Ems Tactical

Question 1

After receiving the run…
I acknowledge the run, confirm with dispatch and the MDT the address, talkgroup and position due. I ensure I know the address, primary route and secondary route, other equipment responding and consider time of day for traffic. I am in full PPE, seated, seatbelted radio on proper talk group. I press enroute on the MDT and drive safely to the call using all lights and sirens, I check for updates while enroute and ask dispatch for additional information. I check my Target hazards and incident preplans and consider the area I am responding to and hydrant locations in the area. Notify companies of my direction of travel, egress/access routes, pass along updates to other responding companies
I focus my enroute and initial size up on the following areas of consideration

Answer 1

After receiving run

Question 2

LINES- WALLACEWASHOT
Location- inside/outside/ street/school where? Incident Type-
Number of Patients-
Equipment Needed-
Staging Area for Responding Companies- Water Supply-
Area- how big is the perimeter of the scene Life Hazards
Location/ Extent
Aux Appliances/ Extrication
Construction Type
Exposure (BSI)
Weather ( provide shelter, recirculate water in the pumper to prevent overheating if no water flowing)
Access/Egress
Street Conditions
Height
Occupancy
Time of day—- Do we need scene lights?

Answer 2

Q1 Wallace was hot/lines

Question 3

Pre-arrival/ Arrival Actions:
Approaching the scene I confirm the address and approach from the uphill upwind direction if at all possible, I stop a minimum 500 feet and use my binoculars to identify any hazardous materials. If none are present I proceed to the scene, park for the best strategic advantage and position apparatus to stop traffic and protect personnel
I perform my windshield survey then I will give my disposition on A1
Dispatch, 201 on the scene xxxxxx.
I perform a 360 degree walk around survey of the scene looking for immediate Life Safety hazards, trapped victims, environmental concerns, fuel and electrical hazards, estimate of patients and resources needed, and take quick accounts given by SMEs
I instruct the walking wounded to proceed to xxxxx and stay there until personnel fully evaluate them
I request additional resources to include:

Answer 3

Pre Arrival/Arrival

Question 4

pumpers
3 Trucks to support extracation efforts
Rescue
202, 203
5 units
MLGW for gas, water and power control
MPD for crowd, traffic, and perimeter control
TDOT for traffic incident management
EPA
EMA for special equipment like dumprucks, bull dozers, wreckers School Board
Coast Guard
Helicopter
ME
Med director
MATA to provide temporary emergency shelter
Rescue Hazmat Team to mitigate hazmat from fuel leaks Equipment Trailer
Liaison Officer
Rehab
Air Truck
PIO

Answer 4

Additional resources

Question 5

I notify companies of hydrant, staging and base locations. I begin ICS, take a stationary command
in my vehicle and advise companies the command post’s location. I initiate the mass casualty plan.
Advise dispatch to have the police shut down the highway. I order companies to park equipment in
a way that considers fire equipment access, wind direction, rescue, and visibility and allows access for ambulances. Blocking traffic lanes to shield and protect everyone in the work zone.

Answer 5

Arrival

Question 6

I do a Risk Benefit Analysis

Answer 6

RBI

Question 7

My Incident Priorities are:
Life Safety, Incident Stabilization, Property Conservation, Evidence Preservation, Environmental Protection, preserving evidence

Answer 7

Incident Priorities

Question 8

My Strategic Goals are
Rescue of victims, isolation by establishing perimeter, create hot, warm and cold zones,
evacuation, medical for TTT and rehab for personnel.

Answer 8

Strategic goals

Question 9

Tactical Objectives:
TDOT and MPD will establish perimeter, secure the scene by controlling traffic making the scene safe. Establish medical branch, triage/treatment/transport sectors and a casualty collection point

Answer 9

Tactical Objectives

Question 10

Actions:
I will establish ICS, and follow ICS protocols activate Mass Casualty plan, create a plan of action,
start a tactical worksheet and assign a medical talk group All crews use full PPE, SCBA, pass device, safety vest, radios on proper talk group and confirm communications. Engine crew will have a precautionary 1 3/4 line laid and truck company will perform the extracation. Unit 1 triage, Unit 2 treatment , unit 3 transport. The paramedic of each respective unit will be my group leader. A fire crew will obtain multiparty refusals for anyone involved who declines transport. I ask for status updates from my crews working in the hot zone.
If actions are needed outside of normal SOPs I provide tactical directives. I keep chief updated on the talkgroup. I continually reassess to make sure my strategy and tactics are making progress towards my goals. If any changes are needed I make those changes and assign them to the appropriate company.

Answer 10

Actions

Question 11

Benchmarks:
When my group leaders notify me that triage is complete, all critical have been transported,
extracation is complete I relay these benchmarks to dispatch I also advise the number of patients in each category to dispatch.. These benchmarks are relayed to dispatch and time stamped.

