ASTM F1288-90(1998)
(Guide)Standard Guide for Planning for and Response to a Multiple Casualty Incident
Standard Guide for Planning for and Response to a Multiple Casualty Incident
SCOPE
1.1 This guide covers the planning, needs assessment, training, integration, coordination, mutual aid, implementation, provision of resources, and evaluation of the response of a local emergency medical service (EMS) organization or agency to a multiple patient producing situation that may or may not involve property loss. This guide is limited to the pre-hospital response and mitigation of an incident up to and including the disposition of patients from the incident scene.
1.2 This guide addresses the background on planning, scope, structure, application, federal, state, local, voluntary, and nongovernmental resources and planning efforts involved in developing, implementing, and evaluating an EMS annex, or component, to the local jurisdiction's emergency operations plan (EOP) as defined in the Federal Emergency Management Agency (FEMA) publication, Civil Preparedness Guide (CPG) 1-8.
1.2 This standard does not purport to address the safety problems associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use.
General Information
Relations
Standards Content (Sample)
NOTICE: This standard has either been superceded and replaced by a new version or discontinued.
Contact ASTM International (www.astm.org) for the latest information.
Designation: F 1288 – 90 (Reapproved1998)
Standard Guide for
Planning for and Response to a Multiple Casualty Incident
This standard is issued under the fixed designation F 1288; the number immediately following the designation indicates the year of
original adoption or, in the case of revision, the year of last revision. A number in parentheses indicates the year of last reapproval. A
superscript epsilon (e) indicates an editorial change since the last revision or reapproval.
1. Scope local resources and of routinely available regional or multi-
jurisdictional medical mutual aid, and for which extraordinary
1.1 This guide covers the planning, needs assessment,
medical aid from state or federal resources is very likely
training, integration, coordination, mutual aid, implementation,
required for further diagnosis and treatment.
provision of resources, and evaluation of the response of a
3.1.3 EMS control/medical group supervision— the first
local emergency medical service (EMS) organization or
emergency medical services response at the incident scene, or
agency to a multiple patient producing situation that may or
designated by the local response plan or incident command to
may not involve property loss. This guide is limited to the
be responsible for the overall management of the incident’s
pre-hospital response and mitigation of an incident up to and
EMS operation.
including the disposition of patients from the incident scene.
3.1.4 extrication management—the function of supervising
1.2 This guide addresses the background on planning,
personnel who remove entrapped victims.
scope, structure, application, federal, state, local, voluntary,
3.1.5 fatality management—the function designated by ex-
and nongovernmental resources and planning efforts involved
isting plans, or the EMS control/medical group supervisor, to
in developing, implementing, and evaluating an EMS annex, or
organize, coordinate, manage, and direct morgue services.
component, to the local jurisdiction’s emergency operations
3.1.6 incident commander—the individual responsible for
plan (EOP) as defined in the Federal Emergency Management
the overall on-site management and coordination of personnel
Agency (FEMA) publication, Civil Preparedness Guide (CPG)
2 and resources involved in the incident.
1–8.
3.1.7 logistics resources management—the function respon-
1.3 This standard does not purport to address the safety
sible for acquiring personnel, equipment (including vehicles),
problems associated with its use. It is the responsibility of the
facilities, supplies, and services as requested by the incident
user of this standard to establish appropriate safety and health
commander.
practices and determine the applicability of regulatory limita-
3.1.8 medical communications management—the function
tions prior to use.
designated by the incident commander or EMS control/ medi-
2. Referenced Documents
cal group supervisor to establish, maintain, and coordinate
effective communication between on-site and off-site medical
2.1 ASTM Standards:
personnel and facilities.
F 1149 Practice for Qualifications, Responsibilities, and
3.1.9 medical supplies management—the function desig-
Authority of Individuals and Institutions Providing Medi-
nated by the incident commander to manage equipment and
cal Direction of Emergency Medical Services
report to EMS control/medical group supervisor.
3. Terminology
3.1.10 mental health coordinator—a qualified mental health
professional responsible for coordinating the psychosocial
3.1 Definitions of Terms Specific to This Standard:
assessments and interventions for responders, affected indi-
3.1.1 command post—the physical location from which
viduals, and groups.
incident command exercises direction over the entire incident.
