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Multiple Casualty Incident Plan

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					Multiple
 Casualty                                   Santa Clara County
                                            Emergency Medical
     Incident                                Services Agency
        Plan
   MULTIPLE CASUALTY INCIDENT ALERT                          CONTENTS         PAGE
                                                             SECTION 1         1-1
REQUEST A MULTIPLE CASUALTY INCIDENT ALERT THROUGH COUNTY
COMMUNICATIONS ANYTIME INFORMATION RECEIVED INDICATES A
POTENTIAL FOR LARGE NUMBERS OF CASUALTIES.                   SECTION 2         2-1
EXAMPLES:
• “ALERT II” FROM SAN JOSE INTERNATIONAL AIRPORT
• LARGE SCALE HAZARDOUS MATERIALS INCIDENT                   SECTION 3         3-1
• MULTIPLE ALARM FIRES
• MULTIPLE HOSTAGE SITUATION                                 SECTION 4         4-1
• HOSPITAL EVACUATION
AN MCI ALERT IS AN ADVISORY NOTIFICATION ONLY.
                                                             SECTION 5         5-1
MULTIPLE CASUALTY INCIDENT ACTIVATION
                                                             SECTION 6         6-1
WHEN TO ACTIVATE THIS PLAN:
  A CONFIRMED SINGLE SITE EVENT WITH CASUALTIES
  OVERWHELMING INITIAL RESPONSE CAPABILITIES.                ANNEX A           A-1
WHO MAY ACTIVATE THIS PLAN:
  ANY FIRE PERSONNEL, LAW ENFORCEMENT OFFICER, PARAMEDIC,    ANNEX B           B-1
  EMT, OR DISPATCHER MAY REQUEST AN MCI PLAN ACTIVATION
  THROUGH THE INCIDENT COMMANDER, OR THE EMS AGENCY MAY
  ACTIVATE THE PLAN TO FACILITATE THE RESOURCE NEEDS OF AN   ANNEX C           C-1
  INCIDENT.

HOW TO ACTIVATE THIS PLAN:
                                                             ANNEX D           D-1
  REPORT TO YOUR EMERGENCY COMMUNICATIONS CENTER THAT
  THE MULTIPLE CASUALTY INCIDENT PLAN SHOULD BE ACTIVATED    ANNEX E           E-1
  THROUGH COUNTY COMMUNICATIONS.

PROVIDE THE FOLLOWING INFORMATION AT TIME OF ACTIVATION:     ANNEX F           F-1
   o TYPE OF INCIDENT
   o LOCATION OF INCIDENT
   o BEST ACCESS ROUTE                                       ANNEX G          G-1
   o NUMBER OF INJURED (APPROXIMATE)
   o TYPE OF INJURIES (BURNS, RESPIRATORY, ETC.)
   o NEED FOR MORE THAN INITIAL FIRST RESPONSE               ANNEX H           H-1

REQUEST SPECIAL RESOURCES AS NEEDED                          ANNEX I           I-1
   o SPECIAL RESCUE EQUIPMENT  o CORONER
   o ADDITIONAL POLICE,        o LIGHTING
      FIRE PERSONNEL           o BARRICADES                  ICS CHECKLISTS   CL-1
   o COMMUNICATIONS EQUIPMENT o HELICOPTER
   o CAL TRANS and/or CHP      o HAZMAT RESPONSE
                                                             MCI FORMS


 Rev. 5/99
Santa Clara Valley Health and Hospital System
Emergency Medical Services Agency
         645 South Bascom Avenue
            San Jose, CA 95128
               408-885-4250
             Fax 408-885-4264
       THIS DOCUMENT HAS BEEN DEVELOPED THROUGH THE COOPERATION AND
                JOINT EFFORT OF THE FOLLOWING ORGANIZATIONS:

                     Santa Clara County Medical Association

                 Santa Clara County Office of Emergency Services

                            Emergency Medical Services Agency
                                  County of Santa Clara

                             American Medical Response-West

                                 San Jose Fire Department

                            Santa Clara County Communications

                                      ARES/RACES
                                     (Radio Amateurs)

                           Hospital Council of Santa Clara County

                                 California Highway Patrol

                                    American Red Cross




5/99
SANTA CLARA COUNTY                                          MULTIPLE CASUALTY INCIDENT PLAN

                          SECTION 1 - OBJECTIVES & SCOPE OF PLAN

1.1    OBJECTIVES

       To ensure adequate and coordinated efforts to minimize loss of life, disabling injuries, and human
       suffering by providing effective emergency medical assistance through efficient utilization of
       medical and other resources in the event of emergencies resulting in multiple casualties.

