describe Staging.
ICS SPECIFIC TO EMS OVERVIEW

SM 2-2

This page intentionally left blank.
ICS SPECIFIC TO EMS OVERVIEW

SM 2-3

MODULE 2: 

ICS SPECIFIC TO EMS 

OVERVIEW

Slide 2-1

OBJECTIVES

• Identify common Incident Command 

System (ICS) terminology specific to 

Emergency Medical Services (EMS).

• Describe the basic structure of the 

medical component within an ICS 

structure.

• Describe methods for incorporating 

Medical Branch organization into ICS 

structure.

• Describe resource typing. Slide 2-2

OBJECTIVES (cont’d)

• Describe Ambulance Strike Teams.

• Define EMS Task Force.

• Describe Staging.

Slide 2-3
ICS SPECIFIC TO EMS OVERVIEW

SM 2-4

I. ICS SPECIFIC TO EMS OVERVIEW 

MEDICAL GROUP 

STRUCTURE WITHIN ICS

• Medical Group generally falls under 

Operations Section.

• Medical Group consists of following Units:

– Triage.

– Treatment.

– Transportation.

Slide 2-4

A. Medical Group structure within Incident Command System (ICS).

At the most basic level of ICS, the Medical Group will generally fall under the 

Operations Section. The Medical Group will, at its most basic, consist of the 

following Units:

1. Triage.

2. Treatment.

3. Transportation.

MEDICAL BRANCH

• Provides Incident Commander (IC) with 

manageable span-of-control.

• Separates out medical component for 

complex incidents.

• Implementation depends on incident size 

and patient numbers.

• People managing incidents must:

– Complete assigned objectives.

– Account for safety.

– Communicate their need for resources.

Slide 2-5

B. Medical Branch.
ICS SPECIFIC TO EMS OVERVIEW

SM 2-5

The Medical Branch is another tool that can be used to provide a more 

manageable span-of-control for the Incident Commander (IC). It is often used to 

separate out the medical component when a complex rescue or fire scenario is 

also present on the incident.

1. The implementation will depend on the size of the incident and the 

number of patients. Most incidents will have Groups, Divisions and Units. 

On large-scale prolonged incidents, Sections and Branches may be 

established.

2. Units under the IC, regardless of their designation, become the eyes and 

ears of the IC. The people managing those incidents must complete their 

assigned objectives, account for safety, and communicate their need for 

resources.

EXPANDABLE UNITS WITHIN 

ICS

Units may be expanded to include, but not be 

limited to:

• Medical supply 

coordinator.

• Triage:

– Morgue manager.

• Treatment:

– Immediate treatment.

– Delayed treatment.

– Minor treatment.

– Treatment dispatch 

manager.

• Transportation:

– Medical 

communications 

coordinator.

– Ambulance 

coordinator.

Slide 2-6

C. Expandable units within ICS.

Depending on the size and complexity of the incident, Groups and Units may be 

expanded to include, but not be limited to:

1. Medical supply coordinator.

2. Triage.

Morgue manager.

3. Treatment.

a. Immediate treatment.

b. Delayed treatment.
ICS SPECIFIC TO EMS OVERVIEW

SM 2-6

c. Minor treatment.

d. Treatment dispatch manager.

4. Transportation.

a. Medical communications coordinator.

b. Ambulance coordinator.
ICS SPECIFIC TO EMS OVERVIEW

SM 2-7

Multicasualty — Reinforced Response Organization

Multicasualty 

—

Reinforced Response Organization
ICS SPECIFIC TO EMS OVERVIEW

SM 2-8

MEDICAL UNIT

• Established under Logistics Section. 

• Responsible for:

– Medical monitoring of response personnel.

– Obtaining medical aid and transportation for 

injured and ill responders or rescue 

personnel.

– Establishment of responder rehabilitation.

-- National Fire Protection Association (NFPA) 

1584.

-- United States Fire Administration (USFA) 

Emergency Incident Rehabilitation.

Slide 2-7

D. Medical Unit.

1. In incidents where response personnel (Emergency Medical Services 

(EMS), Fire, Police) may require medical monitoring and treatment, a 

Medical Unit may be established under the Logistics Section.

2. In addition to medical monitoring for response personnel, the Medical 

Unit is responsible for obtaining medical aid and transportation for injured 

or ill responders/rescue personnel and establishment of responder 

rehabilitation.

3. Additional information on responder rehabilitation can be found in 

National Fire Protection Agency (NFPA) 1584 and the U.S. Fire 

Administration (USFA) Emergency Incident Rehabilitation document.

MULTIPLE TRIAGE AND 

TREATMENT UNITS

• An incident can have multiple Triage and 

Treatment Units:

– Depending on its size.

– If patients can become mobile and exit or 

gather at different locations.

– When problem begins to expand.

Slide 2-8

E. Multiple Triage and Treatment Units.
ICS SPECIFIC TO EMS OVERVIEW

SM 2-9

1. An incident may require multiple Triage and Treatment Units depending 

on the size of the incident and whether patients can become mobile and 

exit and/or gather at different locations.

2. Some examples depicting this behavior include the Columbine School 

Shooting, the sarin attack on the Tokyo Subway, etc.

STRATEGIC 

CONSIDERATIONS

Overall functions of 

incident, including strategic 

planning

Splitting EMS crews to 

double care-giving roles 

(when necessary)

Initiating development of 

formal Incident Action Plan 

(IAP)

Facilitating strategic 

planning meeting

IC 

Responsibilities

Slide 2-9

F. Strategic considerations.

1. The IC is responsible for the overall functions of the incident, including 

strategic planning.

a. During the incident, the IC should continually assess the issues and 

needs of the incident.

b. The IC is responsible for the direction and flow of responding 

units.

c. When necessary, the IC should consider splitting EMS crews to 

double care-giving roles quickly:

- One medic to Triage/Treatment; partner stays with Unit for 

continuous, same-level care during transportation.

- Use nonassigned personnel to drive ambulance.

- Determine location of treatment/care holding areas.

d. Establish initial incident tactical and strategic objectives and 

initiate the development of a formal Incident Action Plan (IAP).
ICS SPECIFIC TO EMS OVERVIEW

SM 2-10

e. Have strategic planning meetings occur at time intervals 

designated by the IC.

- Announce to all personnel in a leadership role the time and 

location of the strategic planning meeting.

- Facilitate strategic planning meeting, until the incident 

organization requires the establishment of a Planning 

Section. Then, the Planning Section Chief (PSC) will 

facilitate the meeting in coordination with the IC.

- Personnel attending these meetings should be prepared to 

discuss the needs and operations of their areas concisely.

- Make organizational changes based on the information 

received.

2. Additional resources specific to incident needs include:

a. Law enforcement for traffic/crowd control.

b. Specialty equipment (cranes, large tow truck).

c. Potential issues, problems and needs of the incident, including 

those that affect the community, such as local hospitals, transit 

system, etc.

d. Other transportation vehicles (buses, wheelchair transport, cabs).

VERTICAL VERSUS 

HORIZONTAL COMMUNICATION

• Within the ICS structure, information is 

normally communicated vertically.

• Horizontal communication may be 

necessary to communicate critical safety 

information.

– For example, triage reports normally go up 

the Command, but may also need to go to 

Rescue Group Supervisor and his or her 

reports.

Slide 2-10

G. Vertical versus horizontal communication.
ICS SPECIFIC TO EMS OVERVIEW

SM 2-11

1. Within the ICS structure, information is normally communicated 

vertically.

2. Horizontal communication may be necessary to communicate critical 

safety information. For example, triage reports normally go up the 

Command, but they may also need to go to the Rescue Group Supervisor 

and his or her reports.

PATIENT STATUS

• Patients divided into: 

– Immediate (red).

– Delayed (yellow).

– Minor (green).

– Deceased/Expectant (black).

Slide 2-11

H. Patient status.

1. There are currently various systems for patient triage. One national 

accepted system in use divides patients into:

a. Immediate.

b. Delayed.

c. Minor.

d. Deceased/Expectant.

2. These patient status categories also correspond to the red, yellow, green 

and black patient triage color schemes.

3. This is the terminology we will use for describing patient status 

throughout this course.
ICS SPECIFIC TO EMS OVERVIEW

SM 2-12

II. RESOURCE TYPING 

RESOURCE TYPING

Categorization and description of resources 

commonly exchanged in disasters via mutual 

aid, by capacity and/or capability.

Slide 2-12

A. Resource typing.

Resource typing is the categorization and description of resources that are 

commonly exchanged in disasters via mutual aid, by capacity and/or capability.

ADVANTAGES

• Helps standardize type of equipment an IC 

can request. 

• Ensures that proper equipment, training, 

and personnel are matched together in an 

organized structure.

• Enables effective and efficient request/ 

receipt of resources through mutual aid 

during a disaster.

Slide 2-13

B. Advantages.

1. Resource typing helps standardize the type of equipment an IC can 

request. It ensures that the proper equipment, training and personnel are 

matched together in an organized structure.

2. As a result of the resource typing process, a resource’s capability is readily 

defined and an emergency manager is able to request and receive 

resources effectively and efficiently through mutual aid during times of 

disaster.
ICS SPECIFIC TO EMS OVERVIEW

SM 2-13

III. AMBULANCE STRIKE TEAMS

AMBULANCE STRIKE 

TEAMS — COMPOSITION 

• Group of five ambulances:

– Same types of ambulances.

– Have common communications and a leader 

(in separate command vehicle).

– May be all advanced life support (ALS) or all 

basic life support (BLS).

• Provides operational grouping of 

ambulances with supervisory element for 

organization command and control.

Slide 2-14

A. Ambulance Strike Teams — composition.

1. An Ambulance Strike Team consists of a group of five ambulances of the 

same type with common communications and a leader. The Strike Team 

may be all advanced life support (ALS) or all basic life support (BLS).

2. This approach to organization provides an operational grouping of 

ambulances complete with supervisory element for organization command 

and control.

CONCEPT OF OPERATION 

• Multicasualty incident primary medical response 

may be from: 

– Fire/EMS service.

– Private service.

– Federalized resources.

• Ambulance Strike Team model is to order in 

bulk.

• Organized response prevents freelancing and 

ambulances self-dispatching.

• Ambulance resources managed under:

– Fire and rescue mutual-aid systems.

– Private-sector ambulances. Slide 2-15

B. Concept of operation.

1. Immediately following a mass casualty incident (MCI), disaster, or 

catastrophic event, the community’s primary field medical response may 

come from fire, private or federalized resources.
ICS SPECIFIC TO EMS OVERVIEW

SM 2-14

2. The basic concept of the Ambulance Strike Team model is to order in 

bulk. An organized response within the framework of an Incident 

Management System is superior to an unorganized response. Requesting 

resources in an organized fashion prevents freelancing and ambulances 

self-dispatching.

3. To date, ambulance resources are generally managed under two different 

systems:

a. Fire and rescue mutual-aid systems coordinated through public 

entities.

b. Private-sector ambulances coordinated through the federal disaster 

contract or statewide mutual-aid system.

NIMS AMBULANCE STRIKE 

TEAM TYPING STRIKE

TEAM

LEVEL

HAZARDOUS

MATERIALS 

CAPABILITY

PERSONNEL FUNCTION CAPABILITY

TYPE 1 ALS Yes

Minimum: one 

paramedic and one 

emergency medical 

technician (EMT) per 

ambulance per shift 

One Strike Team 

Leader per team in a 

separate Command 

vehicle.

Clinical and 

transportation 

services to a 

range of 

patient 

conditions. 

Includes 

vehicles, staff, 

equipment, 

and supplies.

Five 

ambulances of 

the same type

Minimum 

capability of 10 

litter patients 

(two per 

ambulance)

TYPE 2

ALS No

TYPE 3 BLS Yes Minimum: one EMT 

and one Emergency 

Medical Responder per 

ambulance/per shift 

One Strike Team 

Leader per team in a 

separate Command 

vehicle.

TYPE 4

ALS No

Slide 2-16

C. Types.

Ambulance Strike Teams are classified as Type 1, Type 2, Type 3, and Type 4, 

based on their team and personnel — i.e., ALS or BLS.

1. Capability.

a. Five ambulances of the same type.

b. Minimum capability of 10 litter patients (two per ambulance).

2. Function.

a. Clinical and transportation services to a range of patient 

conditions.

b. Includes vehicles, staff, equipment and supplies.
ICS SPECIFIC TO EMS OVERVIEW

SM 2-15

3. Personnel.

a. For Type 1 and Type 2 Ambulance Strike Teams: Minimum of one 

paramedic and one emergency medical technician (EMT) per 

ambulance per shift. One Strike Team Leader per team in a 

separate Command vehicle.

b. For Type 3 and Type 4 Ambulance Strike Teams: Minimum of one 

EMT and one Emergency Medical Responder per ambulance per 

shift. One Strike Team Leader per team in a separate Command 

vehicle.

4. Team.

a. For Type 1 and Type 2 Ambulance Strike Teams: ALS.

b. For Type 3 and Type 4 Ambulance Strike Teams: BLS.

5. Hazardous materials capability.

Type 1 and Type 3 Ambulance Strike Teams must meet or exceed 

standards as addressed by Environmental Protection Agency (EPA), 

Occupational Safety and Health Administration (OSHA) and NFPA 472, 

473, and 29 CFR 1910.120 to work in hazardous materials environments.

NATIONAL INCIDENT MANAGEMENT 

SYSTEM RESOURCE DEFINITIONS FOR 

OPERATION 

• Ambulance Strike Teams should be selfsufficient for 72 hours.

• Support requirements include security, 

fuel, vehicle maintenance support, 

transportation, food, rest facilities.

• Temperature control support may be 

required.

• Additional staff may be required.

Slide 2-17

D. NIMS resource definitions for operation.

NIMS resource definitions for Ambulance Strike Team operation include:

1. Ambulance Strike Teams should be self-sufficient for 72 hours and can be 

deployed to cover 12-hour periods or 24-hour ops, depending on number 

of ambulances needed at one time.
ICS SPECIFIC TO EMS OVERVIEW

SM 2-16

2. Support requirements include security, fuel, vehicle maintenance support, 

transportation, food, rest facilities, support for a minimum of 11/17 

personnel, and resupply of medical supplies.

3. Temperature control support may be required for medical supplies in some 

environments.

4. Additional staff may be needed to ensure the ongoing availability of 

resources required to support the mission assignment safely and 

effectively.

ADVANTAGES OF 

AMBULANCE STRIKE TEAMS

• Built on ICS (organized and systematic 

response).

• Serve as critical resource for disaster 

planning and preparedness.

• Provide supplemental ambulances and 

personnel to an incident whose resources 

are overwhelmed by an emergency.

Slide 2-18

E. Advantages.

Ambulance Strike Teams have a number of advantages:

1. Their concept is built upon ICS, allowing for an organized and systematic 

response.

2. They serve as a critical resource for disaster planning and preparedness.

3. They provide supplemental ambulances and personnel to an incident 

whose resources are overwhelmed by an emergency.
ICS SPECIFIC TO EMS OVERVIEW

SM 2-17

IV. EMS TASK FORCE

EMS TASK FORCE —

COMPOSITION 

• Operational grouping of five different EMS 

resources for medical mission:

– Involves ALS, BLS, air ambulances and other 

EMS response vehicles/teams.

– Provides range of EMS services.

– Includes vehicles, staff, equipment and 

supplies required for mission assignment.

– One Supervisor/Leader per Task Force:

-- Must have separate vehicle with en route and onscene communications capabilities.

-- All Units under Leader’s supervision.

Slide 2-19

A. EMS Task Force — composition.

An EMS Task Force is an operational grouping of five different EMS resources 

for a medical mission; it has the following characteristics:

1. Involves ALS, BLS, air ambulances and other EMS response 

vehicles/teams.

2. Provides range of EMS services.

3. Includes vehicles, staff, equipment and supplies required for mission 

assignment.

4. One Supervisor/Leader per Task Force.

a. Must have separate vehicle with en route and on-scene 

communications capabilities.

b. All units under Leader’s supervision.
ICS SPECIFIC TO EMS OVERVIEW

SM 2-18

• EMS Task Force should be self-sufficient for 

12-hour operational periods.

• Support requirements include: security, fuel, 

vehicle maintenance support, 

transportation, food, rest facilities.

• Temperature control support may be 

required.

• Additional staff may be required.

Slide 2-20

NATIONAL INCIDENT MANAGEMENT 

SYSTEM RESOURCE DEFINITIONS FOR 

OPERATION (cont’d) 

B. NIMS resource definitions for operation.

NIMS resource definitions for EMS Task Force operation include the following:

1. EMS Task Force should be self-sufficient for 12-hour operational periods, 

although they may be deployed longer, depending on need.

2. Support requirements include: security, fuel, vehicle maintenance support, 

transportation, food, rest facilities, support for a minimum of all personnel 

and resupply of medical supplies.

3. Temperature control support may be required for medical supplies in some 

environments.

4. Additional staff may be needed to ensure the ongoing availability of 

resources required to support the mission assignment safely and 

effectively.
ICS SPECIFIC TO EMS OVERVIEW

SM 2-19

V. STAGING

STAGING 

• A temporary location at which resources 

assigned to incident are held until they are 

assigned to a specific function.

• Often classified as:

– Level 1.

– Level 2.

• Deployment time of three minutes or less.

Slide 2-21

A. Staging.

1. A key component to managing any MCI event is “Staging.”

a. Staging is defined as a temporary location at which resources 

assigned to the incident are held until they are assigned to a 

specific function.

b. Many agencies further define Staging as Level 1 and 2:

- Level 1 Staging is commonly a procedure where the EMS 

units stage a block away from the address. This provides 

flexibility to enter a scene from a strategic perspective and 

affords some protection of the crews in an unstable 

situation or potentially violent scene.

- Level 2 Staging designations indicate a specific location for 

all units to meet. It requires a Staging Officer and often 

check-in and check-out procedures.

2. Units in Staging should have a deployment time of three minutes or less.
ICS SPECIFIC TO EMS OVERVIEW

SM 2-20

STAGING FOR EMS 

RESOURCES BEING DEPLOYED 

Two designated Staging Areas for each of the 

following resources:

• Fire/Rescue apparatus.

• Ambulances.

Slide 2-22

B. Staging for EMS resources being deployed.

In incidents in which there are EMS resources being deployed, there may be two 

Staging Areas designated, one for fire or rescue apparatus and another for 

ambulances. Fire equipment will arrive on-scene and go to work on the incident,

essentially staying on-scene for the duration of the event. Ambulance resources,

especially in many small communities or rural settings, will be limited, and in 

events with several patients, ambulances may have to go to and from the scene 

several times.

BENEFITS OF STAGING 

Benefits 

Provides IC 

with time to 

deploy units 

to “right” 

locations at 

“right” time 

Provides IC 

with resource 

pool to 

address 

unexpected 

situations

Provides 

resources, so 

operating 

units can 

transition to 

Rehab

Aids in 

accountability 

of resources

Enhances 

resource 

safety

Slide 2-23

C. Benefits of Staging.

Staging has the following benefits:

1. Provides the IC or Ops Chief discretionary time to deploy units to the 

“right” locations at the “right” time. Allows first-in IC to conduct a good 

size-up.
ICS SPECIFIC TO EMS OVERVIEW

SM 2-21

2. Provides IC or Ops Chief with a pool of resources to address unexpected 

situations.

3. Provides resources so operating units can transition to Rehab.

4. Aids in accountability of resources.

5. Enhances resource safety.

CONSIDERATIONS FOR 

STAGING

• Area large enough to accommodate 

incident resources. 

• Close to the incident’s operational area.

• Accessible from major roads or highways.

• Secure from hazards. 

• Creature comfort availability.

Slide 2-24

D. Considerations for Staging.

The Staging Area should be:

1. Large enough to accommodate incident resources.

2. Close to the incident’s operational area, allowing short deployment times.

3. Accessible from major roads or highways.

4. Secure from hazards.

5. Provide creature comfort availability — e.g., cover for personnel working 

in Staging/bathrooms.
ICS SPECIFIC TO EMS OVERVIEW

SM 2-22

BEST PRACTICES FOR 

STAGING

• Use Strike Teams and Task Forces.

• Brief personnel on safety message before 

deployment.

• Ensure that resources maintain “operational” 

readiness.

• Ensure that all personnel are incident-focused.

• Have separate entrances and exits.

• Place Staging Areas away from Rehab Areas.

• Do not place Staging Areas too close to patient 

loading areas.

Slide 2-25

E. Best practices for Staging.

Some recommended best practices for Staging:

1. Use Strike Teams and Task Forces when filling request for resources.

2. Brief personnel on safety message or other issues before deployment.

3. Ensure that resources maintain “operational” readiness (deployment in less 

than three minutes).

4. Ensure that all personnel are incident-focused.

5. Have separate entrances and exits.

a. Having one entrance and a separate exit helps prevent units from 

having to back up in a congested area.

b. If separate entry and exit points to the Staging Area cannot be 

accomplished, units placed in Staging should be backed in to the 

parking spots with a spotter.

c. Backing units in when they arrive under less urgent circumstances 

averts the potential for backing accidents when an assignment 

comes or there is a need for immediate deployment and/or 

relocation of resources.

6. Staging Areas should be placed away from the Rehab Areas.

a. It is common for rescuers not assigned or waiting to be assigned to 

an incident to fraternize with crews that have been involved in the 

incident.
ICS SPECIFIC TO EMS OVERVIEW

SM 2-23

b. Jeopardizing crew integrity by allowing crews to have a reason not 

to be readily available for deployment or away from their vehicles 

delays the response time for a unit in Staging.

c. Large Staging operations often require support services. Prior to a 

Logistics Section being established, Staging may need to provide 

fuel, mechanical services, maps and support for the personnel 

staffing the vehicles.

7. It is important not to place Staging Areas too close to patient loading 

areas, as vehicle exhaust under certain weather or geographical conditions 

could expose patients lying on the ground to carbon monoxide or diesel 

exhaust.

STAGING SCHEMATIC 

Slide 2-26

F. Staging Schematic.

A schematic of a model Staging situation is shown on the following page.
ICS SPECIFIC TO EMS OVERVIEW

SM 2-24

Staging Schematic Graphic
ICS SPECIFIC TO EMS OVERVIEW

SM 2-25

ACTIVITY 2.1

Resource Typing

Purpose

The purpose of this activity is for you to apply the process of identifying resource types, in 

accordance with NIMS ICS, to resources within your jurisdiction.

Directions

1. This is an individual activity.

2. Choose two EMS resources in your jurisdiction.

3. Use the Resource Typing Guide (Appendix D) to type each resource.

4. You have 10 minutes to complete the worksheet.
ICS SPECIFIC TO EMS OVERVIEW

SM 2-26

This page intentionally left blank.
ICS SPECIFIC TO EMS OVERVIEW

SM 2-27

ACTIVITY 2.1 (cont’d)

Resource Typing

EMS Resource 1: 

Description of Resource: 

Type Assigned: 

Reason for Choosing Type: 

EMS Resource 2: 

Description of Resource: 

Type Assigned: 

Reason for Choosing Type: 
ICS SPECIFIC TO EMS OVERVIEW

SM 2-28

This page intentionally left blank.
ICS SPECIFIC TO EMS OVERVIEW

SM 2-29

ACTIVITY 2.2

EMS Task Force

Purpose

The purpose of this activity is for you to apply the process creating an EMS Task Force to meet a 

resource request, in accordance with NIMS ICS.

Directions

1. This is an individual/small group activity.

2. Granite County has a tornado. The county requires an EMS Task Force to help with 

duties associated with combating the tornado.

3. Discuss with your table group your individual results and compile a Master List of 

resources for an EMS Task Force.

4. You have 10 minutes to complete the worksheet.

5. Choose one group to do a full reporting out of its Master list of EMS Task Force 

Resources.

6. After the first group is done, ask the other groups to briefly describe how/if their resource

lists were different.
ICS SPECIFIC TO EMS OVERVIEW

SM 2-30

This page intentionally left blank.
ICS SPECIFIC TO EMS OVERVIEW

SM 2-31

ACTIVITY 2.2 (cont’d)

EMS Task Force

EMS Resource 1: 

Reason for Choosing Resource: 

EMS Resource 2: 

Reason for Choosing Resource: 

EMS Resource 3: 

Reason for Choosing Resource: 

EMS Resource 4: 

Reason for Choosing Resource: 

EMS Resource 5: 

Reason for Choosing Resource: 

EMS Resource 6: 

Reason for Choosing Resource: 
ICS SPECIFIC TO EMS OVERVIEW

SM 2-32

This page intentionally left blank.
ICS SPECIFIC TO EMS OVERVIEW

SM 2-33

VI. SUMMARY

SUMMARY

• Identify common ICS terminology specific to 

EMS.

• Describe the basic structure of the medical 

component within an ICS structure.

• Describe methods for incorporating Medical 

Branch organization into ICS structure.

• Describe resource typing.

Slide 2-29

SUMMARY (cont’d)

• Describe Ambulance Strike Teams.

• Define EMS Task Force.

• Describe Staging.

Slide 2-30
This page intentionally left blank.
EMS FUNCTIONS IN ICS

SCENARIO A:

MASS CASUALTY INCIDENT —

CAR ACCIDENT

SCENARIO OBJECTIVES

The students will be able to:

SA.1 Develop a Brief Initial Report (BIR) and conduct a size-up of an incident.

SA.2 Develop an Incident Command System (ICS) organizational structure, specific to the Emergency Medical 

Services (EMS)/Medical functions, with resources that reflect incident priorities.

SA.3 Track patients using a Patient Tracking Form. 

SA.4 Use benchmarks to order and assign appropriate resources.
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-2

This page intentionally left blank.
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-3 

SCENARIO A:

MASS CASUALTY INCIDENT —

CAR ACCIDENT

Slide SA-1

SCENARIO OBJECTIVES

•

•

Develop a Brief Initial Report (BIR) and conduct 

a size-up of an incident.

Develop an Incident Command System (ICS) 

organizational structure, specific to the 

Emergency Medical Services (EMS)/Medical 

functions, with resources that reflect incident 

•

priorities. 

Track patients using a Patient Tracking Form.

• Use benchmarks to order and assign 

appropriate resources.

Slide SA-2

I. SCENARIO A: MASS CASUALTY INCIDENT — CAR ACCIDENT

•

•

SCENARIO ROLES AND 

TASKS

In this scenario you are the E-41 Officer.

In this scenario, you will develop/complete:

– BIR.

– ICS Organizational Structures (Initial and Final, 

updated with any new information provided).

– ICS Form MC-306 (Patient Tracking Form).

– Student Response Checklist.

Slide SA-3

A. Scenario roles and tasks.
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-4 

1. In this scenario, you are the E-41 Officer.

2. In this scenario, you will develop/complete:

a. Brief Initial Report (BIR).

b. Incident Command System (ICS) Organizational Structures.

c. ICS Form MC-306 (Patient Tracking Form). 

d. Student Response Checklist. 

•

SCENARIO ROLES AND 

TASKS (cont’d)

Remember: 

– Type 1 Ambulance, advanced life support 

(ALS) = Central City Medic.

– Type 3 Ambulance, basic life support (BLS) = 

Central City Ambulance.

Slide SA-4

3. Remember:

a. Type 1 Ambulance, advanced life support (ALS) = Central City 

Medic.

b. Type 3 Ambulance, basic life support (BLS) = Central City

Ambulance.
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-5 

•

•

INTRODUCTION

Location: Interstate 102 Westbound, 1.5 

miles west of state Route 69.

Current conditions:

– Time: 0730 hours.

– Date: February 25.

– Temperature: 40 F, sunny.

– Humidity: 50 percent.

– Wind: 5 mph east-southeast.

Slide SA-5

B. Introduction. 

1. Location: Interstate 102 Westbound, 1.5 miles west of state Route 69. 

2. Current conditions: 

a. Time: 0730 hours. 

b. Date: February 25. 

c. Temperature: 40 F, sunny. 

d. Humidity: 50 percent. 

e. Wind: 5 mph east-southeast. 
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-6

This page intentionally left blank.
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-7

Scenario A: Student Instructions

Flow of Scenario Time

1. Introduction/Background for Scenario A 1 minute

2. Initial Dispatch 2 minutes

3. Arrival On-scene 2 minutes

4. Group Work 1

(Includes BIR and Model Response) 5 minutes

5. Group Work 2 15 minutes

6. Reporting Out 15 minutes

7. Instructor Debrief and Review of Model Responses 5 minutes

8. Complete the Student Response Checklist 5 minutes

Total Time: 50 Minutes
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-8

This page intentionally left blank.
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-9 

INITIAL DISPATCH

Slide SA-6

C. Initial dispatch.

BRIEF INITIAL REPORT

What do you need to include in a BIR? 

Slide SA-7

D. BIR.
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-10

ON-SCENE ARRIVAL

Slide SA-8

E. On-scene arrival.
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-11

Scenario A: On-scene Images
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-12

This page intentionally left blank.
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-13

GROUP WORK 1

• You are the E-41 Officer, arrived at the 

incident.

– What is your BIR?

• Total working time is three minutes. 

Slide SA-9

F. Group Work 1. 

1. You are the E-41 Officer, arrived at the incident. 

What is your BIR? 

2. Total working time is three minutes. 

SAMPLE BRIEF INITIAL 

REPORT

Slide SA-10

G. Sample BIR.
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-14

GROUP WORK 2

• You are the E-41 Officer, arrived at the 

incident. Develop:

– ICS Organizational Chart.

-- Resource assignment.

•

– Patient tracking.

Review the ICS Forms, maps, sequence of 

arriving units, and other resources provided 

in the Student Manual (SM).

• Total working time is 15 minutes.

Slide SA-11

H. Group Work 2. 

1. You are the E-41 Officer, arrived at the incident. Develop: 

a. ICS Organizational Chart. 

- Resource assignment. 

b. Patient tracking.

2. Review the ICS Forms, maps, sequence of arriving units, and other 

resources provided in the SM. 

3. Total working time is 15 minutes.
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-15

Scenario A: ICS Forms

The ICS forms(s) needed to complete the scenario are attached here. Copies of these forms can 

be found in Appendix A and Appendix B. The easel pads provided can be used to sketch out the 

ICS Organizational Charts and to brainstorm and take notes.
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-16

This page intentionally left blank.
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-17

ICS Form MC-306

Multi-Casualty

Recorder Worksheet

Ambulance 

Company

Ambulance 

ID Number

Patient 

Triage Tag 

Number

Patient 

Status

Hospital 

Destination

Off Scene 

Time

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

ICS-MC-306 (12/89)

DISCLAIMER: This form is not an approved ICS Form but has been provided for your reference and use in this course. 
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-18

This page intentionally left blank.
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-19

Scenario A: Liberty County Map
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-20

This page intentionally left blank.
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-21

Scenario A: Scene
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-22

This page intentionally left blank.
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-23

Scenario A: Sequence of Arriving Units

The sequence of arriving units is listed below. This sequence is based on location of the 

resources within Liberty County.

• Engine 41, Medic 41 arrive first.

• Tower 41, Battalion Chief 41, Medic 31 (two minutes later).

• Ambulance 42, 543 (five minutes later).

• Squad 1, Medic 1001, Engine 81 (10 minutes later).

• Medflight 1 (touch down 15 minutes).

 1 Medic 100 is an EMS Supervisor in a nontransport vehicle. 
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-24

This page intentionally left blank.
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-25

Scenario A: Scene Diagram

The diagram provided below is a schematic of the layout of the incident — including the location 

of the crash vehicles and response vehicles, and the flow of traffic around the incident. It is 

provided as a reference for you as you are working through the scenario. 

Interstate 102

Split Highway
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-26

This page intentionally left blank.
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-27

INJECT 1

• After five minutes, provide the Triage 

Report: 

– Vehicle 1.

-- 58-year-old male. 

– Vehicle 2.

-- 6-year-old male child.

-- 34-year-old male driver.

-- 38-year-old female.

Slide SA-12

I. Inject 1. 

After five minutes, provide the Triage Report: 

1. Vehicle 1.

58-year-old male.

2. Vehicle 2.

a. 6-year-old male child.

b. 34-year-old male driver. 

c. 38-year-old female.

INJECT 1 (cont’d)

– Vehicle 3.

-- 21-year-old male.

Slide SA-13

3. Vehicle 3.

21-year-old male.
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-28

INJECT 2

• After another five minutes, triage is 

completed.

Slide SA-14

J. Inject 2. 

After another five minutes, triage is completed.

INJECT 3

• After another five minutes: 

– ICS structure has been established.

– Resources assigned.

– Scenario ends.

Slide SA-15

K. Inject 3. 

1. ICS structure has been established. 

2. Resources assigned.

3. Scenario ends.
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-29

II. REPORTING OUT

REPORTING OUT

•

•

Groups describe their:

– Organizational charts. 

– Resource assignments.

Remember, one group does full reporting 

•

out; other groups describe significant 

differences.

Total working time is 10 minutes.

Slide SA-16

A. Groups describe their: 

1. Organizational charts.

2. Resource assignments.

B. Remember, one group does full reporting out; other groups describe significant 

differences. 

C. Total working time is 10 minutes.

III. COMPLETING THE SCENARIO

•

•

•

COMPLETING THE 

SCENARIO

Instructor provides Model Responses.

Instructor answers questions.

Students complete Student Response 

Checklist.

• Total working time is 10 minutes.

Slide SA-17

A. Instructor provides Model Responses. 
MASS CASUALTY INCIDENT — CAR ACCIDENT

SM SA-30

B. Instructor answers questions.

C. Students complete Student Response Checklist.

D. Total working time is 10 minutes.
EMS FUNCTIONS IN ICS

MODULE 3:

ON-SCENE CONSIDERATIONS

OBJECTIVES

The students will be able to:

3.1 Discuss Lookouts, Communications, Escape routes and Safety zones (LCES).

3.2 Discuss traffic control devices (TCDs).

3.3 List common roadway incident benchmarks.

3.4 Discuss Conditions, Actions and Needs (CAN) reports.
ON-SCENE CONSIDERATIONS

SM 3-2

This page intentionally left blank.
ON-SCENE CONSIDERATIONS

SM 3-3

MODULE 3: 

ON-SCENE 

CONSIDERATIONS

Slide 3-1

OBJECTIVES

• Discuss Lookouts, Communications, 

Escape routes and Safety zones (LCES).

• Discuss traffic control devices (TCDs).

• List common roadway incident 

benchmarks.

• Discuss Conditions, Actions and Needs 

(CAN) reports.

Slide 3-2

I. ON-SCENE CONSIDERATIONS

LCES: INTRODUCTION

• LCES:

– Lookouts.

– Communications.

– Escape routes.

– Safety zones.

• Widely accepted and required safety 

program:

– Primarily used at wildland fire incidents.

– Can be applied to every emergency incident 

scene, regardless of nature.

Slide 3-3
ON-SCENE CONSIDERATIONS

SM 3-4

A. Lookouts, Communications, Escape routes and Safety zones (LCES): 

Introduction.

The LCES concept is a widely accepted and required safety program used at 

every wildland fire. This concept can be applied to every emergency incident 

scene, regardless of its nature. Since firefighters have already learned the LCES 

concept in wildland training, minimal additional training is required for learning 

and applying this concept elsewhere.

Slide 3-4

LCES: COMPONENTS

• Lookouts:

– Notice minor, major and cumulative changes 

of specific areas.

– Not tactically involved in the response.

– Know plan, fire location and behavior, and 

location of exits.

– Have good communication skills.

– Have portable radio and (optional) thermal 

imaging camera.

B. LCES: Components.

1. Lookouts are situated to notice the minor, major and cumulative changes 

of a specific area in an incident response. The lookout:

a. (Ideally) should not be tactically involved in responding to the 

incident.

b. Must know the plan, fire location and behavior, building 

construction, and location of exits.

c. Must have good communication skills.

d. Must have a portable radio and (optionally) a thermal imaging 

camera.
ON-SCENE CONSIDERATIONS

SM 3-5

LCES: COMPONENTS (cont’d)

• Communications:

– Allow all personnel on-scene to voice their 

concerns.

– Use two-way communication.

– Conduct incident and crew briefings.

