Mid-Atlantic Rescue Systems, Inc.

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Most EMS responders feel comfortable responding to one patient at a time, with backup from his/her crew, especially if they have been riding for a while. But then…unexpectedly, all hell breaks loose and suddenly you are faced with multiple patients, multiple responders, multiple agencies, and no plans, and it is scary. (Don’t try to deny that!). A critical incident is any traumatic event that is outside the usual range of human experience and can cause stress that can affect the performance of even the most menial of tasks.

Perhaps the most confusing aspect is WHO IS IN CHARGE? Sure, we know that EMS responsibilities center around patient care, FD involves fires, entrapments, and rescues, and police maintain order and traffic flow…and there are probably several other agencies depending on whether it is a business location, a mutual aid scene, whether shelters are needed, and a myriad of other possibilities. The truth is, even if your agency has planned for a mass casualty incident in the past, there is no way plans could have been made to cover every possible contingency.

It is never acceptable, and definitely not advised, but often each responding service wants to take the lead, they want to “be the boss”. Hopefully the multiple agencies have practiced together and will at least recognize the strengths and purpose of each facet. These same agencies have hopefully worked out a command system where the people actually in charge know enough of each responders’ responsibilities, skills, and capabilities. In addition, the “leadership team” needs to be able to work together, act united, and, if need be, accommodate any other agencies that are now also needed. Alot rests on the shoulders of the leadership at any critical incident response, each one must be an example.

“As the incident commander your voice sets the tone for emergency scene operations. It’s imperative that you maintain a calm demeanor, despite the enormity of the incident, provide a brief, specific size-up so your members have an idea what they’re rolling in to, and make clear, specific transmissions,” explains David J Kryger, author of SUPERVISE FROM CENTER, LEAD BY EXAMPLE, and owner of THINK LEADERSHIP CONSULTING INC. “If you yell, sound excited, ignore requests or do not issue instructions where needed, you will create a circus atmosphere. Practice calm radio demeanor at every call, then when the big one hits, it will come natural to you.”

FEMA offers multiple courses that will help guide someone through a critical incident response; their courses cover multiple levels from basic responders to the Incident Command position(s). Some of these courses are online and FREE at FEMA.gov. The online and/or classroom lessons and techniques learned through the National Incident Management System (NIMS) – FEMA and through interagency cooperation and drills, can go a long way to ensuring both the recovery of victims and the safety of responders. Practicing simulated scenarios together will help each participant learn to work with, rely on, and assist all the responders in some of the most difficult tasks.

The keywords are always COOPERATION from the bottom up, and calm, LEVELHEADEDNESS from the top down.

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