       To manage the resources necessary for mobilizing teams to effectively handle casualties while also
       maintaining teams to handle other emergency situations associated with the incident.


1.2    SCOPE OF PLAN

       This plan has been prepared to provide a coordinated response to a confined incident which could
       overwhelm the day-to-day emergency medical response system. The Multiple Casualty Incident
       Plan is not designed to accommodate a county-wide disaster, but offers a resource management
       system through which a larger incident (disaster) could be handled.

       Few, if any, government agencies have the resources to properly respond to incidents involving
       multiple casualties. Therefore, multiple casualty emergencies become multi-agency incidents. Law
       enforcement, Fire, Advanced Life Support (ALS) and Basic Life Support (BLS) providers, County
       Communications, County Emergency Medical Services, Hospitals, American Red Cross, and Radio
       Amateurs are among the public and private agencies that become involved with this Plan. Each has
       a specific defined role in this Plan.

       1.2.1 Initiation of this plan, either in the ALERT phase or the ACTIVATION phase, does NOT
             automatically create resource requests and dispatch and................

           RESOURCES MUST BE REQUESTED BY THE INCIDENT COMMANDER.




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SANTA CLARA COUNTY                                          MULTIPLE CASUALTY INCIDENT PLAN

1.3    JURISDICTION AND COMMAND

       Each agency shall retain full command authority within its scope and jurisdiction at all times.

       1.3.1 Agencies which are assisting in support of a single jurisdiction will function under the
             direction of that jurisdiction's designated Incident Commander.

       1.3.2 In multi-jurisdictional incidents, Incident Commanders may establish unified command,
             planning, and coordinated strategies for controlling the overall incident at a single well
             identified Command Post.




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SANTA CLARA COUNTY                                     MULTIPLE CASUALTY INCIDENT PLAN

                               SECTION 2 - PLAN OUTLINE

2.1    DEFINITIONS

       2.1.1 ALERT

                 A medical advisory ALERT signifies that an incident has occurred or a condition
                 exists which may severely impact the pre-hospital and/or hospital resources. This is
                 an advisory notification only.

       2.1.2 ACTIVATION

                 A single site (confined) emergency incident involving any number of injured persons
                 which exceeds the capabilities of an initial response of medical resources within a
                 portion of the County requiring activation of the plan.

2.2    CRITERIA FOR USE

       2.2.1 ALERT

                 A medical advisory ALERT shall be initiated whenever information received
                 indicates the potential for a large number of casualties.

                 It is difficult to adequately define each potential situation. The following list is
                 intended as a guide. In doubtful situations, following consultation with appropriate
                 field and/or jurisdictional personnel, a conservative decision would be to initiate a
                 medical advisory ALERT in response to:

                 1.     Notification of an "Alert II" from San Jose International Airport

                 2.     Large scale hazardous materials incidents

                 3.     Multiple alarm fires in heavily populated areas, or isolated fires in heavily
                        occupied buildings.

                 4.     Hostage situations with the potential for large numbers of casualties.

                 5.     Hospital evacuation.




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SANTA CLARA COUNTY                                         MULTIPLE CASUALTY INCIDENT PLAN

       2.2.2 ACTIVATION

            The Multiple Casualty Incident Plan shall be ACTIVATED upon confirmation of any single
            site multiple casualty incident that overwhelms the capabilities of the initial response unit(s).