• Escape routes:

– Preplanned and understood routes to reach 

safe area.

– Should be wide enough and easy to maneuver 

through.

Slide 3-5

2. Effective communication is critical to ensure a safe and successful 

operation.

a. Allow all personnel on-scene to voice their concerns. This 

promotes the raising of concerns when an error is developing or 

present.

b. Use two-way communication. 

c. Conduct incident and crew briefings.

d. Situational awareness is elevated through strong communications.

3. An escape route is a preplanned and understood route to reach a safe area. 

a. Should be wide enough and easy to maneuver through.

LCES: COMPONENTS (cont’d)

– Should not be obstructed by vehicles, trees, 

creeks or other hazards.

• Safety zones:

– Location where threatened responders can 

find adequate refuge from the hazards.

– Large enough and far enough away from 

hazard so personnel will not have to deploy 

emergency personal protective equipment 

(PPE) (i.e., fire shelters).

– Must be known to all personnel.

Slide 3-6
ON-SCENE CONSIDERATIONS

SM 3-6

b. Should not be obstructed by vehicles, trees, creeks or other 

hazards.

4. A safety zone is a location where the threatened responders can find 

adequate refuge from the hazards.

a. Should be large enough and far enough from hazard so personnel 

will not have to deploy emergency personal protective equipment 

(PPE) — (i.e., fire shelters).

b. Must be known to all personnel.

• Functions sequentially (self-triggering 

mechanism):

– Lookouts assess and reassess fire 

environment and communicate threats to 

safety.

– Firefighters use escape routes to safety 

zones.

LCES: OPERATIONS AND 

BUILDING GUIDELINES

Slide 3-7

C. LCES: Operations and building guidelines.

1. LCES functions sequentially — it’s a self-triggering mechanism.

Lookouts assess and reassess the fire environment and communicate 

threats to safety. Firefighters use escape routes to safety zones. All 

firefighters should be alert to changes in the fire environment and have the 

authority to initiate communication.
ON-SCENE CONSIDERATIONS

SM 3-7

• Building guidelines:

– LCES system is established before the threat 

occurs.

– LCES is continuously re-evaluated as fire 

conditions change.

LCES: OPERATIONS AND 

BUILDING GUIDELINES (cont’d)

Slide 3-8

2. LCES is built on two guidelines:

a. Before safety is threatened, each firefighter must know the LCES 

system will be used.

b. LCES must be continuously re-evaluated as fire conditions change.

• Lookouts:

– Watching out for personnel and other citizens 

on the road.

– Watching traffic and its approach to the 

scene.

– Assigned to a single resource or to an entire 

engine company.

• Communications:

– Protect tactical channels from chatter.

– Establish traffic control on a separate 

channel.

LCES: APPLICATION IN 

ROADWAY EMERGENCIES

Slide 3-9

D. LCES: Application in roadway emergencies.

1. Let us see how LCES is applied in a roadway emergency.

2. Lookouts posted at roadway emergencies must watch out for emergency 

responders and the other citizens on the road. Lookouts are solely 

responsible for watching traffic and its approach to the scene. The lookout 

could be assigned to a single resource or to an entire engine company. For 

example, the apparatus operator could fill this role if he or she is not 

involved in supplying water to the scene.
ON-SCENE CONSIDERATIONS

SM 3-8

3. You must establish and use communications in these incidents. You 

should protect tactical channels from the chatter that occurs on traffic 

direction channels. You should establish traffic control on a separate 

channel so the two team members with the traffic signs can communicate 

without interfering with scene operations.

• Escape routes:

– Established early on in the incident.

– Communicated to all personnel. 

• Safety zones:

– Established early in the incident.

– If possible, second area of refuge established 

as a backup.

LCES: APPLICATION IN ROADWAY 

EMERGENCIES (cont’d)

Slide 3-10

4. Escape Routes should be established early on in the incident and 

communicated to all. 

5. Safety Zones must be established early in the incident. These zones 

should be created using well-known methods of positioning apparatus on 

roadways. If possible, a second area of refuge should be established.

Slide 3-11

TRAFFIC CONTROL DEVICES

• Minimum standards and 

guidance for uniformity 

of TCDs.

• Use of uniform TCDs 

(messages, location, 

size, shapes and colors) 

helps reduce crashes 

and congestion. http://mutcd.fhwa.dot.gov/index.htm

E. Traffic control devices (TCDs).

1. In order to ensure safety of response personnel and efficiency of response 

on roadway incidents, TCDs should be used.
ON-SCENE CONSIDERATIONS

SM 3-9

2. Temporary Traffic Control usage guidelines are available in Chapter 6 of 

the Manual on Uniform Traffic Control Devices (MUTCD). MUTCD can 

be accessed at: http://mutcd.fhwa.dot.gov/index.htm.

3. The figure on the next page showing the Temporary Traffic Control Zone 

components is excerpted from the MUTCD.
ON-SCENE CONSIDERATIONS

SM 3-10
ON-SCENE CONSIDERATIONS

SM 3-11

Examples of common benchmarks at mass 

casualty incident roadway incidents:

• Helicopter on-/off-scene. 

• Patient(s) extricated.

• Patient(s) off-scene.

• Triage report received.

• Last immediate (red) patient transported.

COMMON ROADWAY INCIDENT 

BENCHMARKS

Slide 3-12

F. Common roadway incident benchmarks.

Some common benchmarks for mass casualty incident roadway incidents include: 

1. Helicopter on-/off-scene.

2. Patient(s) extricated.

3. Patient(s) off-scene.

4. Triage report received.

5. Last immediate (red) patient transported.

Slide 3-13

• CAN:

– Conditions.

– Actions.

– Needs.

• Enables person giving the report to identify 

easily how well the team is doing, the 

conditions it is facing, and any support or 

resource needs it has.

CONDITIONS, ACTIONS AND 

NEEDS REPORT

G. Conditions, Actions and Needs (CAN) report.

1. CAN reports provide progress reports on the fireground during all phases 

of operations and are exchanged between personnel operating at the 

incident and the Incident Commander (IC).
ON-SCENE CONSIDERATIONS

SM 3-12

2. The CAN report allows the person transmitting the report to easily identify 

how well the team is doing, the conditions it is facing, and any support or 

resource needs it has.

3. In an Incident Command System (ICS), Incident Action Plans (IAPs) are 

driven by the completion of tactical objectives. If an objective cannot be 

completed, the IC needs to be advised so that the safety of crews operating 

can be evaluated and the tactical and strategic plan modified. 

Slide 3-14

• Conditions:

– One patient pinned under dash.

– Difficulty disentangling lower extremities.

– Stable vital signs.

• Actions:

– Planning to roll up dash.

– Removing glass from windshield.

– Establishing IV on patient.

EXAMPLES OF CONDITIONS, 

ACTIONS AND NEEDS

H. Examples of CAN.

1. Conditions:

a. One patient pinned under dash.

b. Difficulty disentangling lower extremities.

c. Stable vital signs.

2. Actions:

a. Planning to roll up dash.

b. Removing glass from windshield.

c. Establishing IV on patient.
ON-SCENE CONSIDERATIONS

SM 3-13

Slide 3-15

• Needs:

– Hydraulic ram.

– Send another engine or truck company to 

assist.

– Dispatch helicopter.

EXAMPLES OF CONDITIONS, 

ACTIONS AND NEEDS (cont’d)

3. Needs:

a. Hydraulic ram.

b. Send another engine or truck company to assist.

c. Dispatch helicopter.

II. SUMMARY

SUMMARY

• Discuss LCES.

• Discuss TCDs.

• List common roadway incident 

benchmarks.

• Discuss CAN reports.

Slide 3-16
This page intentionally left blank.
EMS FUNCTIONS IN ICS

MODULE 4:

PREPLANNING

OBJECTIVES

The students will be able to:

4.1 Define the purpose of preplanning.

4.2 List principles and features of preplanning.

4.3 Identify guidelines on ordering resources.
PREPLANNING

SM 4-2

This page intentionally left blank.
PREPLANNING

SM 4-3

MODULE 4: 

PREPLANNING

Slide 4-1

OBJECTIVES

• Define the purpose of preplanning.

• List principles and features of 

preplanning.

• Identify guidelines on ordering resources.

Slide 4-2

I. PREPLANNING

PURPOSE

• Provides information required by Incident 

Commander to make good decisions.

• Reduces chances of injuries or fatalities.

Slide 4-3

A. Purpose.
PREPLANNING

SM 4-4

Preplanning provides the information required by the Incident Commander (IC) to 

make good decisions, reducing the chances of injuries or fatalities to responders 

and victims.

• Traditional preplanning:

– Prefire planning and preincident surveys.

– Assess target hazards.

• Emergency Medical Services (EMS)-

focused preplanning:

– Specific incident type.

– Incident complications and complexities.

– Other factors driving incident priorities.

Slide 4-4

TRADITIONAL VERSUS EMSFOCUSED PREPLANNING

B. Traditional versus Emergency Medical Services (EMS)-focused preplanning.

1. Traditionally, the fire service has conducted prefire planning and 

preincident surveys. The local fire station visits a target hazard — e.g., a 

nursing home, school, etc. — to conduct a detailed assessment of the 

structure or situation. Information such as building construction and 

occupancy, design features, contact information, and other pertinent facts 

are recorded on a Quick Access Preplan (QAP) form. This information 

usually is maintained on the first-due apparatus or Chief’s unit.

2. EMS-focused preplanning allows for development of plans for specific 

types of incidents, complications that arise at incidents, complexities of 

the incidents, and other factors that drive the incident priorities. 

Oftentimes EMS personnel can leverage fire service preplans in their 

planning activities and during responses to incidents.
PREPLANNING

SM 4-5

Sample of Preplanning Form
PREPLANNING

SM 4-6

PRINCIPLES

• Comprehensive.

• Logical.

• Efficient.

• Adaptive.

• Responsible.

Slide 4-5

C. Principles.

Preplanning is based on five fundamental principles: comprehensive, logical, 

efficient, adaptive and responsible.

1. Comprehensive: To be useful, the EMS preplan must examine a 

multitude of factors. These are some of the factors.

a. Physical features: Building construction, layout, routes of 

access/egress, obstacles surrounding the facility, etc.

b. Hazards: Things that will cause harm to both the occupants and 

responders.

c. Mitigating factors: Information on how to isolate, eliminate or 

control the hazards.

d. Response: Resources and operational objectives required to meet 

the needs of the incident.

e. Safety: Issues that provide for the safety of the responders and the 

occupants.

2. Logical: The plan must be organized in a logical manner so that actions 

can be anticipated and information can be understood and applied easily to 

the incident. Training is the key to understanding this concept.

3. Efficient: The plan must identify the priority objectives that must be 

accomplished and how to deploy resources efficiently to meet those 

objectives.
PREPLANNING

SM 4-7

4. Adaptive: The plan must be flexible enough to adapt to changing incident 

conditions. 

5. Responsible: An important aspect of preplanning is the development of 

responsibility, resulting in accountability for response tasks. This ensures 

that those important objectives are met.

FEATURES

Preplans must:

• Be all-hazard. 

• Be simple.

• Follow the format routinely used.

• Be accessible to first responders.

• Be used for training to ensure responder 

familiarity.

Slide 4-6

D. Features.

Preplans must:

1. Be all-hazard.

2. Be simple, so they can be used in evolving situations.

3. Follow the format routinely used by the agency(ies).

4. Be accessible to the first responders.

5. Be used for training to ensure that responders are familiar with them.
PREPLANNING

SM 4-8

• Type of event.

• Geographic size and complexity.

• Hazard/Risk assessment.

• Vulnerability assessment.

• History with that specific event or a similar 

event.

• A similar community experience with this 

type of event.

CONSIDERATIONS FOR EMS 

RESOURCE DEPLOYMENT AT EVENTS

Slide 4-7

E. Considerations for EMS resource deployment at events.

The following factors need to be considered for deploying resources at events:

1. Type of event.

2. Geographic size and complexity of event.

3. Hazard/Risk assessment.

4. Vulnerability assessment.

5. History with that specific event or a similar event.

6. A similar community experience with this type of event.

• Can use mass transportation for green (minor) 

patients.

• Order additional engines, squads and trucks as 

required. 

• Give special consideration to advance practice 

or specialty care transports.

• Make requests using normal terminology.

MATRIX FOR ORDERING 

RESOURCES

Slide 4-8

1 

Ambulance

1 

Immediate 

(Red) 

Patient 

1 

Ambulance

2 

Delayed 

(Yellow) 

Patients

1 

Ambulance

4 Minor 

(Green) 

Patients

F. Matrix for ordering resources.
PREPLANNING

SM 4-9

1. The matrix for ordering resources provides guidelines on requesting 

resources.

a. Order one ambulance for every red (immediate) patient.

b. Order one ambulance for every two yellow/green (delayed/minor) 

patients (unless you are using mass transportation for green

(minor) patients).

c. Order additional engines, squads and trucks, as required.

d. Give special consideration to advance practice or specialty care 

transports.

e. Requests should be made using normal terminology, e.g., 

“Dispatch four additional ambulances and a full commercial 

assignment.”

2. More information on this topic is available in Nancy L. Caroline’s book 

“Emergency Care in the Streets” (2007). (Commercial products mentioned 

in this course are not endorsements by the National Fire Academy (NFA). 

These documents and products are provided as examples and/or resources 

for course students.)

II. SUMMARY

SUMMARY

• Define the purpose of preplanning.

• List principles and features of 

preplanning.

• Identify guidelines on ordering resources.

Slide 4-9
This page intentionally left blank.
EMS FUNCTIONS IN ICS

MODULE 5:

MULTIPATIENT MEDICAL TRANSPORT 

VEHICLES

OBJECTIVES

The students will be able to:

5.1 Define Multipatient Medical Transport (MPMT) vehicles.

5.2 Describe types and function of MPMT vehicles.

5.3 List federal guidance for deployment of MPMT vehicles.

5.4 Describe alternatives to MPMT vehicles.

5.5 Discuss possible sources of funding for MPMT vehicles.
MULTIPATIENT MEDICAL TRANSPORT VEHICLES

SM 5-2

This page intentionally left blank.
MULTIPATIENT MEDICAL TRANSPORT VEHICLES

SM 5-3

MODULE 5: 

MULTIPATIENT MEDICAL

TRANSPORT VEHICLES

Slide 5-1

OBJECTIVES

• Define Multipatient Medical Transport 

(MPMT) vehicles. 

• Describe types and function of MPMT 

vehicles.

• List federal guidance for deployment of 

MPMT vehicles.

• Describe alternatives to MPMT vehicles.

• Discuss possible sources of funding for 

MPMT vehicles.

Slide 5-2

I. MULTIPATIENT MEDICAL TRANSPORT VEHICLES

PURPOSE

• Increase in major Emergency Medical Services 

(EMS) responses in urban areas with incredibly 

dense populations necessitates alternative 

transportation. 

• Ability to transport multiple patients.

• Current fluid deployment/system status 

management does not allow for excess response 

capacity in case of sudden surge of patients.

• MPMT vehicles are known in many jurisdictions 

as Medical Ambulance Buses (MABs).

Slide 5-3

A. Purpose.
MULTIPATIENT MEDICAL TRANSPORT VEHICLES

SM 5-4

1. Increase in major Emergency Medical Services (EMS) responses in urban 

areas with incredibly dense populations necessitates alternative 

transportation.

2. In a mass casualty incident (MCI), due to volume and the need to account 

for people who must be evaluated or interviewed, the ability to transport 

multiple patients is a must.

Consider the example of an EMS response situation involving a tourist bus 

charter to a rural area; this creates the potential for 30 to 60 victims in a 

community with one or two ambulances.

3. Current fluid deployment/system status management:

a. Matches the number of ambulances with the call demand in an 

area.

b. Does not allow for excess capacity in the event of a sudden surge 

of patients.

4. In many jurisdictions, Multipatient Medical Transport (MPMT) vehicles

are known as Medical Ambulance Buses (MABs).

PRIMARY FUNCTIONS

• MPMT vehicles used primarily for: 

– Basic life support (BLS).

– Evacuation.

– Transportation services.

– Importing personnel and/or equipment or 

supplies into the area of need.

Slide 5-4

B. Primary functions.

MPMT vehicles are used primarily for:

1. Basic life support (BLS).

2. Evacuation.

3. Transportation services.
MULTIPATIENT MEDICAL TRANSPORT VEHICLES

SM 5-5

4. Importing personnel and/or equipment or supplies into the area of need.

ADDITIONAL FUNCTIONS

• Additional functions of MPMT vehicles:

– Surge capacity.

– Help with patient overflow.

– Emergency patient housing.

Slide 5-5

C. Additional functions.

Additional functions of MPMT vehicles:

1. Surge capacity.

2. Patient overflow.

3. Emergency patient housing.

TYPES OF MPMT VEHICLES

Slide 5-6

CAPACITY FUNCTION PERSONNEL EQUIPMENT

TYPE 1

Minimum of 10 

seated patients 

and one wheeled 

ambulance cot

Basic medical 

transportation 

during largescale 

evacuation

BLS

Driver: 

Possess license 

and be certified 

as an 

emergency 

medical 

technician 

(EMT)

Emergency 

Medical Staff:

Specific to 

mission

Oxygen and 

compressed air

Minimum 

equipment and 

supplies 

commensurate 

with mission

Personal 

protective 

equipment 

(PPE)

TYPE 2 Minimum of 10 

seated patients

TYPE 3 Minimum of six 

seated patients

D. Types of MPMT vehicles.

MPMT vehicles are classified as Type 1, Type 2, and Type 3 based on their 

capacities. Other than differing capacities, all share the same function, personnel 

and equipment.
MULTIPATIENT MEDICAL TRANSPORT VEHICLES

SM 5-6

1. Capacity: All MPMT vehicles are climate-controlled.

a. Type 1 MPMT vehicle: Capacity for a minimum of 10 seated 

patients and one wheeled ambulance cot.

b. Type 2 MPMT vehicle: Capacity for a minimum of 10 seated 

patients.

c. Type 3 MPMT vehicle: Capacity for a minimum of six seated 

patients.

2. Function.

a. Basic medical transportation services during large-scale 

evacuation.

b. BLS.

3. Personnel.

a. Driver should have a license, be able to operate a vehicle, and be 

certified as an emergency medical technician (EMT).

b. Emergency medical staff: commensurate with the assignment.

4. Equipment.

a. Oxygen.

b. Compressed air.

c. Minimum equipment commensurate with mission assignment.

d. Personal protective equipment (PPE) consistent with Occupational 

Safety and Health Administration (OSHA) requirements.
MULTIPATIENT MEDICAL TRANSPORT VEHICLES

SM 5-7

MPMT VEHICLE FEATURES

Slide 5-7

Adjustable Liter 

Flow Valves

Removable Ramp

Removable Stretchers

Attendant Seats

E. MPMT vehicle features.

1. Adjustable liter flow valves.

2. Removable ramp.

3. Attendant seats.

4. Removable stretchers.

NATIONAL INCIDENT MANAGEMENT 

SYSTEM RESOURCE DEFINITION FOR 

MPMT VEHICLES

• The National Incident Management System 

(NIMS) resource definition for MPMT 

vehicle operation includes:

– Security, fuel, vehicle maintenance support, 

transportation, food, and rest facilities by 

requesting jurisdiction, barring other 

arrangements.

– Additional staff.

– Ground safety assurance and traffic control.

– Minimum medical transportation resources 

needed. Slide 5-8

F. NIMS resource definition for MPMT vehicles.

The NIMS resource definition for MPMT vehicle operation includes the 

following:

1. Each MPMT vehicle must be provided with security, fuel, vehicle 

maintenance support, transportation, food, and/or rest facilities by the 

requesting jurisdiction, unless other arrangements have been made.
MULTIPATIENT MEDICAL TRANSPORT VEHICLES

SM 5-8

2. Additional staff.

a. Administrative, logistics, and maintenance staff are recommended 

to ensure the ongoing availability of resources required to support 

the mission assignment safely and effectively.

b. Each team/unit can work a maximum of 12-hour shifts, depending 

upon individual policies and procedures. If assigned for fewer than 

five days, additional staff will be needed to provide for crew rest.

3. Ground safety assurance and traffic control are important support 

requirements.

4. Minimum medical transportation resources needed:

a. Based on factors such as the nature of the mission, logistics, 

intensity of demand, duration of service activity, and allowance for 

rest periods.

b. A minimum of Td toxoid or Tdap (receipt of primary series and 

booster within the past 10 years) and a complete Hepatitis B 

Vaccination Series or a waiver of liability.

ALTERNATIVE MPMT 

TRANSPORTATION

Slide 5-9

City/Municipal Buses Military Transport Buses

Alternative 

MPMT 

Vehicles

School Buses Private Buses

G. Alternative MPMT transportation.

During an emergency response situation, all types of buses may be used, 

depending on availability.

1. School buses.

a. Availability: may not be available at start and end of the school 

day.
MULTIPATIENT MEDICAL TRANSPORT VEHICLES

SM 5-9

b. Must have capability to have a backboard placed across the seats 

either perpendicularly or horizontally.

c. Not equipped with seatbelts.

2. City/Municipal buses.

a. Operate longer hours with more excess capacity.

b. Have climate controls.

c. Have lifts for wheelchairs.

d. Have radio system.

e. Have video surveillance.

f. Have room for bags or medical equipment.

g. Dispatch center is open 24 hours a day and emergency procedures 

for municipal/city bus service or management have typically been 

exercised and rehearsed.

3. Private buses.

a. Need to be inspected and assessed for safety.

b. Appropriate safety and support services should be pre-positioned 

with the fleet operations.

4. Military transport buses.

a. Capable of transporting multiple stretcher patients.

b. Need a Memorandum of Understanding (MOU) and a wellestablished communication channel to the base commander prior to 

the event.
MULTIPATIENT MEDICAL TRANSPORT VEHICLES

SM 5-10

AMBUBUS CONVERSION KIT 

• Quickly and easily retrofits 

school/Metro buses into mass 

casualty transport vehicles.

• Capable of transporting up to 

18 stretcher-bound patients 

when majority of bus seats 

are removed.

• Makes mass evacuation of 

nonambulatory people 

efficient, effective, affordable 

and simple.

Slide 5-10

H. AmbuBus® conversion kit.

The AmbuBus kit is an effective and efficient solution for mass evacuation, 

shelter-in-place, and transport of special-needs patients, casualties, and those who 

require nonambulatory transport. The AmbuBus kit:

1. Quickly and easily retrofits school/Metro buses into mass casualty 

transport vehicles.

2. Is capable of transporting up to 18 stretcher-bound patients when majority 

of bus seats are removed.

3. Makes mass evacuation of nonambulatory people efficient, effective, 

affordable and simple.

Where and how do you 

get buses in your 

jurisdiction? 

How long does it take 

and are there any times 

that they are 

unavailable?

Slide 5-11
MULTIPATIENT MEDICAL TRANSPORT VEHICLES

SM 5-11

POSSIBLE SOURCES OF 

FUNDING

• Homeland Security Grant Program 

(HSGP):

– Urban Area Security Initiative (UASI).

– Metropolitan Medical Response System 

(MMRS).

• State Emergency Response Commission 

(SERC).

Slide 5-12

I. Possible sources of funding.

Some possible sources of funding for improving emergency planning, 

preparedness, mitigation, response and recovery capabilities:

1. Homeland Security Grant Program (HSGP): HSGP is a grant program 

authorized by Congress to help strengthen the nation against risks 

associated with potential terrorist attacks. It has subprograms which 

include:

a. Urban Area Security Initiative (UASI).

- Focuses on enhancing regional preparedness in major 

metropolitan areas.

- More information on this program is available at the 

following website: http://www.fema.gov/government/grant/

hsgp/index.shtm#2.

b. Metropolitan Medical Response System (MMRS).

- Supports the integration of emergency management, health 

and medical systems into a coordinated response to MCIs

caused by any hazard.

- More information on this program is available at the 

following website: http://www.fema.gov/government/grant/

hsgp/index.shtm#2.
MULTIPATIENT MEDICAL TRANSPORT VEHICLES

SM 5-12

2. State Emergency Response Commission (SERC).

Develops and supports programs of state and local governments as well as 

local university-sponsored programs that are designed to improve 

emergency planning, preparedness, mitigation, response and recovery 

capabilities, with special emphasis on emergencies associated with 

hazardous chemicals.

II. SUMMARY

SUMMARY

• Define MPMT vehicles. 

• Describe types and function of MPMT 

vehicles.

• List federal guidance for deployment of 

MPMT vehicles.

• Describe alternatives to MPMT vehicles.

• Discuss possible sources of funding for 

MPMT vehicles.

Slide 5-13
EMS FUNCTIONS IN ICS

SCENARIO B:

STRUCTURE FIRE

SCENARIO OBJECTIVES

The students will be able to:

SB.1 Develop the Medical Branch within an Incident Command System (ICS) organizational structure, and 

assign resources to reflect incident priorities.

SB.2 Track patients using a Patient Tracking System.

SB.3 Use benchmarks to order and assign appropriate resources. 
STRUCTURE FIRE

SM SB-2

This page intentionally left blank.
STRUCTURE FIRE

SM SB-3

SCENARIO B:

STRUCTURE FIRE

Slide SB-1

SCENARIO OBJECTIVES

• Develop the Medical Branch within an 

Incident Command System (ICS) 

organizational structure, and assign 

resources to reflect incident priorities. 

• Track patients using a Patient Tracking 

Form.

• Use benchmarks to order and assign 

appropriate resources.

Slide SB-2

I. SCENARIO B: STRUCTURE FIRE

SCENARIO ROLES AND 

TASKS

• In this scenario, you are the EMS 100.

• In this scenario, you will develop/complete:

– ICS Organizational Structures.

– ICS Form MC-306 (Patient Tracking Form).

– Student Response Checklist.

• Remember, EMS 100 is the Central City 

EMS Supervisor in a nontransport vehicle.

Slide SB-3

A. Scenario roles and tasks.
STRUCTURE FIRE

SM SB-4

1. In this scenario, you are the EMS 100.

2. In this scenario, you will develop/complete:

a. Incident Command System (ICS) Organizational Structures.

b. ICS Form MC-306 (Patient Tracking Form).

c. Student Response Checklist.

3. Remember, EMS 100 is the Central City EMS Supervisor in a 

nontransport vehicle.

INTRODUCTION

• Scenario is taking place at the Sunshine 

Nursing Home in Deep River.

• Current conditions:

– Time: 1900 hours.

– Date: July 17.

– Temperature: 90 F.

– Humidity: 50 percent.

– Wind: 0 mph.

Slide SB-4

B. Introduction.

1. Scenario is taking place at the Sunshine Nursing Home in Deep River.

2. Current conditions:

a. Time: 1900 hours.

b. Date: July 17.

c. Temperature: 90 F.

d. Humidity: 50 percent.

e. Wind: 0 mph.
STRUCTURE FIRE

SM SB-5

Scenario B: Student Instructions

Flow of Scenario Time

1. Introduction/Background for Scenario B 1 minute

2. Initial Dispatch + E-51 Brief Initial Report 2 minutes

3. Review of Sunshine Nursing Home Preplan 5 minutes

4. En Route Injects 1 minute

5. On-scene Arrival 1 minute

6. Group Work 30 minutes

7. Reporting Out 15 minutes

8. Instructor Debrief and Review of Model Responses 5 minutes

9. Complete the Student Response Checklist 5 minutes

Total Time: 65 Minutes
STRUCTURE FIRE

SM SB-6

This page intentionally left blank.
STRUCTURE FIRE

SM SB-7 

INITIAL DISPATCH

Slide SB-5

C. Initial dispatch.
STRUCTURE FIRE

SM SB-8 

This page intentionally left blank. 
STRUCTURE FIRE

SM SB-9

Sunshine Nursing Home Preplan

Sunshine Nursing Home is a skilled nursing/assisted living facility located in Deep River in 

Liberty County (LC). The Liberty County Fire Department (LCFD) updates its preplans on a 

yearly basis. The latest preplan information provided by the facility is below.
STRUCTURE FIRE

SM SB-10
STRUCTURE FIRE

SM SB-11

CURRENTLY DISPATCHED 

RESOURCES

• E-51 (on-scene).

• BC-51.

• BC-21.

• E-21.

• E-22.

• E-41.

• Ladder 21.

Slide SB-6

E = Engine

BC = Battalion Chief

WT = Water Tender

MC = Mass Casualty

M = Medic

Amb = Ambulance

1. Currently dispatched resources.

a. E-51 (on-scene).

b. BC-51.

c. BC-21.

d. E-21.

e. E-22.

f. E-41.

g. Ladder 21.

CURRENTLY DISPATCHED 

RESOURCES (cont’d)

Slide SB-7

E = Engine

BC = Battalion Chief

WT = Water Tender

MC = Mass Casualty

M = Medic

Amb = Ambulance

• WT-51.

• EMS 100.

• MC-22.

• M-7.

• M-9.

• Amb-8.

• Amb-61.

h. WT-51.

i. EMS 100.
STRUCTURE FIRE

SM SB-12

j. MC-22.

k. M-7.

l. M-9.

m. Amb-8.

n. Amb-61.

EN ROUTE INJECTS

Slide SB-8

• After 30 seconds: There are confirmed 

reports of fire in the laundry room.

• After another 10 seconds: Staff is 

attempting to evacuate the building.

• After another 20 seconds: Battalion Chief 

51 has arrived on-scene and has assumed 

Command.

2. En route injects.

a. After 30 seconds: There are confirmed reports of fire in the 

laundry room.

b. After another 10 seconds: Staff is attempting to evacuate the 

building.

c. After another 20 seconds: Battalion Chief 51 has arrived on-scene 

and has assumed Command.
STRUCTURE FIRE

SM SB-13

ON-SCENE ARRIVAL

Slide SB-9

D. On-scene arrival.
STRUCTURE FIRE

SM SB-14

This page intentionally left blank.
STRUCTURE FIRE

SM SB-15

Scenario B: On-scene Images
STRUCTURE FIRE

SM SB-16
STRUCTURE FIRE

SM SB-17

Slide SB-10

INITIAL REPORT

• Incident Commander (IC) provides you 

with: 

– Verbal description of the current ICS structure.

– Location of fire.

– Areas that are off-limits.

E. Initial report.

You arrive at the Incident Command Post (ICP) and report to the Incident 

Commander (IC). He provides you with a quick initial report that includes:

1. Verbal description of the current ICS organization.

2. Location of the fire.

3. Areas that are off-limits.
STRUCTURE FIRE

SM SB-18

This page intentionally left blank.
STRUCTURE FIRE

SM SB-19

Initial Report Packet: Verbal Description of Current ICS Organization

Deep River Command has been set up. The Rescue Branch, Fire Attack Group, and Ventilation 

Group have been established under Operations. 

You (EMS 100) have been assigned as the Medical Branch Director and instructed to set up the 

Medical Branch. 
STRUCTURE FIRE

SM SB-20

Initial Report Packet: Off-limits Area and Location of Fire

The area on the map marked as the “Fire Area” is off-limits until we get the fire out. 
STRUCTURE FIRE

SM SB-21

GROUP WORK

Slide SB-11

• You are EMS 100, arrived at the incident. Set 

up the Medical Branch and develop:

– ICS Organizational Chart.

-- Resource assignment.

– Patient tracking.

• Total working time is 30 minutes.

• Remember, you are to focus on assigning the 

medical resources. To help you with this, a 

partially completed ICS Organizational Chart 

has been provided in your Student Manual 

(SM).

F. Group Work.

1. You are EMS 100, arrived at the incident. Set up the Medical Branch and 

develop:

a. ICS Organizational Chart.

- Resource assignment.

b. Patient tracking.

2. Total working time is 30 minutes.

3. Remember, you are to focus on assigning the medical resources. To help 

you with this, a partially completed ICS Organizational Chart has been 

provided in your SM.
STRUCTURE FIRE

SM SB-22

This page intentionally left blank.
STRUCTURE FIRE

SM SB-23

Scenario B: ICS Forms

The ICS forms(s) needed to complete the scenario are attached here. Copies of these forms can 

be found in Appendix A and Appendix B. The easel pads provided can be used to sketch out the 

ICS Organizational Charts and to brainstorm and take notes.
STRUCTURE FIRE

SM SB-24

This page intentionally left blank.
STRUCTURE FIRE

SM SB-25

ICS Form MC-306

Multi-Casualty

Recorder Worksheet

Ambulance 

Company

Ambulance 

ID Number

Patient 

Triage Tag 

Number

Patient 

Status

Hospital 

Destination

Off Scene 

Time

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

ICS-MC-306 (12/89)

DISCLAIMER: This form is not an approved ICS Form but has been provided for your reference and use in this course. 
STRUCTURE FIRE

SM SB-26

This page intentionally left blank.
STRUCTURE FIRE

SM SB-27

Scenario B: Partially Completed ICS Organizational Chart

This is a partially completed ICS Organizational Chart with the fire resources (and some medical 

resources placed into the fire response) prefilled. This partially completed chart includes 

resources from the initial dispatch and additional injects that you will be receiving. 
STRUCTURE FIRE

SM SB-28

This page intentionally left blank.
STRUCTURE FIRE

SM SB-29

INJECT 1

• After 10 minutes, provide Triage Report.

Slide SB-12

G. Inject 1.

After 10 minutes, provide Triage Report.

INJECT 2

• After another 10 minutes:

– Upgraded to second alarm fire. Additional 

Units arriving on-scene: 

-- E 151, 31.

-- Ladder 31.

-- Squad 21, 61.

-- Air Unit 6.

-- Light 6.

-- Rehab 32.

-- Medic 41, 31.

-- Ambulance 122, 101.

Slide SB-13

H. Inject 2.

After another 10 minutes:

1. Upgraded to second alarm fire. Additional Units arriving on scene:

a. E 151, 31.

b. Ladder 31.

c. Squad 21, 61.

d. Air Unit 6.
STRUCTURE FIRE

SM SB-30

e. Light 6.

f. Rehab 32.

g. Medic 41, 31.

h. Ambulance 122, 101.

INJECT 2 (cont’d)

– Two staffers pulled from building.

-- A 25-year-old male, cardiac arrest, no burns, 

Immediate. (Triage Tag: 4509870027.)

-- A 27-year-old female, respiratory arrest, no 

burns, Immediate. (Triage Tag: 4509870028.)

Slide SB-14

2. Two staffers pulled from building.

a. A 25-year-old male, cardiac arrest, no burns, Immediate. (Triage 

Tag: 4509870027.)

b. A 27-year-old female, respiratory arrest, no burns, Immediate. 

(Triage Tag: 4509870028.)

INJECT 3

• After another five minutes:

– Upgraded to third alarm fire. Additional Units 

arriving on scene: 

-- E 122, 32.

-- Medic 22.

-- Squirt 41. 

Slide SB-15

I. Inject 3.
STRUCTURE FIRE

SM SB-31

After five minutes:

1. Upgraded to third alarm fire. Additional Units arriving on scene.

a. E 122, 32.

b. Medic 22.

c. Squirt 41.

INJECT 3 (cont’d)

– Three additional patients found:

-- A 80-year-old male, cardiac arrest, Deceased. 

(Triage Tag: 4509870029.)

-- A 78-year-old male, burns to 60 percent of the 

body, altered mental status, Immediate. (Triage 

Tag: 4509870030.)

-- A 79-year-old male, unconscious with pulse, 

smoke inhalation, Immediate. (Triage Tag: 

4509870031.)

Slide SB-16

2. Three additional patients found:

a. A 80-year-old male, cardiac arrest, Deceased. (Triage Tag: 

4509870029.)

b. A 78-year-old male, burns to 60 percent of the body, altered 

mental status, Immediate. (Triage Tag: 4509870030.)

c. A 79-year-old male, unconscious with pulse, smoke inhalation, 

Immediate. (Triage Tag: 4509870031.)
STRUCTURE FIRE

SM SB-32

INJECT 4

Slide SB-17

• After another three minutes: Special Call.

– Type 1 Ambulance Strike Team. (Medic 503, 

Medic 504, Medic 603, Medic 604, Medic 

22.)

– Type 3 Ambulance Strike Team. (Amb 104, 

Amb 32, Amb 533, Amb 42, Amb 543.)

