1. Northeast Colorado All Hazards Region 1 Mass Casualty Incident Plan Training Section 8 – Roles & Responsibilities

2. Northeast Colorado All Hazards Region 8-2 Overview  Individual Roles & Responsibilities  Case (final)

3. Northeast Colorado All Hazards Region 8-3 Position Descriptions  Medical Branch Director  Medical Group/Division Director  Triage Unit Leader  Triage Personnel  Morgue Manager  Treatment Unit Manager  Treatment Dispatch Manager  Immediate Treatment Manager  Delayed Treatment Manager  Minor Treatment Manager  Transportation Supervisor  Medical Communications Coordinator  Ground Ambulance Coordinator  Medical Supply Coordinator  Strike Teams

4. Northeast Colorado All Hazards Region 8-4 Medical Branch Director Definition: Most Qualified ALS EMT Commanded by: Incident Commander; Operations Chief Subordinates: All Medical Groups; All Transportation Groups Radio Designation: Medical Command Function: Responsible for the implementation of the Incident Action Plan within the Medical Branch. Duties:  Review Common Responsibilities (NIMS EMS MCI Plan page 2-3).  Review Group Assignments for effectiveness of current operations and modify as needed.  Provide input to Operations Section Chief for the Incident Action Plan.  Supervise Branch activities.  Report to Operations Section Chief on Branch activities.  Maintain Unit/Activity Log (ICS Form 214).

5. Northeast Colorado All Hazards Region 8-5 Medical Branch Director Command Planning Finance/Admin Logistics Operations Medical Staging Transport Treatment Triage Morgue Supply Immediate Delayed Minor Tarp (10) Medical Branch Director Dispatch Medical Branch Director Dispatch

6. Northeast Colorado All Hazards Region 8-6 Medical Group/Division Supervisor Definition: Senior EMT, prefer ALS (First on scene and independent of jurisdiction.) Commanded by: Incident Commander, or Branch Director. Subordinates: Triage; Treatment; Transportation, Medical Supply and Morgue Supervisors. Radio Designation: Medical Function: Responsible for the overall management and delegation of all functions of the Medical Division. Duties:  Establish and supervise a Medical Division. (See Medical Division Matrix)  Review Common Responsibilities (NIMS EMS MCI Plan page 2-3).  Participate in Medical Branch/Operations Section planning activities.  Establish Medical Group with assigned personnel, request additional personnel and resources sufficient to handle the magnitude of the incident.  Designate Unit Leaders and Treatment Area locations as appropriate.  Isolate Morgue and Minor Treatment Area from Immediate and Delayed Treatment Areas.  Request law enforcement/coroner involvement as needed.  Determine amount and types of additional medical resources and supplies needed to handle the magnitude of the incident (medical caches, backboards, litters, and cots).  Ensure activation or notification of hospital alert system, local EMS/health agencies.

7. Northeast Colorado All Hazards Region 8-7 Medical Group/Division Supervisor Command Planning Finance/Admin Logistics Operations Medical Staging Transport Treatment Triage Morgue Supply Immediate Delayed Minor Tarp (10) Medical Group/Division Director Dispatch Medical Group/Division Director Dispatch

8. Northeast Colorado All Hazards Region 8-8 Triage Unit Leader Definition: Paramedic or EMT Commanded by: Medical Division Supervisor Subordinates: Triage personnel Radio Designation: Triage Leader Function: Assure responsibility for providing triage. Duties:  Develop organization sufficient to handle assignment.  Inform Medical Group Supervisor of resource needs.  Implement triage process.  Coordinate movement of patients from the Triage Area to the appropriate Treatment Area.  Give periodic status reports to Medical Group Supervisor.  Maintain security and control of the Triage Area.  Establish Morgue.  Maintain Unit/Activity Log (ICS Form 214).