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SANTA CLARA COUNTY                                           MULTIPLE CASUALTY INCIDENT PLAN

                                  SECTION 3 - ADVISORY ALERT

3.1    INITIATION - AGENCY RESPONSIBILITIES

       3.1.1 Santa Clara County Communications

              1.     Initiate an "all-call" to all pre-hospital units and provider supervisors.

              2.     Notify the on-call EMS Coordinator.

              3.     Initiate a Medical Facility Status System MCI-ALERT and provide known
                     information.


       3.1.2 Fire and Law Enforcement Providers

              1.     Respond to dispatch according to internal procedure for potential multiple casualty
                     incidents.

              2.     Verify incident status and relay all appropriate information to County
                     Communications.

       3.1.3 Pre-hospital Providers

              1.     Initiate internal notification procedures.

       3.1.4 Hospitals

              1.     Initiate internal notification procedures.

              2.     Respond to Medical Facility Status System with casualty capacities when requested.

              3.     Monitor Pre-hospital radio system for scene information.

3.2    ALERT TERMINATION

       A medical advisory ALERT should be canceled by the initiating agency through County
       Communications upon determination that a multiple casualty incident has not occurred, and that the
       conditions for which the ALERT was initiated no longer exist.

       Santa Clara County Communications should then notify all agencies to which it communicated the
       ALERT of the cancellation.




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SANTA CLARA COUNTY                                           MULTIPLE CASUALTY INCIDENT PLAN

              SECTION 4 - ACTIVATION OF THE MULTIPLE CASUALTY PLAN

4.1    INITIATING AN ACTIVATION

       Any public safety officer (fire or law), paramedic, EMT, or dispatcher having direct knowledge of
       the incident may request an ACTIVATION through the INCIDENT COMMANDER. The EMS
       Agency may also initiate an ACTIVATION to facilitate the resource needs of an incident.

       4.1.1 HOW TO ACTIVATE THIS PLAN:

              1.     The INCIDENT COMMANDER reports to his/her emergency communications
                     center that the MULTIPLE CASUALTY INCIDENT PLAN should be
                     ACTIVATED through County Communications.

              2.     Provide the following information:

                     Type of incident
                     Location of incident
                     Best access route
                     Number of injured (approximate)
                     Type of injuries (burns, respiratory, etc.)
                     Known hazards to responding units

              3.     Request Resources:

                     Initial response: ____FIRE ____LAW ____MEDICAL
                     Special rescue equipment
                     Additional Police / CHP for scene safety
                     Additional Fire personnel for extrication or medical assistance
                     Communications resources such as ARES/RACES (Amateur Radio) shadows
                     CALTRANS
                     Hazardous Materials response team
                     Coroner
                     Lighting
                     Barricades

       4.1.2 HOW TO DEACTIVATE THE PLAN:

              1.     Demobilize the ACTIVATION once incident operations are complete.

              2.     The INCIDENT COMMANDER notifies his/her communications center to inform
                     County Communications to deactivate the MCI Plan. Request demobilization of all
                     notified agencies.




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SANTA CLARA COUNTY                                         MULTIPLE CASUALTY INCIDENT PLAN

               SECTION 5 - ICS ORGANIZATION - GENERAL DUTY STATEMENTS

5.1    ICS ORGANIZATION - (See chart page 5-5)

       The incident scene is organized using the "Incident Command System (ICS)" which provides both
       an organized management structure to accomplish established incident objectives, and a
       communication pathway to facilitate multiple agency interface at multiple casualty incidents. The
       ICS system uses a modular, flexible structure that allows the Incident Commander the option to
       activate only the necessary functional branches needed to respond to the event.

5.2    GENERAL DUTY STATEMENT The general duty statements of the Command Staff and the
       specialized multiple casualty positions are contained below: (Note: Position radio call signs are
       indicated in (“CALLSIGN”) format.

       5.2.1      Incident Commander (“IC”)

       Responsible for ensuring development and implementation of strategic plans for overall
       management of the incident, and for approving the ordering and release of resources. Initially may
       be the senior law enforcement, fire or emergency medical services person on scene.

       5.2.2      Liaison Officer (“Liaison”)

       Functions as the point of contact for assisting and coordinating representatives from other agencies
       and/or jurisdictions.