J. Inject 4.

After another three minutes: Special Call.

1. Type 1 Ambulance Strike Team. (Medic 503, Medic 504, Medic 603, 

Medic 604, Medic 22.)

2. Type 3 Ambulance Strike Team. (Amb 104, Amb 32, Amb 533, Amb 42, 

Amb 543.)

INJECT 4 (cont’d)

Slide SB-18

– SP Air 1.

– SP Air 2.

– SP Air 3.

– Med Flight 1.

– Flight for life. 

3. SP Air 1.

4. SP Air 2.

5. SP Air 3.

6. Med Flight 1.
STRUCTURE FIRE

SM SB-33

7. Flight for life.

II. REPORTING OUT

REPORTING OUT

Slide SB-19

• Groups describe their:

– Organizational charts. 

– Resource assignments.

• Remember, one group does full reporting 

out; other groups describe significant 

differences.

A. Groups describe their:

1. Organizational charts.

2. Resource assignments.

B. Remember, one group does full reporting out; other groups describe significant 

differences.

III. COMPLETING THE SCENARIO

COMPLETING THE 

SCENARIO

Slide SB-20

• Instructor provides Model Responses.

• Instructor answers questions.

• Students complete Student Response 

Checklist.

A. Instructor provides Model Responses.
STRUCTURE FIRE

SM SB-34

B. Instructor answers questions.

C. Students complete Student Response Checklist.
EMS FUNCTIONS IN ICS

MODULE 6:

SPECIAL CONSIDERATIONS IN 

WILDLAND FIRES

OBJECTIVES

The students will be able to:

6.1 List types of Incident Management Teams (IMTs).

6.2 Identify prequalifications for assistance in wildland fire operations.

6.3 Identify functions of Emergency Medical Services (EMS) personnel in wildland fire incidents.

6.4 Identify EMS responsibilities and processes for setting up the initial Medical Unit.

6.5 Identify elements of proper gear and documentation for EMS personnel in wildland fire incidents.

6.6 Explain importance of preparing in advance for wildland fires.
SPECIAL CONSIDERATIONS IN WILDLAND FIRES

SM 6-2

This page intentionally left blank.
SPECIAL CONSIDERATIONS IN WILDLAND FIRES

SM 6-3

MODULE 6: 

SPECIAL CONSIDERATIONS 

IN WILDLAND FIRES

Slide 6-1

OBJECTIVES

• List types of Incident Management Teams 

(IMTs).

• Identify prequalifications for assistance in 

wildland fire operations.

• Identify functions of Emergency Medical 

Services (EMS) personnel in wildland fire 

incidents.

• Identify EMS responsibilities and 

processes for setting up the initial Medical 

Unit. Slide 6-2

OBJECTIVES (cont’d)

• Identify elements of proper gear and 

documentation for EMS personnel in 

wildland fire incidents.

• Explain importance of preparing in 

advance for wildland fires.

Slide 6-3

I. SPECIAL CONSIDERATIONS IN WILDLAND FIRES
SPECIAL CONSIDERATIONS IN WILDLAND FIRES

SM 6-4

WILDLAND FIRE HAZARDS

• Tremendous potential to generate injuries 

or illnesses.

• Responding to wildland fire incident.

– Need personnel with sharp tools, saws and 

heavy equipment.

– Sudden change in fire direction can result in 

smoke inhalation or burns.

– Firefighters may have to respond in areas 

with a variety of animals, insects and 

reptiles.

Slide 6-4

A. Wildland fire hazards.

A wildland fire of any size has a tremendous potential to generate injuries or 

illnesses. To control and extinguish a wildland fire often requires a lot of 

personnel operating with sharp tools, saws and heavy equipment. A sudden 

change in the direction of the fire can result in smoke inhalation or burns. The 

urban interface often places firefighters in harm’s way as they battle structural 

fires, often resulting in injuries. The “wild” part of wildland fires places 

firefighters in areas where they can be engaged by a variety of animals, insects 

and reptiles.

• Wildland fires are costly, and 

reimbursement depends heavily on proper 

documentation.

• IMTs manage wildland fire operations. 

– Ensure methodical management of structure 

of a wildland fire.

– Are classified as Type 3, Type 2 or Type 1.

Slide 6-5

INCIDENT MANAGEMENT TEAM

B. Incident Management Team (IMT).

Wildland fires are costly, and the reimbursement mechanisms depend heavily on 

the proper documentation. With the risk level involved, a wildland fire operation 

usually is managed by an IMT. With an IMT in place, the structure of a wildland 

fire is managed in a more methodical way. IMTs are classified as Type 3, Type 2 

or Type 1.
SPECIAL CONSIDERATIONS IN WILDLAND FIRES

SM 6-5

• Type 3:

– State or regional multiagency/multijurisdictional 

team for extended incidents.

– Deployed as team of 10 to 20 trained 

personnel. 

– May also initially manage larger, more complex 

incidents that are later transitioned to a Type 2 

or Type 1 IMT.

Slide 6-6

INCIDENT MANAGEMENT TEAM 

TYPES

C. IMT types.

1. A Type 3 IMT is a state or regional multiagency/multijurisdictional team 

for extended incidents.

a. It is a multiagency/multijurisdictional team for extended incidents, 

formed and managed at the state, regional or metropolitan level.

b. It is a designated team of trained personnel from different 

departments, organizations, agencies and jurisdictions within a 

state or Department of Homeland Security Urban Area Security 

Initiative Region, activated to support management at incidents 

that extend beyond one operational period.

c. Type 3 IMTs are deployed as a team of 10 to 20 trained personnel 

to manage major and/or complex incidents requiring a significant 

number of local, regional, and state resources and incidents that 

extend into multiple operational periods and require a written 

Incident Action Plan (IAP), such as a tornado touchdown, 

earthquake, flood or multiday hostage/standoff situation, or at 

planned mass-gathering events. 

d. A Type 3 IMT also may initially manage larger, more complex 

incidents that are later transitioned to a Type 2 or Type 1 IMT.
SPECIAL CONSIDERATIONS IN WILDLAND FIRES

SM 6-6

• Type 2:

– National or state team for incidents of regional 

significance.

– Deployed as team of 20 to 35.

• Type 1:

– National or state team for incidents of national 

significance.

– Deployed as team of 35 to 50.

Slide 6-7

INCIDENT MANAGEMENT TEAM 

TYPES (cont’d)

2. A Type 2 IMT is a national or state team for incidents of regional 

significance.

a. It is a self-contained, all-hazard or wildland team recognized at the 

national and state levels, coordinated through the state, Geographic 

Area Coordination Center (GACC) or National Interagency Fire 

Center (NIFC).

b. All personnel meet the National Wildfire Coordinating Group 

(NWCG) training regimen at the Type 2 level for their specific 

position.

c. A Type 2 IMT is deployed as a team of 20 to 35 to manage 

incidents of regional significance and other incidents requiring a 

large number of local, regional, state and national resources. This 

includes incidents in which Operations Section personnel approach 

200 per operational period and total incident personnel approach 

500.

d. Several dozen Type 2 IMTs are currently in existence and operate 

through the United States Forest Service (USFS).

3. A Type 1 IMT is a national or state team for incidents of national 

significance.

a. It is a self-contained, all-hazard team recognized at the national 

and state level, coordinated through the state, GACC or NIFC. 

b. All personnel meet the NWCG training regimen at the Type 1 level 

for their specific position.
SPECIAL CONSIDERATIONS IN WILDLAND FIRES

SM 6-7

c. A Type 1 IMT is deployed as a team of 35 to 50 to manage 

incidents of national significance and other incidents requiring a 

large number of local, regional, state and federal resources over 

multiple operational periods. This includes incidents in which 

Operations Section personnel may exceed 500 per operational 

period and total incident personnel may exceed 1,000.

d. Eighteen Type 1 IMTs are now in existence and operate through 

the USFS.

PREQUALIFICATIONS

• Courses under National Wildfire 

Coordinating Group: 

– S-110 (Basic Wildland Fire 

Suppression Orientation).

– S-130 (Firefighter Training). 

– S-190 (Introduction to Wildland 

Fire Behavior). 

• Obtain “Red Card.”

• Resource Ordering and Status 

System.

Slide 6-8

D. Prequalifications.

For the Emergency Medical Services (EMS) provider, response to assist in a 

wildland fire operation is preceded by prequalifications.

1. A course in S-110 (Basic Wildland Fire Suppression Orientation), S-130 

(Firefighter Training), and S-190 (Introduction to Wildland Fire Behavior) 

under the NWCG is the basic training for all personnel responding to a 

wildland incident. This training includes the basics of safety in the 

wildland environment, fire behavior, and orientation to the wildland 

operations tools, paperwork, and organizational structure. This training 

also includes instruction and demonstration of proficiency of deployment 

of a fire shelter, cutting a fire line, and a physical abilities test that requires 

trainees to carry a pack over a mile in a prescribed amount of time.

2. Successful completion of this training qualifies you to obtain your “Red 

Card,” which qualifies you to fight fire with a federal agency or on federal 

land.

3. Once a Red Card is obtained, additional qualifications are required for 

staffing the Medical Unit Leader and line Emergency Medical Technician 

(EMT) positions in the wildland organizations’ structure.
SPECIAL CONSIDERATIONS IN WILDLAND FIRES

SM 6-8

4. Red Cards and additional qualifications are placed in the Resource 

Ordering and Status System, a national credential database to which 

wildland command teams have access and from which they order 

resources.

• Line emergency medical technician:

– Support firefighters directly engaged in 

firefighting operations.

– Equipped with supplies to handle lacerations, 

exhaustion, eye injuries and other 

emergencies.

• EMS Units in Base, Camp, Branch or 

Division.

– Support various injuries or illnesses arising 

from operations.

EMS FUNCTIONS IN WILDLAND 

FIRE INCIDENTS

Slide 6-9

E. EMS functions in wildland fire incidents.

EMS personnel can find themselves in one of three functions in a wildland fire 

incident. 

1. Line EMT: A line EMT supports the firefighters directly engaged in 

firefighting operations. Often firefighters on a handcrew, Strike Team or 

other suppression unit are spread out over several hundred yards. On large 

fires, a line EMT may be covering several Divisions with a large number 

of personnel. They are equipped with the basic EMS supplies to handle 

lacerations, exhaustion, eye injuries and other emergencies. This position 

reports to the Division Supervisor under the Operational Units.

2. EMS Units in Base, Camp, Branch or Division: In the Medical Unit, 

under the Logistics Section, EMS Units can find themselves stationed in a 

Base, Camp, Branch or Division supporting various injuries or illnesses 

that can arise from the operations. This can include issues related to foodand water-borne illnesses, injuries from exertion and exposure, and 

trauma. In certain circumstances, EMS crews will find themselves 

providing clinic medicine, treating and supplying treatments for routine 

illnesses due to the remoteness of the location and lack of a nearby 

hospital.
SPECIAL CONSIDERATIONS IN WILDLAND FIRES

SM 6-9

• EMS Branch, Group or Unit:

– Operate when wildland fire creates risk to 

civilian population.

– May operate in an area where an evacuation 

is occurring.

EMS FUNCTIONS IN WILDLAND 

FIRE INCIDENTS (cont’d)

Slide 6-10

3. EMS Branch, Group or Unit: In circumstances in which a wildland fire 

has an urban interface and there is a risk to the civilian population, an 

EMS Branch, Group or Unit may be assigned to the incident and operate 

under the Incident Commander (IC) or the Operations Section. These 

Units may operate in an area where an evacuation is occurring and may be 

detailed to cover vehicle accidents or burns affecting people who were 

caught in areas that were burned over or who stayed in an attempt to 

protect their property.

EMS RESPONSIBILITIES FOR 

SETTING UP INITIAL MEDICAL UNIT

Slide 6-11

Medical Unit Leader responsible for:

• Developing. 

– Incident Command System (ICS) Form 206, 

Medical Plan. 

– ICS Form 214, Unit Log. 

• Obtaining medical aid and transportation 

for injured and ill incident personnel.

• Establishing responder rehabilitation. 

• Preparing reports and records.

F. EMS responsibilities for setting up initial Medical Unit.

1. The Medical Unit Leader, under the direction of the Service Branch 

Director or Logistics Section Chief, is primarily responsible for 

developing the Incident Command System (ICS) Form 206 (Medical 

Plan), obtaining medical aid and transportation for injured and ill incident 

personnel, establishing responder rehabilitation, and preparing reports and 

records.
SPECIAL CONSIDERATIONS IN WILDLAND FIRES

SM 6-10

2. Medical Unit Leaders:

a. Review common responsibilities.

b. Review Unit Leader responsibilities.

c. Participate in Logistics Section/Service Branch planning activities.

d. Establish and staff Medical Unit.

e. Establish Responder Rehabilitation.

f. Prepare ICS Form 206.

g. Prepare procedures for a major medical emergency.

h. Declare a major medical emergency as appropriate.

i. Respond to requests for medical aid, medical transportation, and 

medical supplies.

j. Prepare and submit necessary documentation.

k. Maintain ICS Form 214 (Unit/Activity Log).

PROCESS FOR FIRST EMS ON-SCENE 

TO SET UP MEDICAL UNIT

Slide 6-12

• Get briefing from Incident Commander.

• Reinforce situational awareness.

• Order and distribute EMS resources.

• Provide adequate documentation.

• Provide adequate coverage.

• Fill out.

– ICS Form 206. 

– ICS Form 214.

G. Process for first EMS on-scene to set up Medical Unit.

The following process summarizes how the first EMS on-scene should set up a 

Medical Unit:

1. Get a briefing from the IC.
SPECIAL CONSIDERATIONS IN WILDLAND FIRES

SM 6-11

2. Reinforce situational awareness.

3. Order and distribute EMS resources.

4. Provide adequate documentation.

5. Provide adequate coverage.

6. Fill out ICS Form 206 and ICS Form 214.

Whatever role is assigned to 

the EMS provider at the scene 

of a wildland incident, it is 

important to have or be issued 

the proper gear. This includes:

• Proper protective clothing. 

• A fire shelter. 

• Water. 

• Communications. 

• Clear orders and situational 

awareness.

Slide 6-13

GEAR

H. Gear.

Whatever role is assigned to the EMS provider at the scene of a wildland incident, 

it is important to have or be issued the proper gear. This includes:

1. Proper protective clothing.

2. A fire shelter.

3. Water.

4. Communications.

5. Clear orders and situational awareness.
SPECIAL CONSIDERATIONS IN WILDLAND FIRES

SM 6-12

• Obtain tasking number:

– Required for you to get paid or reimbursed for 

any services, equipment or supplies.

• Complete: 

– ICS Form 206. 

– ICS Form 214.

Slide 6-14

DOCUMENTATION

I. Documentation.

Official paperwork is required on wildland fire incidents.

1. The most important step to ensuring that there is proper paperwork 

completed at a wildland incident is to obtain a tasking number. A tasking 

number is an order issued by the Logistics Section that allows you access 

and gives you permission to be part of the incident. It is this tasking 

number that is required for you to get paid or reimbursed for any services, 

equipment or supplies. 

2. The form most likely to be requested by EMS and to be used in the IAP, 

assembled for any operational briefing, and required for the Postincident 

Analysis or demobilization is the ICS Form 206. EMS Units and personnel 

are required to complete an ICS Form 206 and ICS Form 214 for time and 

actions on the scene. Sample copies of these forms and the instructions for 

filling them out are available in Appendix A — NIMS-approved ICS 

Forms.

• Supplement EMS, rehab or medical care 

for responders under direction of Medical 

Unit Leader until team with proper 

qualifications arrives.

• Obtain proper qualifications and 

credentialing prior to an incident.

• Ensure backfill or mutual-aid coverage for 

service area, so as not to underserve 

existing populations.

Slide 6-15

PREPARING IN ADVANCE
SPECIAL CONSIDERATIONS IN WILDLAND FIRES

SM 6-13

J. Preparing in advance.

1. On occasion, the local EMS agencies will be asked to supplement EMS, 

rehab or medical care for responders under the direction of the Medical 

Unit Leader until a team of individuals arrives with the proper 

qualifications.

2. Obtaining the proper qualifications and credentialing prior to an incident 

places you or your agency in a position to help and be more cost-effective 

to the operation, as compared to waiting for a resource to arrive much 

later. This will depend on how much an incident will draw down the 

resources of the local community and affect its ability to respond to the 

normal volume of emergencies in the jurisdictions.

3. While most of the efforts are focused on the incident, it is important to 

ensure backfill or mutual-aid coverage for the service area, so as not to 

underserve the existing populations.

II. SUMMARY

SUMMARY

• List types of IMTs.

• Identify prequalifications for assistance in 

wildland fire operations.

• Identify functions of EMS personnel in 

wildland fire incidents.

• Identify EMS responsibilities and 

processes for setting up the initial Medical 

Unit.

Slide 6-16
SPECIAL CONSIDERATIONS IN WILDLAND FIRES

SM 6-14

•

SUMMARY (cont’d)

Identify elements of proper gear and 

documentation for EMS personnel in 

•

wildland fire incidents.

Explain importance of preparing in 

advance for wildland fires.

Slide 6-17
EMS FUNCTIONS IN ICS

 

SCENARIO C: 

WILDLAND FIRE

SCENARIO OBJECTIVES

The students will be able to:

SC.1 Develop a Medical Unit in the Incident Command System (ICS) organizational structure.

SC.2 Perform the duties of the Medical Unit Leader.

SC.3 Track patients using a Patient Tracking Form. 

SC.4 Use benchmarks to order and assign appropriate resources.
WILDLAND FIRE

SM SC-2

This page intentionally left blank.
WILDLAND FIRE

SM SC-3

SCENARIO C:

WILDLAND FIRE

Slide SC-1

SCENARIO OBJECTIVES

• Develop a Medical Unit in the Incident 

Command System (ICS) organizational 

structure.

• Perform the duties of the Medical Unit 

Leader.

• Track patients using a Patient Tracking 

Form.

• Use benchmarks to order and assign 

appropriate resources.

Slide SC-2

I. SCENARIO C: WILDLAND FIRE

SCENARIO ROLES AND 

TASKS

• In this scenario, you are EMS 100.

• In this scenario, you will develop/complete:

– ICS Organizational Structure.

– ICS Form 206 (Medical Plan).

– ICS Form 214 (Unit Log).

– ICS Form MC-306 (Patient Tracking Form).

– Student Response Checklist.

Slide SC-3

A. Scenario roles and tasks.
WILDLAND FIRE

SM SC-4

1. In this scenario, you are EMS 100.

2. In this scenario, you will develop/complete:

a. Incident Command System (ICS) Organizational Structure.

b. ICS Form 206, Medical Plan.

c. ICS Form 214, Unit Log.

d. ICS Form MC-306 (Patient Tracking Form).

e. Student Response Checklist.

SCENARIO ROLES AND 

TASKS (cont’d)

• Remember: 

– Type 1 Ambulance, advanced life support 

(ALS) = Central City Medic.

– Type 3 Ambulance, basic life support (BLS) = 

Central City Ambulance.

Slide SC-4

3. Remember:

a. Type 1 Ambulance, advanced life support (ALS) = Central City 

Medic.

b. Type 3 Ambulance, basic life support (BLS) = Central City 

Ambulance.
WILDLAND FIRE

SM SC-5

INTRODUCTION

Slide SC-5

B. Introduction.

INTRODUCTION (cont’d)

• Scenario is taking place at Mineral 

Mountains at the headwaters of Swatera

Creek.

• Current conditions:

– Time: 1300 hours.

– Date: August 5.

– Temperature: 90 F, sunny, windy.

– Humidity: 30 to 40 percent.

– Wind: 15 mph south-southwest.

Slide SC-6

1. Scenario is taking place in the Mineral Mountains at the headwaters of 

Swatera Creek.

2. Current conditions:

a. Time: 1300 hours.

b. Date: August 5.

c. Temperature: 90 F, sunny, windy.

d. Humidity: 30 to 40 percent.

e. Wind: 15 mph south-southwest.
WILDLAND FIRE

SM SC-6

INTRODUCTION (cont’d)

• The Columbia State Department of Forestry 

and the Department of Wildlife have 

requested mutual aid and the United States 

Forest Service (USFS) has a team en 

route. 

• Liberty County’s Type 3 Incident 

Management Team (IMT) has been 

activated to run the incident until the Type 1 

Team arrives to manage what will be a 

campaign fire. Slide SC-7

3. The Columbia State Department of Forestry and the Department of 

Wildlife have requested mutual aid and the United States Forest Service 

(USFS) has a team en route.

4. Liberty County’s Type 3 Incident Management Team (IMT) has been 

activated to run the incident until the Type 1 Team arrives to manage what 

will be a campaign fire.
WILDLAND FIRE

SM SC-7

Scenario C: Student Instructions

Flow of Scenario Time

1. Introduction/Background for Scenario C 2 minutes

2. Initial Dispatch 1 minute

3. En Route Injects 1 minute

4. Arrival On-scene 1 minute

5. Initial Report Review 5 minutes

6. Group Work 30 minutes

7. Reporting Out 15 minutes

8. Instructor Debrief and Review of Model Responses 5 minutes

9. Complete the Student Response Checklist 5 minutes

Total Time: 65 Minutes
WILDLAND FIRE

SM SC-8

This page intentionally left blank.
WILDLAND FIRE

SM SC-9

Map: Mineral Mountains Area Map and Information

The Mineral Mountains are full of maple, oak and walnut hardwoods, as well as pines. These 

mountains cut across the northwest corner of Liberty County. This sparsely populated area is 

used extensively by the timber industry. 

Fall foliage is a major tourist attraction in the area.
WILDLAND FIRE

SM SC-10

This page intentionally left blank.
WILDLAND FIRE

SM SC-11

INITIAL DISPATCH

Slide SC-8

• Liberty County Bat 71, WT 71, WT 51, 

Brush 61, 91, 11, 75, 51, Medic 11, 501, 

Ambulance 71, 176, Traffic 71, Rehab 32 

special assignment respond to Base for the 

Mineral Mountains Fire Incident. Med Flight 

1 on standby. 

• All Units to report to the Staging Area and 

Base at the Liberty County Fairgrounds. 

C. Initial dispatch.

Liberty County Bat 71, WT 71, WT 51, Brush 61, 91, 11, 75, 51, Medic 11, 501, 

Ambulance 71, 176, Traffic 71, Rehab 32 special assignment respond to Base for 

the Mineral Mountains Fire Incident. Med Flight 1 on standby.

All Units to report to the Staging Area and Base at the Liberty County 

Fairgrounds.

EN ROUTE INJECT 1

Slide SC-9

• After two minutes en route, additional 

information received:

– Extreme fire behavior and rapid movement of 

fire.

– With south-southwest winds at 15 mph, the fire 

is expected to move north-northeast very 

quickly.

– Fire anticipated to move toward state Route 52 

and parallel Interstate 107.

D. En Route Inject 1.

After two minutes en route, additional information received:

1. Extreme fire behavior and rapid movement of fire.

2. With south-southwest winds at 15 mph, the fire is expected to move northnortheast very quickly.
WILDLAND FIRE

SM SC-12

3. Fire anticipated to move toward state Route 52 and parallel Interstate 107.

EN ROUTE INJECT 2

Slide SC-10

• After 30 seconds:

– Special call for EMS 100, Medic 501, Amb 176, 

Safety 30.

• EMS 100 report to Incident Command Post 

(ICP).

E. En Route Inject 2.

1. After 30 seconds:

Special call for EMS 100, Medic 501, Amb 176, Safety 30.

2. EMS 100 report to Incident Command Post (ICP).

ON-SCENE ARRIVAL

Slide SC-11

F. On-scene arrival.
WILDLAND FIRE

SM SC-13

Scenario C: On-scene Images
WILDLAND FIRE

SM SC-14
WILDLAND FIRE

SM SC-15
WILDLAND FIRE

SM SC-16

This page intentionally left blank.
WILDLAND FIRE

SM SC-17

Slide SC-12

INTIAL REPORT

• Incident Commander instructs you (EMS 

100) to set up the Medical Unit.

• Provided with: 

– Current ICS Form 201 (Incident Briefing).

– Fire map.

– Schematic of Base Camp.

– Map of area businesses.

– Lookouts, Communications, Escape Routes 

and Safety Zones Considerations.

G. Initial report.

You arrive at the Incident Command Post (ICP) and report to the IC. He provides 

you with a quick initial report that includes:

1. Current ICS Form 201.

2. Fire map.

3. Schematic of the Base Camp.

4. Map of businesses in the area affected.

5. Lookouts, Communications, Escape Routes and Safety Zones 

Considerations.
WILDLAND FIRE

SM SC-18

This page intentionally left blank.
WILDLAND FIRE

SM SC-19

Scenario C: Initial Report Packet

Current ICS Form 201

INCIDENT 

BRIEFING

1. Incident Name

Mineral Mtn.

2. Date Prepared

8/5/2010

3. Time Prepared

1030 hrs

4. Map Sketch

ICS 201

Page 1 of 4

5. Prepared by (Name and Position)

Chief Hudson, Incident Commander
WILDLAND FIRE

SM SC-20

6. Summary of Current Actions

Objectives:

Ensure firefighter safety.

Evacuate civilians in projected fire travel path.

Protect structures as required.

Construct fire line paralleling I-107/East Division.

Protect SR 52 and prevent fire from crossing North Division.

Fire Behavior: Extreme fire behavior/wind from SW at 15 mph/30 percent humidity.

• Established ICP and base at LC Fairgrounds/Established Logistics.

• Deployed hand crew on east flank/requested air support: Established East Division.

• Deployed LC Brush Strike Team to SR-52 with two Tenders: Established North Division.

• Requested a Type 1 IMT from Columbia State Dept of Forestry and Wildlife.

• Requested air support from Columbia State Dept of Forestry and Wildlife.

ICS 201 Page 2
WILDLAND FIRE

SM SC-21

7. Current Organization

ICS 201 Page 3
WILDLAND FIRE

SM SC-22

8. Resources Summary

Resources Ordered Resource Identification ETA On 

Scene

Location/Assignment

Brush Strike team LC Brush-61,91,11,75 

and 51 x

North-Div

Water Tenders LC WT 71/51 x North-Div

IC LC Batt 71 x ICP

Log Chief LC Admin 1 x Base 

Medical Unit Leader LC/CC EMS 100 x Base 

Transport medics LC/CC Medic 501

x Camp North Division 

(Winery)

Transport medics Central City Medic 11 x Base 

Ambulance LC Blue Water 71 x Base 

Ambulance LC/Tribal EMS 176 x East Div Line

Rehab LC Rehab 32 x Base 

Type 1 IMT CS DOF/W 12hrs

Air support CS DOF/W 8hrs

Safety CC Safety 30 x Base

ICS 201 Page 4
WILDLAND FIRE

SM SC-23

Liberty County Fairgrounds Base
WILDLAND FIRE

SM SC-24

Area Businesses
WILDLAND FIRE

SM SC-25

Lookouts, Communications, Escape Routes and Safety Zones Considerations

For Scenario C line EMTs and Camp at Great Grapes Winery:

L The fire is moving north-northeast in the Mineral Mountains. Lookouts and observers 

have been placed at the Great Grapes Winery, state Route 52 (SR 52) and Interstate 107 

(I-107), Swatera Creek and I-107, and aloft in a Columbia State Patrol helicopter. 

C Line EMT and squad bosses have radio communication with Division Supervisor. 

Spacing has been reviewed and the firefighters and line EMTs are spaced for verbal 

communication.

E Escape routes on SR 52 are to the east toward I-107 and Blue Water and to the west to

the Great Grapes Winery. The escape route along the fire line paralleling I-107 will be 

south of the Fairgrounds entrance.

S Safety areas are the Great Grapes Winery parking areas and main building, Blue Water 

Fire Station, and north entrance to the Fairgrounds.
WILDLAND FIRE

SM SC-26

This page intentionally left blank.
WILDLAND FIRE

SM SC-27

Slide SC-13

GROUP WORK

• You are EMS 100, arrived at the incident. 

Set up the Medical Unit and develop:

– ICS Organizational Structure. 

-- Resource assignment.

– ICS Form 206, Medical Plan.

– ICS Form 214, Unit Log.

– Patient Tracking Form.

H. Group work.

You are EMS 100, arrived at the incident. Set up the Medical Unit and develop:

1. ICS Organizational Structure.

Resource assignment.

2. ICS Form 206, Medical Plan.

3. ICS Form 214, Unit Log.

4. Patient Tracking Form.
WILDLAND FIRE

SM SC-28

This page intentionally left blank.
WILDLAND FIRE

SM SC-29

Scenario C: ICS Forms

The ICS forms(s) needed to complete the scenario are attached here. Copies of these forms can 

be found in Appendix A and Appendix B. The easel pads provided can be used to sketch out the 

ICS Organizational Charts and to brainstorm and take notes.
WILDLAND FIRE

SM SC-30

This page intentionally left blank.
WILDLAND FIRE

SM SC-31

ICS Form 206

MEDICAL PLAN 1. Incident Name 2. Date Prepared 3. Time Prepared 4. Operational Period

5. Incident Medical Aid Station

Medical Aid Stations Location Paramedics

 Yes No

6. Transportation

A. Ambulance Services

Name Address Phone Paramedics

 Yes No

B. Incident Ambulances

Name Location Paramedics

 Yes No

7. Hospitals

Name Address Travel Time

Air Ground Phone HelipadYes No

Burn Center

Yes No

8. Medical Emergency Procedures

Prepared by (Medical Unit Leader) 10. Reviewed by (Safety Officer)
WILDLAND FIRE

SM SC-32

This page intentionally left blank.
WILDLAND FIRE

SM SC-33

ICS Form 214

UNIT LOG 1. Incident Name 2. Date Prepared 3. Time Prepared

4. Unit Name/Designators 5. Unit Leader (Name and Position) 6. Operational 

Period

7. Personnel Roster Assigned

Name ICS Position Home Base

8. Activity Log

Time Major Events

9. Prepared by (Name and Position)
WILDLAND FIRE

SM SC-34

This page intentionally left blank.
WILDLAND FIRE

SM SC-35

ICS Form MC-306

Multi-Casualty

Recorder Worksheet

Ambulance 

Company

Ambulance 

ID Number

Patient 

Triage Tag 

Number

Patient 

Status

Hospital 

Destination

Off Scene 

Time

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

ICS-MC-306 (12/89)

DISCLAIMER: This form is not an approved ICS Form but has been provided for your reference and use in this course. 
WILDLAND FIRE

SM SC-36

This page intentionally left blank.
WILDLAND FIRE

SM SC-37

I. Injects.

Slide SC-14

INJECT 1

• M-11, M-501, Amb 71, Amb 176 assigned to 

Medical Unit.

• After one minute: Injury Report. 

– 36-year-old male.

– Eye injury.

– Status: Minor.

– Triage Tag: 30300001.

1. Inject 1.

a. M-11, M-501, Amb 71, Amb 176 assigned to Medical Unit.

b. After one minute: Injury Report. 

- 36-year-old male.

- Eye injury.

- Status: Minor.

- Triage Tag: 30300001.

Slide SC-15

INJECT 2

• After another minute: Injury Report.

– 25-year-old male.

– Burn to hands.

– Status: Immediate.

– Triage Tag: 30300002.

2. Inject 2.
WILDLAND FIRE

SM SC-38

After another minute: Injury Report.

a. 25-year-old male.

b. Burn to hands.

c. Status: Immediate.

d. Triage Tag: 30300002.

Slide SC-16

INJECT 3

• After another minute: Two firefighters have 

been stung by bees.

• Patient 1:

– 27-year-old female.

– Bee sting.

– Status: Delayed.

– Triage Tag: 30300003.

3. Inject 3.

a. After another minute: Two firefighters have been stung by bees.

b. Patient 1:

- 27-year-old female.

- Bee sting.

- Status: Delayed.

- Triage Tag: 30300003.
WILDLAND FIRE

SM SC-39

Slide SC-17

INJECT 3 (cont’d)

• Patient 2:

– 25-year-old male.

– Bee sting.

– Status: Immediate.

– Triage Tag: 30300004.

c. Patient 2:

- 25-year-old male.

- Bee sting.

- Status: Immediate.

- Triage Tag: 30300004.

Slide SC-18

INJECT 4

• After another minute: Water Tender 71 

rolled over; one person was trapped inside 

but has now been extricated. 

– 28-year-old male.

– Multitrauma.

– Status: Immediate.

– Triage Tag: 30300005.

4. Inject 4.

After another minute: Water Tender 71 rolled over; one person was 

trapped inside but has now been extricated.

a. 28-year-old male.

b. Multitrauma.
WILDLAND FIRE

SM SC-40

c. Status: Immediate.

d. Triage Tag: 30300005.

Slide SC-19

INJECT 5

• After another minute: Injury Report. 

– 30-year-old male.

– Major laceration.

– Status: Delayed.

– Triage Tag: 30300006.

5. Inject 5.

After another minute: Injury Report. 

a. 30-year-old male.

b. Major laceration.

c. Status: Delayed.

d. Triage Tag: 30300006.

Slide SC-20

INJECT 6

• After another minute: Injury Report. Four 

patients with similar injuries: 

– 30-year-old male (Triage Tag: 30300007), 21-

year-old male (Triage Tag: 30300008), 22-

year-old male (Triage Tag: 30300009), 22-

year-old male (Triage Tag: 30300010).

– Nausea, vomiting, diarrhea.

– Status: Minor.

6. Inject 6.
WILDLAND FIRE

SM SC-41

After another minute: Injury Report. Four patients with similar injuries: 

a. 30-year-old male (Triage Tag: 30300007), 21-year-old male 

(Triage Tag: 30300008), 22-year-old male (Triage Tag: 

30300009), 22-year-old male (Triage Tag: 30300010).

b. Nausea, vomiting, diarrhea.

c. Status: Minor.

Slide SC-21

INJECT 7

• After another minute: Injury Report. 

– 24-year-old.

– Snakebite.

– Status: Immediate.

– Triage Tag: 30300011.

7. Inject 7.

After another minute: Injury Report. 

a. 24-year-old.

b. Snakebite.

c. Status: Immediate.

d. Triage Tag: 30300011.

II. REPORTING OUT
WILDLAND FIRE

SM SC-42

REPORTING OUT

Slide SC-22

• Groups describe their:

– Organizational charts. 

– Resource assignments.

– Information included on ICS Form 206.

– Information included on ICS Form 214.

• Remember, one group does full reporting 

out; other groups describe significant 

differences.

• Total time is 15 minutes.

A. Groups describe their:

1. Organizational charts. 

2. Resource assignments.

3. Information included on ICS Form 206.

4. Information included on ICS Form 214.

B. Remember, one group does full reporting out; other groups describe significant 

differences.

C. Total time is 15 minutes. 

III. COMPLETING THE SCENARIO

COMPLETING THE 

SCENARIO

Slide SC-23

• Instructor provides Model Responses.

• Instructor answers questions.

• Students complete Student Response 

Checklist.

• Total time is 10 minutes.
WILDLAND FIRE

SM SC-43

A. Instructor provides Model Responses.

B. Instructor answers questions.

C. Students complete Student Response Checklist.

D. Total time is 10 minutes.
This page intentionally left blank.
EMS FUNCTIONS IN ICS

MODULE 7:

SPECIAL CONSIDERATIONS IN MASS 

GATHERINGS

OBJECTIVES

The students will be able to:

7.1 List special considerations related to various types of mass gatherings.

7.2 Identify Emergency Medical Services (EMS) event classification and resource deployment factors and 

personnel.

7.3 Discuss alternative modes of transporting EMS resources.

7.4 Review the Mass Gathering Checklist.

7.5 Discuss the Incident Action Plan (IAP).
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-2

This page intentionally left blank.
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-3

MODULE 7: 

SPECIAL CONSIDERATIONS 

IN MASS GATHERINGS

Slide 7-1

OBJECTIVES

• List special considerations related to 

various types of mass gatherings.

• Identify Emergency Medical Services 

(EMS) event classification and resource 

deployment factors and personnel.

• Discuss alternative modes of transporting 

EMS resources.

• Review the Mass Gathering Checklist.

• Discuss the Incident Action Plan (IAP).