3.1.11 multiple casualty incident (MCI)—a type of signifi-
3.1.2 disaster—a sudden calamity, with or without casual-
cant medical incident that may fall into the following catego-
ties, so defined by local, county, or state guidelines.
ries:
3.1.2.1 medical disaster—a type of significant medical in-
3.1.11.1 extended—an incident for which local medical
cident which exceeds, or overwhelms, or both, the capability of
resources are available and adequate to provide for field
medical triage and stabilization, and for which appropriate
This guide is under the jurisdiction of ASTM Committee F30 on Emergency
local facilities are available and adequate for further diagnosis
Medical Services and is the direct responsibility of Subcommittee F30.03 on
and treatment.
Organization/Management.
Current edition approved July 6, 1990. Published August 1990.
Available from FEMA, P.O. Box 70274, Washington, DC 20024.
Annual Book of ASTM Standards, Vol 13.02.
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959, United States.
NOTICE: This standard has either been superceded and replaced by a new version or discontinued.
Contact ASTM International (www.astm.org) for the latest information.
F 1288 – 90 (1998)
3.1.11.2 major—an incident producing large numbers of 4.2 The body of knowledge on which the guide is based was
casualties, for which routinely available regional or multi- drawn from a wide variety of sources, including individual
jurisdictional medical mutual aid is necessary and adequate for authors, academic institutions, and federal, state, regional, and
further diagnosis and treatment. local organizations.
3.1.12 mutual aid—the coordination of resources, including 4.3 This guide is organized in such a way as to provide
but not limited to facilities, personnel, vehicles, equipment, and those responsible for planning, implementing, and evaluating
services, pursuant to an agreement between jurisdictions pro- the emergency medical components of the local pre-hospital
viding for such interchange on a reciprocal basis in responding response to multiple casualty incidents with information they
to a disaster or emergency. can readily use to ensure that their response is as expedient and
3.1.13 needs assessment—a preliminary survey of real or appropriate as is reasonably possible.
potential hazards in a specific geographic area. 4.4 The guide was created to organize, collate, and distrib-
3.1.14 operations offıcer—individual who assists the inci- ute related information in such a way as to be readily accessible
dent commander on issues relating to the operations of the to people in the fields of emergency medical services and
incident. emergency management.
3.1.15 public information—a function designated by the 4.5 This guide should not be perceived as an inflexible rule
incident commander for the dissemination of factual and timely or standard but as a guide that should be adapted to the needs
reports to the news media. of the individual community, and should be refined and
3.1.16 safety management—the function that identifies real improved as the body of knowledge on which it is based
or potential hazards, unsafe environment or procedures at the increases.
incident scene, and recommends the appropriate corrective or
5. Significance and Use
preventive actions under the authority of the incident com-
mander, to ensure the safety of all personnel at the incident 5.1 This guide is intended to assist the management of the
scene.
local EMS agencies or organizations in the design, planning,
3.1.17 sector offıcers (group supervisors/leaders/ and response of their jurisdiction’s resources to multiple
managers)—qualified personnel who control a specific area or
casualty incidents (MCIs).
task assignment. 5.2 This guide does not address all of the necessary plan-
3.1.18 staging area—the location where responding emer-
ning and response of pre-hospital care agencies to an incident
gency services equipment and personnel assemble for assign- that involves the total destruction of community services and
ment.
systems.
3.1.19 staging management—the function designated by the 5.3 This guide does not address the necessary design,
incident commander that is responsible for the orderly assem-
planning, and response to be undertaken by a medical care
bly and utilization of resources in a designated area. facility to an internal or external event that necessitates the
3.1.20 transportation management—the function desig-
activation of the facility’s disaster plan.
nated by the EMS control/medical group supervisor that is 5.4 This guide provides procedures to coordinate and pro-
responsible for the transportation of the patients from the
vide a systematic and standardized response by responsible
incident scene and for coordination with EMS control/ medical parties, including the local elected officials, emergency man-
group supervisor, communications, and the incident com- agement officials, public safety officials, medical care officials
mander. (pre-hospital and hospital), local EMS agencies/organizations
3.1.21 treatment area—the site at or near the incident for and others with objectives and tasks for the pre-hospital
emergency medical treatment prior to transport.
management of a significant incident.
3.1.22 treatment management—the function that is respon- 5.5 This guide provides for the establishment of an incident
sible for the definitive on-scene medical treatment of patients.
command system with position descriptions that identify mis-
3.1.23 triage—the process of sorting and prioritizing emer- sion, functions, and responsibilities of the command structure
gency medical care of the sick and injured on the basis of
to be used at a MCI. The incident command functions include
urgency and type of condition present, and the number of but are not limited to staging, logistics, rescue/extrication,
patients and resources available in order to properly treat and
triage, treatment, transportation (air, land, and water), commu-
transport them to medical facilities appropriately situated and nications, and fatality management.
equipped for their care.