       5.2.3      Public Information Officer (“PIO”)

       Responsible for formulation and release of information about the incident and will normally be the
       point of contact for the media and other appropriate agencies which desire information directly.

       5.2.4      Safety Officer (“Safety”)

       Responsible for assessing all situations for hazards and unsafe conditions and developing measures
       for assuring personnel safety.

       5.2.5      Operations Section Chief (“Operations”)

       Responsible for the direct management of all incident tactical activities, including requests for and
       release of resources; and development and implementation of the incident action plan with the IC
       and Logistics.




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SANTA CLARA COUNTY                                          MULTIPLE CASUALTY INCIDENT PLAN

       5.2.6      Plans Section Chief (“Plans”)

       Responsible for collecting, evaluating, and disseminating information about the incident. Must
       understand the current situation and predict probable course of incident. Prepares primary and
       alternate strategies for the Incident Commander.

       5.2.7      Logistics Section Chief (“Logistics”)

       Responsible for managing those units which provide for personnel, apparatus, equipment, facilities
       and personal needs in support of incident activities. Participate with OPS and IC to develop and
       implement Incident Action Plan.

       5.2.8      Staging Manager (“Staging”)

       Responsible for checking in all incoming resources except ambulances; dispatch of resources at the
       request of the Operations Section Chief; and requests of Logistics Section support for resources
       located in the staging area.

       5.2.9      Medical Support Unit Leader (“Medical Support”)

       Responsible for providing assessment and treatment to personnel assigned to the incident,
       developing the medical portion of the Incident Action Plan, and, in conjunction with the Safety
       Officer, establishing a rehabilitation area.

       5.2.10     Medical Group Supervisor (“Medical”)

       Responsible for establishing command and control of medical group. Supervises triage, treatment
       areas, transportation and morgue functions, designate Ambulance Staging Area. Will usually be an
       EMT-P or EMT-P Supervisor.

       5.2.11     Medical Supply Unit Leader (“Med Supply”)

       Responsible to acquire and maintain control of appropriate medical equipment and supplies.

       5.2.12     Triage Unit Leader (“Triage”)

       Responsible for managing the sorting and tagging of casualties for movement into treatment areas,
       utilizing the START triage system.

       5.2.13     Treatment Unit Leader (“Treatment”)

       Responsible for coordinating medical care to injured who are waiting for transportation.




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SANTA CLARA COUNTY                                           MULTIPLE CASUALTY INCIDENT PLAN

       5.2.14     Morgue Unit Leader (“Morgue”)

       Responsible for establishing or maintaining temporary morgue designated by Medical Group
       Supervisor. Collect, protect and identify bodies and their personal effects.

       5.2.15     Transportation Group Supervisor (“Transportation”)

       Responsible for coordinating appropriate utilization of available ambulances, directing traffic flow,
       and insuring that patient records accompany patients to hospitals. Coordinates with Hospital
       Coordinator to avoid overloading any single hospital and to ensure that patient records are complete.

       5.2.16      Ambulance Staging Manager (“Ambulance Staging”)

       Responsible for coordinating the movement and tracking of all medical transportation vehicles
       immediately prior to moving into the patient loading area.

       5.2.17     Hospital Coordinator (“Hospital”)

       Responsible for records relating to patient identification, injuries, mode of transportation and
       destination, and communicating incident and patient information to local receiving facilities.

       5.2.18     Air Ambulance Unit Leader (“Air Medical”)

       Responsible for coordinating the movement and tracking of all air medical transportation vehicles
       immediately prior to moving the patient into the loading area.

       5.2.19     Fire Group Supervisor (“Fire”)

       Responsible for suppression of fire, control of other hazards and extrication.

       5.2.20     Rescue Unit Leader (“Rescue”)

       Responsible for coordinating the removal of endangered victims to a safe location for immediate
       triage, after ensuring the safety of the scene for entry by extrication personnel.

       5.2.21     Extrication Unit Leader (“Extrication”)

       Responsible for coordinating and directing victim removal which involves the use of specialized
       equipment, after ensuring the safety of the scene for entry by extrication personnel.