Slide 7-2

I. SPECIAL CONSIDERATIONS IN MASS GATHERINGS

EVENT PHASES

Slide 7-3

Pre-event Event 

Operations

Post-event 

Actions

A. Event phases.
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-4

1. Events are divided into three phases. They are Pre-event, Event Operations 

and Post-event Actions.

2. In the Pre-event phase, planning activities — including identifying risks 

and hazards and determining resource requirements — are performed. 

3. The Event Operations phase is broken into three components —

Mobilization, Operations and Demobilization. 

4. In the Post-event Actions phase, open discussion and review of lessons 

learned is encouraged.

PRE-EVENT PLANNING

• Attendees:

– Event hosts and community public safety 

officials.

• Actions:

– Create multidisciplinary planning team.

– Develop an IAP.

Slide 7-4

B. Pre-event planning.

1. Event hosts and community public safety officials should meet prior to the 

event to create a multidisciplinary planning team composed of the event 

sponsor and any agency that holds a functional stake in the event — e.g., 

emergency management, law enforcement, fire and rescue, public 

works/utilities, public health, etc. 

2. The lead agency’s Planning Section Chief for the event is responsible for 

developing the Incident Action Plan (IAP) with cooperation from other 

members of the planning team. In some communities this is a function of 

emergency management.
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-5

• Type of event.

• Geographic size and complexity:

– Number of venues.

– Indoor events.

– Outdoor events.

– Accessibility.

– Means of egress.

IDENTIFY RISKS

Slide 7-5

C. Identify risks.

1. The event planner should consider any event that has the potential to 

produce a significant number of injuries or illnesses or to involve a large 

number of high-risk participants as a patient generator. Special events with 

activities such as contact sports, horse or vehicle racing, etc. or events 

scheduled to occur during seasons that produce oppressive weather should 

all be considered in this group.

2. The following points should be kept in mind when identifying risks:

a. Type of event.

b. Geographic size and complexity.

- Number of venues.

- Indoor events.

- Outdoor events.

- Accessibility.

- Means of egress.
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-6

• Human hazards:

– Elevated emotional levels.

– Historical conflict between participants/ 

spectators.

– High-profile or controversial participants/ 

spectators.

– Crush loads.

• Physical hazards:

– Structural situations.

– Assigned seating versus festival seating.

– Mechanical hazards. Slide 7-6

IDENTIFY HAZARDS

D. Identify hazards.

Hazards can be potentially categorized into three types:

1. Human hazards:

a. Events with participants or spectators potentially achieving 

elevated emotional levels.

b. Participants and/or spectators who historically have a conflict —

e.g., gang activity, religious or cultural differences.

c High-profile or controversial participants/spectators.

d. Crush load (the assembly of people inside or outside a facility that

overwhelms the capacity of a given area, resulting in gridlock, 

limited access, and hazards incompatible with life safety).

2. Physical hazards:

a. Structural situations such as unusual buildings or structures that 

create a hazard — e.g., stage, bleachers, or other temporary 

structures.

b. Assigned seating versus festival seating.

c. Mechanical hazards such as vehicle sports, contact sports, flying 

debris, etc.
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-7

– Fire or thermal hazards.

– Water.

– Animals.

– Archery/Firearm ranges. 

– Special hazards. 

• Environmental hazards:

– Heat index.

– Snow or ice.

– Storms, high winds, or other unexpected 

weather.

Slide 7-7

IDENTIFY HAZARDS (cont’d)

d. Fire or thermal hazards such as pyrotechnics, fireworks, cooking 

equipment, special fuel for vehicles, etc.

e. People in or near the water.

f. Animals (e.g., horses, dogs, exotic animals, etc.).

g. Archery/Firearm ranges.

h. Other special hazards.

3. Environmental hazards:

a. Heat index of 90 degrees or greater.

b. Snow or ice.

c. Storms, high winds, or other unexpected weather.

• People: deaths, injuries and displacement.

• Critical facilities: days of service loss and 

repair time.

• Community functions: disruption.

• Property: damage, destruction and cost of 

replacement or repair.

• Secondary hazards: shortage of medical 

supplies.

POTENTIAL CONSEQUENCES 

OF HAZARDS

Slide 7-8
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-8

E. Potential consequences of hazards.

To determine the potential consequences of a hazard, estimate the lives, property 

and services at risk. Evaluate the extent of the hazard by closely examining your 

community in terms of the following.

1. People: deaths, injuries and displacement.

2. Critical facilities: days of service loss, repair time.

3. Community functions: disruption.

4. Property: damage, destruction, cost of replacement or repair.

5. Potential secondary hazards: shortage of medical supplies.

• Loss of revenue: people not wanting to 

attend future events.

• Negative public image: inadequate 

planning and response.

POTENTIAL CONSEQUENCES 

OF HAZARDS (cont’d)

Slide 7-9

6. Loss of revenue: people not wanting to attend future events.

7. Negative public image of jurisdiction: inadequate planning and response.
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-9

Slide 7-10

• Consumption of mind-altering substances.

• Event type.

• Seating.

• Medical care for entertainers, VIPs, 

athletes, etc.

• Attending populace.

SPECIAL CONSIDERATIONS —

DURING EVENT

F. Special considerations — during event:

1. Consumption of mind-altering substances.

a. Alcohol: Learning whether alcoholic beverages will be allowed at 

the site coupled with knowledge of the type of people attending 

and the duration of the event will allow you to plan, if necessary, 

for dealing with intoxicated people. If this is a possibility, then you 

may wish to plan for an area where intoxicated people can be 

observed until it is safe for them to rejoin the activities or go home. 

Identify when the alcohol sales will be cut off.

b. Potential illegal drug use: Some events are more likely than 

others to attract users of illicit drugs. If this is a possibility, you 

must make plans to deal with the attendant medical issues. 

2. Event type: The type of event may give some idea of the age range of 

those attending, information that will provide some idea of the medical 

problems to be expected. 

a. A rock concert will be attended predominantly by young people.

b. A state or county fair will be attended by people of all ages.

c. A gathering of retired people predominantly those over 55 years 

old.

3. Seating: Another consideration involves whether the crowd will be seated 

(e.g., indoor concert) or mostly moving about (e.g., outdoor fair). The 

logistics of reaching an unconscious patient in the middle seat of the 

central section of an enormous auditorium are different from those of 

reaching a patient stretched out under a tree in a meadow.
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-10

4. Medical care for entertainers, VIPs, athletes, etc.

a. If the event has a speaker, band or group of entertainers separate 

from spectators, it must be determined ahead of time who will 

provide medical care to the entertainers. An aid station should be 

located appropriately to cover their medical needs.

b. Athletic teams most likely will provide their own team physicians.

c. Some events will have VIPs, such as high government officials and 

foreign dignitaries, whose potential medical problems must be 

considered. In some cases, their own medical personnel will 

accompany them, but most likely they will not. Your meeting 

beforehand with the event coordinators should address this 

situation. In some cases, you may wish to assign a physician just to 

attend to the VIPs.

5. Attending populace.

a. Pediatrics.

b. Geriatrics.

c. People with special needs (physical and mental): Take note of the 

number of handicapped people expected to be in attendance, as 

people in wheelchairs or on crutches may need special mechanisms 

of transport to your aid station, or you may need to attend to them 

where they are.

• Roads:

– Traffic plan.

– Emergency vehicle access and egress.

– Internal event transportation.

– Intra-venue versus extra-venue transport. 

• Utilities (water and sewer):

– Sufficient to meet demand? 

• Power (electrical and gas): 

– Sufficient to meet demand? 

Slide 7-11

SPECIAL CONSIDERATIONS —

SYSTEMS SUPPORTING EVENT

G. Special considerations — systems supporting event.

1. Roads:
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-11

a. Traffic plan to accommodate increased load.

b. Emergency vehicle access and egress.

c. Internal event transportation.

d. Intra-venue versus extra-venue transport.

2. Utilities (water and sewer):

Are they sufficient to meet demand?

3. Power (electrical and gas):

Is it sufficient to meet demand?

• Low-risk event:

– Fewer than 5,000 spectators.

– Minimum staffing: five personnel.

• Medium-risk event:

– Between 5,000 and 15,000 spectators.

– Minimum staffing: 11 personnel.

• High-risk event:

– More than 15,000 spectators.

– Minimum staffing: depends on deployed 

resources.

Slide 7-12

EMS EVENT CLASSIFICATION AND 

RESOURCE DEPLOYMENT

H. Emergency Medical Services (EMS) event classification and resource 

deployment.

Events can be classified into low-, medium- or high-risk categories based on the 

number of spectators attending the event. The following resources should be 

deployed at events based on event classifications.

1. Low-risk event. This event has fewer than 5,000 spectators and requires 

a minimum total staffing of five personnel comprised of the following:

a. Event Commander.

b. Usually one Bike Team or Walking Team.

c. Optional Medical Aid Station with advanced life support (ALS).

d. One ALS Transport Unit.
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-12

2. Medium-risk event. This event has from 5,000 to 15,000 spectators and 

requires a minimum total staffing of 11 personnel comprised of the 

following:

a. Event Commander.

b. Two Bike Teams or Walking Teams for fixed seating situations.

c. Medical Aid Station (ALS).

d. Two ALS EMS Carts.

e. One or two ALS Transport Units.

3. High-risk event. This event has more than 15,000 spectators and 

requires personnel comprised of the following:

a. One Bike Team for every 7,500 spectators.

b. One Walking Team for every 7,500 spectators for fixed-seating 

situations.

c. One ALS EMS Cart for every 7,500 spectators.

d. Medical Aid Station(s).

e. One ALS Transport Unit for every 7,500 to 10,000 spectators, 

considering transport time and level of Aid Station.

f. Other special resources as required.

4. These categories and numbers are based on the three sources listed in the 

Mass Gathering Checklist — Sample 2 toward the end of this module. 

These numbers can be modified to meet specific criteria based on these 

sources, the community’s history with events, and the venue location 

compared to hospital location.
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-13

• Gather intelligence prior 

to event/gathering.

– Attendee demographics.

– Type of seating.

– Alcohol and vendor 

policies.

• Post Transport Units or 

Aid Stations strategically.

Slide 7-13

STRATEGIES FOR MEETING 

RESPONSE TIME GOALS

Courtesy of Charleston County EMS

I. Strategies for meeting response time goals.

1. Gather intelligence prior to event/gathering on:

a. Attendee demographics. The demographics of the attendees to a 

mass gathering should be evaluated, as certain crowds bring certain 

problems. An assessment should be made of the potential for 

violence or clashes between social groups or rival interests, 

including whether or not there are groups known to create issues 

(i.e., motorcycle clubs, gangs, political protesters).

b. Type of seating. Festival seating is often a risk for crush loads 

forming at certain choke points or against barriers to a stage or exit 

area. Assigned seating at a venue is safer; however, if there is 

inadequate security to enforce that policy, a venue can change to

festival seating quickly.

c. Alcohol and vendor policies. The alcohol and vendor policies also 

are important to have information about. In the event that attendees 

cannot bring water into an outdoor venue, this can increase the 

likelihood of dehydration. More patients can be generated due to 

the demands of extreme weather at an outdoor event. In many 

venues, alcohol sales are discontinued after a certain period to 

allow the crowd to sober up before departing. 

2. Post Transport Units or Aid Stations strategically:

Aid Station and/or Transport Units should be placed near target hazard 

areas such as travel corridors and performance venues. A major 

consideration in the placement of these resources is the maintenance of an 

egress route for the departure of the transport vehicle, should the need 

arise, and the restocking of the resource by Logistics if required. A map of 

the entire venue or facility should be provided to all responders.
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-14

• Use alternative service delivery vehicles.

– Motor EMS Units.

– Bike Medic Teams.

– Mounted EMS Units.

Slide 7-14

STRATEGIES FOR MEETING 

RESPONSE TIME GOALS (cont’d)

3. Use alternative service delivery vehicles:

The use of Bike Teams, motorcycles, EMS carts, and other alternative 

EMS delivery vehicles has been a very successful trend over the last 

couple of decades. EMS Bike Teams are now an industry norm for use at 

special events and mass gatherings. During events at which both Walking 

Teams and Bike Teams are deployed, Bike Teams will typically have half 

the response time of the Walking Team.

a. Bike Medic Teams: Bike Medic Teams can navigate crowds, 

curbs, stairs, escalators and elevators with great ease. SegwaysTM, 

golf carts, and utility vehicles such as Mules and Gators will not be 

able to negotiate all of these obstacles.

b. Mounted EMS Units: Mounted EMS Units are very adept at 

navigating crowds. In addition to “parting” the crowds, horses are 

very useful in difficult terrain. Mounted Units are often able to 

access areas that other units cannot. Mounted Units are beneficial 

for searches and provide the mounted rider with an excellent visual 

field to assess the crowd.
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-15

• Golf carts.

• Gas-powered units 

(Gators/Mules/Rangers).

• Other resources.

Slide 7-15

TRANSPORTING PATIENTS

Courtesy of Diversified Golf Cars, Inc. 

J. Transporting patients.

Once care has begun, the patient may need transportation to a local care center or 

to an over-the-road Transport Unit for transport to an appropriate hospital. There 

are several types of vehicles to choose from for patient transport.

1. Golf carts: Golf carts are an excellent choice if your venue is indoors or 

on a mostly flat surface. 

a. One advantage of golf carts is their quiet operation. Both electrical 

and gas units operate very quietly, allowing the vehicle to 

transverse the venue without disrupting the spectators’ enjoyment. 

b. Golf carts often can be limited in their power and may be slow or 

unable to overcome areas when carrying a patient, equipment 

and/or rescuers.

c. In rough or large venues, these vehicles may not be the best choice 

because of their limited ability to navigate rough terrain and their 

limited speed.

d. If the vehicle is electrically powered, recharging may be an issue in 

times of heavy incident volume.

2. Gas-powered units (Gators/Mules/Rangers): These are not the best 

choice in small or enclosed venues.

a. These units are relatively noisy compared to an electric golf cart 

and they do exhaust fumes; however, in an outdoor environment or 

a venue where speed is a consideration, these types of vehicles are 

excellent.
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-16

b. Many gas-powered units are offered in all-wheel drive, and some 

models are completely enclosed, offering all the advantages of a 

small ambulance.

c. Patient privacy, patient warming or cooling capabilities, and the 

ability to operate equipment requiring a fixed power source are 

some of the advantages of this type of transport.

3. Other resources: Another recent development in EMS alternative 

vehicles is the Multipatient Medical Transport (MPMT) vehicle.

a. The majority of these vehicles are designed to accommodate six to 

12 patients whose condition is not acute. They increase the 

availability and flexibility of primary units by treating and 

transporting all of the patients in one vehicle.

b. These vehicles make excellent Mobile Aid Stations at special 

events and mass gatherings. They can be moved in the venue as the 

dynamics of the event change. They also offer a location to rehab 

public safety event personnel.

• Examples:

– National Association of EMS Physicians 

Checklist.

– Special Events Planning Checklist.

– EMS Venue Assessment Checklist. 

– Sample Checklist.

• You will need to tailor these to your 

jurisdiction’s needs and available 

resources! 

Slide 7-16

MASS GATHERING 

CHECKLISTS

K. Mass Gathering Checklist.

Checklists for mass gatherings and special events assist in an effective medical 

response to the event. Some Mass Gathering Checklists are provided and 

referenced below.

1. Mass Gathering Medical Care: The Medical Director’s Checklist: can be 

ordered from the National Association of EMS Physicians website,

http://www.naemsp.org/Pages/Products.aspx.
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-17

2. Special Events Planning Checklist (available as Appendix E: Special 

Events Planning Checklist).

3. EMS Venue Assessment Checklist (provided on the following page).

4. Sample Henrico County checklist.
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-18

This page intentionally left blank.
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-19

Mass Gathering Checklist — Sample 1: EMS Venue Assessment

This sample is the EMS Venue Assessment Checklist excerpted from the IS-15.B Special Events 

Contingency Planning for Public Safety Agencies course and can be accessed at: 

http://training.fema.gov/EMIWeb/IS/courseoverview.aspx?code=is-15.b.
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-20

This page intentionally left blank.
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-21

EMS Venue Assessment Checklist
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-22
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-23

Mass Gathering Checklist — Sample 2: Henrico Division of Fire Planning Form

This sample is provided as a reference tool for you to use in developing your own planning form/

checklist. Remember, each jurisdiction should develop a form specific to their own needs and 

available resources. (Form provided courtesy of Henrico Division of fire.)
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-24

This page intentionally left blank.
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-25

Henrico Division of Fire’s EMS/Fire Risk Assessment and Resource Deployment 

Matrix Planning Form

Purpose: To provide a consistent level of public safety special events held within Henrico 

County. The Henrico Division of Fire’s Fire/EMS Risk Assessment and Resource Deployment 

matrix is a tool providing the special event planner with specific parameters and objective 

decision-making criteria for determining level of service requirements. 

The risk assessment category is defined as: Low, Medium or High.

All high-level service events should be referred to the Special Events Group to identify service 

requirements. (The Special Events Group is appointed by the Assistant Chief, Operations to 

assist with the planning of special events.)

EMS Risk level: ______

Resource deployment factors:

1. Type of event. 

2. Geographic size and complexity of event. 

3. The Hazard/Risk assessment.

4. The Vulnerability assessment.

5. Our history with this event or a similar event.

6. A similar community experience with this kind of event.

Type of event: 

The event planner should consider any event that has the potential to produce a significant 

number of injuries or illnesses or involve a large number of high-risk participants as a patient 

generator. Special Events with activities such as horse racing, contact sports, vehicle racing, etc. 

or events scheduled to occur during seasons that produce oppressive weather should all be 

considered in this group.

Geographic size and complexion of event: 

Meets criteria for consideration.

• Number of venues? Inside Outside .

• Accessible/means of egress.

• Any situation with the potential for an EMS response time (to the patient’s side) 

greater than five minutes.
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-26

Hazards and risk assessment:

Human Hazards: 

Meets criteria for consideration.

• Fixed seating versus festival seating.

• Event with participants or spectators potentially achieving elevated emotional 

levels.

• Participants and/or spectators that have a historical conflict. (Gang activity, 

religious or cultural differences).

Physical Hazards:

Meets criteria for consideration.

• Structural situations: unusual buildings or structures that create a hazard.

• Mechanical hazard: vehicle sports, contact sports, flying debris, etc. 

• Fire or thermal hazard: pyrotechnics, fireworks, cooking equipment, special fuel 

for vehicles, etc.

• Water: people in or near the water that cannot swim.

• Animals: horses, dogs, exotic critters, etc.

• Archery/Firearms ranges.

• Other special hazards (explain).

Environmental Hazards:

Meets criteria for consideration.

• Heat index of 90 degrees.

• Snow or ice.

• Storms, high winds or other unexpected weather.

Weather related situations should be examined and monitored for at least 72 hours preevent.

The Vulnerability assessment:

Meets criteria for consideration

1. Mind altering substances.

• Alcohol (controlled or uncontrolled).

• Potential illegal drug use.

2. Attending populist.

• Pediatrics.

• Geriatrics.

• People with special needs. (Physical and Mental.)
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-27

Henrico Division of Fire’s history with event:

Meets criteria for consideration.

• History with the promoter or entertainment company.

• History with this event or an event of this type.

Other community experience with a similar event:

Meets criteria for consideration.

• Check the event’s history prior to coming to Henrico County.

Should the special event trigger two but less than five EMS resource deployment factors the 

event shall be elevated to the next highest level of risk category. All special events 

triggering five or more resource deployment factors shall be considered a high risk. 

Less than 5,000 spectators (Low risk)

(Smaller events will be examined on a case by case to determine resource needs.)

• Event Commander.

• Usually requires one Bike Team or Walking Team.

• Consider using a Medical Aid Station (ALS).

• One ALS Transport Unit.

Minimum total staffing: five personnel.

5,000 to 15,000 spectators (Medium risk)

• Event Commander.

• Two Bike Teams or Walking Teams (for fixed seating situations).

• Medical Aid Station (ALS).

• Two ALS EMS Carts.

• One or two ALS Transport Units.

Minimum total staffing: 11 personnel.

15,000 + (High risk)

• One Bike team for every 7,500 spectators.

• One Walking Team for every 7,500 spectators (for fixed seating situations).

• One ALS EMS Cart for every 7,500 spectators.

• One ALS Transport Unit for every 7,500 to 10,000 spectators. (Transport time and 

level of Aid Station must factor.)

• Medical Aid station(s).

• Other special resources as required.

Minimum total staffing: To be determined.
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-28

FIRE Risk level: _______

Below is a list of parameters that should be considered to determine level of service 

requirements:

1. Weather — Forestry Class III or greater.

2. Any fireworks or outside pyrotechnics.

3. Open burning.

4. Hydrants greater than 1,000 feet from the venue.

5. 15,000+ spectators.

6. History of fire problems at past events.

7. Heat index 90 degrees or greater.

8. Geographic size or configuration provides limited access or long response time.

9. High fuel loading (tents, trailers, straw, etc.).

Low risk

Any outside event that involves only one parameter listed above.

Requirements:

• Brush unit (preferably B3) with two firefighters.

• Add a tanker if parameter 4, 7 or 9 is present.

Medium risk

Any outside event that involves two to four parameters listed above.

Requirements:

• Brush unit with one firefighter.

• Tanker with one firefighter.

• Fire Bike team with two bike team members.

High risk

Any outside event that involves five or more parameters listed above.

Requirements:

• To be determined by the Special Events Group, under the direction of the Assistant Chief, 

Operations.

Resource deployment matrix:

The resource deployment matrix is a recommendation to the event planner to determine the 

event’s minimal staffing requirements. The event commander can elect to deploy personnel and 

equipment in a configuration that is more advantageous to the event’s situation.

Sources:

1. American College of Emergency Physicians. EMS Committee report: Provisions of 

emergency medical care for crowds 1995/96.

2. National Fire Academy. Emergency Medical Service Special Operations Guide.

3. National Fire Protection Association (NFPA). NFPA Handbook.
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-29

• Develop prior to incident and document on 

standard Incident Command System (ICS) 

forms.

• Include provision for all stakeholders.

• Use Unified Command (UC).

• Divide event into operational periods:

– Mobilization.

– Operations.

– Demobilization.

INCIDENT ACTION PLAN

Slide 7-17

L. IAP.

1. The use of Incident Command System (ICS) is paramount for a successful 

operation. A comprehensive IAP must be developed prior to an incident, 

and an incident briefing must be conducted prior to mobilization for the 

event. The IAP should be documented on standard ICS forms.

2. The IAP should include provisions for all stakeholders. 

Promoters/Sponsors and some agencies may not be familiar with ICS and 

may require some training to understand the system and use it 

appropriately.

3. A “best practice” is to use Unified Command whenever possible. 

4. The Event Operations phase has three distinct components or periods of 

work where different objectives must be met. They are Mobilization, 

Operations and Demobilization.

5. Although they are described here as functional periods, they should 

actually be documented in the IAP by a standard time and date format. 

a. Mobilization: The Mobilization operational period relies heavily 

on the Logistics Section. 

- It should include the establishment of incident facilities 

(Incident Command Post, Base, and other facilities as 

required). 

- Timelines for the delivery of operational equipment and 

supplies required to sustain the operation (fuel, rehab 

supplies, etc.) should be addressed. 
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-30

- Reporting times of event personnel, credentialing details, 

and other human resources items should be provided. 

b. Operations: It is the operational period that is the primary focus of 

the IAP. 

- The Operations Section is fully deployed to conduct the 

event and mitigate incidents as required. 

- The IAP should address all aspects of the event operations 

in order to operate the event safely and functionally, and 

address any incidents as required.

c. Demobilization: Demobilization should be planned just as 

carefully as the event itself. 

- It begins during the planning stages of an event and 

continues during the event.

- Planners must decide on a logical order in which to release 

response agencies and other resources, and they must 

authorize a point of contact to release resources. 

- The impact on the community and its resources must also 

be considered in the demobilization process.

- The Incident Commander (IC) should direct the 

demobilization process through the Demobilization Unit in 

the Planning Section.

• Allows open discussion of what went well 

and what could have gone better. 

• Lessons learned lay groundwork for future 

events.

POST-EVENT ANALYSIS

Slide 7-18
SPECIAL CONSIDERATIONS IN MASS GATHERINGS

SM 7-31

M. Post-event analysis:

Post-event analysis allows open discussion of what went well and what could 

have gone better during the event, and lays the groundwork for applying the 

lessons learned in future events.

II. SUMMARY 

SUMMARY

• List special considerations related to 

various types of mass gatherings.

• Identify EMS event classification and 

resource deployment factors and 

personnel.

• Discuss alternative modes of transporting 

EMS resources.

• Review the Mass Gathering Checklist.

• Discuss the IAP.

Slide 7-19
This page intentionally left blank.
EMS FUNCTIONS IN ICS

SCENARIO D:

MASS GATHERING — PLANNED 

PROTEST

SCENARIO OBJECTIVES

The students will be able to:

SD.1 Develop a Medical Branch and a Medical Unit in the Incident Command System (ICS) organizational 

structure.

SD.2 Develop a Medical Plan.

SD.3 Track patients using a Patient Tracking Form.

SD.4 Use benchmarks to order and assign appropriate resources.
MASS GATHERING — PLANNED PROTEST

SM SD-2

This page intentionally left blank.
MASS GATHERING — PLANNED PROTEST

SM SD-3

SCENARIO D:

MASS GATHERING —

PLANNED PROTEST

Slide SD-1

SCENARIO OBJECTIVES

• Develop a Medical Branch and a Medical 

Unit in the Incident Command System 

(ICS) organizational structure.

• Develop a Medical Plan.

• Track patients using a Patient Tracking 

Form.

• Use benchmarks to order and assign 

appropriate resources.

Slide SD-2

I. SCENARIO D: MASS GATHERING — PLANNED PROTEST

SCENARIO ROLES AND 

TASKS

• In this scenario, you are EMS 100.

• In this scenario, you will develop/complete:

– Updated ICS Organizational Chart.

– ICS Form 206 (Medical Plan).

– Updated ICS Form 201 (Incident Briefing).

– ICS Form MC-306 (Patient Tracking Form).

– Student Response Checklist.

Slide SD-3

A. Scenario roles and tasks.
MASS GATHERING — PLANNED PROTEST

SM SD-4

1. In this scenario, you are EMS 100.

2. In this scenario, you will develop/complete:

a. Updated Incident Command System (ICS) Organizational Chart.

b. ICS Form 206 (Medical Plan).

c. Updated ICS Form 201 (Incident Briefing).

d. ICS Form MC-306 (Patient Tracking Form).

e. Student Response Checklist.

INTRODUCTION

• Scenario is taking place at Farmers A&M 

University.

• Current conditions:

– Time: 1700 hours.

– Date: April 5.

– Temperature: 75 F.

– Humidity: 10 percent.

– Wind: 5 mph south-southwest.

Slide SD-4

B. Introduction.

1. Scenario is taking place at the Farmers A&M University.

2. Current conditions: 

a. Time: 1700 hours.

b. Date: April 5.

c. Temperature: 75 F.

d. Humidity: 10 percent.

e. Wind: 5 mph south-southwest.
MASS GATHERING — PLANNED PROTEST

SM SD-5

Slide SD-5

INTRODUCTION (cont’d)

You get a call from Farmers A&M University 

Police Lieutenant (Lt.) Rickles.

• Flash mob conducted by the Animal 

Protection League in protest of 

experimentation on animals.

• EMS 100 (Jolley), Battalion 2 report to 

Central City Fire Department (CCFD) 

Station 3 (on the southwest corner of 

Farmers A&M University).

3. You get a call from Farmers A&M University Lieutenant (Lt.) Rickles. 

4. Flash mob conducted by the Animal Protection League in protest of 

experimentation on animals. 

5. EMS 100 (Jolley), Battalion 2 report to Central City Fire Department 

(CCFD) Station 3 (on the southwest corner of Farmers A&M University).

6. Engine 3, Tower 3, Ambulance 3 and Special Weapons and Tactics 

(SWAT) Medic 3 are already at CCFD Station 3 and will be committed to 

this incident.

Slide SD-6

INTRODUCTION (cont’d)

• Engine 3, Tower 3, Ambulance 3, and 

Special Weapons and Tactics (SWAT) 

Medic 3 are already at CCFD Station 3 and 

will be committed to this incident.
MASS GATHERING — PLANNED PROTEST

SM SD-6

Slide SD-7

Briefing includes:

• Description of events.

• ICS Form 201: 

– Incident objectives.

– Campus maps with relevant buildings marked.

INCIDENT COMMANDER 

BRIEFING

C. Incident Commander (IC) briefing.

Briefing includes:

1. Description of event.

2. ICS Form 201:

a. Incident objectives.

b. Campus maps with relevant buildings marked.
MASS GATHERING — PLANNED PROTEST

SM SD-7

Scenario D: Student Instructions

Flow of Scenario Time

1. Introduction/Background for Scenario D 1 minute

2. IC Briefing 5 minutes

3. Group Work 1 15 minutes

4. Injects + On-scene 4 minutes

5. Group Work 2 5 minutes

6. Group Work 3 20 minutes

7. Reporting Out 15 minutes

8. Instructor Debrief and Review of Model Responses 5 minutes

9. Complete the Student Response Checklist 5 minutes

Total Time: 75 Minutes
MASS GATHERING — PLANNED PROTEST

SM SD-8

This page intentionally left blank.
MASS GATHERING — PLANNED PROTEST

SM SD-9

Scenario D: Farmers A&M University Planned Protest: Event Description

Intelligence is indicating that a flash mob will be conducted by the Animal Protection League in 

protest of experimentation on animals. Three buildings have animal experimentation being 

conducted. Research on large animals is being conducted in the West and North Barn at 3385 

and 3465 Second Street. Small-animal genetic research and dissection is being conducted in the 

three-story Thorsten Hall, located at 3100 Fourth Street.

The flash mob was supposed to gather at Thorsten Hall at 1700 hours for prime-time news 

coverage.
MASS GATHERING — PLANNED PROTEST

SM SD-10

Scenario D: Farmers A&M University Planned Protest: Lt. Rickles’ 

Briefing (Initial Form)

ICS Form 201

INCIDENT 

BRIEFING

1. Incident Name

Farmers A&M University 

2. Date Prepared

Today

3. Time Prepared

1700 hrs

4. Map Sketch

ICS 201

Page 1 of 4

5. Prepared by (Name and Position)

FAMU LT. Rickles
MASS GATHERING — PLANNED PROTEST

SM SD-11

6. Summary of Current Actions

Objectives:

Ensure public safety personnel’s safety.

Isolate the protesters from strategic campus property — Rapid Deployment Strike Team.

1

Lock down campus.

Establish a perimeter to contain protesters/prevent migration to noncampus community.

Contain property damage.

Arrest and process protesters as required.

Large group (about 300 protestors expected) of disorganized protesters threatening campus.

• Established ICP.

• Ensured lock-down of campus. Notified campus through Emergency Alert system. 

Campus Safety Officer to handle.

• Deployed personnel to isolate the protesters from strategic campus property.

• Established a Perimeter/Squad of Campus PD officers.

• Requested and staged fire and EMS personnel. Have fire/EMS Command personnel 

report to ICP.

• Requested EOC be opened.

ICS 201 Page 2

1 A Rapid Deployment Strike Team is the current Law Enforcement Resource Typing term used to define a swift deployment of 

law enforcement resources that does not include a medical resource. Once a medical resource is added, the resources may be 

called a Rapid Deployment Task Force. Currently, many jurisdictions are using the terms Emergency Response Team (ERT) or 

Immediate Action Rapid Deployment IARD). This terminology is in the process of being refined.
MASS GATHERING — PLANNED PROTEST

SM SD-12

7. Current Organization

ICS 201 Page 3
MASS GATHERING — PLANNED PROTEST

SM SD-13

8. Resources Summary

Resources Ordered Resource Identification ETA On Scene Location/Assignment

IC A&M PD Lt Rickles x ICP

A&M PD Crew AMPD 15,11,8, 21, 6 x Rapid Deployment Strike Team

A&M Sgt Sgt Storm x Rapid Deployment Strike Team

SWAT Medic SWAT Medic 3 x Rapid Deployment Strike Team

LC SWAT LC SWAT x Rapid Deployment Strike Team

CCPD K-9 CCPD K-9 Units 20,21,22 x Rapid Deployment Strike Team

AMPD Crew AMPD 12,13,9,10 x Rapid Deployment Strike Team

AMPD Sgt Sgt Cruz x Perimeter Group Sup

CC Uniform Strike Team CC Uniform Strike Team x Perimeter Group

Fire and EMS Engine 3, Tower 3, and 

Battalion 2 

x Staging

Fire and EMS EMS 100 (Jolley) x Medical Unit Leader

Fire and EMS Ambulance 3, Medic 11 x Medical Unit

ICS 201 Page 4
MASS GATHERING — PLANNED PROTEST

SM SD-14

This page intentionally left blank.
MASS GATHERING — PLANNED PROTEST

SM SD-15

Slide SD-8

GROUP WORK 1

• Complete ICS Form 206.

• Total working time is 15 minutes.

D. Group Work 1.

1. Complete ICS Form 206.

2. Total working time is 15 minutes.
MASS GATHERING — PLANNED PROTEST

SM SD-16

This page intentionally left blank.
MASS GATHERING — PLANNED PROTEST

SM SD-17

Scenario D: ICS Forms

The ICS form(s) needed to complete the scenario are attached here. Copies of these forms can be 

found in Appendix A and Appendix B. The easel pads provided can be used to sketch out the 

ICS Organizational Charts and to brainstorm and take notes.
MASS GATHERING — PLANNED PROTEST

SM SD-18

This page intentionally left blank.
MASS GATHERING — PLANNED PROTEST

SM SD-19

ICS Form 206

MEDICAL PLAN 1. Incident Name 2. Date Prepared 3. Time Prepared 4. Operational Period

5. Incident Medical Aid Station

Medical Aid Stations Location Paramedics

 Yes No

6. Transportation

A. Ambulance Services

Name Address Phone Paramedics

 Yes No

B. Incident Ambulances

Name Location Paramedics

 Yes No

7. Hospitals

Name Address Travel Time

Air Ground Phone HelipadYes No

Burn Center

Yes No

8. Medical Emergency Procedures

Prepared by (Medical Unit Leader) 10. Reviewed by (Safety Officer)
MASS GATHERING — PLANNED PROTEST

SM SD-20

This page intentionally left blank.
MASS GATHERING — PLANNED PROTEST

SM SD-21

Updated ICS Form 201 (Unified Command)

INCIDENT 

BRIEFING

1. Incident Name

Farmers A&M University 

2. Date Prepared

Today

3. Time Prepared

1700 hrs

4. Map Sketch

ICS 201

Page 1 of 4

5. Prepared by (Name and Position)

FAMU LT. Rickles
MASS GATHERING — PLANNED PROTEST

SM SD-22

6. Summary of Current Actions

Objectives:

Ensure public safety personnel’s safety.

Isolate the protesters from strategic campus property — Rapid Deployment Strike Team.

Lock down campus.

Establish a perimeter to contain protesters/prevent migration to noncampus community.

Contain property damage.

Arrest and process protesters as required.

Large group (about 300 protestors expected) of disorganized protesters threatening campus.

• Established ICP.

• Ensured lock-down of campus. Notified campus through Emergency Alert system. 

Campus Safety Officer to handle.

• Deployed personnel to isolate the protesters from strategic campus property.

• Established a Perimeter/Squad of Campus PD officers.

• Requested and staged fire and EMS personnel. Have fire/EMS Command personnel 

report to ICP.

• Requested EOC be opened.