5.6 This guide provides examples and other management
3.1.24 triage area—a location near the incident site to tools that can assist in providing training objectives and
which injured persons should be brought, triaged, and taken
decision making models for dispatch, response, triage, treat-
directly to the treatment area. ment, and transportation for local jurisdictions experiencing
3.1.25 triage management—the function that is responsible
multiple casualty incidents.
for triage and preliminary treatment of casualties.
PLANNING
4. Summary of Guide
6. Planning
4.1 This guide is based upon a body of knowledge on the
planning, implementation, and evaluation of the emergency 6.1 Purpose—Planning should be a cooperative effort be-
medical components of the local pre-hospital response to tween local EMS providers and the jurisdiction in which they
multiple casualty incidents. deliver services. The plan should be written to establish the
NOTICE: This standard has either been superceded and replaced by a new version or discontinued.
Contact ASTM International (www.astm.org) for the latest information.
F 1288 – 90 (1998)
emergency organization, basic policies, responsibilities, and 6.4.3.1 Consideration of the potential for specific incidents,
actions required for support of local operations of emergency
6.4.3.2 Evaluation of the potential harm resulting from the
medical/health plans. Plans should ensure rapid medical assis- incident, and
tance to persons requiring aid due to an incident. Plans should
6.4.3.3 Evaluation of the resources required to respond to
describe a system for coordination of alerting, dispatching, and the incident.
uses of medical personnel and resources whenever a local
6.4.4 Approach—The following are suggested approaches
emergency medical health agency requires assistance from
to completing a needs assessment:
another EMS agency/jurisdiction. The plan should be designed
6.4.4.1 Form a team to identify the potential hazards, risks,
to be an extension of day to day service, facilities, and
and impact relating to potential MCIs.
resources.
6.4.4.2 Consult the local or state civil defense/emergency
6.2 Goal—The plan ensures adequate and coordinated ef-
preparedness offices for assessment information.
forts that will minimize loss of life, disabling injuries, and
6.4.4.3 After identifying potential MCIs, evaluate them for
human suffering by providing effective medical assistance
their potential hazards, risks, and impact.
through efficient use of medical and other resources in the
6.4.4.4 Evaluate the area’s resources.
event of emergencies resulting in multiple casualty incidents.
6.4.5 Resources Assessment—Consider the personnel re-
6.3 Objectives—The primary objectives of a plan should
quired for performing such tasks as emergency medical ser-
include a process whereby:
vices, firefighting, and rescue. Inventory equipment for the job
6.3.1 Each EMS agency/jurisdiction should have a plan to
and evaluate its ability to perform the task. Prepare a written
meet its own needs within its capabilities.
description of what potential incidents exist, and the ability to
6.3.2 Each EMS agency/jurisdiction should enter into mu- respond to these incidents.
tual aid agreements with other local or regional jurisdictions
6.4.6 Once complete, the needs assessment becomes part of
which can be invoked when local capability to manage a
the plan.
situation has been exceeded. Each jurisdictional plan should
6.5 Plan Components— The plan should include provision
facilitate the access and utilization of local and state resources.
for the following:
6.3.3 The EMS agency/jurisdiction’s plan should conform
6.5.1 Organizational Structure for Response:
to appropriate regional and state plans.
6.5.1.1 The plan should define an overall incident organiza-
6.3.4 Each EMS agency/jurisdiction should define training
tion based on a strategy of efficient and effective utilization of
requirements, and develop and utilize a training program based
resources.
on the needs assessment of the community.
6.5.1.2 The plan should address chain of command, includ-
6.3.5 The plan should be a coordinated interagency effort.
ing transfer of authority of any officer or position.
Responsible agencies should have regular interaction in order
6.5.2 Organization of Manpower and Resources for Re-
to facilitate working relations during an incident.
sponse:
6.3.6 Plans and procedures should be reviewed and revised
6.5.2.1 The plan should provide for delineation of respon-
regularly on the basis of tabletop exercises, simulated inci-
sibilities and authority for all involved response personnel and
dents, or actual events.
agencies.
6.4 Needs Assessment and Hazards Analysis:
6.5.2.2 The plan should address necessary resources for
6.
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