Incident Command System (ICS) Overview

• Learning Objectives: To understand Incident Command System (ICS) comprehensively, including its principles, organizational structure (command and general staff), and the entry point for medical responders.

Disaster Definition

• A disaster refers to a major incident that overwhelms local facilities due to location, number of casualties, and severity of injuries.

"Yo-Yo-48 Rule"

• Individuals are on their own for the first 48 hours following a disaster.

Major Incidents

• Simple Major Incident: The local infrastructure remains intact, as seen in the 1990 Killer Earthquake in Dagupan city.
• Compound Major Incident: Infrastructure is destroyed and non-functional, including transportation, communication, and medical facilities, as exemplified by Typhoon Yolanda.

Incident Command System (ICS)

• ICS is a management system designed for organizing and ensuring an effective response by providing command, coordination, communication, and control.
• It directs efforts of individual agencies toward a common goal, to stabilize an emergency/disaster, and protect life, property, and the environment.
• ICS adopts a standardized, all-hazard incident management concept with an integrated organizational structure
• The structure is adaptable to match the complexity/demands of single or multiple incidents and is not hindered by jurisdictional boundaries.
• The purpose of ICS is to meet the needs of incidents of any kind/size
• ICS allows inter-agency/organization personnel to rapidly blend into a common management structure, ensure cost-effectiveness by avoiding duplication of efforts, and address common management weaknesses in MCI/disasters.

Common Management Weaknesses During MCI/Disaster

• Unclear chain of command, poor communication, lack of a common/flexible pre-designed management structure, and failure to plan for demobilization, rehabilitation, and return to normal service levels.

Benefits from ICS

• Greater Efficiency is achieved through trained personnel who direct/coordinate efforts effectively in crisis, managing internal/external crisis effectively.
• Better Coordination facilitates inter-agency/organization coordination during crisis.
• Effective Communication relies on using common terminology.

ICS Principles

• Span of Control: One person can effectively supervise a limited number of personnel during response and recovery, ideally 5 to 8 people, ensuring safety, accountability, and monitoring.
• Chain of Command: Orderly hierarchical line of command within the ranks defines how positions fit together.
• Unity of Command: Each individual is accountable to a single designated supervisor, creating a system where you know whom to talk to and clarifies reporting relationships.
• Common Terminology: Plain, simplistic language should be used to communicate effectively through clear text
• Plain English, avoiding 10-codes.
• Pre-designated Incident Location and Facilities: Pre-determined, temporary sites and facilities are used during response, including standard perimeters which include: Impact zone/Hot Zone, Secondary Area/Warm Zone, and Tertiary Area/Cold Zone.

Incident Command Post (ICP)

• A pre-designated, temporary facility serves as the base of operations located in the immediate vicinity of the incident, where primary command functions are performed.
• There is only one ICP per incident.
• Guidelines for Establishing ICP include positioning away from incident noise and confusion, outside the present and potential hazard zone, within view of the incident, and announcing ICP activation and location.

Staging Area

• A staging area is a temporary location where resources stay awaiting assignments, located close to the incident but out of the immediate impact zone, and within 5 minutes of the location of tactical assignment.
• Guidelines when establishing staging include, having different access routes for incoming and outgoing resources, being large enough to accommodate available resources and have room for growth, including necessary security controls.

Benefits of Staging Area

• Provide locations for immediately available resources to await active assignments and to be formed into operational units like task forces and strike teams.
• Staging also provides for accountability by having available personnel and resources together in one location, safe locations for personnel and equipment to await assignments, preventing resources from freelancing, and minimizing excessive communications of resources calling for assignments.
• Staging controls and assists the check-in of personnel arriving at the incident via privately owned vehicles or other private means and allows the Operations Section Chief or IC to properly plan for resource use and provide for contingencies.

Incident Location and Facilities

• Extrication Area: Area where patients are disentangled and removed from a hazardous environment, allowing them to be moved to the triage area.
• Decontamination Area: Special area for removing the AGENT from any patients or responders, located AFTER the extrication area and BEFORE triage area.
• Triage Area: A sorting area where all patients are assessed and tagged according to their injuries.
• Treatment Area (Advance Medical Post): 2nd triage happens before entering Treatment area, with a more thorough on-scene assessment, where treatment takes place with in the standard of EMS system.
• Transportation Area: Area where ambulances and crews are organized to transport patient from treatment sector to the hospital.
• Supply Area: Area where extra equipment and supplies are placed for dispersal to other areas as needed.
• Rehabilitation Area: Provides treatment and rest to emergency responders working at the scene and ensures the safety and health of emergency workers who might be injured.

Command Types

• Single Command: Based on first arriving emergency units, the Initial Incident Commander begins assessment of incident; Rescue, Triage, Treatment, Transport.
• Unified Command: Incidents involve jurisdictions or agencies involved in the decision making and planning process. It insures the plan is communicated and supported by all resources assembled, the control of joint operations, maximum use of resources, use in massive or long term response.

Incident Commander Responsibilities

• Sets incident objectives in order of priority including: 1. Safety, 2. Incident Stabilization, 3. Preservation of Property and Environment.
  • Has overall responsibility at the incident/event and must be fully briefed.

Incident Commander Characteristics

• Leadership, Legal Authority, and Comprehensive Understanding: ability to demonstrate leadership with experience during operations that involve crises and complex, comprehensive operations with legal authority to carry out the responsibilities tied to the position and a comprehensive understanding of incident management and emergency management systems.
• Operational Knowledge: Includes knowledge of emergency response plans, public health law and safety regulations.
• Public Speaking and Media Skills: Includes training and experience to effectively speak publicly and deal with the media; maintain an objective and calm demeanor and quick-thinking skills.

Transfer of Command

• This is the process of moving the responsibility for incident command from one Incident Commander to another.
• Always requires a Transfer of Command Briefing either oral/written or both that covers topics such as current situation, response needs, and available resources.
• Transfer occurs when a more qualified person assumes command, to meet the needs of the incident, and when incident response concludes, transferring incident responsibility back to a home agency.

Command Staff

• Assist the incident commander in commanding the incident by overseeing different aspects of response.
• Safety Officer: Advises the IC on issues regarding incident safety and the safety of all incident personnel and works closely with the Operation section to ensure safety of field personnel during operations.
• Public Information Officer: Advises the IC on public messaging, information dissemination, and media relations, serving as a conduit for information to all external stakeholders.
• Liaison Officer: Assists the IC as a contact person to agency representatives who are helping to support the response operation, providing briefings to supporting agencies.

General Staff

• These staff members carry out the detailed activities and operations under the Incident Commander, Planning, Logistics, Finance/Admin, Operations.
  • Planning: Preparing and documenting Incident Action Plans, collecting, evaluating and displaying incident information, maintaining incident documentation, tracking resources and developing plans for demobilization.
  • Logistics: Order, obtain, maintain and account essential personnel, equipments and supply; setting up food services, transportation and communication planning resources.
  • Finance/Admin: Cost analysis, contract negotiation and monitoring, timekeeping, and compensation for injury or damage to property.
  • Operations: First to be assigned to the incident, directs and coordinates all incident tactical operations.

Operations

• Include: BFP, PNP, Rescue, and Medical. Rescue includes: Extrication, and HazMat. Medical includes Triage, Treatment, and Transport.

Entry Point to ICS

• Skilled medical or EMT personnel typically enter within an ICS through: Incident Commander, Operations Officer, Staging Officer, Medical/Treatment Team Leader.