ICS 201 Page 2
MASS GATHERING — PLANNED PROTEST

SM SD-23

7. Current Organization

ICS 201 Page 3
MASS GATHERING — PLANNED PROTEST

SM SD-24

8. Resources Summary

Resources Ordered Resource Identification ETA On Scene Location/Assignment

IC A&M PD Lt Rickles x ICP

A&M PD Crew AMPD 15,11,8, 21, 6 x Rapid Deployment Strike Team

A&M Sgt Sgt Storm x Rapid Deployment Strike Team

SWAT Medic SWAT Medic 3 x Rapid Deployment Strike Team

LC SWAT LC SWAT x Rapid Deployment Strike Team

CCPD K-9 CCPD K-9 Units 20,21,22 x Rapid Deployment Strike Team

AMPD Crew AMPD 12,13,9,10 x Rapid Deployment Strike Team

AMPD Sgt Sgt Cruz x Perimeter Group Sup

CC Uniform Strike Team CC Uniform Strike Team x Perimeter Group

Fire and EMS Engine 3, Tower 3, and 

Battalion 2 

x Staging

Fire and EMS EMS 100 (Jolley) x Medical Unit Leader

Fire and EMS Ambulance 3, Medic 11 x Medical Unit

ICS 201 Page 4
MASS GATHERING — PLANNED PROTEST

SM SD-25

ICS Form MC-306

Multi-Casualty

Recorder Worksheet

Ambulance 

Company

Ambulance 

ID Number

Patient 

Triage Tag 

Number

Patient 

Status

Hospital 

Destination

Off Scene 

Time

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

ICS-MC-306 (12/89)

DISCLAIMER: This form is not an approved ICS Form but has been provided for your reference and use in this course. 
MASS GATHERING — PLANNED PROTEST

SM SD-26

This page intentionally left blank.
MASS GATHERING — PLANNED PROTEST

SM SD-27

INJECT 1

• The crowd is much larger than expected.

• Now it is estimated at >3,000 people.

Slide SD-9

E. Inject 1. 

1. The crowd is much larger than expected. 

2. Now it is estimated at >3,000 people. 

•

•

INJECT 2

Due to large number of protestors, need 

additional resources.

Reinforced Response called in: 

– Engine 11.

– Medic 11. 

– Engine 2.

– Medic 2. 

– Liberty County SWAT on-site.

Slide SD-10

F. Inject 2. 

1. Due to large number of protestors, need additional resources. 

2. Reinforced Response called in.

a. Engine 11. 

b. Medic 11. 

c. Engine 2. 
MASS GATHERING — PLANNED PROTEST

SM SD-28

d. Medic 2.

e. Liberty County SWAT on-site.

–

–

–

INJECT 2 (cont’d)

SWAT 1-10 Tactical Officers. 

SWAT Medic 4 Tactical Medics on PD 

frequency.

Bike patrol officers from Columbia are backfilling police coverage on the rest of the 

campus. 

Slide SD-11

f. SWAT 1-10 Tactical Officers.

g. SWAT Medic 4 Tactical Medics on PD frequency.

h. Bike patrol officers from Columbia are back-filling coverage on 

the rest of the campus. 

ON-SCENE

Slide SD-12

G. On-scene.
MASS GATHERING — PLANNED PROTEST

SM SD-29

Scenario D: On-scene Images
MASS GATHERING — PLANNED PROTEST

SM SD-30
MASS GATHERING — PLANNED PROTEST

SM SD-31
MASS GATHERING — PLANNED PROTEST

SM SD-32

This page intentionally left blank.
MASS GATHERING — PLANNED PROTEST

SM SD-33

GROUP WORK 2

Slide SD-13

• Update the ICS Organizational Chart 

provided by Lt. Rickles.

– Determine additional resources (if needed).

• Patient tracking.

• Total working time is five minutes.

H. Group Work 2.

1. Update the ICS Organizational Chart provided by Lt. Rickles.

Determine additional resources (if needed).

2. Patient tracking.

3. Total working time is five minutes.

Slide SD-14

INJECT 3

Several students and protesters have chained 

themselves to streetlights and the doors to 

Thorsten Hall.

I. Inject 3.

Several students and protesters have chained themselves to streetlights and the 

doors to Thorsten Hall.
MASS GATHERING — PLANNED PROTEST

SM SD-34

Slide SD-15

INJECT 4

• Injuries reported due to crush loads at two 

of the areas around the North Barn.

– Patient 1.

– Patient 2.

• Moving to Unified Command (UC).

J. Inject 4.

1. Injuries reported due to crush loads at two of the areas around the North 

Barn.

a. Patient 1.

b. Patient 2.

2. Moving to Unified Command (UC).

• Set up UC: 

– ICS Organizational Chart.

– Resource assignment.

• Updated ICS Form 201 (Unified 

Command):

– Use the form provided in the Student Manual 

(SM).

• Patient tracking.

• Total working time is 20 minutes.

Slide SD-16

GROUP WORK 3

K. Group Work 3.

1. Set up UC:

a. ICS Organizational Chart.

b. Resource assignment.
MASS GATHERING — PLANNED PROTEST

SM SD-35

2. Updated ICS Form 201 (Unified Command):

Use the form provided in the SM.

3. Patient tracking.

4. Total working time is 20 minutes.

Officer was struck in the head with a bottle 

and requires extrication from crowd.

Slide SD-17

INJECT 5

L. Inject 5.

Officer was struck in the head with a bottle and requires extrication from crowd.

• Tear gas and baton strikes. 

• Many students complaining of shortness of 

breath and baton strikes are showing up at 

CCFD Fire Station 3.

Slide SD-18

INJECT 6

M. Inject 6.

1. Tear gas and baton strikes.

2. Many students complaining of shortness of breath and baton strikes are 

showing up at CCFD Fire Station 3.
MASS GATHERING — PLANNED PROTEST

SM SD-36

Slide SD-19

Several officers splashed with what appears 

to be animal blood.

INJECT 7

N. Inject 7.

Several officers splashed with what appears to be animal blood.

II. REPORTING OUT

• Groups describe their:

– ICS Form 206.

– Updated ICS Organizational Chart.

– Updated ICS Form 201 (Unified Command).

-- Includes UC ICS Organizational Chart.

• Remember, one group does full reporting 

out; other groups describe significant 

differences.

• Total working time is 15 minutes.

Slide SD-20

REPORTING OUT

A. Groups describe their:

1. ICS Form 206.

2. Updated ICS Organizational Chart.

3. Updated ICS Form 201 (Unified Command).

Includes UC ICS Organizational Chart.
MASS GATHERING — PLANNED PROTEST

SM SD-37

B. Remember, one group does full reporting out; other groups describe significant 

differences.

C. Total working time is 15 minutes.

III. COMPLETING THE SCENARIO

Slide SD-21

COMPLETING THE SCENARIO

• Instructor provides Model Responses.

• Instructor answers questions.

• Students complete Student Response 

Checklist.

• Total working time is 10 minutes.

A. Instructor provides Model Responses.

B. Instructor answers questions.

C. Students complete Student Response Checklist.

D. Total working time is 10 minutes.
This page intentionally left blank.
EMS FUNCTIONS IN ICS

MODULE 8:

SPECIAL CONSIDERATIONS IN 

TACTICAL EMERGENCY MEDICAL 

SUPPORT

OBJECTIVES

The students will be able to:

8.1 Discuss special considerations in violent situations.

8.2 Discuss management considerations for Tactical Emergency Medical Support (TEMS).
SPECIAL CONSIDERATIONS IN TACTICAL EMERGENCY MEDICAL SUPPORT

SM 8-2

This page intentionally left blank.
SPECIAL CONSIDERATIONS IN TACTICAL EMERGENCY MEDICAL SUPPORT

SM 8-3

MODULE 8:

SPECIAL CONSIDERATIONS 

IN TACTICAL EMERGENCY 

MEDICAL SUPPORT

Slide 8-1

OBJECTIVES

• Discuss special considerations in violent 

situations.

• Discuss management considerations for 

Tactical Emergency Medical Support 

(TEMS).

Slide 8-2

I. SPECIAL CONSIDERATIONS IN TACTICAL EMERGENCY MEDICAL 

SUPPORT

DEFINITION OF MASS 

CASUALTY INCIDENT

Human-caused or natural event resulting in 

illness and/or injuries exceeding the 

Emergency Medical Services (EMS) 

capabilities of a hospital, locality, jurisdiction 

and/or region

Slide 8-3
SPECIAL CONSIDERATIONS IN TACTICAL EMERGENCY MEDICAL SUPPORT

A. Definition of mass casualty incident (MCI).

An MCI is defined as a human-caused or natural event which results in illnesses 

and/or injuries that exceed the Emergency Medical Services (EMS) capabilities of 

a hospital, locality, jurisdiction and/or region. Essentially, the patient volume 

becomes greater than the resources, requiring the implementation of an Incident 

Command System (ICS).

MCI CLASSIFICATION

Slide 8-4

• > 100 patients

• "Dollar" Type 1

• 50-100 patients

• "50 cents" Type 2

• 25-50 patients

• "Quarter" Type 3

• 10-25 patients

• "Dime" Type 4

• 5-10 patients

Type • "Nickel"

5

This example is based upon a best practice or lesson learned and 

is not presented as policy, rule, regulation or published standard.

B. MCI classification.

1. Many jurisdictions have assigned patient quantities to MCI type sizes. 

This is an example of how MCIs can be classified by types.

a. Type 1 is greater than 100 patients (dollar).

b. Type 2 is 50 to 100 patients (50 cents).

c. Type 3 is 25 to 50 patients (quarter).

d. Type 4 is 10 to 25 patients (dime).

e. Type 5 is five to 10 patients (nickel).

2. This example is a comparative typing that has been adopted by many 

communities throughout the country to determine agency and community 

response objectives. 

3. You should develop a comprehensive response matrix to each level 

specific for your jurisdiction. 

SM 8-4
SPECIAL CONSIDERATIONS IN TACTICAL EMERGENCY MEDICAL SUPPORT

SM 8-5

Slide 8-5

PATIENT GENERATOR

• Hazard, action or situation that creates 

patient volume.

– Patient Generator (PG) causes human 

vulnerability, which leads to patient volume 

(casualties).

• Two types.

– Static: PG is inactive and no additional damage 

is expected.

– Dynamic: PG is still active and may have to be 

mitigated before care begins.

C. Patient Generator (PG).

1. The PG is the hazard, action or situation that creates patient volume.

PG causes human vulnerability, which leads to patient volume 

(casualties). 

2. There are two types of PGs.

a. Static: The PG is inactive and no additional damage is expected. 

Some examples follow.

- Improvised explosive device detonation.

- Bleacher collapse.

- Car driving into a crowd.

b. Dynamic: The PG is still active and may have to be mitigated 

before care begins. Some examples follow.

- Active shooter.

- Hazardous materials.

- Fire.

- Environmental.

- Flu pandemic.
SPECIAL CONSIDERATIONS IN TACTICAL EMERGENCY MEDICAL SUPPORT

SM 8-6

Slide 8-6

INCIDENT COMMAND SYSTEM 

AND PATIENT GENERATOR

An objective of the Incident Command System 

(ICS) is to mitigate PG and ensure resources 

are available to rescue, treat and transport 

patients/victims.

• If PG is dynamic, may be impossible to mitigate 

PG or ensure that resources are available to 

rescue, treat and transport patients/victims.

• It may not be under your agency’s authority to 

address PG.

• Ensure that Site Safety Plan is in place.

D. ICS and PG.

An objective of ICS is to mitigate the PG and ensure that resources are available 

to rescue, treat and transport patients/victims impacted by the PG. 

1. Mitigating the PG and ensuring that resources are available to rescue, treat 

and transport patients/victims affected by the PG may not be possible in 

the event of a dynamic PG. You may have to wait for the event to run its 

course, changing tactics as resources become available.

2. It may not be under your agency’s authority to address the PG. In the case 

of an active shooter, it will be the law enforcement agencies’ 

responsibility to mitigate the PG. In the event that a tactical EMS program 

is available, it may be the agency’s responsibility to assist in addressing 

the PG. Strategic and tactical objectives in the Incident Action Plan (IAP)

should address these issues. Many times it is left to the primary EMS 

agency to address consequences management.

3. A Site Safety Plan is paramount to address safety concerns, ensuring that 

static PGs do not become dynamic PGs.

E. Safety and response personnel.

1. Acts of urban unrest, violence and terrorism will continue to draw in fire 

and EMS personnel and potentially place them in harm’s way. Often these 

events originate as a common emergency call, only to present a dynamic 

and changing scenario on the arrival of emergency teams. Several 

incidents have occurred in which fire and EMS crews were ambushed on 

arrival.

2. Follow these recommendations for ensuring safety of personnel and 

mitigating a dynamic PG, such as an active shooter.
SPECIAL CONSIDERATIONS IN TACTICAL EMERGENCY MEDICAL SUPPORT

SM 8-7

Slide 8-7

SAFETY OF RESPONSE 

PERSONNEL

• Do preincident planning and have a 

multiagency standard operating procedure 

defining:

– Roles and responsibilities.

– Interoperability.

– Unified Command (UC) procedures.

• Ensure smooth transition to UC.

• Create school violence response plan.

a. EMS’s role in an active-shooter situation is consequence 

management. The best way to ensure a successful operation is to 

do preincident planning and have a multiagency standard operating 

procedure that defines roles and responsibilities, interoperability, 

Unified Command (UC) procedures, etc. 

b. Early in the incident, the lead or primary function of ensuring life 

safety (namely, stopping the PG) will belong to law enforcement. 

As a result, the initial Incident Commander (IC) should come from 

this discipline. History has shown that the sooner the transition to 

UC can take place and the smoother it is, the more successful the 

operation will be.

c. Take the example of a school. Every school should have a school 

violence response plan. This plan should include:

- The school’s fire preplan information.

- Key personnel and contact manifest.

- Command Post location.

- Primary Staging location.

- Secondary Staging location.

- Tertiary Staging location.

- Public Information Officer (PIO) Staging location.

- Location to which to relocate students.

- Known hazards (added modular classrooms, wood lines 

separating buildings, fenced areas, etc.)
SPECIAL CONSIDERATIONS IN TACTICAL EMERGENCY MEDICAL SUPPORT

SM 8-8

Slide 8-8

SAFETY OF RESPONSE 

PERSONNEL (cont’d)

• Train together, not only at tactical level but 

across incident management spectrum.

• Ensure that Emergency Operations Center 

is staffed.

• Set up Joint Information System and Center 

to provide up-to-date information about the 

incident.

d. Training is a key component for ensuring safety of personnel. All 

agencies must train together, not only at the tactical level but 

across the entire spectrum of incident management. The most 

opportune time to meet your incident management partners is not 

under fire. 

e. Emergency Operations Center (EOC) support is essential for 

ensuring safety of personnel. Coordinating the support to an 

incident command team is paramount for ensuring that all the 

incident needs are being met. The immediate staffing of an EOC in 

a major incident gives the politicians, Command Staff, and media a 

location to conduct business and operations without interfering 

with the operations. This is critical to ensure that supplies and 

resources are provided to the IC. 

f. Any active-shooter incident today will draw national media 

attention. A coordinated Joint Information System and Center will 

be beneficial for providing the most up-to-date and accurate 

information to the victims’ families and the public. Most schools 

have emergency notification systems that alert students via social 

media or text messaging to inform them of emerging dangers. 
SPECIAL CONSIDERATIONS IN TACTICAL EMERGENCY MEDICAL SUPPORT

SM 8-9

Slide 8-9

• Plan, exercise and review Emergency 

Operations Plans within response area 

and with mutual-aid partners and their 

target hazards.

SAFETY OF RESPONSE 

PERSONNEL (cont’d)

g. Plan, exercise and review Emergency Operations Plans at schools, 

major employers, other target hazards within the response area, 

and with mutual-aid partners and their target hazards.

F. Hazardous materials model of time, distance and shielding.

Unless EMS personnel are trained as tactical medics and have been equipped with 

appropriate personal equipment, such as tactical vests and helmets, the best 

approach to ensuring personnel safety is to follow the hazardous materials model 

of time, distance and shielding.

Slide 8-10

HAZARDOUS MATERIALS MODEL 

OF TIME, DISTANCE AND SHIELDING

• Time.

– If unavoidable, limit personnel exposure to 

PG.

– Do not provide advanced life support in 

hazard area.

• Distance.

– Set up Staging site where PG does not pose 

hazard.

1. Time: If personnel must be exposed to the PG, limit their exposure time as 

much as possible. The hazard area is no place for advanced life support 

procedures, just basic airway and bleeding control. A good approach is to 

have personnel with the appropriate personal protective equipment remove 

injured parties to a Casualty Collection Point (CCP).
SPECIAL CONSIDERATIONS IN TACTICAL EMERGENCY MEDICAL SUPPORT

SM 8-10

2. Distance: Staging is a key factor to personnel safety. Staging must be far 

enough away to ensure the PG does not present a hazard. Good 

intelligence is important, as the PG can move or expand to areas that 

encompass the staging areas or routes to the emergency — e.g., roving 

shooter, chemical leak, or rising flood waters.

Slide 8-11

• Shielding.

– If EMS personnel are in field of fire, they 

must seek cover.

– Concealment is another option for shielding.

– Remember: Cover stops bullets; 

concealment does not.

HAZARDOUS MATERIALS MODEL OF 

TIME, DISTANCE AND SHIELDING (cont’d)

3. Shielding: If EMS personnel find themselves in the field of fire, they must 

seek cover. Ensure that the cover is adequate to protect personnel from the 

hazard. Examples of this follow.

a. Block and brick walls.

b. Fire trucks.

c. Area of the engine compartment in ambulances (not the rear).

d. Concealment is also a consideration. They can’t shoot what they 

can’t see. However, remember that cover stops bullets;

concealment does not.

G. MCI tactical management considerations.

1. There are a number of MCI tactical management considerations that must 

be addressed:
SPECIAL CONSIDERATIONS IN TACTICAL EMERGENCY MEDICAL SUPPORT

SM 8-11

Slide 8-12

MCI TACTICAL MANAGEMENT 

CONSIDERATIONS

• EMS should provide support to police 

tactical resources.

• Casualty Collection Point (CCP) should 

be well-marked and announced to all 

tactical resources.

• Place Triage Unit Leader at CCP with 

police resources delivering/directing 

patients.

a. Providing support to police tactical resources is an important 

function for EMS personnel. Not only must EMS personnel 

provide critical emergency medical care and transportation for 

injured officers, it must be prepared to provide rehab and routine 

medical care for lower-acuity events such as dehydration or 

headache. 

b. The CCP, usually located just outside the Hot Zone, is the funnel 

to the treatment area and transportation. CCP location(s) should be 

well-marked and announced to all tactical resources via radio in 

order to ensure that all injuries get timely care. Triage tags are 

usually placed in this area. Depending on the geographic size of 

the incident, there may be more than one CCP and treatment area. 

c. Actuating triage is important to get enough resources to handle the 

incident. This is a difficult task in an active-shooter incident. A 

best practice is to place the Triage Unit Leader at the CCP and 

have police resources deliver severely injured patients to that 

location or direct the walking wounded patients there to be sorted 

into the appropriate treatment area. Localized announcements of 

“Medical Help Here” on a unit at the CCP public address system 

also may help collect patients. 
SPECIAL CONSIDERATIONS IN TACTICAL EMERGENCY MEDICAL SUPPORT

SM 8-12

Slide 8-13

• Benchmarking.

– Triage Report.

– Last immediate (red) patient transported.

MCI TACTICAL MANAGEMENT 

CONSIDERATIONS (cont’d)

d. Benchmarking keeps the incident progressing. There are two very 

important benchmarks that must be transmitted to Command.

- Triage Report.

- Last immediate (red) patient transported — Visine 

principle: “Get the red out.”

2. Consider Air Medical Transport to reduce transport time to Trauma 

Center.

Slide 8-14

• Address student reunification.

• Set up perimeter and maintain traffic 

control so resources can arrive and depart 

incident.

• If Critical Incident Stress Management has 

been planned, remember: Don’t force, just 

provide.

• Notify hospitals early of the situation.

• Don’t rely on cellphones.

OTHER MCI TACTICAL MANAGEMENT 

CONSIDERATIONS FOR SCHOOLS

H. Other MCI tactical management considerations for schools.

1. Student reunification must be addressed early in the incident. Typically, 

the school official in the UC addresses this issue in the IAP. However, it is 

important for EMS resources to provide accurate information about 

patients so parents can be directed to the right location.
SPECIAL CONSIDERATIONS IN TACTICAL EMERGENCY MEDICAL SUPPORT

SM 8-13

2. The patient loading area and ambulance traffic plan may be affected by 

law enforcement and parent response to the incident. An objective in the 

IAP for law enforcement will be setting up a perimeter and maintaining 

traffic control so resources can arrive and depart the incident. This must be 

done early in the incident. A new phenomenon is the “texting” of the 

situation to parents by students from the school, prompting parental 

response. In some cases, the parents arrive before first responders.

3. If Critical Incident Stress Management has been planned, remember: 

Don’t force, just provide.

4. Depending on the immediate proximity of a hospital, some patients may 

self-refer or self-evacuate. Considering that resources will need to be sent 

to a hospital emergency room, small clinic, or other obvious health care 

facility or office to assist an easily overwhelmed staff, make sure to notify 

the hospital of the situation early on.

5. Don’t rely on cellphones — they will become jammed and useless.

Slide 8-15

• The Public Information Officer (PIO) 

should handle all communications and 

inquiries.

• Reporters should be discouraged from 

entering premises. 

DEALING WITH FRIENDS AND 

FAMILY

I. Dealing with friends and family.

1. The PIO should handle all communications and inquiries and make 

specific arrangements for a press briefing to inform the community about 

the disaster.

2. Every effort should be made to discourage reporters from entering the 

premises or having access to staff, students and parents. 
SPECIAL CONSIDERATIONS IN TACTICAL EMERGENCY MEDICAL SUPPORT

SM 8-14

Slide 8-16

• Arranging a secondary location for picking 

up children may not be an EMS function.

– Depends on incident factors, jurisdiction 

and agency protocols.

• Emergency Operations Plan must consider 

ways to minimize disruption to a child’s 

routine during/after incident. 

CHILD SAFETY AND 

PICKUP

J. Child safety and pickup.

Children tend to be very sensitive and will struggle to make sense of the situation 

they are in, be it a hazardous materials incident or natural or human-caused 

disaster. Remember that arranging a secondary location for picking up children 

may not be an EMS function and will depend on incident factors, jurisdiction and 

agency protocols.

1. Each child will respond differently to the situation, and there will be a 

wide range of emotional reactions. Children may hurt deeply and find it 

hard to recover from frightening experiences. They need support, and 

adult responders can provide this support.

2. Because stable routines are critical to the physical and emotional wellbeing of a child, an EOP must consider ways to prevent or minimize 

disruption to a child’s routine during and after an incident. 

Slide 8-17

• Children need to be moved to a safe 

location. 

• Teacher/Day care provider should be kept 

with children.

• PIO should publicize where children can 

be picked up.

CHILD SAFETY AND 

PICKUP (cont’d)
SPECIAL CONSIDERATIONS IN TACTICAL EMERGENCY MEDICAL SUPPORT

SM 8-15

3. During and after an incident, children need to be moved to a safe location. 

Depending on the number of children involved, it may be necessary to 

divide them into smaller groups. If the incident is at a school or day care, 

keep the children in their classroom groups. This will help reduce some of 

the trauma surrounding the incident because the children are with 

individuals who are familiar to them.

4. If at all possible, keep the teacher/day care provider with the children. It is 

more than likely that the teacher/day care provider is familiar with parents 

and can ensure that each child goes with the correct parent. 

5. Incidents at public places where large numbers of children congregate 

(swimming pools, parks, etc.) may require that law enforcement or your 

jurisdiction’s Emergency Manager be involved to keep the children in a 

centralized location so parents/guardians can pick them up.

6. The IC and PIO will have to be made aware of the children’s location. The 

PIO can publicize where children can be picked up.

II. SUMMARY

Slide 8-18

• Discuss special considerations in violent 

situations.

• Discuss management considerations for 

TEMS. 

SUMMARY
This page intentionally left blank.
EMS FUNCTIONS IN ICS

SCENARIO E:

TACTICAL LAW ENFORCEMENT 

SUPPORT — UNIVERSITY ACTIVE 

SHOOTER

SCENARIO OBJECTIVES

The students will be able to:

SE.1 Develop a Medical Branch and a Rescue Branch in the Incident Command System (ICS) organizational 

structure. 

SE.2 Using best practices, determine the best location for facilities required in the management of a mass 

casualty incident (MCI). 

SE.3 Practice horizontal and vertical communication.

SE.4 Track patients using a Patient Tracking Form.

SE.5 Use benchmarks to order and assign appropriate resources.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-2

This page intentionally left blank.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-3

SCENARIO E:

TACTICAL LAW ENFORCEMENT 

SUPPORT — UNIVERSITY 

ACTIVE SHOOTER

Slide SE-1

SCENARIO OBJECTIVES

• Develop a Medical Branch and a Rescue 

Branch in the Incident Command System 

(ICS) organizational structure. 

• Using best practices, determine the best 

location for facilities required in the 

management of a mass casualty incident 

(MCI). 

• Practice horizontal and vertical 

communication.

Slide SE-2

SCENARIO OBJECTIVES 

(cont’d)

• Track patients using a Patient Tracking 

Form.

• Use benchmarks to order and assign 

appropriate resources.

Slide SE-3

I. SCENARIO E: TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY 

ACTIVE SHOOTER
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-4

SCENARIO ROLES AND 

TASKS

• In this scenario, you will have multiple 

roles.

– During Group Work 1: Engine 9 Officer.

– During Group Work 2: Class splits.

-- Rescue Branch Director.

-- Medical Branch Director (EMS 100).

Slide SE-4

A. Scenario roles and tasks.

1. In this scenario, you will have multiple roles.

a. During Group Work 1: Engine 9 Officer.

b. During Group Work 2: Class splits.

- Rescue Branch Director.

- Medical Branch Director (EMS 100).

SCENARIO ROLES AND 

TASKS (cont’d)

Slide SE-5

• In this scenario, you will develop/complete:

– ICS Organizational Charts (Rescue Branch, 

Medical Branch and Final).

– Incident Map.

– Updated ICS Form 201, Incident Briefing.

– ICS Form MC-306, Patient Tracking Form.

– Student Response Checklist.

2. In this scenario, you will develop/complete:

a. Incident Command System (ICS) Organizational Charts (Rescue 

Branch, Medical Branch and Final).
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-5

b. Incident Map.

c. Updated ICS Form 201, Incident Briefing.

d. ICS Form MC-306, Patient Tracking Form.

e. Student Response Checklist.

INTRODUCTION

• Scenario is taking place at Columbia State 

University (CSU).

• Liberty County (LC) has planned for activeshooter event with CSU.

• Aggressive policy: 

– Teams broken into Emergency Response 

Teams (ERTs)1 with three officers and a 

tactical medic.

– Two on-call tactical medics who have trained 

with all police agencies in LC.

Slide SE-6 1See note in Student Manual (SM).

B. Introduction.

1. Scenario is taking place at Columbia State University (CSU) and is 

modeled after the Virginia Tech and other school shootings. 

2. Liberty County (LC) has planned for this event with CSU and has a very 

aggressive active-shooter policy, breaking teams into Emergency 

Response Teams (ERTs)

1

, consisting of three officers and a tactical medic, 

which move toward the sounds of shots to neutralize the shooter. (

1

The 

ERT is the same type of team referred to in previous scenarios and 

modules as a Rapid Deployment Strike Team or a Rapid Deployment Task 

Force. In some jurisdictions, the ERT is also called Initial Action Rapid 

Deployment (IARD). For this scenario we will call the resource an ERT 

since that is the terminology currently used in the Exercise Simulation 

System Document (ESSD) (LC).)

3. Liberty County Fire Department (LCFD) has a well-developed tactical 

EMS program with two on-call tactical medics who have trained with 

every LC police agency.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-6

INTRODUCTION (cont’d)

• Current conditions:

– Time: 0721 hours.

– Date: April 18.

– Temperature: 65 F.

– Humidity: 0 percent.

– Wind: 0 mph.

Slide SE-7

4. Current conditions.

a. Time: 0721 hours.

b. Date: April 18.

c. Temperature: 65 F.

d. Humidity: 0 percent.

e. Wind: 0 mph.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-7

Scenario E: Student Instructions

Flow of Scenario Time

1. Introduction/Background for Scenario E 1 minute

2. Initial Dispatch 1 minute

3. Arrival On-scene and Updates 3 minutes

4. Group Work 1 15 minutes

5. Group Work 1: Reporting Out 5 minutes

6. Group Work 2 10 minutes

7. Group Work 2: Reporting Out — Part A 10 minutes

8. Group Work 2: Completion 20 minutes

9. Group Work 2: Reporting Out — Part B 10 minutes

10. Instructor Debrief and Review of Model Responses 10 minutes

11. Complete the Student Response Checklist 5 minutes

Total Time: 90 Minutes
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-8

This page intentionally left blank.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-9

Scenario E Background Information:

Columbia State University Map
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-10

This page intentionally left blank.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-11

INITIAL DISPATCH

Slide SE-8

C. Initial dispatch.

ON-SCENE ARRIVAL

Slide SE-9

D. On-scene arrival.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-12

This page intentionally left blank.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-13

Scenario E: On-scene Images
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-14
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-15

Scenario E: Liberty County Resource List

The following is a list of Liberty County resources that you may need in this scenario. These 

resources also can be found in the Columbia State Profile provided to you as a reference. 

Note: Additional information on available resources can be found in Appendix E (Fire Services) 

and Appendix G (EMS Services) in the Columbia State Profile document. 

1st Alarm Fire

Engine 8

Engine 1

Engine 2

(Engine 9 is already committed)

Squirt 10

Snorkel 8

Squad 1

Battalion 8

1st Alarm MCI

EMS 100

Ambulance 10

Ambulance 8

Medic 1

Medic 502

Swat Medics 1 and 4 have been paged

2nd Alarm MCI

Medic 2

Medic 601

Medic 11

Ambulance 6

MCI 12

Additional Requests

Medic 503

Medic 602

Medic 7

Medic 31

Medic 41

Request additional Liberty County resources as needed.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-16

This page intentionally left blank.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-17

Slide SE-10

ON-SCENE UPDATE

• Upon arrival: 

– A 21-year-old female:

-- Found on floor of the dorm with gunshot wound 

(GSW) to the head.

-- Placed on backboard, intubated and transported by 

Medic 9 to Central City Hospital.

– A 21-year-old male:

-- GSW to the chest.

-- E-9 crew is treating.

-- Waiting for Medic 501 for treatment/transport.

E. On-scene update.

Upon arrival:

1. A 21-year-old female:

a. Found on floor of the dorm with gunshot wound (GSW) to the 

head.

b. Placed on backboard, intubated and transported by Medic 9 to 

Central City Hospital.

2. A 21-year-old male:

a. GSW to the chest.

b. E-9 crew is treating.

c. Waiting for Medic 501 for treatment/transport.

Slide SE-11

ON-SCENE UPDATE (cont’d)
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-18

GROUP WORK 1

Slide SE-12

• You are currently the E-9 Officer, who 

has assumed Command.

• Set up the initial ICS organizational 

structure.

– ICS Organizational Chart.

-- Resource assignment.

• Resources will be provided in the 

following injects.

• Total time is 15 minutes.

F. Group Work 1.

1. You are currently the E-9 Officer, who has assumed Command.

2. Set up the initial ICS organizational structure (ICS Organizational Chart 

and resource assignment).

3. Resources will be provided in the following injects.

4. Total time is 15 minutes.

Slide SE-13

GROUP WORK 1 (cont’d)

Note: This is a dynamic and fast-paced 

situation; you will be getting several injects 

with resources and situational information. 

Make sure you have a way of keeping track 

of everything.

Note: This is a dynamic and fast-paced situation; you will be getting several 

injects with resources and situation information. Make sure you have a way of 

keeping track of everything.

G. Injects.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-19

INJECT 1

Slide SE-14

• After one minute: 

– CSU Police Department (PD) is reporting that 

the shooter is in Hogan Hall.

– Multiple calls are coming in from students in 

that building reporting people are shot. 

– Officers are reporting that the shooter is 

wearing body armor and is armed with multiple 

automatic weapons.

1. Inject 1.

After one minute:

a. CSU Police Department (PD) is reporting that the shooter is in 

Hogan Hall.

b. Multiple calls are coming in from students in that building 

reporting people are shot.

c. Officers are reporting that the shooter is wearing body armor and is 

armed with multiple automatic weapons.

INJECT 1 (cont’d)

Slide SE-15

– Deputy Chief Stratter of CSU PD is en route to 

the Command Post to assume Command.

– Chief Owen of Columbia PD has initiated the 

opening of the CSU Emergency Operations 

Center (EOC). 

d. Deputy Chief Stratter of CSU PD is en route to the Command Post 

to assume Command.

e. Chief Owen of Columbia PD has initiated the opening of the CSU 

Emergency Operations Center (EOC).
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-20

INJECT 2

• Special Weapons and Tactics (SWAT) 

Medic 4 has arrived and has been placed 

with Sergeant Stevens and two other 

officers as an ERT which is en route to 

enter Hogan Hall as part of the activeshooter protocol. 

• Other Columbia and Central City officers 

are exchanging gunfire with the shooter. 

Slide SE-16

2. Inject 2.

a. Special Weapons and Tactics (SWAT) Medic 4 has arrived and has 

been placed with Sergeant Stevens and two other officers as an 

ERT which is en route to enter Hogan Hall as part of the activeshooter protocol.

b. Other Columbia and Central City officers are exchanging gunfire 

with the shooter.

INJECT 2 (cont’d)

Slide SE-17

• It has been reported that several exit 

doors are chained in Hogan Hall, and 

students cannot exit.

• Several students are reported to have 

jumped out of windows. 

• Arrived on-scene: Engine 8, Battalion 8.

• Battalion 8 has assumed Command.

c. It has been reported that several exit doors are chained in Hogan 

Hall, and students cannot exit.

d. Several students are reported to have jumped out of windows.

e. Arrived on-scene: E-8, Battalion 8.

f. Battalion 8 has assumed Command.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-21

INJECT 3

Slide SE-18

• Officers have reported that the shooter 

has exited Hogan Hall and entered the 

Phi Delta Theta Fraternity. 

• Columbia PD are reporting that students 

are also returning fire inside the fraternity 

on the shooter. 

• A small explosion was heard in the 

fraternity, and there is light smoke 

coming from the fraternity. 

3. Inject 3.

a. Officers have reported that the shooter has exited Hogan Hall and 

entered the Phi Delta Theta Fraternity.

b. Columbia PD are reporting that students are also returning fire 

inside the fraternity on the shooter. 

c. A small explosion was heard in the fraternity, and there is light 

smoke coming from the fraternity.

INJECT 3 (cont’d)

Slide SE-19

• Students are exiting the fraternity.

• Arrived on-scene: Squirt 10, Snorkel 8, 

Ambulance 10, Ambulance 8.

• Deputy Chief requests: Engine 11, 

Engine 7 and Truck 1.

d. Students are exiting the fraternity.

e. Arrived on-scene: Squirt 10, Snorkel 8, Ambulance 10, Ambulance 

8.

f. Deputy Chief requests: E-11, E-7, and Truck 1.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-22

INJECT 4

Slide SE-20

• One officer is reported shot in the leg and 

barricaded behind his patrol car. 

• The ERT has reported that the tactical 

medic has performed a surgical airway and 

stabilized a GSW to the face in Hogan 

Hall. 

• Arrived on-scene: Squad 1, Engine 1, 

Medic 1.

• Request: Medic 503, Medic 602, Medic 7, 

Medic 31, Medic 41.

4. Inject 4.

a. One officer is reported shot in the leg and barricaded behind his 

patrol car.

b. The ERT has reported that the tactical medic has performed a 

surgical airway and stabilized a GSW to the face in Hogan Hall.

c. Arrived on-scene: Squad 1, E-1, Medic 1.

d. Request: Medic 503, Medic 602, Medic 7, Medic 31, Medic 41.

INJECT 5

Slide SE-21

• Several self-evacuated patients have 

reported to Laye Hall at Student Health 

Services, and CSU PD is requesting EMS 

to respond.

• Arrived on-scene: Engine 2, EMS 100, 

Medic 502.

5. Inject 5.

a. Several self-evacuated patients have reported to Laye Hall at 

Student Health Services, and CSU PD is requesting EMS to 

respond.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-23

b. Arrived on-scene: E-2, EMS 100, Medic 502.