Answer 11

Benchmarks

Question 12

U1 paramedic becomes Triage Unit leader and that crew will performs rapid triage, identifys critical patients needing care, transportation, and
And extrication. They use the START triage tag system. Documenting triage and injuries. Triage Unit Leader updates me on the number of Red, Yellow, Green, and Black Tagged patients and I keep dispatch updated.

Answer 12

Tasks

Triage

Question 13

U2’s crew establishes a treatment sector and the paramedic become Treatment Unit Leader. They document on the triage tag any treatment rendered and retain the pt ID section of the tag. Treatment Unit Leader advises the Transport Unit Leader when patients are ready for transport and controls the movement of patients in and out of the treatment area. Names and injuries are documented.

Answer 13

Tasks

Transport

Question 14

203: establishes transport sector and becomes Transport Unit Leader. TUL plans the entry and exit routes the units will take and makes it known to units prior to their arrival.

Answer 14

Tasks

Transport

Question 15

If a helicopter is needed 100x 100/ 200x200 at night

MATA busses can be used to transport a large number of walking wounded staffed with paramedics and equipment.

Answer 15

Tasks…

Question 16

he Triage, Treatment, and Transport Unit leaders work closely and communicate so everyone may plan ahead. Updates are to the Regional Medical Communications Center so hospitals can be prepared. All Unit Leaders keep me updated.
All patients are transported in the order of most critical to least. If a large amount of extra medical supplies are needed I call for the Manager of Logistics who becomes the Supply Unit Leader.

Answer 16

Task Summary

Question 17

E1: investigates, pulls a charged 1 3/4 line and prepares for light water operations to mitigate fuel spills. Crew is in full PPE with SCBA in order to react quickly if a car catches fire

E1 driver has accountability.
E2: supply’s E1 with an unlimited water primary supply and crew assists in the triage and Treatment sectors
E3: gains a secondary water supply, pull a 1 3/4 handline to protect exposure
And assume RIT
E4: driver establishes, name location, and manage staging. E4 Lt is Saftey
Officer and ensure no one gets outside the safe perimeter of the scene into traffic, is wearing BSI and eye protection, vehicles and been cribbed and deenergized.
E5: becomes my Incident Management Team. They receive an assignment in areas of resource management, planning, situational awareness,
T1&2: Becomes Rescue Sector and stabilize vehicles, performs extracation operations, forces entry and removes victims
T3: establishes, name location, and manage base
R1: identifies and control leaking fluids from vehicles and run off and prevent it from entering sewers and waterways

Answer 17

Tasks

Question 18

Rehab.- Creates Rehab and a temporary emergency shelter for victims
The liaison officer- contacts RMCC and notifies them of the number of patients and requests they. Alert the hospitals. The liaison officer makes sure the school board contacts pediatric patient’s parents and notifies the schools
. Liaison officer will notifies EMA, EPA, and coast guard pollution control is needed.
The PIO will speak with news crews
Companies will search nearby areas for missing victims that may have Been ejected utilizing the TIC

Answer 18

Tasks

Question 19

Once all the patients have been triaged and treated unit 1 and 2 reports to Transport Sector
U3 assigned a patient
U4: assigned a patient
U5: assigned a patient
Xxxx: Unit assigned patient
U1, U2, U3: Reassigned to transport

Answer 19

Final Tasks

Question 20

Terminate Scene:
Once all pts have been transported or declined. I will ensure all hazards are removed, vehicles towed from the scene, allow MPD & medical examiner to conduct accident investigation. Companies will rehab personnel, refill tanks, replenish air bottles and supplies, reload hose, decon equipment and turnouts, have medical evaluations, swap hood and gloves. I will perform a tail board debriefing .

Answer 20

Terminating the scene

Question 21

It is at this time I demobilize equipment; eng 1,2 truck 1,2 remain on scene to extricate DOA pt when ordered by the medical examiner. All other company’s return to an in service status at this time. Once the DOA pt are extricated and handed off to the medical examiner I terminate command and all companies return to an in service status and scene turned over to MPD. I terminate command. I then respond to every hospital that pt were transported to. I check with every units personnel for any injuries, complaints, or concerns and handle them appropriately at

Answer 21

Demob 1/2

Question 22

hat time. I will assist them with completing their documentation to ensure it’s completion. I will thank thcem for their hard work, tell them they did a great job, and inform them when the cisd and PIA is. I will then check with patients and see if I can be of assistance to them. I’ll give them MPD contact info and let them know they are handling their car/personal effects. I’ll give them my contact info and let them know they can contact me if they think I can be of assistance. I will coordinate an immediate cisd with the safety chief. The next working day we will have our pia talk about what worked what didn’t and any changes that need to be made. I will again thank everyone for their hard work and tell them they did a great job. If I identified any deficiencies I will provide the appropriate training and follow up on the training to make sure it was sufficient.

Answer 22

Demob 2/2