9. Northeast Colorado All Hazards Region 8-9 Triage Unit Leader Command Planning Finance/Admin Logistics Operations Medical Staging Transport Treatment Triage Morgue Supply Immediate Delayed Minor Tarp (10) Dispatch Triage Team

10. Northeast Colorado All Hazards Region 8-10 Triage Personnel Definition: Paramedic or EMT Commanded by: Triage Unit Leader Subordinates: None Radio Designation: Triage Function: Triage patients and assign them to appropriate treatment areas. Duties:  Report to designated on-scene triage location.  Triage and tag injured patients. Classify patients while noting injuries and vital signs if taken.  Direct movement of patients to proper Treatment Areas.  Provide appropriate medical treatment to patients prior to movement as incident conditions dictate.

11. Northeast Colorado All Hazards Region 8-11 Triage Personnel Command Planning Finance/Admin Logistics Operations Medical Staging Transport Treatment Triage Morgue Supply Immediate Delayed Minor Tarp (10) Dispatch Triage Team Triage Personnel

12. Northeast Colorado All Hazards Region 8-12 Morgue Manager Definition: Personnel designated by Incident Command Commanded by: Medical Division Supervisor (Coroner's Office Subordinates: Aides as required Radio designation: Morgue Function: Manage all morgue activities. Duties:  Establish a temporary morgue remote from the patient areas.  Secure the area.  Maintain records, including victims' identity, location where found.

13. Northeast Colorado All Hazards Region 8-13 Morgue Manager Command Planning Finance/Admin Logistics Operations Medical Staging Transport Treatment Triage Morgue Supply Immediate Delayed Minor Tarp (10) Dispatch Triage Team Morgue Manager

14. Northeast Colorado All Hazards Region 8-14 Treatment Unit Leader Definition: Paramedic or EMT Commanded by: Medical Division Supervisor Subordinates: Treatment Groups Radio Designation: Treatment Functions: Responsible for supervision of treatment of victims assigned to the Treatment Areas. Duties:  Don identifying vest.  Establish the Treatment Area. Consider size, safety, space, weather, lighting, and ease of access and egress for transport vehicles. Arrange Treatment Area in parallel rows of separate patient groupings IMMEDIATE (RED) / DELAYED (YELLOW) / MINOR (GREEN). Report location to MEDICAL DIVISION SUPERVISOR.  Prioritize patients arriving in the Treatment Area for treatment.  Account for all personnel assigned to TREATMENT.  Establish Treatment Area Supervisors.  Determine the order of transport of patients and most appropriate transport based on recommendations from ALS treatment personnel.  Maintain communications with TRIAGE and TRANSPORTATION.  Provide essential and frequent progress reports to MEDICAL DIVISION SUPERVISOR.

15. Northeast Colorado All Hazards Region 8-15 Treatment Unit Leader Command Planning Finance/Admin Logistics Operations Medical Staging Transport Treatment Triage Morgue Supply Immediate Delayed Minor Tarp (10) Dispatch Triage Team Treatment Unit Leader

16. Northeast Colorado All Hazards Region 8-16 Treatment Dispatch Manager Definition: Paramedic or EMT Commanded by: Treatment Unit Leader Subordinates: Treatment Groups Radio Designation:??? Functions: Responsible for coordinating transportation of patients out of the Treatment Areas with the Patient Transportation Unit Leader Duties:  Establish communications with the Immediate, Delayed, and Minor Treatment Managers.  Establish communications with the Patient Transportation Unit Leader.  Verify that patients are prioritized for transportation.  Advise Medical Communications Coordinator of patient readiness and priority for transport.  Coordinate transportation of patients with Medical Communications Coordinator.  Assure that appropriate patient tracking information is recorded.  Coordinate ambulance loading with the Treatment Managers and ambulance personnel.  Maintain Unit/Activity Log (ICS Form 214)

17. Northeast Colorado All Hazards Region 8-17 Treatment Dispatch Manager Command Planning Finance/Admin Logistics Operations Medical Staging Transport Treatment Triage Morgue Supply Immediate Delayed Minor Tarp (10) Dispatch Triage Team Treatment Dispatch Manager