INJECT 6

Slide SE-22

• The shooter has exited the fraternity and is 

moving toward Tudor Hall. 

• Arrived on-scene: Ambulance 6.

6. Inject 6.

a. The shooter has exited the fraternity and is moving toward Tudor 

Hall. 

b. Arrived on-scene: Ambulance 6.

INJECT 7

Slide SE-23

• Sergeant Bylerly ERT with SWAT Medic 1 

are reporting the main shooter is down just 

outside the east door of Tudor Hall and 

has been neutralized. 

• Arrived on-scene: MCI 12, Medic 2, Medic 

601, Medic 11.

• Arrived on-scene: Engine 11, Engine 7, 

Truck 1.

7. Inject 7.

a. Sergeant Bylerly ERT with SWAT Medic 1 are reporting the main 

shooter is down just outside the east door of Tudor Hall and has 

been neutralized.

b. Arrived on-scene: MCI 12, Medic 2, Medic 601, Medic 11.

c. Arrived on-scene: E-11, E-7, Truck 1.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-24

INJECT 7 (cont’d)

Slide SE-24

• Arrived on-scene: Medic 503, Medic 602, 

Medic 7, Medic 31, Medic 41.

• Moving to Unified Command.

d. Arrived on-scene: Medic 503, Medic 602, Medic 7, Medic 31, 

Medic 41.

e. Moving to Unified Command.

GROUP WORK 1: 

REPORTING OUT

Slide SE-25

• Groups describe their:

– Organizational charts. 

– Resource assignments.

• Remember, one group does full reporting 

out; other groups describe significant 

differences.

• Provide Model Responses.

• Total time is five minutes.

H. Group Work 1: Reporting Out.

1. Groups describe their:

a. Organizational charts.

b. Resource assignments.

2. Remember, one group does full reporting out; other groups describe 

significant differences.

3. Total time is five minutes.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-25

GROUP WORK 2

Slide SE-26

• Deputy Chief Krolic has assumed 

Command.

• You have been instructed to establish:

– Rescue Branch. 

– Medical Branch.

• Each individual table group should be 

assigned as either the Rescue Branch or 

Medical Branch.

I. Group Work 2.

1. Deputy Chief Krolic has assumed Command.

2. You have been instructed to establish:

a. Rescue Branch. 

b. Medical Branch.

3. Each individual table group should be assigned as either the Rescue 

Branch or Medical Branch.

Slide SE-27

GROUP WORK 2 (cont’d)

• Review tasks for each Branch prior to 

splitting into two groups.

• Total working time is 30 minutes.

– Part 2A is 10 minutes. 

– Part 2B is 20 minutes.

4. Review tasks for each Branch prior to splitting into two groups.

5. Total working time is 30 minutes.

a. Part 2A is 10 minutes. 
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-26

b. Part 2B is 20 minutes.

GROUP WORK 2: 

RESCUE BRANCH

Slide SE-28

• A systematic search of every location the 

shooter has been is mandatory.

• Battalion 8 has been assigned as the 

Rescue Branch Director.

J. Group Work 2: Rescue Branch.

1. A systematic search of every location the shooter has been is mandatory.

2. Battalion 8 has been assigned as the Rescue Branch Director.

GROUP WORK 2: 

RESCUE BRANCH (cont’d)

Slide SE-29

• Part 2A: Determine how this search is to 

be completed.

– Rescue Branch ICS Organizational Chart.

-- Resource assignment.

– Rationale for ICS Organizational Chart.

• Part 2B: 

– Complete ICS Organizational Chart.

– Patient tracking.

3. Part 2A: Determine how this search is to be completed.

a. Rescue Branch ICS Organizational Chart.

Resource assignment.

b. Rationale for ICS Organizational Chart.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-27

4. Part 2B: 

a. Complete ICS Organizational Chart.

b. Patient tracking.

GROUP WORK 2: 

MEDICAL BRANCH

Slide SE-30

• EMS 100 has been assigned as the 

Medical Branch Director.

• Part 2A: 

– Create the Incident Map to include (but not 

limited to) locations for: 

-- Command Post.

-- Staging Area.

-- Treatment Area.

– Rationale for locations.

There is an enlarged 

campus map in your 

Student Manuals for 

you to mark up with 

incident locations. 

K. Group Work 2: Medical Branch.

1. EMS 100 has been assigned as the Medical Branch Director.

2. Part 2A: 

a. Create the Incident Map to include (but not limited to) locations 

for: 

- Command Post.

- Staging Area.

- Treatment Area.

b. Rationale for locations.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-28

GROUP WORK 2: 

MEDICAL BRANCH (cont’d)

Slide SE-31

• Part 2B: 

– ICS Organizational Chart.

-- Resource assignment.

– Patient tracking.

3. Part 2B: 

a. ICS Organizational Chart.

Resource assignment.

b. Patient tracking.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-29

Scenario E: Building Information

• Baker Hall is building 35 and is a four-story dorm with 300 students.

• Phi Delta Theta Fraternity is building 39 and is a four-story dorm with 100 students.

• Hogan Hall is building 38 and is a three-story classroom building, and the office complex 

for Reserve Officer Training Corps.

• Laye Hall is building 16 and is a two-story building housing Student Health Services.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-30

Scenario E: Columbia State University Map
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-31

Scenario E: ICS Forms

The ICS forms(s) needed to complete the scenario are attached here. Copies of these forms can 

be found in Appendix A and Appendix B. The easel pads provided can be used to sketch out the 

ICS Organizational Charts and to brainstorm and take notes.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-32

This page intentionally left blank.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-33

ICS Form MC-306

Multi-Casualty

Recorder Worksheet

Ambulance 

Company

Ambulance 

ID Number

Patient 

Triage Tag 

Number

Patient 

Status

Hospital 

Destination

Off Scene 

Time

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

ICS-MC-306 (12/89)

DISCLAIMER: This form is not an approved ICS Form but has been provided for your reference and use in this course. 
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-34

This page intentionally left blank.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-35

ICS Form MC-306

Multi-Casualty

Recorder Worksheet

Ambulance 

Company

Ambulance 

ID Number

Patient 

Triage Tag 

Number

Patient 

Status

Hospital 

Destination

Off Scene 

Time

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

ICS-MC-306 (12/89)

DISCLAIMER: This form is not an approved ICS Form but has been provided for your reference and use in this course. 
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-36

This page intentionally left blank.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-37

ICS Form MC-306

Multi-Casualty

Recorder Worksheet

Ambulance 

Company

Ambulance 

ID Number

Patient 

Triage Tag 

Number

Patient 

Status

Hospital 

Destination

Off Scene 

Time

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

ICS-MC-306 (12/89)

DISCLAIMER: This form is not an approved ICS Form but has been provided for your reference and use in this course. 
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-38

This page intentionally left blank.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-39

Slide SE-32

GROUP WORK 2: 

REPORTING OUT — PART A

• Rescue Branch.

– Search strategy.

– Rationale.

– Initial ICS Organizational Chart.

• Medical Branch.

– Incident Map.

• Provide Model Responses.

• Total time is 10 minutes.

L. Group Work 2: Reporting Out — Part A.

1. Rescue Branch.

a. Search strategy.

b. Rationale.

c. Initial ICS Organizational Chart.

2. Medical Branch.

Incident Map.

3. Provide Model Responses.

4. Total time is 10 minutes.

Slide SE-33

GROUP WORK 2: 

REPORTING OUT — PART B

• Rescue Branch.

– Complete ICS Organizational Chart.

– Patient tracking.

• Medical Branch.

– ICS Organizational Chart.

-- Resource assignment.

– Patient tracking.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-40

M. Group Work 2: Reporting Out — Part B.

1. Rescue Branch.

a. Complete ICS Organizational Chart.

b. Patient tracking.

2. Medical Branch.

a. ICS Organizational Chart.

Resource assignment.

b. Patient tracking.

N. Rescue Branch injects.

Slide SE-34

RESCUE BRANCH INJECT 1

• Baker Division and North Division have 

completed their search.

• Review the Baker Division Triage Report 

and the North Division Triage Report.

1. Inject 1.

a. Baker Division and North Division have completed their search.

b. Review the Baker Division Triage Report and the North Division 

Triage Report.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-41

Slide SE-35

RESCUE BRANCH INJECT 2

• Fraternity Division has completed its 

search.

• Review the Fraternity Division Triage 

Report.

2. Inject 2.

a. Fraternity Division has completed its search.

b. Review the Fraternity Division Triage Report.

Slide SE-36

RESCUE BRANCH INJECT 3

• Hogan Division has completed its search.

• Review the Hogan Division Triage 

Report.

• Additional Triage Report has come in 

from Laye Hall/Student Health Services.

3. Inject 3.

a. Hogan Division has completed its search.

b. Review the Hogan Division Triage Report.

c. Additional Triage Report has come in from Laye Hall/Student 

Health Services.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-42

Slide SE-37

GROUP WORK 2: 

REPORTING OUT — PART 2B

• Groups describe their:

– Organizational charts. 

– Resource assignments.

• Remember, one group does full reporting 

out; other groups describe significant 

differences.

• Total time is 10 minutes.

O. Group Work 2: Reporting Out — Part 2B.

1. Groups describe their:

a. Organizational charts. 

b. Resource assignments.

2. Remember, one group does full reporting out; other groups describe 

significant differences.

3. Total time is 10 minutes.

II. COMPLETING THE SCENARIO

COMPLETING THE 

SCENARIO

Slide SE-38

• Instructor provides Model Responses.

• Instructor answers questions.

• Students complete Student Response 

Checklist.

• Total time is 15 minutes.
TACTICAL LAW ENFORCEMENT SUPPORT — UNIVERSITY ACTIVE SHOOTER

SM SE-43

A. Provide Model Responses.

B. Answer questions.

C. Students complete Student Response Checklist.

D. Total time is 15 minutes.
This page intentionally left blank.
EMS FUNCTIONS IN ICS

MODULE 9:

SPECIAL CONSIDERATIONS IN 

HAZARDOUS MATERIALS SITUATIONS

OBJECTIVES

The students will be able to:

9.1 Discuss special circumstances and considerations in hazardous materials situations.

9.2 Discuss the differences in meeting the needs of responder/entry teams and other patients.
SPECIAL CONSIDERATIONS IN HAZARDOUS MATERIALS SITUATIONS

SM 9-2

This page intentionally left blank.
SPECIAL CONSIDERATIONS IN HAZARDOUS MATERIALS SITUATIONS

SM 9-3

MODULE 9: 

SPECIAL CONSIDERATIONS 

IN HAZARDOUS MATERIALS 

SITUATIONS

Slide 9-1

OBJECTIVES

• Discuss special circumstances and 

considerations in hazardous materials 

situations.

• Discuss the differences in meeting the 

needs of responder/entry teams and other 

patients. 

Slide 9-2

I. SPECIAL CONSIDERATIONS IN HAZARDOUS MATERIALS SITUATIONS 

ROLE OF INCIDENT COMMANDER IN 

HAZARDOUS MATERIALS SITUATIONS 

Slide 9-3

Identify relationship between 

emergency and roles of 

Emergency Medical Services 

(EMS) personnel.

Identify and manage EMS 

personnel at incident.

Able to use various means of 

recognition and identification 

of hazardous materials.

• Not identifying presence of 

hazardous material

Use Department of 

Transportation (DOT) 

Emergency Response 

Guidebook at incident. 

Incident 

Commander 

(IC) Role

A. Role of Incident Commander (IC) in hazardous materials situations.
SPECIAL CONSIDERATIONS IN HAZARDOUS MATERIALS SITUATIONS

SM 9-4

Hazardous materials emergencies present a very different set of circumstances for 

the IC and for the Emergency Medical Services (EMS) personnel at the incident. 

An IC:

1. Must identify the relationship between a hazardous materials emergency 

and the roles of EMS, and must manage the EMS response appropriately.

2. Must be able to identify and manage the EMS personnel at a hazardous 

materials incident that requires actions ranging from the safety and 

medical monitoring of responders to decontamination and treatment of 

casualties.

3. Is not responsible for identifying the presence of a hazardous material. 

However, he or she should be able to use the various means of recognition 

and identification of hazardous materials, e.g., Department of 

Transportation (DOT) Hazard Class Placards, and National Fire Protection 

Association (NFPA) 704 Diamond Signs.

4. Must be able to use the DOT Emergency Response Guidebook at a 

hazardous materials incident.

EVOLVING HAZARDOUS 

MATERIALS INCIDENT 

Slide 9-4

A hazardous materials 

emergency may be 

dispatched/initiated as 

an EMS call ... 

... but may evolve 

into a full-blown 

hazardous materials 

incident.

B. Evolving hazardous materials incident.

A hazardous materials emergency may be dispatched initially as an EMS call 

because a single person is unconscious or sick. By the time EMS arrives at the 

incident scene, the hazardous product may have dispersed so that a large number 

of people are affected to varying degrees. In addition, responders and emergency 

medical technicians (EMTs), not realizing that it is a hazardous materials incident, 

may become contaminated or affected by the hazardous product. When this 

occurs, the objectives, strategy, and tactics for the incident have changed from 

one of an EMS response for a single patient into one of hazardous materials and 

EMS response.
SPECIAL CONSIDERATIONS IN HAZARDOUS MATERIALS SITUATIONS

SM 9-5

EMS HAZARDOUS 

MATERIALS RESPONSE 

Slide 9-5

Special 

Monitoring 

Equipment

Personal 

Protective 

Equipment 

(PPE)

Plan of Action Responder 

Safety

C. EMS hazardous materials response.

1. Responder Safety: The EMS Branch Director will coordinate with the IC 

and the Site Safety Officer to ensure that all individuals entering, working 

near, or on a Rapid Intervention Crew (RIC) are monitored before entering 

the site and upon exiting the site. The IC and all responders must be 

familiar with:

a. NFPA 473, Standard for Competencies for EMS Personnel 

Responding to Hazardous Materials/Weapons of Mass Destruction 

Incidents (current edition).

b. Occupational Safety and Health Administration (OSHA) 

Hazardous Waste Operations and Emergency (29 CFR 1910.120).

2. Plan of Action: Develop an EMS response Plan of Action that will ensure 

all responders at the incident are safe.

3. Personal Protective Equipment (PPE): The IC will ensure that EMS 

personnel have the appropriate PPE for the type of hazardous product.

4. Special Monitoring Equipment: IC should ensure that all members of 

the EMS team are able to operate any toxicology and monitoring 

equipment that may be used.
SPECIAL CONSIDERATIONS IN HAZARDOUS MATERIALS SITUATIONS

SM 9-6

SECONDARY EXPOSURE 

Slide 9-6

• Perform gross decontamination at same 

time the patient is stabilized. 

• Emergency personnel should avoid contact 

with any potentially hazardous substances, 

clothing or other materials.

D. Secondary exposure.

When dealing with a hazardous materials incident, there is always the risk of 

secondary contamination or exposure.

1. The IC should ensure that procedures are in place so that gross 

decontamination is performed at the same time the patient is stabilized.

2. Throughout the gross decontamination procedures, every effort should be 

made by emergency personnel to avoid contact with any potentially 

hazardous substances and to avoid coming in contact with contaminated 

clothing or other materials.

• Classified by 

safety and the 

degree of hazard:

– Hot Zone.

– Warm Zone.

– Cold Zone. 

Slide 9-7

Source: U.S. Army Chemical, Biological, 

Radiological and Nuclear School. Guidelines of 

Mass Casualty Decontamination During a 

HAZMAT/Weapon of Mass Destruction Incident

CONTROL ZONES

E. Control Zones.

Control Zones are areas at a hazardous materials incident that are classified based 

on safety and the degree of hazard.
SPECIAL CONSIDERATIONS IN HAZARDOUS MATERIALS SITUATIONS

SM 9-7

1. The Hot Zone is the zone immediately surrounding a hazardous materials 

incident, which extends far enough to prevent hazardous materials releases 

from adversely affecting personnel outside the zone.

2. The Cold Zone at a hazardous materials incident will contain the 

Command Post (CP) and other support functions as are deemed necessary 

to control the incident.

3. The Warm Zone at a hazardous materials incident site is the place where 

personnel and equipment decontamination and Hot Zone support take 

place.

• Various 

decontamination 

setups and 

methods:

– Clothing removal.

– Water shower.

– Dry 

decontamination.

Slide 9-8

Source: U.S. Army Chemical, Biological, 

Radiological and Nuclear School. Guidelines of 

Mass Casualty Decontamination During a 

HAZMAT/Weapon of Mass Destruction Incident

DECONTAMINATION

F. Decontamination.

Decontamination of both response personnel and patients may be required. This 

may or may not be an EMS function.

MANAGING PATIENT NEEDS 

• Primary goals of managing a patient:

– Terminate patient exposure.

– Remove patient from danger.

– Decontaminate.

– Initiate treatment.

– When transporting contaminated patient, 

responder should wear appropriate PPE.

Slide 9-9

G. Managing patient needs.
SPECIAL CONSIDERATIONS IN HAZARDOUS MATERIALS SITUATIONS

SM 9-8

1. The primary goals of managing a patient involved in a medically 

hazardous materials emergency response is to:

a. Terminate patient exposure.

b. Remove patient from danger.

c. Decontaminate.

d. Initiate treatment.

2. There will be times when a patient needs immediate treatment and 

transport. The patient may have to be transported without being fully 

decontaminated.

a. In a situation like this, you will have to ensure that the transport 

team and vehicle are prepared. The responder may need to be in 

PPE and use self-contained breathing apparatus (SCBA), or at a 

minimum some form of impervious clothing/Kevlar suit, doublegloved and wearing a face shield.

b. The IC should determine whether or not to transport such a patient.

ASSIGNING PERSONNEL 

• Incident Commander (IC) must ensure 

that individuals assigned to work the 

incident have appropriate training.

• Hazardous materials response personnel 

classification:

– EMS Level 1.

– EMS Level 2.

Slide 9-10

H. Assigning personnel.

The IC is responsible for assigning various duties to personnel. It is imperative 

that in a hazardous materials incident, the individuals assigned to work the 

incident have the appropriate training. EMS personnel should not be assigned or 

sent into a zone they are not trained for. The following levels are used to classify 

the knowledge and skills of personnel responding to hazardous material incidents.
SPECIAL CONSIDERATIONS IN HAZARDOUS MATERIALS SITUATIONS

SM 9-9

1. EMS Level 1: Level 1 personnel have the knowledge and skills necessary 

to provide emergency medical care in the Cold Zone and are able to 

analyze a hazardous materials emergency and determine what risks are 

present to the provider and the patient.

2. EMS Level 2: Level 2 personnel are certified as EMT-B level or higher 

and meet all competencies for EMS/HM Level 1. In addition, Level 2

EMTs have the skills necessary to perform and/or coordinate patient care 

activities and medical support of hazardous materials response personnel 

in the Warm Zone.

RESPONDER SAFETY 

Slide 9-11

• IC should:

– Ensure medical monitoring is provided based 

on incident type/environmental conditions.

– Evaluate vital signs, examine responders, 

and make disposition recommendations.

– Make go/no-go decision for responders 

involved in hazardous materials entries or 

decontamination assignments.

I. Responder safety.

The IC is in charge of responder safety. He or she should:

1. Ensure that medical monitoring is provided based on the incident 

type/environmental conditions and according to the local area medical 

control guidelines.

2. Evaluate and document vital signs, examine responders, and make proper 

disposition recommendations — i.e., return to duty, continued 

rehabilitation, or medical treatment and transport to a medical facility.

3. Oversee the medical exam for the entry team and be responsible for a go 

or no-go decision for responders involved in hazardous materials entries or 

decontamination assignments.
SPECIAL CONSIDERATIONS IN HAZARDOUS MATERIALS SITUATIONS

SM 9-10

MEDICAL MONITORING AND 

REHABILITATION 

Slide 9-12

• Medical monitoring should be provided:

– For all incidents of extended duration.

– During incidents requiring high level of exertion.

– When individuals have to wear PPE.

• Rehabilitation should consist of:

– Additional monitoring of vital signs.

– Rest.

– Fluids for rehydration.

– Ongoing physical assessment.

J. Medical monitoring and rehabilitation.

1. Medical monitoring and rehabilitation should be provided:

a. For all incidents of extended duration.

b. During incidents requiring a high level of exertion by responders.

c. When individuals have to don PPE for any length of time.

2. Continued rehabilitation should consist of:

a. Additional monitoring of vital signs.

b. Rest.

c. Fluids for rehydration.

d. Ongoing physical assessment.

3. First responders with signs and/or symptoms indicating potential problems 

should have treatment provided in accordance with established medical

control protocols. EMS personnel should be assertive in their efforts to 

find potential medical problems early.
SPECIAL CONSIDERATIONS IN HAZARDOUS MATERIALS SITUATIONS

SM 9-11

MEDICAL MONITORING 

EVALUATIONS 

• PPE/Self-contained breathing apparatus 

(SCBA) operations:

– Monitor vital signs.

– Conduct physical 

assessment and monitor 

temperature.

– Conduct pre- and post-entry 

exams.

Slide 9-13

K. Medical monitoring evaluations.

1. PPE/SCBA: The IC should ensure that the following are 

monitored/conducted for all PPE and SCBA operations, or other 

operations that require moderate to heavy exertion.

a. Vital signs.

b. Physical assessment and temperature.

c. Pre- and post-entry exams.

2. Per NFPA 1584, 2008 Edition, medical personnel evaluating first 

responders will assess and document the following guidelines for entry 

personnel and for discharge from the Rehab Area.

a. Blood pressure: under 160 systolic and/or 100 diastolic.

b. Heart rate: under 100 beats per minute (resting).

c. Respirations: between 12 to 20 breaths per minute (resting).

d. Temperature: Body temperature is a vital piece of information to 

assessing individuals with both heat and cold stress exposures, but 

due to the various errors and inaccuracies that occur with 

measuring devices, core body temperature should not be used to 

exclude the possibility of a heat-related issue.
SPECIAL CONSIDERATIONS IN HAZARDOUS MATERIALS SITUATIONS

SM 9-12

MEDICAL MONITORING 

EVALUATIONS (cont’d) 

• Brief physical exam.

• Hydration.

• Documentation.

Slide 9-14

3. Brief Physical Exam: For post-activity evaluation, vital signs should 

return to normal within 10 to 20 minutes of rest.

All members are encouraged to drink water and/or sports drinks while in 

rehab in order to rehydrate.

4. Hydration: A critical factor in the prevention of heat injury is the 

maintenance of water and electrolytes.

a. Rehydration is important even during cold weather operations —

where, despite the outside temperature, heat stress may occur 

during firefighting or other strenuous activity when protective 

equipment is worn.

b. Goal is to match the volume of fluid intake with the volume of 

sweat output.

c. When hydration is taken with a meal, water is appropriate.

d. Consider sports drinks for rehydration and calorie and electrolyte 

replacement for activities that are moderate to high intensity or last 

longer than one hour.

e. To avoid overhydration, drink one sports drink for each 2 to 3 

liters of water.

f. Consumption of smaller amounts of fluids (2 to 4 oz.) more 

frequently is recommended.
SPECIAL CONSIDERATIONS IN HAZARDOUS MATERIALS SITUATIONS

SM 9-13

g. Avoid:

- Carbonated, high fructose content, and high sugar drinks 

(exceeding 7 percent carbohydrate solution).

- Foods with high fat and/or high protein content.

- Alcohol within eight hours prior to duty.

- Excessive fluids.

- Tobacco.

- Creatine.

- Ephedrine.

h. Be aware of overhydration and hypnoatremia.

5. Documentation: Per NFPA 473, 2008 Edition, responders should 

complete the reporting and documentation requirements that are consistent 

with their jurisdiction/agency emergency response plan or standard 

operating procedures (SOPs).

DEALING WITH FRIENDS/FAMILY 

AND CHILD SAFETY/PICK-UP 

• The Public Information Officer (PIO) 

should handle all communications and 

inquiries.

• Arranging secondary location for child 

pick-up may not be an EMS function.

– Depends on incident factors, jurisdiction and 

agency protocols.

Slide 9-15

L. Dealing with friends/family and child safety/pick-up.

1. The Public Information Officer (PIO) should handle all communications 

and inquiries.

2. Remember that arranging secondary locations for picking up children may 

not be an EMS function and will depend on incident factors, jurisdiction 

and agency protocols.
SPECIAL CONSIDERATIONS IN HAZARDOUS MATERIALS SITUATIONS

SM 9-14

DEALING WITH FRIENDS/FAMILY 

AND CHILD SAFETY/PICK-UP (cont’d) 

• Emergency Operations Plan (EOP) must 

consider ways to minimize disruption to 

child’s routine during and after incident. 

Slide 9-16

3. Because stable routines are critical to the physical and emotional wellbeing of a child, an Emergency Operations Plan (EOP) must consider 

ways to prevent or minimize disruption to a child’s routine during and 

after the incident.

II. SUMMARY

SUMMARY

• Discuss special circumstances and 

considerations in hazardous situations.

• Discuss the differences in meeting the 

needs of responder/entry teams and other 

patients. 

Slide 9-17
EMS FUNCTIONS IN ICS

SCENARIO F:

HAZARDOUS MATERIALS

SCENARIO OBJECTIVES

The students will be able to:

SF.1 Determine initial actions.

SF.2 Determine information to be included in a hazardous materials size-up.

SF.3 Develop a Medical Branch and a Medical Unit in the Incident Command System (ICS) organizational 

structure.

SF.4 Develop a Medical Plan.

SF.5 Track patients using a Patient Tracking Form.

SF.6 Use benchmarks to order and assign appropriate resources.
HAZARDOUS MATERIALS

SM SF-2

This page intentionally left blank.
HAZARDOUS MATERIALS

SM SF-3

SCENARIO F: 

HAZARDOUS MATERIALS

Slide SF-1

SCENARIO OBJECTIVES

• Determine initial actions.

• Determine information to be included in a 

hazardous materials size-up.

• Develop a Medical Branch and a Medical Unit in 

the Incident Command System (ICS) 

organizational structure.

• Develop a Medical Plan.

• Track patients using a Patient Tracking Form.

• Use benchmarks to order and assign 

appropriate resources.

Slide SF-2

I. SCENARIO F: HAZARDOUS MATERIALS

SCENARIO ROLES AND 

TASKS

• In this scenario, you have various roles: 

– Group Work 1: Safety 30.

– Group Work 2: EMS 100.

– Group Work 3: Medic 502.

• In this scenario, you will develop/complete:

– ICS Organizational Charts (Initial Response, 

Reinforced Response, Final).

– ICS Form 206 (Medical Plan).

– ICS Form MC-306 (Patient Tracking Form).

– Student Response Checklist.

Slide SF-3

A. Scenario roles and tasks.
HAZARDOUS MATERIALS

SM SF-4

1. In this scenario, you have various roles:

a. Group Work 1: Safety 30.

b. Group Work 2: EMS 100.

c. Group Work 3: Medic 502.

2. In this scenario, you will develop/complete:

a. Incident Command System (ICS) Organizational Charts (Initial 

Response, Reinforced Response, Final).

b. ICS Form 206 (Medical Plan).

c. ICS Form MC-306 (Patient Tracking Form).

d. Student Response Checklist.

INTRODUCTION

• Scenario is taking place at the Central City 

North Side Park Facility Recreation Building. 

• It is currently: 

– June 1, 1600 hours.

Slide SF-4

B. Introduction.

1. Scenario is taking place at the Central City North Side Park Facility 

Recreation Building.

2. Current conditions:

a. Time: 1600 hours.

b. Date: June 1.
HAZARDOUS MATERIALS

SM SF-5

Scenario F: Student Instructions

Flow of Scenario Time

1. Introduction/Background for Scenario F and Building 

Profile Review 1 minute

2. Initial Dispatch 1 minute

3.

En Route Injects

(Includes Review of Preplan and Material Safety 

Data Sheet (MSDS))

3 minutes

4. Arrival On-scene 2 minutes

5. Brief Initial Report (BIR) + Hazardous Materials Sizeup3 minutes

6. Group Work 1 10 minutes

7. Group Work 2 15 minutes

8. Group Work 3 15 minutes

9. Reporting Out 15 minutes

10. Instructor Debrief and Review of Model Responses 5 minutes

11. Complete the Student Response Checklist 5 minutes

Total Time: 75 Minutes
HAZARDOUS MATERIALS

SM SF-6

This page intentionally left blank.
HAZARDOUS MATERIALS

SM SF-7

Profile: Central City North Side Park Facility Recreation Building

The Central City North Side Park Facility Recreation Building is located within North Side Park 

(see location on map) at P and 10th Streets. Amenities in the park include:

• Eight youth soccer fields.

• Four Little League baseball fields.

• Four softball fields.

• Indoor swimming pool.

• Outdoor water park.

• General picnic areas.

Open from Memorial Day weekend to Labor Day, the swimming pool is housed in the 

Recreation Building. The Recreation Building also contains basketball courts, racquetball courts, 

a workout room with cardio machines and weights, a variety of mixed-use meeting spaces that 

can be rented out by members of the community, and separate male, female and family locker 

rooms with showers. 

There is a separate maintenance building that houses chlorine and other chemicals.
HAZARDOUS MATERIALS

SM SF-8

This page intentionally left blank.
HAZARDOUS MATERIALS

SM SF-9

INITIAL DISPATCH

Slide SF-5

C. Initial dispatch.

EN ROUTE INJECT 1

After one minute en route, receive additional 

information from Dispatch. 

• Updated information: The Regional 

Hazardous Materials Team has 

acknowledged its estimated time of arrival 

(ETA) to be 20 minutes.

• Training 1 (Central City Training Officer) is 

en route with the regional hazardous 

material trailer. 

Slide SF-6

D. En Route Injects 1 and 2.

1. After one minute en route, receive additional information from Dispatch.

Updated information: The Regional Hazardous Materials Team has 

acknowledged its estimated time of arrival (ETA) to be 20 minutes.
HAZARDOUS MATERIALS

SM SF-10

Slide SF-7

EN ROUTE INJECT 2

After another two minutes en route, receive 

additional information from Dispatch: Staff is 

reporting several people missing, and the 

chlorine sensors are sounding alarms in the 

chemical area of the pool maintenance 

building.

2. After another two minutes en route, receive additional information from 

Dispatch:

Staff is reporting several people missing, and the chlorine sensors are 

sounding alarms in the chemical area of the pool maintenance building.
HAZARDOUS MATERIALS

SM SF-11

Scenario F Preplan: 

Central City North Side Park Facility Recreation Building

(a) Floor Plan — Lower Level
HAZARDOUS MATERIALS

SM SF-12

(b) Floor Plan — Upper Level
HAZARDOUS MATERIALS

SM SF-13

(c) Aerial Shot of Building
HAZARDOUS MATERIALS

SM SF-14

(d) Quick Action Plan

North Side Park Facility Recreation Building

Quick Access Prefire Plan

Building Address: 1030 P Street, Central City

Building Description: 2-story “ordinary” construction with basement utilities

Roof Construction: Beam and rafter, 1” x 8” sheathing, composition covering

Floor Construction: Concrete with 2” x 10” joists; 1” x 6” sheathing over west area

Occupancy Type:

 North Side Recreation Center

Initial Resources Required:

 1 Rescue, 2 Engines, 1 Ladder

Hazards to Personnel:

Large amount of Chlorine and Pool Chemicals (1-ton chlorine cylinder in Maintenance 

Building)

Location of Water Supply:

10th and P Avenue

Available Flow:

1,500 gpm

Estimated Fire Flow

Level of 

Involvement 25% 50% 75% 100%

Estimated Fire 

Flow

800 1,600 2,400 3,200

Fire Behavior Prediction:

Rapid horizontal and vertical spread

Predicted Strategies:

Rescue, large area search, confinement, hazardous materials containment, ventilation, 

extinguishment

Problems Anticipated:

Large area search, multiple individual areas (i.e., courts, locker rooms, workout area) 

Standpipe Sprinklers Fire Detection 
HAZARDOUS MATERIALS

SM SF-15

Scenario F MSDS Packet: 

Bluewater Liquid Pool Chlorine
HAZARDOUS MATERIALS

SM SF-16
HAZARDOUS MATERIALS

SM SF-17
HAZARDOUS MATERIALS

SM SF-18
HAZARDOUS MATERIALS

SM SF-19
HAZARDOUS MATERIALS

SM SF-20
HAZARDOUS MATERIALS

SM SF-21

Scenario F MSDS Packet: 

Chlorine
HAZARDOUS MATERIALS

SM SF-22
HAZARDOUS MATERIALS

SM SF-23
HAZARDOUS MATERIALS

SM SF-24
HAZARDOUS MATERIALS

SM SF-25
HAZARDOUS MATERIALS

SM SF-26
HAZARDOUS MATERIALS

SM SF-27
HAZARDOUS MATERIALS

SM SF-28

This page intentionally left blank.
HAZARDOUS MATERIALS

SM SF-29

Scenario F MSDS Packet:

Sodium Hydroxide
HAZARDOUS MATERIALS

SM SF-30
HAZARDOUS MATERIALS

SM SF-31
HAZARDOUS MATERIALS

SM SF-32
HAZARDOUS MATERIALS

SM SF-33
HAZARDOUS MATERIALS

SM SF-34
HAZARDOUS MATERIALS

SM SF-35
HAZARDOUS MATERIALS

SM SF-36
HAZARDOUS MATERIALS

SM SF-37

Scenario F MSDS Packet: 

Muriatic Acid
HAZARDOUS MATERIALS

SM SF-38

This page intentionally left blank.
HAZARDOUS MATERIALS

SM SF-39

ON-SCENE ARRIVAL

Slide SF-8

E. On-scene arrival.
HAZARDOUS MATERIALS

SM SF-40

This page intentionally left blank.
HAZARDOUS MATERIALS

SM SF-41

Scenario F: On-scene Images
HAZARDOUS MATERIALS

SM SF-42
HAZARDOUS MATERIALS

SM SF-43
HAZARDOUS MATERIALS

SM SF-44
HAZARDOUS MATERIALS

SM SF-45

Slide SF-9

BRIEF INITIAL REPORT

F. BIR. 

Script:

Safety 30 on scene at North Side Park Recreation Center at P and 10th. We have 

a two-story Type 1 construction assembly building with occupants evacuating 

and appearing in need of medical assistance. There is an odor of chlorine in the 

parking lot. Safety 30 will be establishing Park Command (could be Central City 

Command, North Command, or Recreation Center Command). Command will 

be located at 10th and M. Ambulance 5, you will be the Triage Unit, E-5, you 

will be the Rescue Group; Command will be establishing perimeters.

•

•

INITIAL ACTIONS AND 

SIZE-UP

What are your initial actions (prior to sizeup)?

What do you need to include in a hazardous 

materials size-up?

Slide SF-10

G. Initial actions and size-up. 
HAZARDOUS MATERIALS

SM SF-46

GROUP WORK 1 

• You are Safety 30, arrived at the incident. 

Develop:

– Initial Response ICS Organizational Chart.

– Resource assignment.

• Total working time is 10 minutes.

Slide SF-11

H. Group Work 1.

1. You are Safety 30, arrived at the incident. Develop:

a. Initial Response ICS Organizational Chart.

b. Resource assignment.

