Operational Templates and Guidance for EMS Mass Incident Deployment June 2012 U.S. Fire Administration Mission Statement We provide National leadership to foster a solid foundation for our fire and emergency services stakeholders in prevention, preparedness, and response. Developed for the U.S. Fire Administration (USFA) under Funding Opportunity Number DHS-10-USFA-105-000-04 by the National Emergency Medical Services Management Association. Operational Templates and Guidance for EMS Mass Incident Deployment This page was intentionally left blank. Acknowledgements i Acknowledgements The expert review panel for this publication was composed of senior Emergency Medical Service (EMS) leadership from a broad domain of stakeholders. Each contributed time and expertise to ensure that the fi- nal publication was useful to local level emergency planners in the EMS sector. Without their guidance and commitment to developing a practical, accurate, and relevant set of tools, this document would not have made it out of the planning stages. A special thank you goes out to Aarron Reinert, Steve Delahousey, and Mike McAdams for preparing and presenting information of key interest during the meeting for this proj- ect. Without the input and guidance from each stakeholder organization and their representatives on the expert review panel, this document would not have come to fruition. Finally, Federal partners Rick Patrick and Bill Troup provided background and guidance as the project pro- gressed from idea to implementation. Expert Review Panel National EMS Management Association: Project Team Skip Kirkwood, NEMSMA President/Chief, Wake County EMS Sean Caffrey, Project Manager/EMS Operations Program Manager, CDPHE Jim Buell, Editor in Chief and Subject Matter Expert/Managing Partner, MTOG LLC Keith Hart, Subject Matter Expert/Senior Partner, MTOG LLC Rosalind Cooper, Editor, Wheat Ridge, Colorado Jeff Dyar, Meeting Facilitator, The Far View Group, LLC American Ambulance Association Steve Delahousey, Vice President, American Medical Response Center for Leadership Innovation and Research in EMS Gary Wingrove, Director of Strategic Affairs, Mayo Medical Transport International Association of EMS Chiefs James Robinson, Operations Chief, Denver Health Paramedic Division National Association of Emergency Medical Technicians Don Lundy, EMS Director, Charleston County, South Carolina International Association of Fire Chiefs John Sinclair, Fire Chief/Emergency Manager, Kittitas Valley Fire Rescue International Association of Fire Fighters Lori Moore-Merrill, Assistant to the General President International Association of Flight Paramedics T.J. Kennedy, Program Manager/Assistant Vice President, Science Applications International Corporation (SAIC) National Association of EMS Physicians Dr. Kathy Rinnert, Director GEMSS/EMS Fellowship Programs, University of Texas Southwestern at Dallas Dr. Brian Schwartz, Executive Lead, Sunnybrook-Osler Center for Prehospital Care ii Operational Templates and Guidance for EMS Mass Incident Deployment National Association of State EMS Officials Joe Schmider, EMS Director, State of Pennsylvania National Fire Protection Association Ken Holland, Public Fire Protection Programs National Highway Traffic Safety Administration Gamunu “Gam” Wijetunge Office of Emergency Medical Services National Volunteer Fire Council Ken Knipper, Chair/EMS Rescue Section Subject Matter Experts Mike McAdams, Assistant Chief of Operations, Montgomery County Fire Rescue Aarron Reinert, National EMS Advisory Committee, Executive Director, Lakes Region EMS Al Martin, Fire Chief, City of Tuscaloosa, Alabama U.S. Fire Administration Bill Troup, Project Officer United States Department of Health and Human Services Jack Beall, Director, National Disaster Medical System United States Department of Homeland Security Rick Patrick, Director, Medical First Response Coordination, Office of Health Affairs Dr. Michael Zanker, MD, Senior Medical Officer, Office of Health Affairs Table of Contents iii Table of Contents Introduction ............................................................................................................................................... 1 SECTION I: Emergency Medical Services Deployment Templates ........................................................... 3 TEMPLATE 1: The Emergency Medical Services Emergency Operations Plan .............................................. 3 TEMPLATE 2: Basic Hazard Vulnerability Analysis ...................................................................................... 6 TEMPLATE 3: Incident and Event Plans ....................................................................................................... 9 TEMPLATE 4: Basic Incident Deployment Checklists ................................................................................. 14 SECTION II: Mass Care Coordination Toolkit ........................................................................................ 19 Introduction to the Coordination Planning Toolkit .................................................................................... 19 High School Football Game .................................................................................................................. 20 Residential Medical Facility Evacuation ................................................................................................ 22 County Fair .......................................................................................................................................... 25 Marathon or Similar Running Events ................................................................................................... 27 Weather-Related Disaster Declaration ................................................................................................... 29 Large College Sporting Event ................................................................................................................ 31 Political Assembly ................................................................................................................................ 34 Auto Racing/Competition ..................................................................................................................... 36 Cancer Walk ......................................................................................................................................... 38 SECTION III: Case Studies in Mass Incident Deployment ...................................................................... 41 Case 1: 2010 Bus Crash in Hartford, CT .................................................................................................... 41 Case 2: 2005 F3 Tornado in Marshall County, KY ..................................................................................... 43 Case 3: 2010 Veterans Administration Hospital Evacuation, Lebanon, PA .................................................. 46 Case 4: 2008 Imperial Sugar Dixie Crystal Plant Fire, Port Wentworth, GA .............................................. 49 Case 5: 2006 Woodward Dream Cruise, Berkley, MI ................................................................................. 52 Case 6: 2010 Ironman Triathlon Event, St. George, UT ............................................................................. 55 Case 7: 2004 Democratic National Convention, Boston, MA ..................................................................... 57 Case 8: Annual Creation Music Festival, Mount Union, PA ........................................................................ 60 SECTION IV: Policy Guidance for Mass Casualty Contingency Planning at Mass Gathering Events ..... 63 Introduction ............................................................................................................................................... 63 Relationship of Event Command to Responding Resources ........................................................................ 67 Communications ........................................................................................................................................ 68 Expanded Scope/Emerging Mass Casualty Incident Management Considerations ....................................... 68 Mass Casualty Incident Planning Checklist ................................................................................................. 71 Incident Action Plan Safety and Risk Analysis, ICS Form 215A ................................................................... 73 SECTION V: Policy Guidance for Emergency Medical Services Aspects of Mass Shelter and Feeding ....75 Emergency Medical Services Participation in Mass Shelter and Feeding ..................................................... 75 Key Functional Roles and Tasks ............................................................................................................ 76 SECTION VI: Local Mutual Aid ............................................................................................................... 81 TEMPLATE: Local, Regional, and State Mutual Aid .................................................................................... 81 TEMPLATE: Inter-Local Government Agreement–Mutual Aid ................................................................... 83 ANNEX I: Sample Mutual Aid Agreements ............................................................................................. 89 EXAMPLE: Single County Mutual Aid Agreement .....................................................................................