18. Northeast Colorado All Hazards Region 8-18 Immediate Treatment Manager Definition: Paramedic Commanded by: Treatment Supervisor Subordinates: Treatment Area Personnel Radio Designation: Red Treatment Function: Responsible for treatment of victims in the Immediate Treatment Area Duties:  Receive and treat victims assigned to your unit.  Assure standing orders for A.L.S. procedures have been obtained.  Assure patients are prioritized for transport.  Coordinate transportation of victims through "TRANSPORT" Supervisor.  Assure that appropriate medical and patient information is recorded.

19. Northeast Colorado All Hazards Region 8-19 Command Planning Finance/Admin Logistics Operations Medical Staging Transport Treatment Triage Morgue Supply Immediate Delayed Minor Tarp (10) Dispatch Triage Team Immediate Treatment Manager Immediate Treatment Manager

20. Northeast Colorado All Hazards Region 8-20 Delayed Treatment Manager Definition: Paramedic or EMT Commanded by: Treatment Supervisor Subordinates: Treatment Area Personnel Radio Designation: Yellow Treatment Function: Responsible for treatment of victims in the Delayed Treatment area Duties:  Receive and treat victims assigned to your unit.  Assure standing orders for A.L.S. procedures have been obtained.  Assure patients are prioritized for transport.  Coordinate transportation of victims through "TRANSPORT" Supervisor.  Assure that appropriate medical and patient information is recorded.

21. Northeast Colorado All Hazards Region 8-21 Command Planning Finance/Admin Logistics Operations Medical Staging Transport Treatment Triage Morgue Supply Immediate Delayed Minor Tarp (10) Dispatch Triage Team Delayed Treatment Manager Delayed Treatment Manager

22. Northeast Colorado All Hazards Region 8-22 Minor Treatment Manager Definition: Paramedic or EMT Commanded by: Treatment Supervisor Subordinates: Treatment Area Personnel Radio Designation: Green Treatment Function: Responsible for treatment of victims in the Minor Treatment Area Duties:  Receive and treat victims assigned to your unit.  Assure standing orders for A.L.S. procedures have been obtained.  Assure patients are prioritized for transport.  Coordinate transportation of victims through "TRANSPORT" Supervisor.  Assure that appropriate medical and patient information is recorded.

23. Northeast Colorado All Hazards Region 8-23 Minor Treatment Manager Command Planning Finance/Admin Logistics Operations Medical Staging Transport Treatment Triage Morgue Supply Immediate Delayed Minor Tarp (10) Dispatch Triage Team Minor Treatment Manager Minor Treatment Manager

24. Northeast Colorado All Hazards Region 8-24 Transportation Supervisor Definition: Senior Paramedic or Paramedic Supervisor Commanded by: Medical Division Supervisor Subordinates: Communications, staging, and records personnel. Radio Designation: Transport Function: Coordinate patient transportation. Communicate with receiving facilities. Maintain records. Duties:  Designate a Vehicle Staging Area (within sight of the loading area).  Establish an ambulance loading area near the treatment area (within 25 feet).  Coordinate patient transportation with "RED, YELLOW, GREEN TREATMENT" Area Supervisors.  Supervise the loading of patients into ambulances.  Request additional ambulances through "MEDICAL" division commander.  Request additional helicopters through "AIR OPS" if activated.  Communicate with receiving hospitals to include: number of victims; their severity and destination.  Obtain bed space information.  Assure patient information and destination is recorded.