2. Total working time is 10 minutes.
HAZARDOUS MATERIALS

SM SF-47

Scenario F: ICS Forms

The ICS forms(s) needed to complete the scenario are attached here. Copies of these forms can 

be found in Appendix A and Appendix B. The easel pads provided can be used to sketch out the 

ICS Organizational Charts and to brainstorm and take notes.
HAZARDOUS MATERIALS

SM SF-48

This page intentionally left blank.
HAZARDOUS MATERIALS

SM SF-49

ICS Form 206

MEDICAL 

PLAN

1. INCIDENT NAME 2. DATE PREPARED 3. TIME PREPARED 4. OPERATIONAL PERIOD

5. INCIDENT MEDICAL AID STATIONS

MEDICAL AID STATIONS LOCATION PARAMEDICS

YES NO

6. TRANSPORTATION

A. AMBULANCE SERVICES

NAME ADDRESS PHONE PARAMEDICS

YES NO

B. INCIDENT AMBULANCES

NAME LOCATION PARAMEDICS

YES NO

7. HOSPITALS

NAME ADDRESS TRAVEL TIME PHONE HELIPAD BURN CENTER

AIR GRND YES NO YES NO

8. MEDICAL EMERGENCY PROCEDURES

206 ICS 8-78 9. PREPARED BY (MEDICAL UNIT LEADER) 10. REVIEWED BY (SAFETY OFFICER)
HAZARDOUS MATERIALS

SM SF-50

This page intentionally left blank.
HAZARDOUS MATERIALS

SM SF-51

ICS Form MC-306

Multi-Casualty

Recorder Worksheet

Ambulance 

Company

Ambulance 

ID Number

Patient 

Triage Tag 

Number

Patient 

Status

Hospital 

Destination

Off Scene 

Time

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

ICS-MC-306 (12/89)

DISCLAIMER: This form is not an approved ICS Form but has been provided for your reference and use in this course.
HAZARDOUS MATERIALS

SM SF-52

This page intentionally left blank.
HAZARDOUS MATERIALS

SM SF-53

ICS Form MC-306

Multi-Casualty

Recorder Worksheet

Ambulance 

Company

Ambulance 

ID Number

Patient 

Triage Tag 

Number

Patient 

Status

Hospital 

Destination

Off Scene 

Time

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

(I) (D) (M)

ICS-MC-306 (12/89)

DISCLAIMER: This form is not an approved ICS Form but has been provided for your reference and use in this course.
HAZARDOUS MATERIALS

SM SF-54

This page intentionally left blank.
HAZARDOUS MATERIALS

SM SF-55

INJECT 1

Arrived on-scene: 

• Engine 5.

• Engine 6.

• Squirt 4.

• EMS 100.

• Ambulance 5.

• Ambulance 6.

• Medic 4.

• Medic 501.

Slide SF-12

I. Inject 1.

Arrived on-scene: 

1. Engine 5.

2. Engine 6.

3. Squirt 4.

4. EMS 100.

5. Ambulance 5.

6. Ambulance 6.

7. Medic 4.

8. Medic 501.
HAZARDOUS MATERIALS

SM SF-56

INJECT 2

• Arrived on-scene: – Battalion Chief 2.

– Squad 1.

– Hazmat 1.

• Command has been transferred to 

Battalion Chief 2.

• Request an upgrade to second alarm 

Hazardous Materials and second alarm 

mass casualty incident (MCI).

Slide SF-13

J. Inject 2.

1. Arrived on-scene: 

a. Battalion Chief 2.

b. Squad 1.

c. Hazmat 1.

2. Command has been transferred to Battalion Chief 2.

3. Request an upgrade to second alarm Hazardous Materials and second

alarm mass casualty incident (MCI).

UPGRADED DISPATCH

• Engine 1.

• Engine 2.

• Ladder 1.

• Ladder 2.

• Deputy Chief 1.

• Medic 2.

• Medic 502.

• Ambulance 3.

• Ambulance 8.

Slide SF-14

K. Upgraded dispatch.

1. Engine 1.
HAZARDOUS MATERIALS

SM SF-57

2. Engine 2.

3. Ladder 1.

4. Ladder 2.

5. Deputy Chief 1.

6. Medic 2.

7. Medic 502.

8. Ambulance 3.

9. Ambulance 8.

GROUP WORK 2 

• You are now EMS 100, which has been 

assigned as the Medical Group Supervisor. 

Develop:

– Reinforced Response ICS Organizational 

Chart.

-- Resource assignment.

– Patient tracking.

• Total working time is 15 minutes.

Slide SF-15

L. Group Work 2.

1. You are now EMS 100, which has been assigned as the Medical Group 

Supervisor. Develop:

a. Reinforced Response ICS Organizational Chart.

Resource assignment.

b. Patient tracking.

2. Total working time is 15 minutes.
HAZARDOUS MATERIALS

SM SF-58

Slide SF-16

INJECT 3

• Arrived on-scene:

– Engine 1.

– Engine 2.

– Ladder 1.

– Ladder 2.

– Medic 2.

– Ambulance 3.

– Ambulance 8.

• Medic 502, ETA: two minutes. 

M. Inject 3.

1. Arrived on-scene:

a. Engine 1.

b. Engine 2.

c. Ladder 1.

d. Ladder 2.

e. Medic 2.

f. Ambulance 3.

g. Ambulance 8.

2. Medic 502, ETA: two minutes. 

N. Inject 4.
HAZARDOUS MATERIALS

SM SF-59

Slide SF-17

INJECT 4

• Rescue Group Recon Report.

• Triage is completed.

– Triage Report.

1. Rescue Group Recon Report.

2. Triage is completed.

Triage Report.

Slide SF-18

GROUP WORK 3

• Deputy Chief 1 has arrived on-scene and 

Command has been transferred. 

• Medic 502 is on-scene and has been 

instructed to set up Medical Unit under 

Logistics.

• You should create/complete: – Final ICS Organizational Chart.

-- Assign resources.

– ICS Form 206.

• Total working time is 15 minutes.

O. Group Work 3.

1. Deputy Chief 1 has arrived on-scene and Command has been transferred. 

2. Medic 502 is on-scene and has been instructed to set up Medical Unit 

under Logistics.

3. You should create/complete:

a. Final ICS Organizational Chart.

Assign resources.
HAZARDOUS MATERIALS

SM SF-60

b. ICS Form 206.

4. Total working time is 15 minutes.

Slide SF-19

INJECT 5

Responders are reporting that civilian patients 

still smell strongly of chlorine. 

P. Inject 5.

Responders are reporting that civilian patients still smell strongly of chlorine. 

II. REPORTING OUT

REPORTING OUT

• Groups describe their:

– Organizational charts.

– Resource assignments.

– ICS Form 206 (Medical Plan).

• Remember, one group does full reporting 

out; other groups describe significant 

differences. (Have different groups do full 

reporting out of each group work 

assignment.)

• Total working time is 15 minutes.

Slide SF-20

A. Groups describe their:

1. Organizational charts.

2. Resource assignments.

3. ICS Form 206 (Medical Plan).
HAZARDOUS MATERIALS

SM SF-61

B. Remember, one group does full reporting out; other groups describe significant 

differences. (Have different groups do full reporting out of each group work 

assignment.)

C. Total working time is 15 minutes.

III. COMPLETING THE SCENARIO

COMPLETING THE 

SCENARIO

• Instructor provides Model Responses.

• Instructor answers questions.

• Students complete Student Response 

Checklist.

• Total working time is 10 minutes.

Slide SF-21

A. Instructor provides Model Responses.

B. Instructor answers questions.

C. Students complete Student Response Checklist.

D. Total working time is 10 minutes.
This page intentionally left blank.
EMS FUNCTIONS IN ICS

MODULE 10:

SPECIAL CONSIDERATIONS FOR EMS 

AS INCIDENT COMMANDER

OBJECTIVES

The students will be able to:

10.1 Identify special considerations for Emergency Medical Services (EMS) as the Incident Commander (IC).

10.2 Apply the formula for determining transport resources.
SPECIAL CONSIDERATIONS FOR EMS AS INCIDENT COMMANDER

SM 10-2

This page intentionally left blank.
SPECIAL CONSIDERATIONS FOR EMS AS INCIDENT COMMANDER

SM 10-3

MODULE 10:

SPECIAL CONSIDERATIONS 

FOR EMS AS INCIDENT 

COMMANDER

Slide 10-1

OBJECTIVES

• Identify special considerations for 

Emergency Medical Services (EMS) as 

the Incident Commander (IC).

• Apply the formula for determining 

transport resources.

Slide 10-2

I. SPECIAL CONSIDERATIONS FOR EMS AS INCIDENT COMMANDER

SPECIAL CONSIDERATIONS FOR EMS AS 

INCIDENT COMMANDER

Slide 10-3

Allocating 

resources to 

Staging

1/3 of resources 

on-scene 

committed to 

Staging

Triage and 

Staging

Practice Triage 

and Staging on a 

regular basis

Organize into 

predefined 

response matrices

Ambulance 

Strike Teams

EMS Task Force

Preplan

Perform 

preplanning 

activities

Ensure preestablished 

mutual-aid 

agreements

Allocating patients

Alert hospitals

Distribute 

patients evenly
SPECIAL CONSIDERATIONS FOR EMS AS INCIDENT COMMANDER

SM 10-4

A. Some recommended special considerations for Emergency Medical Services 

(EMS) as the Incident Commander (IC):

1. Allocating resources to Staging: An IC should always have one-third of 

the resources committed on the scene in Staging. 

a. For example, if you have six ambulances working an incident, you 

should assign two to Staging or moving toward the incident. 

b. This is good practice, as incidents of any size often produce 

patients during the evolution of the event (rescuer injuries, patients 

missed in triage, or minor injuries) that progress to more serious 

circumstances. 

2. Triage and Staging: Fundamental tasks, such as Triage and Staging, have 

the greatest potential to contribute to inefficiencies in IC operations.

a. Triage should be practiced at least monthly. 

b. For example, practice “Triage Tuesdays,” where each patient has a 

Triage Tag applied. 

c. Triage should be a part of the size-up and a tactical benchmark. 

d. The scene may be very large geographically, and the IC may not 

be able to get an accurate assessment of the situation. The Triage 

Report helps clarify this for the IC. The Triage Report, coupled 

with some hazard information and rescue requirements, allows the 

IC to request and deploy resources correctly. 

e. Staging is another fundamental skill that is often overlooked and 

requires unit discipline. 

f. For the IC to achieve his or her objectives in the correct sequence,

resources cannot self-dispatch to the scene — they must wait to be 

deployed. 

3. Organize into predefined response matrices: Organize into predefined 

response matrices for EMS. 

4. Preplan: It is important to preplan and organize mutual-aid resources. 

a. A standard should be developed that “types” and organizes 

resources into functional units (Strike Teams/Task Forces) before 

the incident. 
SPECIAL CONSIDERATIONS FOR EMS AS INCIDENT COMMANDER

SM 10-5

b. For example, a Rescue Task Force would be a Heavy, a Truck, and 

two or three Transport Units with a Supervisor.

5. Alert the hospital and distribute the patients evenly: Do not forget to 

alert the hospital and distribute the patients evenly. Do not just move the 

patients from one disaster site to another disaster site.
SPECIAL CONSIDERATIONS FOR EMS AS INCIDENT COMMANDER

SM 10-6

This page intentionally left blank.
SPECIAL CONSIDERATIONS FOR EMS AS INCIDENT COMMANDER

SM 10-7

Additional Special Considerations

1. Be alert when working at a mass gathering and be aware of all the risk factors that are 

present (heat, humidity, alcohol, etc.), even if the volume is low. Once it starts, it 

cascades quickly. One of the worst mass casualty incidents (MCIs) in Virginia had two 

patients at 1410 hours but in less than 20 minutes EMS personnel were treating 40

patients, and there were ultimately 216! 

2. People want to participate whether they are trained or not. Resources that show up and

are not dispatched can jeopardize a good operation just by being present.

3. Rehab is important! Resources will wear out in about 30 minutes, regardless of the 

weather. It is worse in the heat, but the constant lifting and moving of patients is 

strenuous, no matter what. 

4. The porters that move patients are only going to move one patient for every four porters. 

The Triage Unit and Rescue/Extrication Group must work together to overcome this 

benchmark. Adequate resources must be placed into triage in order to get patients to the 

treatment areas. Anyone can do this as long as he or she has the right personal protective 

equipment. 

5. Never use personnel from Transport Units for any purpose other than transportation. Try 

to fill all staff functions, the treatment area, and the loading area with firefighters from 

on-scene apparatus or other staff. It takes a lot of resources to get patients to the Casualty 

Collection Point (CCP), treated, and loaded.

6. To determine the number of Transport Units to request in the first size-up report, guess

the number of patients and divide it in half. For example, a 15-person passenger van 

carrying a girls’ volleyball squad overturns on the highway. Guess about 12 patients, 

which would result in six to seven Transport Units. The Triage Report will confirm the 

actual number in about two minutes.

7. Secure all functional areas, Incident Command Post (ICP), CCP, and treatment areas. 

Isolate the area as the public, spectators and good Samaritans come out of the woodwork. 

People must be qualified immediately for you to be able to use their assistance 

successfully — e.g. military medics or other off-duty personnel at incidents.

8. School incidents are complicated by students texting or using social media to 

communicate with their parents and friends, thereby bringing them into the mix faster 

than the first responders. It is imperative to partner with schools and police to train 

together. Have your station captains visit the schools and view the schools’ safety plans. 

a. School administrators have a tendency to try to keep things in-house and not share 

information on incidents that may be damaging to the school image.

b. Keep an accurate transportation log with time and destinations.
SPECIAL CONSIDERATIONS FOR EMS AS INCIDENT COMMANDER

SM 10-8

9. Embed your Critical Incident Stress Debriefing or mental health professional into field 

operations before an incident and maintain his or her presence over the long haul so that 

when the “Bad One” does occur, there is already trust among all the team members. 

10. Taking your target hazard into consideration, develop a medical cache based on the types 

of harm the target hazard can cause. In addition to the construction of the cache, you must 

have a plan to get the medical cache to the scene of the incident. 

11. Train and equip a station company to be the MCI team. Develop a company that works 

just like the Hazardous Materials or Tech Rescue Team and have them train on MCIs 

weekly. Their role is not to fill the functional positions in ICS, but to deploy and resupply 

the MCI equipment as required. They should be able to set up a functioning treatment 

area on-scene in less than five minutes. They can also be deployed to all special events to 

set up the Aid Station or whatever is required. 
SPECIAL CONSIDERATIONS FOR EMS AS INCIDENT COMMANDER

SM 10-9

Checklist: Initial Actions for First Arriving Units

Initial Actions

• Priorities are Command, Initial Hazard Control, Triage, and Staging.

• Establish Command.

• Triage, Staging, Red Treatment Area (tarps carried on all truck and squad companies).

• Activate the mass casualty plan.

• Estimate the number of patients.

• Estimate the number of ambulances required. 

• Designate a Staging Area for fire and rescue units.

• Address the “patient generator (PG).”

• Convey hazards, mode of operation and request other resources.

• Coordinate scene security with police.

• Coordinate fire/hazardous materials/mass decontamination of victims.

• Example: “Radio, I-64 Command — I have a commercial bus on its side. Activate the 

mass casualty plan. This is a Type 2 MCI involving 20 patients. Dispatch 10 additional 

ambulances along with an additional full commercial assignment. All units respond to 

Staging at I-64 and Parham Road.”
SPECIAL CONSIDERATIONS FOR EMS AS INCIDENT COMMANDER

SM 10-10

This page intentionally left blank.
SPECIAL CONSIDERATIONS FOR EMS AS INCIDENT COMMANDER

SM 10-11

DETERMINING TRANSPORT 

RESOURCES

Slide 10-4

• Use the equation below to calculate how 

many units you will need in order to meet 

your time requirements.

X = Nt/Tn

• X = number of ambulances.

B. Determining transport resources.

Use the equation below to calculate how many units you will need in order to 

meet your time requirements.

X = Nt/Tn

1. X = number of ambulances.

DETERMINING TRANSPORT 

RESOURCES (cont’d)

Slide 10-5

• n = # of people to be transported per unit. 

– We should be able to get an Immediate (red) 

and an additional Delayed (yellow) or Minor 

(green) patient on 50 percent of the transports, 

allowing 1.5 patients per trip.

– Therefore n = 1.5. 

• N = # of people requiring transport.

• t = round-trip travel time including return to 

service.

• T = total time available for operations. 

2. n = number of people to be transported per unit.

a. We should be able to get a red and an additional yellow or green 

patient on 50 percent of the transports, allowing 1.5 patients per 

trip. 

b. Therefore, n = 1.5.

3. N = number of people requiring transport.
SPECIAL CONSIDERATIONS FOR EMS AS INCIDENT COMMANDER

SM 10-12

4. t = round-trip travel time including return to service.

5. T = total time available for operations.

Slide 10-6

EXAMPLE: DETERMINING 

TRANSPORT RESOURCES

If you are transporting 24 patients within a 

one-hour period, and it takes you 30 minutes 

(0.5 hours) to travel between the locations, 

how many units will you need?

X = Nt/Tn

C. Example: determining transport resources.

Slide 10-7

SOLUTION

If you are transporting 24 patients within a 

one-hour period, and it takes you 30 minutes 

(0.5 hours) to travel between the locations, 

how many units will you need?

X = Nt/Tn

X = (24)(0.5)/(1)(1.5)

X = 8

So you will need eight ambulances to meet 

your goal.

D. Solution.
SPECIAL CONSIDERATIONS FOR EMS AS INCIDENT COMMANDER

SM 10-13

II. SUMMARY

Slide 10-8

SUMMARY

• Identify special considerations for EMS as 

the IC.

• Apply the formula for determining transport 

resources.
This page intentionally left blank.
EMS FUNCTIONS IN ICS

SCENARIO G:

EVACUATIONS

SCENARIO OBJECTIVES

The students will be able to:

SG.1 Develop an Incident Command System (ICS) organizational structure for a mass evacuation and move.

SG.2 Develop incident safety message.

SG.3 Develop an Incident Briefing.

SG.4 Track patients using a Patient Tracking Form.

SG.5 Use benchmarks to order and assign appropriate resources.
EVACUATIONS

SM SG-2

This page intentionally left blank.
EVACUATIONS

SM SG-3

SCENARIO G:

EVACUATIONS

Slide SG-1

SCENARIO OBJECTIVES

• Develop an Incident Command System 

(ICS) organizational structure for a mass 

evacuation and move.

• Develop incident safety message. 

• Develop an Incident Briefing.

• Track patients using a Patient Tracking 

Form.

• Use benchmarks to order and assign 

appropriate resources.

Slide SG-2

I. SCENARIO G: EVACUATIONS

SCENARIO ROLES AND 

TASKS

• In this scenario, you are the Bayport 

Emergency Medical Services (EMS) Chief, 

EMS 90.

• In this scenario, you will develop/complete:

– ICS Organizational Charts.

– ICS Form 202 (Incident Objectives).

-- Given incident objectives, complete the safety 

message.

– ICS Form 201 (Incident Briefing).

– Student Response Checklist.

Slide SG-3

A. Scenario roles and tasks.
EVACUATIONS

SM SG-4

1. In this scenario, you are the Bayport Emergency Medical Services (EMS) 

Chief, EMS 90.

2. In this scenario, you will develop/complete:

a. Incident Command System (ICS) Organizational Charts.

b. ICS Form 202 (Incident Objectives).

- Given incident objectives, complete the safety message.

c. ICS Form 201 (Incident Briefing).

d. Student Response Checklist.

INTRODUCTION

• Current conditions:

– Time: 1015 hours.

– Date: June 22.

– Temperature: 88 F, sunny.

– Wind: 8 mph southwest.

Slide SG-4

B. Introduction.

Current conditions:

1. Time: 1015 hours.

2. Date: June 22.

3. Temperature: 88 F, sunny.

4. Wind: 8 mph southwest.
EVACUATIONS

SM SG-5

INTRODUCTION (cont’d)

Slide SG-5

ON-SCENE

Slide SG-6

C. On-scene.

A larger version of this image is available in the in the package of information 

provided after the Gilmore Nursing Home Preplan.

GROUP WORK

• Assign the destination where each patient is 

to be moved.

• Review the available resources and ensure 

that they will be sufficient to meet your 

evacuation goals. 

• Assign resources to move patients.

• Develop ICS Organizational Charts.

Slide SG-7
EVACUATIONS

SM SG-6

D. Group Work.

1. Assign the destination where each patient is to be moved.

2. Review the available resources and ensure that they will be sufficient to 

meet your evacuation goals.

3. Assign resources to move patients.

4. Develop ICS Organizational Charts.

Slide SG-8

GROUP WORK (cont’d)

• Develop the ICS Form 202 (Incident 

Objectives).

• Develop the ICS Form 201 (Incident 

Briefing).

• Total working time is 50 minutes.

5. Develop the ICS Form 202 (Incident Objectives).

6. Develop the ICS Form 201 (Incident Briefing).

7. Total working time is 50 minutes.
EVACUATIONS

SM SG-7

Scenario G: Student Instructions

Flow of Scenario Time

1. Introduction/Background for Scenario G 5 minutes

2. Group Work 50 minutes

3. Reporting Out 20 minutes

4. Instructor Debrief and Review of Model Responses 5 minutes

5. Complete the Student Response Checklist 5 minutes

Total Time: 85 Minutes
EVACUATIONS

SM SG-8

This page intentionally left blank.
EVACUATIONS

SM SG-9

Scenario G: Gilmore Nursing Home Preplan
EVACUATIONS

SM SG-10
EVACUATIONS

SM SG-11
EVACUATIONS

SM SG-12
EVACUATIONS

SM SG-13

Scenario G: Liberty County EMS Evacuations Resources

Ambulance Strike Team 1

• Fisherville EMS Chief (EMS 20)

• M-91 Bayport

• M-591 Bayport

• M-593 Bayport

• M-95 Gish

• Medtrans 1 Private CCT

Ambulance Strike Team 2 

• EMS 100

• CCFD Ambulance 101

• CCFD Ambulance 104

• CCFD Ambulance 10

• CCFD Ambulance 6

• CCFD Ambulance 8

Ambulance Strike Team 3 

• Kingston EMS Chief (EMS 40)

• Ambulance 543 Kingston

• Ambulance 77 Tribal EMS

• Ambulance 176 Tribal EMS

• Ambulance 42 Kingston

• Ambulance 533 Harvest Junction

EMS Task Force 1 

• Harvest Junction EMS Chief (EMS 30)

• Ambulance 92 Bayport

• Ambulance 23 Fisherville

• Medic 522 Fisherville

• Two Liberty County School Buses with Wheelchair Lifts (LC Bus 1, LC Bus 2)

Additional Resources

• CC Ladder 5

• Squirt 4

• Engine 9
EVACUATIONS

SM SG-14

Scenario G: Available Bed Space at Area Nursing Homes

Jurisdiction Nursing Home Location Number of 

Available Beds

Central City Columbia D Street and 11th

Avenue

10

Hill Top J Street and 3rd

Avenue

10

Garden Run T Street and 35th

Avenue

10

Happy Times N Street at 1st Avenue 10

Bayport Oceanside Ocean Street and 7th 

Avenue

25

Fisherville Turkey Hill AA and 14th Streets 12

Harvest Junction Harvest Junction F and 12th Streets 12

Total: 89
EVACUATIONS

SM SG-15

Scenario G: Gilmore Nursing Home Patient List

The list below includes 89 patients with their condition descriptions and their assigned nursing 

home destination.

Last

Name

First

Name Condition/Illness Destination AssignedUnit

1. Achen Mathew Bedridden/Oxygen

2. Anderson Janet Wheel Chair 

3. Baker Barbara Bedridden

4. Bangs Darrold Bedridden

5. Baxter Robert Wheel Chair 

6. Beebe Sara Bedridden/Oxygen

7. Beaudoin Harold Wheel Chair 

8. Bell Sue Bedridden

9. Bellamy Etta Bedridden

10. Bradshaw Kerry Bedridden

11. Carnell Belinda Wheel Chair 

12. Clark Arlo Bedridden

13. Claypool Edward Bedridden

14. Cobb Sandy Wheel Chair/Oxygen

15. Colinger Lucinda Bedridden

16. Dethman Susan Bedridden

17. Deitz Margaret Ambulatory 

18. Drier Sophia Wheel Chair 

19. Drier Hank Wheel Chair 

20. Eldred Thomas Bedridden

21. Eckhardt Fritz Bedridden

22. Edwards Madeline Bedridden

23. Fritz Lucinda Bedridden

24. Gentry Gwen Bedridden

25. George Roger Wheel Chair 

26. Grahnert Linda Bedridden

27. Gorman Mike Bedridden

28. Hancock David Ambulatory 

29. Hixon Ronald Ambulatory 

30. Hoffman Robert Bedridden/Oxygen

31. Harris Evelyn Bedridden/Oxygen

32. Hausinger Irene Bedridden

33. Held Gregg Bedridden

34. Howe Alan Bedridden/Oxygen

35. Hughes Howard Bedridden

36. Hughes Covita Ambulatory 

37. Jack Amelia Wheel Chair 

38. Jacobson Swevn Bedridden
EVACUATIONS

SM SG-16

Last

Name

First

Name Condition/Illness Destination AssignedUnit

39. Kelsy Carrol Ambulatory 

40. Kelsy Richard Wheel Chair 

41. Kern Jill Bedridden

42. Johnson Bradley Bedridden

43. Joiner Amber Bedridden

44. Kelly Gene Ambulatory/Oxygen

45. Kelsey Bethaney Bedridden/Oxygen

46. Kerwin Anita Bedridden/Oxygen

47. Klineline Cody Ambulatory/Oxygen

48. Konkel Bernadette Bedridden

49. Kramer Florence Bedridden

50. Kravits La’Toya Bedridden

51. Lawson Lloyd Bedridden

52. Lamke Ellis Bedridden

53. Lowery Pauline Bedridden

54. Long Hester Bedridden

55. Luce Clair Bedridden

56. Mason Charles Bedridden

57. Lindsley Sandra Ambulatory 

58. Lock Patti Bedridden

59. McAbee Jillion Ambulatory 

60. McMilan Symanthia Bedridden

61. Morrow Max Bedridden

62. Munger Martin Bedridden

63. Nolan Dennis Bedridden

64. Peebles Edgar Bedridden/Oxygen

65. Picket Joan Bedridden/Oxygen

66. Ray Sunny Ambulatory/Oxygen

67. Olsen Shelia Bedridden

68. Olsen Samuel Bedridden

69. Paradis Brent Bedridden/Oxygen

70. Reeves Stanislaus Bedridden

71. Reiners Mary Lynn Bedridden

72. Rochester Cassidy Wheel Chair 

73. Rusk Rodney Ambulatory 

74. Schue Heather Ambulatory 

75. Sherrell Tim Bedridden

76. Sherman Katelyn Bedridden

77. Stickney Edward Bedridden

78. Severson Shirley Ann Wheel Chair 

79. Schovil Daniel Bedridden

80. Streitt Monique Bedridden

81. Stults Juanita Bedridden
EVACUATIONS

SM SG-17

Last

Name

First

Name Condition/Illness Destination AssignedUnit

82. Sloat Tracie Bedridden

83. Thaut Lance Bedridden

84. Watson Willie Ambulatory 

85. Volentine Xavier Bedridden

86. Winston Clint Ambulatory 

87. Wokal Gaylord Ambulatory 

88. Williams Thomas Wheel Chair 

89. Wilder Mike Wheel Chair 
EVACUATIONS

SM SG-18

This page intentionally left blank.
EVACUATIONS

SM SG-19

Scenario G: ICS Forms

The ICS form(s) needed to complete the scenario are attached here. Copies of these forms can be 

found in Appendix A and Appendix B. The easel pads provided can be used to sketch out the 

ICS Organizational Charts and to brainstorm and take notes.
EVACUATIONS

SM SG-20

This page intentionally left blank.
EVACUATIONS

SM SG-21

ICS Form 202

INCIDENT OBJECTIVES 1. INCIDENT NAME

Gilmore Command 

2. DATE

6/11/10

3. TIME

0800

4. OPERATIONAL PERIOD (DATE/TIME)

6/11/2010 0900-1800

5. GENERAL CONTROL OBJECTIVES FOR THE INCIDENT (INCLUDE ALTERNATIVES)

1. Move 89 patients from the Gilmore Nursing Home to corresponding homes in Central City, 

Bayport, Fisherville, and Harvest Junction. 

2. Coordinate multiple roundtrip deliveries to Central City. 

3. Ensure community EMS coverage for those cities contributing resources.

4. Evenly distribute patients in a timely fashion as to not overwhelm nursing staff.

5. Move patients to local destination in Bayport without impacting normal responses.

7. GENERAL SAFETY MESSAGE

8. Attachments ( if attached)

 Organization List (ICS 203)  Medical Plan (ICS 206)  Weather Forecast

 Assignment List (ICS 204)  Incident Map 

 Communications Plan (ICS 205)  Traffic Plan 

9. PREPARED BY (PLANNING SECTION 

CHIEF)

10. APPROVED BY (INCIDENT 

COMMANDER)

Winston EMS 90 Bayport FD
EVACUATIONS

SM SG-22

This page intentionally left blank.
EVACUATIONS

SM SG-23

ICS Form 201

INCIDENT BRIEFING

1. Incident Name 2. Date Prepared 3. Time Prepared

4. Map Sketch

ICS 201

Page 1 of 4

5. Prepared by (Name and Position)
EVACUATIONS

SM SG-24

6. Summary of Current Actions

ICS 201 Page 2
EVACUATIONS

SM SG-25

7. Current Organization

ICS 201 Page 3
EVACUATIONS

SM SG-26

8. Resources Summary

Resources Ordered Resource Identification ETA On Scene Location/Assignment

ICS 201 Page 4
EVACUATIONS

SM SG-27

II. REPORTING OUT

• Groups describe their:

– ICS Organizational Charts. 

– Resource assignments.

– Rationale on where they moved patients.

• Groups describe their ICS 201.

• Remember, one group does full reporting 

out; other groups describe significant 

differences.

• Total working time is 20 minutes.

REPORTING OUT

Slide SG-9

A. Groups describe their:

1. ICS Organizational Charts.

2. Resource assignments.

3. Rationale on where they moved patients.

B. Groups describe their ICS Form 201.

C. Remember, one group does full reporting out; other groups describe significant 

differences.

D. Total working time is 20 minutes.

III. COMPLETING THE SCENARIO

COMPLETING THE SCENARIO

• Instructor provides Model Responses.

• Instructor answers questions.

• Students complete Student Response 

Checklist.

• Total working time is 10 minutes.

Slide SG-10
EVACUATIONS

SM SG-28

A. Instructor provides Model Responses.

B. Instructor answers questions.

C. Students complete Student Response Checklist.

D. Total working time is 10 minutes.
EMS FUNCTIONS IN ICS

MODULE 11:

WRAPPING UP INCIDENTS

OBJECTIVE

The students will be able to:

11.1 Identify tasks involved in wrapping up incidents.
WRAPPING UP INCIDENTS

SM 11-2

This page intentionally left blank.
WRAPPING UP INCIDENTS

SM 11-3

MODULE 11: 

WRAPPING UP INCIDENTS

Slide 11-1

OBJECTIVE

Identify tasks involved in wrapping up 

incidents.

Slide 11-2

I. WRAPPING UP INCIDENTS

DEMOBILIZATION

Ensure that:

• Oxygen has been refilled. 

• Medical supplies have been restocked. 

• Batteries have been changed.

• Backboards have been restocked. 

• All equipment has been cleaned and 

disinfected.

Slide 11-3

A. Demobilization.
WRAPPING UP INCIDENTS

SM 11-4

The final tasks that are required of the Incident Command are to ensure proper 

demobilization, conduct a Postincident Analysis (PIA), and do a debriefing. It is 

important to ensure that:

1. Oxygen has been refilled.

2. Medical supplies have been restocked.

3. Batteries have been changed.

4. Backboards have been restocked.

5. All equipment has been cleaned and disinfected (i.e., suction, gurneys and 

airway equipment).

• Postincident analysis (PIA) and 

documentation:

– Assemble facts.

– Create electronic folders/files for every event.

– Samples of documentation should include 

dispatch tapes, triage reports, etc.

• Debriefing:

– First round discussion is roles/actions of team 

members in incident.

– Second round discussion is what was done 

well and what could be done better. Slide 11-4

POSTINCIDENT ANALYSIS, 

DOCUMENTATION AND DEBRIEFING

B. PIA, documentation and debriefing.

1. PIA and documentation: A PIA and documentation is necessary after 

every major Emergency Medical Services (EMS) incident. The process 

starts by assembling the facts.

a. An electronic folder or file should be created for every special 

event and declared mass casualty incident (MCI). Every file 

associated with that incident should be pushed to that folder. This 

helps when the agency receives request for legal documentation of 

events. 

b. All Incident Command System (ICS) forms and other hard copies 

should be scanned to this folder along with any incident photos. 

The documentation should speak for itself, and usually includes the 

following: 

- Run reports.
WRAPPING UP INCIDENTS

SM 11-5

- Dispatch tapes.

- Triage reports.

- Patient transport list and hospital destination.

- Photos and videotape.

2. Debriefing: All tactical operations should be reviewed for ideas for 

improvement and to assess the best practices.

a. The debriefing process typically involves a circle of chairs facing 

each other. 

b. The leader begins by going around asking each person to describe 

his or her role and/or actions in the incident. 

c. A second round is conducted asking what could be done better and 

what was done well. 

d. The session is wrapped up with final comments summarized and 

distributed to other members as an after-action report.

e. During the debrief, the supervisors should be assessing employees 

who may need employee assistance service or additional debriefing 

or counseling.

II. SUMMARY

Identify tasks involved in wrapping up 

incidents.

SUMMARY

Slide 11-5
WRAPPING UP INCIDENTS

SM 11-6

III. COURSE WRAP-UP

Talk about one new concept you learned in 

this course that you will apply to your job.

COURSE WRAP-UP

Slide 11-6

• Thank you!

• Course evaluations.

COURSE WRAP-UP (cont’d)

Slide 11-7
EMS FUNCTIONS IN ICS

A-1

APPENDIX A

NIMS-APPROVED ICS FORMS
EMS FUNCTIONS IN ICS

A-2

This page intentionally left blank.
EMS FUNCTIONS IN ICS

A-3

TABLE OF CONTENTS

Appendix A Introduction ............................................................................................................. 5

ICS Form 201 — Incident Briefing* ........................................................................................... 7

Instructions for Completing ICS Form 201 ................................................................................. 11

ICS Form 202 — Incident Objectives* ....................................................................................... 13

Instructions for Completing ICS Form 202 ................................................................................. 14

ICS Form 203 — Organization Assignment List* ...................................................................... 15

Instructions for Completing ICS Form 203 ................................................................................. 16

ICS Form 204 — Assignment List* ............................................................................................ 17

Instructions for Completing ICS Form 204 ................................................................................. 18

ICS Form 205 — Incident Radio Communications Plan*........................................................... 19

Instructions for Completing ICS Form 205 ................................................................................. 20

ICS Form 206 — Medical Plan* ................................................................................................. 21

Instructions for Completing ICS Form 206 ................................................................................. 22

ICS Form 207 — Organizational Chart....................................................................................... 23

ICS Form 209 — Incident Status Summary ................................................................................ 25

Instructions for Completing ICS Form 209 ................................................................................. 27

ICS Form 210 — Status Change Card......................................................................................... 29

ICS Form 211 — Check-in List*................................................................................................. 31

Instructions for Completing ICS Form 211 ................................................................................. 32

ICS Form 213 — General Message ............................................................................................. 35

ICS Form 214 — Unit Log* ........................................................................................................ 37

ICS Form 215 — Operational Planning Worksheet .................................................................... 39

ICS Form 215a — Incident Action Plan Safety Analysis............................................................ 41

ICS Form 216 — Radio Requirements Worksheet...................................................................... 43

ICS Form 217 — Radio Frequency Assignment Worksheet....................................................... 45

ICS Form 218 — Support Vehicle Inventory.............................................................................. 47

Instructions for Completing ICS Form 218 ................................................................................. 48

ICS Form 219-2 — Card Stock: Green (Crew) ........................................................................... 49

ICS Form 219-4 — Card Stock: Blue (Helicopter) ..................................................................... 51

ICS Form 219-6 — Card Stock: Orange (Aircraft) ..................................................................... 53

ICS Form 219-7 — Card Stock: Yellow (Dozer)........................................................................ 55

ICS Form 220 — Air Operations Summary ................................................................................ 57

ICS Form 221 — Demobilization Checkout ............................................................................... 59

Instructions for Completing ICS Form 221 ................................................................................. 60

ICS Form 226 — Individual Personnel Rating............................................................................ 61

ICS Form 308 — Resource Order Form...................................................................................... 63

*Indicates an ICS Form that is used in this course.
EMS FUNCTIONS IN ICS

A-4

This page intentionally left blank.
EMS FUNCTIONS IN ICS

A-5

Appendix A Introduction

This appendix includes a full set of the NIMS-approved ICS forms as of August 2010. You can 

access the most up-to-date forms and instructions from the ICS Resource Center website located 

at http://training.fema.gov/EMIWeb/IS/ICSResource/index.htm.
EMS FUNCTIONS IN ICS

A-6

This page intentionally left blank.
EMS FUNCTIONS IN ICS

A-7

ICS Form 201 — Incident Briefing*

INCIDENT 

BRIEFING

1. INCIDENT NAME 2. DATE PREPARED 3. TIME PREPARED

4. MAP SKETCH

ICS 201 (12/93)

NFES 1325

PAGE 1

5. PREPARED BY (NAME AND POSITION)
EMS FUNCTIONS IN ICS

A-8

6. SUMMARY OF CURRENT ACTIONS

ICS 201 (12/93)

NFES 1325

PAGE 2
EMS FUNCTIONS IN ICS

A-9

7. CURRENT ORGANIZATION

ICS 201 (12/93)

NFES 1325

PAGE 3
EMS FUNCTIONS IN ICS

A-10

8. RESOURCES SUMMARY

RESOURCES 

ORDERED

RESOURCES 

IDENTIFICATION

ETA

ON 

SCENE 

√

LOCATION/ASSIGNMENT

ICS 201 (12/93)

NFES 1325

PAGE 4
EMS FUNCTIONS IN ICS

A-11

Instructions for Completing ICS Form 201

ITEM 

NUMBER ITEM TITLE INSTRUCTIONS

1. Incident Name Print the name assigned to the incident.

2. Date Prepared Enter date prepared (Month, Day, Year).

3. Time Prepared Enter time prepared (24-hour clock).

4. Map Sketch Show perimeter and control lines, resources’ assignments, 

incident facilities, and other special information on a 

sketch map or attached to the topographic or orthophoto 

map.

5. Prepared By Enter the name and position of the person completing the 

form.

6. Summary of 

Current Actions

Enter the strategy and tactics used on the incident and note 

any specific problem areas.

7. Current 

Organization

Enter on the organization chart the names of the 

individuals assigned to each position. Modify the chart as 

necessary.

8. Resources 

Summary

Enter the following information about the resources 

allocated to the incident. Enter the number and type of 

resources ordered.

Resources 

Ordered

Enter the number and type of resources ordered.

Resource 

Identification

Enter the agency three-letter designator, S/T, Kind/Type 

and resource designator.

ETA/On Scene Enter the estimated arrival time and place the arrival time 

or a checkmark in the “on scene” column upon arrival.

Location/

Assignment

Enter the assigned location of the resource and/or the 

actual assignment.

*Note Additional pages may be added to ICS Form 201 if 

needed.
EMS FUNCTIONS IN ICS

A-12

This page intentionally left blank.
EMS FUNCTIONS IN ICS

A-13

ICS Form 202 — Incident Objectives*

INCIDENT 

OBJECTIVES

1. INCIDENT NAME 2. DATE PREPARED 3. TIME PREPARED

4. OPERATIONAL PERIOD (DATE/TIME)

5. GENERAL CONTROL OBJECTIVES FOR THE INCIDENT (INCLUDE ALTERNATIVES)

6. WEATHER FORECAST FOR OPERATIONAL PERIOD

7. GENERAL SAFETY MESSAGE

8. ATTACHMENTS (√ IF ATTACHED)

ORGANIZATION LIST (ICS 203) MEDICAL PLAN (ICS 206)

ASSIGNMENT LIST (ICS 204) INCIDENT MAP

COMMUNICATIONS PLAN (ICS 205) TRAFFIC PLAN

202 ICS 3-80 9. PREPARED BY 

(PLANNING SECTION CHIEF)

10. APPROVED BY 

(INCIDENT COMMANDER)
EMS FUNCTIONS IN ICS

A-14

Instructions for Completing ICS Form 202

ITEM 

NUMBER ITEM TITLE INSTRUCTIONS

Note: ICS Form 202, Incident Objectives, serves only as a 

cover sheet and is not considered complete until 

attachments are included.

1. Incident Name Print the name assigned to the incident.

2. Date Prepared Enter date prepared (Month, Day, Year).

3. Time Prepared Enter time prepared (24-hour clock).

4. Operational 

Period

Enter the time interval for which the form applies. Record 

the start time and end time and include date(s).

5. General Control 

Objectives 

(include 

alternatives)

Enter short, clear, and concise statements of the objectives 

for managing the incident, including alternatives. The 

control objectives usually apply for the duration of the 

incident.

6. Weather 

Forecast for 

Operational 

Period

Enter weather prediction information for the specified 

operational period.

7. General/Safety 

Message

Enter information such as known safety hazards and 

specific precautions to be observed during this operational 

period. If available, a safety message should be referenced 

and attached.

8. Attachments The form is ready for distribution when appropriate 

attachments are completed and attached to it.

9. Prepared By Enter the name and position of the person completing the 

form (usually the Planning Section Chief).

10. Approved By Enter the name and position of the person approving the 

form (usually the Incident Commander).
EMS FUNCTIONS IN ICS

A-15

ICS Form 203 — Organization Assignment List*

ORGANIZATION ASSIGNMENT LIST 1. INCIDENT NAME 2. DATE PREPARED 3. TIME PREPARED

POSITION NAME OPERATIONAL PERIOD (DATE/TIME)

4. INCIDENT COMMANDER AND STAFF

INCIDENT COMMANDER 8. OPERATIONS SECTION

DEPUTY CHIEF

SAFETY OFFICER DEPUTY

INFORMATION OFFICER a. BRANCH I - DIVISION/GROUPS

LIAISON OFFICER BRANCH DIRECTOR

5. AGENCY REPRESENTATIVES DEPUTY

AGENCY NAME DIVISION/GROUP

DIVISION/GROUP

DIVISION/GROUP

DIVISION/GROUP

b. BRANCH II - DIVISION/GROUPS

BRANCH DIRECTOR

6. PLANNING SECTION DEPUTY

CHIEF DIVISION/GROUP

DEPUTY DIVISION/GROUP

RESOURCES UNIT DIVISION/GROUP

SITUATION UNIT DIVISION/GROUP

DOCUMENTATION UNIT DIVISION/GROUP

DEMOBILIZATION UNIT c. BRANCH III - DIVISION/GROUPS

TECHNICAL SPECIALISTS BRANCH DIRECTOR

DEPUTY

DIVISION/GROUP

DIVISION/GROUP

DIVISION/GROUP

7. LOGISTICS SECTION DIVISION/GROUP

CHIEF d. AIR OPERATIONS BRANCH

DEPUTY AIR OPERATIONS BR. DIR.

a. SUPPORT BRANCH AIR TACTICAL GROUP SUP.

DIRECTOR AIR SUPPORT GROUP SUP.

SUPPLY UNIT HELICOPTER COORDINATOR

FACILITIES UNIT AIR TANKER/FIXED-WING CRD.

GROUND SUPPORT UNIT FINANCE SECTION

b. SERVICE BRANCH CHIEF

DIRECTOR DEPUTY

TIME UNIT

COMMUNICATIONS UNIT PROCUREMENT UNIT

MEDICAL UNIT COMPENSATION/CLAIMS UNIT

FOOD UNIT COST UNIT

203 ICS 1-82

9. PREPARED BY (RESOURCES UNIT)
EMS FUNCTIONS IN ICS

A-16

Instructions for Completing ICS Form 203

ITEM 

NUMBER ITEM 

TITLE

INSTRUCTIONS

An Organization Assignment List may be completed any 

time the number of personnel assigned to the incident 

increases or decreases or a change in assignment occurs.

1. Incident 

Name

Print the name assigned to the incident.

2. Date 

Prepared

Enter date prepared (Month, Day, Year).

3. Time 

Prepared

Enter time prepared (24-hour clock).

Operational 

Period

Enter the time interval for which the assignment list applies. 

Record the start time and end time and include date(s).

4.–8. Enter the names of personnel staffing each of the listed 

positions. Use at least first initial and last name. For Unit, 

indicate Unit Leader and for Divisions/Groups, indicate 

Division/Group Supervisor. Use an additional page if more 

than three branches are activated.

9. Prepared by Enter the name of the Resources Unit member preparing the 

form. Attach form to the Incident Objectives.
EMS FUNCTIONS IN ICS

A-17

ICS Form 204 — Assignment List*

1. BRANCH 2. DIVISION/GROUP

ASSIGNMENT LIST

3. INCIDENT NAME 4. OPERATIONAL PERIOD

DATE

TIME 

5. OPERATIONS PERSONNEL

OPERATIONS CHIEF DIVISION/GROUP SUPERVISOR 

BRANCH DIRECTOR AIR TACTICAL GROUP SUPERVISOR 

6. RESOURCES ASSIGNED THIS PERIOD

STRIKE TEAM/TASK FORCE 

RESOURCE DESIGNATOR LEADER NUMBER PERSONS

TRANS. 

NEEDED

DROP OFF

PT/TIME

PICK-UP

PT/TIME

7. CONTROL OPERATIONS

8. SPECIAL INSTRUCTIONS

9. DIVISION/GROUP COMMUNICATIONS SUMMARY

FUNCTION FREQ. SYSTEM CHAN. FUNCTION FREQ. SYSTEM CHAN.

COMMAND

LOCAL

SUPPORT

LOCAL

REPEAT REPEAT

DIV/GROUP

TACTICAL

GROUND-TOAIR

10. PREPARED BY (RESOURCES UNIT) 11. APPROVED BY (PLANNING SECTION CHIEF) DATE TIME
EMS FUNCTIONS IN ICS

A-18

Instructions for Completing ICS Form 204

ITEM 

NUMBER ITEM TITLE INSTRUCTIONS

1. Branch Enter the identifier assigned to the Branch. This may be a 

Roman Numeral, function, or jurisdiction.

2. Division/Group Either circle the appropriate designation (DIVISION or 

GROUP) or cross out the inappropriate designation. Enter 

the identifier of the Division or Group. A separate sheet is 

used for each Division or Group. 

3. Incident Name Print the name assigned to the incident.

4. Operational 

Period

Enter the time interval for which the form applies. Record 

the start time and end time and include date(s).

5. Operations 

Personnel

Enter the name of the Operations Chief, applicable Branch 

Director, and Division Supervisor.

6. Resources 

Assigned

Strike 

Team/Task 

Force/Resource 

Designator

List resource designators, leader name, and total number of 

personnel for strike teams, task forces, or single resources 

assigned. Indicate whether the resource needs 

transportation to the assigned work area. If transportation 

is needed, enter the pick-up and drop-off points as well as 

the reporting time to these points. 

7. Control 

Operations

Provide a statement of the tactical objectives to be 

achieved within the operational period. Include any 

special instructions for individual resources.

8. Special 

Instructions

Enter statement calling attention to any safety problems or 

specific precautions to be exercised or other important 

information.

9. Division 

Communication 

Summary

This information is taken from the ICS Form 205 (Incident 

Radio Communications Plan). Indicate the Command, 

Division, Tactical, Support, and Ground-to-Air frequencies 

as appropriate.

10. Prepared By Enter the name of the Resources Unit Member preparing 

the form.

11. Approved By Enter the name of the person approving the form (Planning 

Section Chief) as well as the time and date of approval.
EMS FUNCTIONS IN ICS

A-19

ICS Form 205 — Incident Radio Communications Plan*
EMS FUNCTIONS IN ICS

A-20

Instructions for Completing ICS Form 205

ITEM 

NUMBER ITEM TITLE INSTRUCTIONS

1. Incident Name Print the name assigned to the incident.

2. Date/Time Prepared Enter date (month, day, year) and time 

prepared (24-hour clock).

3. Operational Period 

Date/Time

Enter the date and time interval for which 

the Radio Communications Plan applies. 

Record the start time and end time and 

include date(s).

4. Basic Radio Channel

Utilization

System/Cache

Enter the radio cache system(s) assigned 

and used on the incident (e.g., Boise 

Cache, FIREMARS, Region 5 Emergency 

Cache, VHF, UHF, 800-mHz, etc.).

Channel Number Enter the radio channel numbers assigned.

Function Enter the function each channel number is 

assigned (i.e., command, support, division 

tactical, and ground-to-air).

Frequency Enter the radio frequency tone number 

assigned to each specified function (e.g., 

153.400).

Assignment Enter the ICS organization assigned to 

each of the designated frequencies (e.g., 

Branch I, Division A).

Remarks This section should include narrative 

information regarding special situations.

5. Prepared By Enter the name of the Communications 

Unit Leader preparing the form.
EMS FUNCTIONS IN ICS

A-21

ICS Form 206 — Medical Plan*

MEDICAL 

PLAN

1. INCIDENT NAME 2. DATE PREPARED 3. TIME PREPARED 4. OPERATIONAL PERIOD

5. INCIDENT MEDICAL AID STATIONS

MEDICAL AID STATIONS LOCATION PARAMEDICS

YES NO

6. TRANSPORTATION

A. AMBULANCE SERVICES

NAME ADDRESS PHONE PARAMEDICS

YES NO

B. INCIDENT AMBULANCES

NAME LOCATION PARAMEDICS

YES NO

7. HOSPITALS

NAME ADDRESS TRAVEL TIME PHONE HELIPAD BURN CENTER

AIR GRND YES NO YES NO

8. MEDICAL EMERGENCY PROCEDURES

206 ICS 8-78

9. PREPARED BY (MEDICAL UNIT LEADER) 10. REVIEWED BY (SAFETY OFFICER)
EMS FUNCTIONS IN ICS

A-22

Instructions for Completing ICS Form 206

ITEM 

NUMBER ITEM TITLE INSTRUCTIONS

1. Incident Name Print the name assigned to the incident.

2. Date Prepared Enter date prepared (Month, Day, Year).

3. Time Prepared Enter time prepared (24-hour clock).

4. Operational 

Period

Date/Time

Record the date and time of the operational period for 

which this plan is in effect.

5. Incident 

Medical Aid 

Stations

Enter name and location of incident medical aid 

stations (e.g., Cajon Staging Area, Cajon Campground) 

and indicate with a √ (check mark) if paramedics are 

located at the site.

6. Transportation

A. Ambulance 

Services

List name and address of ambulance services (e.g., 

Shaeffer, 4358 Brown Parkway, Corona). Provide 

phone number and indicate if ambulance company has 

paramedics.

B. Incident 

Ambulances

Indicate name of organization providing ambulances 

and the incident location. Also indicate if paramedics 

are aboard.

7. Hospitals List hospitals which could serve this incident: name, 

address, the travel time by air and ground from the 

incident to the hospital, phone number, and indicate 

with a √ (check mark) if the hospital is a burn center 

and has a helipad. 

8. Medical 

Emergency 

Procedures

Note any special emergency instructions for use by 

incident personnel.

9. Prepared By Enter the name of the Medical Unit Leader preparing 

the form.

10. Reviewed By Obtain the name of the Safety Officer who must 

review the plan.
EMS FUNCTIONS IN ICS

A-23

ICS Form 207 — Organizational Chart
EMS FUNCTIONS IN ICS

A-24

This page intentionally left blank.
EMS FUNCTIONS IN ICS

A-25

ICS Form 209 — Incident Status Summary
EMS FUNCTIONS IN ICS

A-26
EMS FUNCTIONS IN ICS

A-27

Instructions for Completing ICS Form 209

ITEM 

NUMBER INSTRUCTIONS

1. Enter date and time report completed (mandatory).

2. Check appropriate space (mandatory-no computer entry).

3. Provide name given to incident by Incident Commander or Agency 

(mandatory).

4. Enter number assigned to incident by Agency (mandatory).

5. Enter first initial and last name of Incident Commander (optional).

6. Enter Agency or Municipality (mandatory).

7. Enter County where incident is occurring (optional).

8. Enter type incident, e.g., wildland fire (enter fuel type), structure fire, 

hazardous chemical spill, etc. (mandatory).

9. Enter legal description and general location. Use remarks for additional 

data if necessary (mandatory).

10. Enter date and Zulu time incident started (mandatory--maximum of 6 

characters for date and 4 characters for time).

11. Enter specific cause or under investigation (mandatory).

12. Enter area involved, e.g., 50 acres, top three floors of building, etc. 

(mandatory).

13. Enter estimate of percent of containment (mandatory).

14. Enter estimate of date and time of total containment (mandatory).

15. Enter estimated date and time of control (mandatory).

16. Enter actual date and time fire was declared controlled (mandatory).

17. Report significant threat to structures, watershed, timber, wildlife habitat, or 

other valuable resources (mandatory).

18. Enter control problems, e.g., accessibility, fuels, rocky terrain, high winds, 

structures (mandatory).

19. Enter estimated dollar value of total damage to date. Include structures, 

watershed, timber, etc. Be specific in remarks (mandatory).

20. Enter estimate of values saved as result of all suppression efforts (optional).

21. Enter any serious injuries or deaths which have occurred since the last 

report. Be specific in remarks (mandatory).
EMS FUNCTIONS IN ICS

A-28

22. Indicate the extent of line completed by chains or other units of 

measurement (optional).

23. Indicate line to be constructed by chains or other units of measurement 

(optional).

24. Indicate current weather conditions at the incident (mandatory).

25. Indicate predicted weather conditions for the next operational period 

(mandatory).

26. Provide total incident cost to date (optional).

27. Provide estimated total cost for entire incident (optional).

28. List agencies which have resources assigned to the incident (mandatory).

29. Enter resource information under appropriate Agency column by single 

resource or strike team (mandatory).

30. List by name those agencies which are providing support, e.g., Salvation

Army, Red Cross, law enforcement, National Weather Service, etc. 

(mandatory).

31. The remarks space can be used to (1) list additional resources not covered in 

Section 28/29; (2) provide more information on location; (3) enter additional 

information regarding threat control problems, anticipated release, or 

demobilization, etc. (mandatory).

32. This will normally be the incident Situation Unit Leader (mandatory).

33. This will normally be the incident Planning Section Chief (mandatory).

34. The ID of the Agency entering the report will be entered (optional-no 

computer entry).
EMS FUNCTIONS IN ICS

A-29

ICS Form 210 — Status Change Card
EMS FUNCTIONS IN ICS

A-30

This page intentionally left blank.
EMS FUNCTIONS IN ICS

A-31

ICS Form 211 — Check-in List*
EMS FUNCTIONS IN ICS

A-32

Instructions for Completing ICS Form 211

ITEM 

NUMBER ITEM TITLE INSTRUCTIONS

Incident Dispatchers, upon receipt of a check-in message by 

radio, record the information on the Check-in List (ICS 

Form 211) and then give the information to the Resources 

Unit.

Resource Unit Recorders, upon receipt of information on an 

in-person check in, record the information directly onto the 

Check-in List form.

1. Incident Name Print the name assigned to the incident.

2. Check-in 

Location

Place a checkmark in the appropriate box indicating where 

the resource or person checked in at the incident.

3. Date/Time 

Prepared

Enter date (Month, Day, Year) and time prepared (24-hour 

clock).

4. List Personnel 

(Overhead) by 

Agency & 

Name

Use this section to list agency three-letter designator and 

individual names for all overhead (supervisory) personnel. 

When listing equipment, use three-letter designator, indicate 

if resource is a single resource, task force, or strike team; 

enter kind of resource (letter for single resources, Number 

1–3 for Strike Team); enter type of resource (1-4), and 

designated identification number.

5. Order/Request 

Number Order number will be assigned by Agency dispatching the 

resources or personnel to the incident.

6. Date/Time 

Check-In

Self-explanatory.

7. Leader’s Name Self-explanatory.

8. Total Number 

Personnel

Enter total number of personnel in strike teams, task forces, 

or manning single resources. Include leaders.

9. Manifest Indicate if a manifest was prepared.

10. Crew Weight or 

Individual’s 

Weight

Self-explanatory.

11. Home Base Location at which the resource/individual is normally 

assigned. (May not be departure location.)

12. Departure Point Location from which resource/individual departed for this 

incident.
EMS FUNCTIONS IN ICS

A-33

13. Method of 

Travel

Means of travel to incident (bus, truck, engine, personal 

vehicle, etc.).

14. Incident 

Assignment

Assignment at time of dispatch.

15. Other 

Qualifications

List any other ICS position the individual has been trained 

to fill.

16. Sent to Enter initials and time that the information pertaining to that 

entry was sent to the Resources Unit.

17. Page Indicate page number and number of pages being used for 

Check-In at this location.

18. Prepared by Enter name of Check-In Recorder.
EMS FUNCTIONS IN ICS

A-34

This page intentionally left blank.
EMS FUNCTIONS IN ICS

A-35

ICS Form 213 — General Message

GENERAL MESSAGE

TO: POSITION:

FROM: POSITION:

SUBJECT: DATE: TIME:

MESSAGE:

SIGNATURE: POSITION:

REPLY:

DATE: TIME: SIGNATURE/POSITION:
EMS FUNCTIONS IN ICS

A-36

This page intentionally left blank.
EMS FUNCTIONS IN ICS

A-37

ICS Form 214 — Unit Log* 

UNIT LOG 1. Incident Name 2. Date Prepared 3. Time Prepared

4. Unit Name/Designators 5. Unit Leader (Name and Position) 6. Operational Period

7. Personnel Roster Assigned

Name ICS Position Home Base

8. Activity Log

Time Major Events

9. Prepared by (Name and Position)
EMS FUNCTIONS IN ICS

A-38

This page intentionally left blank.
EMS FUNCTIONS IN ICS

A-39

ICS Form 215 — Operational Planning Worksheet
EMS FUNCTIONS IN ICS

A-40

This page intentionally left blank.
EMS FUNCTIONS IN ICS

A-41

ICS Form 215a — Incident Action Plan Safety Analysis
EMS FUNCTIONS IN ICS

A-42

This page intentionally left blank.
EMS FUNCTIONS IN ICS

A-43

ICS Form 216 — Radio Requirements Worksheet
EMS FUNCTIONS IN ICS

A-44

This page intentionally left blank.
EMS FUNCTIONS IN ICS

A-45

ICS Form 217 — Radio Frequency Assignment Worksheet
EMS FUNCTIONS IN ICS

A-46

This page intentionally left blank.
EMS FUNCTIONS IN ICS

A-47

ICS Form 218 — Support Vehicle Inventory
EMS FUNCTIONS IN ICS

A-48

Instructions for Completing ICS Form 218

ITEM 

NUMBER ITEM TITLE INSTRUCTIONS

Note:

a. The Ground Support Unit Leader may prefer to 

use separate sheets for each type of support 

vehicle (e.g., buses, pickups, and food tenders).

b. More than one line may be used to record

information on each vehicle. If this is done, 

separate individual vehicle entries with a heavy 

line.

c. Several pages may be used. When this occurs, 

number the pages consecutively (in the page 

number box at bottom of the form, e.g. 1 of x, 

etc.).

1. Incident Name Print the name assigned to the incident.

2. Date Prepared Enter date (month, day, year) prepared.

3. Time Prepared Enter time prepared (24-hour clock).

4. Vehicle 

Information

Record the following vehicle information:

Type a. Specific vehicle type (e.g., bus, stakeside, etc.). 

It is also useful to note whether the vehicle is 

gasoline or diesel powered.

Make b. Vehicle manufacturer name (e.g., GMC, 

International).

Capacity/Size c. Vehicle capacity/size, (e.g., 30-person bus, 3/4 

ton truck).

Owner d. Owner of vehicle (agency or private owner).

ID Number e. Serial or other identification number.

Location f. Location of vehicle.

Release Time g. Time vehicle is released from the incident.

5. Prepared By Enter the name and position of the person completing the 

form.
EMS FUNCTIONS IN ICS

A-49

ICS Form 219-2 — Card Stock: Green (Crew)
EMS FUNCTIONS IN ICS

A-50

This page intentionally left blank.
EMS FUNCTIONS IN ICS

A-51

ICS Form 219-4 — Card Stock: Blue (Helicopter)
EMS FUNCTIONS IN ICS

A-52

This page intentionally left blank.
EMS FUNCTIONS IN ICS

A-53

ICS Form 219-6 — Card Stock: Orange (Aircraft)
EMS FUNCTIONS IN ICS

A-54

This page intentionally left blank.
EMS FUNCTIONS IN ICS

A-55

ICS Form 219-7 — Card Stock: Yellow (Dozer)
EMS FUNCTIONS IN ICS

A-56

This page intentionally left blank.
EMS FUNCTIONS IN ICS

A-57

ICS Form 220 — Air Operations Summary
EMS FUNCTIONS IN ICS

A-58

This page intentionally left blank.
EMS FUNCTIONS IN ICS

A-59

ICS Form 221 — Demobilization Checkout

DEMOBILIZATION CHECKOUT

1. Incident Name/Number 2. Date/Time 3. Demob No.

4. Unit/Personnel Released

5. Transportation Type/No.

6. Actual Release Date/Time 7. Manifest Yes No Number

8. Destination 9. Notified Agency Region Area Dispatch

Name: 

Date: 

10. Unit Leader Responsible For Collecting Performance Rating

11.Unit/Personnel

You and your resources have been released subject to signoff from the following:

Demob. Unit Leader check appropriate box

Logistics Section

Supply Unit 

Communications Unit 

Facilities Unit 

Ground Support Unit Leader 

Planning Section

DOCUMENTATION UNIT 

Finance Section

TIME UNIT 

Other

12. Remarks

13. Prepared by (include Date and Time)
EMS FUNCTIONS IN ICS

A-60

Instructions for Completing ICS Form 221

ITEM 

NUMBER ITEM TITLE INSTRUCTIONS

1. Incident 

Name/No.

Print the name and/or number assigned to the incident.

2. Date/Time Enter date and time prepared.

3. Demob No. Enter Agency Request Number, Order Number, or Agency 

Demob Number if applicable.

4. Unit/Personnel 

Released

Enter appropriate vehicle or Strike Team/Task Force ID. 

Number(s) and Leader’s name or individual overhead or staff 

personnel being released.

5. Transportation 

Type/No.

Method and vehicle ID. Number for transportation back to 

home unit. Enter N/A if own transportation is provided. 

*Additional specific details should be included in Remarks, 

block #12.

6. Actual Release 

Date/Time

To be completed at conclusion of demobilization at time of 

actual release from incident. Would normally be last item of 

form to be completed.

7. Manifest Mark appropriate box. If yes, enter manifest number. Some 

agencies require a manifest for air travel.

8. Destination Location to which Unit or personnel have been released, i.e., 

Area, Region, Home base, Airport, Mobilization Center, etc.

9. Area/Agency/

Region Notified

Identify Area, Agency, or Region notified and enter date and 

time of notification.

10. Unit Leader 

Responsible for 

Collecting 

Performance 

Ratings

Self-explanatory. Note, not all agencies require these ratings.

11. Unit/Personnel Demobilization Unit Leader will identify with a check in the 

box to the left of those units requiring check-out. Identified 

Unit Leaders are to initial to the right to indicate release.

Blank boxes are provided for any additional check (unit 

requirements as needed), i.e., Safety Officer, Agency 

Representative, etc.

12. Remarks Any additional information pertaining to demobilization or 

release.
EMS FUNCTIONS IN ICS

A-61

ICS Form 226 — Individual Personnel Rating
EMS FUNCTIONS IN ICS

A-62

This page intentionally left blank.
EMS FUNCTIONS IN ICS

A-63

ICS Form 308 — Resource Order Form
EMS FUNCTIONS IN ICS

A-64
EMS FUNCTIONS IN ICS

B-1

APPENDIX B

NONAPPROVED ICS FORMS
EMS FUNCTIONS IN ICS

B-2

This page intentionally left blank.
EMS FUNCTIONS IN ICS

B-3

TABLE OF CONTENTS

Appendix B Introduction ............................................................................................................. 5

ICS Form MC-305 — Multi-Casualty Branch Worksheet.......................................................... 7

ICS Form MC-306 — Multi-Casualty Recorder Worksheet*..................................................... 9

ICS Form MC-308 — Multi-Casualty Hospital Resource Availability ...................................... 11

ICS Form MC-310 — Multi-Casualty Ambulance Resource Status........................................... 13

ICS Form MC-312 — Medical Supply Receipt and Inventory Form ......................................... 15

*Indicates an ICS Form that is used in this course.
EMS FUNCTIONS IN ICS

B-4

This page intentionally left blank.
EMS FUNCTIONS IN ICS

B-5

Appendix B Introduction

This appendix includes forms and worksheets that are not NIMS-approved but you may find 

useful. You may have similar forms in your jurisdictions that meet the same purposes as the 

forms and worksheets provided here. 
EMS FUNCTIONS IN ICS

B-6

This page intentionally left blank.
EMS FUNCTIONS IN ICS

B-7

ICS Form MC-305 — Multi-Casualty Branch Worksheet

MULTI-CASUALTY

BRANCH WORKSHEET

INCIDENT NAME DATE TIME

INCIDENT COMMANDER MULTI-CASUALTY BRANCH DIRECTOR

MEDICAL CACHES

AIR AMBULANCES

LAW ENFORCEMENT

RADIO FREQUENCIES

CORONER

RED CROSS

CHAPLAIN

BUSES

MENTAL HEALTH

ICS-MC-305

MEDICAL GROUP/DIVISION 

SUPERVISOR

TREATMENT UNIT LEADER

IMMEDIATE TREATMENT 

MANAGER

HOSPITAL TEAM

DELAYED TREATMENT 

MANAGER

HOSPITAL TEAM

MINOR TREATMENT 

MANAGER

TREATMENT DISPATCH 

MANAGER

TRIAGE UNIT LEADER

TRIAGE PERSONNEL

MORGUE MANAGER

MEDICAL SUPPLY 

COORDINATOR

PATIENT TRANSPORTATION 

GROUP SUPERVISOR

MEDICAL COMMUNICATIONS 

COORDINATOR

AIR AMBULANCE 

COORDINATOR

GROUND AMBULANCE 

COORDINATOR
EMS FUNCTIONS IN ICS

B-8

This page intentionally left blank.
EMS FUNCTIONS IN ICS

B-9

ICS Form MC-306 — Multi-Casualty Recorder Worksheet*

MULTI-CASUALTY

RECORDER WORKSHEET

Ambulance 

Company

Ambulance 

ID Number

Patient Triage 

Tag Number

Patient 

Status

Hospital 

Destination

Off Scene 

Time

(I) (D) (M) ----- : -----

(I) (D) (M) ----- : -----

(I) (D) (M) ----- : -----

(I) (D) (M) ----- : -----

(I) (D) (M) ----- : -----

(I) (D) (M) ----- : -----

(I) (D) (M) ----- : -----

(I) (D) (M) ----- : -----

(I) (D) (M) ----- : -----

(I) (D) (M) ----- : -----

(I) (D) (M) ----- : -----

(I) (D) (M) ----- : -----

(I) (D) (M) ----- : -----

(I) (D) (M) ----- : -----

(I) (D) (M) ----- : -----

(I) (D) (M) ----- : -----

(I) (D) (M) ----- : -----

(I) (D) (M) ----- : -----

(I) (D) (M) ----- : -----

ICS-MC-306 (12/89)
EMS FUNCTIONS IN ICS

B-10

This page intentionally left blank.
EMS FUNCTIONS IN ICS

B-11

ICS Form MC-308 — Multi-Casualty Hospital Resource Availability

MULTI-CASUALTY

HOSPITAL RESOURCE AVAILABILITY

HOSPITAL CRITICAL NON-CRITICAL

A

U

A

U

A

U

A

U

A

U

A

U

A

U

A

U

A=AVAILABLE U=USED 

ICS-MC-308 (12/89)
EMS FUNCTIONS IN ICS

B-12

This page intentionally left blank.
EMS FUNCTIONS IN ICS

B-13

ICS Form MC-310 — Multi-Casualty Ambulance Resource Status

MULTI-CASUALTY

AMBULANCE RESOURCE STATUS

AGENCY UNIT NO. IN OUT

ICS-MC-310 (01/08/92)
EMS FUNCTIONS IN ICS

B-14

This page intentionally left blank.
EMS FUNCTIONS IN ICS

B-15

ICS Form MC-312 — Medical Supply Receipt and Inventory Form

MEDICAL SUPPLY

RECEIPT & INVENTORY FORM

INCIDENT NAME: INCIDENT #: 

A. Supplies/Equipment received from: DATE: / / .

Agency: Unit ID#: Name:

(Whenever possible, use masking tape and markers to identify all equipment)

B. Supplies/Equipment Received by:

NAME: INCIDENT POSITION:

No. Item Description (Print All Entries) Unit* Amount

*Unit - list a measurable description of the item (gauge, gm, ml, bag, doz., etc.) 

Form distribution: (Use carbon paper) Original - Medical Supply Coordinator 

Copy - Source of Supply ICS-MC-312 (1/8/92) 

INCIDENT RE-IMBURSEMENT OF ANY SUPPLIES/EQUIPMENT WILL BE BASED 

ONLY UPON ORIGINAL FORM LISTINGS.

1.

2.

3.

4.

5.

6.

7.

8.

9. 

10.

11.

12.

16.

17.

18.
This page intentionally left blank.
EMS FUNCTIONS IN ICS

C-1

APPENDIX C

FIELD OPERATIONS GUIDE (ICS 420-1) 

EXCERPT — MULTICASUALTY
EMS FUNCTIONS IN ICS

C-2

This page intentionally left blank.
EMS FUNCTIONS IN ICS

C-3
EMS FUNCTIONS IN ICS

C-4
EMS FUNCTIONS IN ICS

C-5
EMS FUNCTIONS IN ICS

C-6
EMS FUNCTIONS IN ICS

C-7
EMS FUNCTIONS IN ICS

C-8
EMS FUNCTIONS IN ICS

C-9
EMS FUNCTIONS IN ICS

C-10
EMS FUNCTIONS IN ICS

C-11
EMS FUNCTIONS IN ICS

C-12
EMS FUNCTIONS IN ICS

C-13
EMS FUNCTIONS IN ICS

C-14
EMS FUNCTIONS IN ICS

D-1

APPENDIX D

NIMS TYPED RESOURCE DEFINITIONS
EMS FUNCTIONS IN ICS

D-2

This page intentionally left blank.
EMS FUNCTIONS IN ICS

D-3
EMS FUNCTIONS IN ICS

D-4
EMS FUNCTIONS IN ICS

D-5
EMS FUNCTIONS IN ICS

D-6
EMS FUNCTIONS IN ICS

D-7
EMS FUNCTIONS IN ICS

D-8
EMS FUNCTIONS IN ICS

D-9
EMS FUNCTIONS IN ICS

D-10
EMS FUNCTIONS IN ICS

D-11
EMS FUNCTIONS IN ICS

D-12
EMS FUNCTIONS IN ICS

D-13
EMS FUNCTIONS IN ICS

D-14
EMS FUNCTIONS IN ICS

D-15
EMS FUNCTIONS IN ICS

D-16
EMS FUNCTIONS IN ICS

D-17
EMS FUNCTIONS IN ICS

D-18
EMS FUNCTIONS IN ICS

D-19
EMS FUNCTIONS IN ICS

D-20
EMS FUNCTIONS IN ICS

D-21
EMS FUNCTIONS IN ICS

D-22
EMS FUNCTIONS IN ICS

D-23
This page intentionally left blank.
EMS FUNCTIONS IN ICS

E-1

APPENDIX E

SPECIAL EVENTS PLANNING CHECKLIST
EMS FUNCTIONS IN ICS

E-2

This page intentionally left blank.
EMS FUNCTIONS IN ICS

E-3

Appendix E Introduction

This appendix contains a Special Events Checklist for EMS personnel. It is excerpted from the 

IS-15.B Special Events Contingency Planning for Public Safety Agencies course and can be 

accessed at: http://training.fema.gov/EMIWeb/IS/courseoverview.aspx?code=is-15.b.
EMS FUNCTIONS IN ICS

E-4

This page intentionally left blank.
EMS FUNCTIONS IN ICS

E-5
EMS FUNCTIONS IN ICS

E-6
EMS FUNCTIONS IN ICS

E-7
EMS FUNCTIONS IN ICS

E-8
EMS FUNCTIONS IN ICS

E-9
This page intentionally left blank.