25. Northeast Colorado All Hazards Region 8-25 Command Planning Finance/Admin Logistics Operations Medical Staging Transport Treatment Triage Morgue Supply Immediate Delayed Minor Tarp (10) Dispatch Triage Team Transportation Manager

26. Northeast Colorado All Hazards Region 8-26 Medical Communications Coordinator Definition: Paramedic or EMT Commanded by: Transportation Unit Leader Subordinates: Treatment Groups Radio Designation: ??? Functions: Responsible for continuous communications with the hospital alert system to maintain status of available hospital beds to assure proper patient transportation. The Medical Communication Coordinator assures proper patient transportation and destination. Duties:  Establish communications with the hospital alert system.  Determine and maintain current status of hospital/medical facility availability and capability.  Receive basic patient information and condition from Treatment Dispatch Manager.  Coordinate patient destination with the hospital alert system.  Communicate patient transportation needs to Ambulance Coordinators based upon requests from Treatment Dispatch Manager.

27. Northeast Colorado All Hazards Region 8-27 Medical Communications Coordinator Command Planning Finance/Admin Logistics Operations Medical Staging Transport Treatment Triage Morgue Supply Immediate Delayed Minor Tarp (10) Dispatch Triage Team Medical Communications Coordinator Medical Communications Coordinator Medical Communications Medical Communications Ground Transportation Air Transportation

28. Northeast Colorado All Hazards Region 8-28 Ground Ambulance Coordinator Definition: Paramedic or EMT Commanded by: Transportation Unit Leader Subordinates: Treatment Groups Radio Designation: ??? Functions: Manages the Ambulance Staging Area(s), and dispatches ambulances as requested. Duties:  Establish appropriate staging area for ambulances.  Establish routes of travel for ambulances for incident operations.  Establish and maintain communications with the Air Operations Branch Director regarding Air Ambulance Transportation assignments. Establish and maintain communications with the Medical Communications Coordinator and Treatment Dispatch Manager. Provide ambulances upon request from the Medical Communications Coordinator.  Assure that necessary equipment is available in the ambulance for patient needs during transportation.  Establish contact with ambulance providers at the scene.  Request additional transportation resources as appropriate.  Provide an inventory of medical supplies available at ambulance staging area for use at the scene.  Maintain records as required and Unit/Activity Log (ICS Form 214)

29. Northeast Colorado All Hazards Region 8-29 Ground Ambulance Coordinator Command Planning Finance/Admin Logistics Operations Medical Staging Transport Treatment Triage Morgue Supply Immediate Delayed Minor Tarp (10) Dispatch Triage Team Medical Communications Medical Communications Ground Transportation Air Transportation

30. Northeast Colorado All Hazards Region 8-30 Medical Supply Coordinator Definition: Qualified personnel Commanded by: Medical Division Supervisor Subordinates: Aides as required. Radio designation: Supply Function: Responsible for maintaining required medical supplies for the division. Duties:  Acquires, distributes, and maintains status of medical equipment and supplies.  Requests additional medical equipment and supplies as needed, through "MEDICAL" division commander.

31. Northeast Colorado All Hazards Region 8-31 Medical Supply Coordinator Command Planning Finance/Admin Logistics Operations Medical Staging Transport Treatment Triage Morgue Supply Immediate Delayed Minor Tarp (10) Dispatch Triage Team Medical Supply Coordinator Medical Supply Coordinator Medical Communications Medical Communications Ground Transportation Air Transportation

32. Northeast Colorado All Hazards Region 8-32 Strike Team Definition: Qualified Personnel / volunteers Commanded by: Triage or Transport Supervisors Subordinates: None Radio Designation: Strike Team1; Strike Team 2; etc. Function: Work at assigned tasks Duties:  Evacuate victims to the triage and/or treatment areas.  Record and relay the location of all patients found.  Transport patients to and from the various patient areas.  Load victims into ambulances from the treatment areas.

33. Northeast Colorado All Hazards Region 8-33 Review & Questions  Individual Roles & Responsibilities  Case (final) Questions about Roles & Responsibilities?

34. Northeast Colorado All Hazards Region 8-34 Case Example You are completing the after action report for this call. Questions 1.What roles or responsibilities were not filled for this particular incident?