       5.2.22     Suppression Unit Leader (“Suppression”)

       Responsible for coordinating fire suppression activities.




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SANTA CLARA COUNTY                                            MULTIPLE CASUALTY INCIDENT PLAN

       5.2.23     Law Group Supervisor (“Law”)

       Responsible for traffic control and security of the incident.

       5.2.24     Perimeter Enforcement Unit Leader (“Perimeter Enforcement”)

       Responsible for perimeter traffic control. Coordinate with Staging Manager and Ambulance Staging
       for ingress and egress of resources.

       5.2.25     Internal Enforcement Unit Leader (“Internal Enforcement”)

       Responsible for internal traffic flow and equipment security. Coordinate with Ambulance Staging
       and Perimeter Control for ingress and egress of ambulances, and delivery of medical supplies.

       5.2.26     Air Operations Group Supervisor (“Air OPS”)

       Responsible for all activities related to helicopter support to the incident, including setup and
       security of helicopter landing zones.




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SANTA CLARA COUNTY                                                                                  MULTIPLE CASUALTY INCIDENT PLAN


                                                                               INCIDENT COMMANDER
                                                                                      (5.2.1)


                                                                 LIASON                             P.I.O.
                                                                  (5.2.2)                           (5.2.3)

                                                                 SAFETY
                                                                  (5.2.4)




                                       PLANS                           OPERATIONS                                                              LOGISTICS
                                       (5.2.6)                           (5.2.5)                                                                 (5.2.7)


                                                      STAGING
                                                       (5.2.8)                                                                                 MEDICAL SUPPORT UNIT
                                                                                                                                                       5.2.9



       MEDICAL GROUP           TRANSPORTATION GROUP                         FIRE GROUP                        LAW GROUP             AIR OPS
           (5.2.10)                   (5.2.15)                                 (5.2.19)                         (5.2.23)            (5.2.26)



         MEDICAL SUPPLY UNIT       AMBULANCE STAGING UNIT                        RESCUE UNIT           PERIMETER ENFORCEMENT UNIT
               (5.2.11)                   (5.2.16)                                 (5.2.20)                      (5.2.24)

             TRIAGE UNIT          HOSPITAL COORDINATION UNIT                  EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
               (5.2.12)                     (5.2.17)                               (5.2.21)                       (5.2.25)

           TREATMENT UNIT             AIR AMBULANCE UNIT                      SUPPRESSION UNIT
               (5.2.13)                     (5.2.18)                               (5.2.22)

             MORGUE UNIT
               (5.2.14)




5/99                                                                                                                                                                  5-5
SANTA CLARA COUNTY                                            MULTIPLE CASUALTY INCIDENT PLAN


                                  SECTION 6 - SCENE OPERATIONS

6.1    COMMAND POST

       A single site, easily identified Command Post shall be established by the Incident Commander.

       6.1.1 Command Post Location

       Command Post location shall be established keeping in mind:

       a.     Ease of access and visibility.
       b.     Perspective of operations which does not conflict with emergency operations
       c.     Safety of the Command Post staff.

       6.1.2 Command Post Identification

       Command Post will be identified in a clear and conspicuous manner.

       6.1.3 Command Post Functions

       The Command Post is the location from which all incident operations are directed. Law
       Enforcement, Fire, Liaison, P.I.O., Safety may co-locate at the Command Post. All other agencies
       or responders will report to the Staging Area.


6.2    STAGING

       This plan assumes incidents may dictate establishment of staging area(s). Two areas are suggested:
       General Staging and Ambulance Staging. If two locations are established, ambulance staging may
       be located closer to the incident scene at the direction of the Medical Group Supervisor and supplies
       may be deposited at the scene by incoming units before staging at this location.


       6.2.1 General Staging Area

       Is established for temporary location of all arriving resources.

       6.2.2 Ambulance Staging Area

       Is established by the Transportation Group Supervisor for the staging of all (ground) medical
       transportation vehicles until needed in the patient loading area. Ambulance Staging Area should be
       located so that move-up for loading can be signaled visually or by radio.




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SANTA CLARA COUNTY                                           MULTIPLE CASUALTY INCIDENT PLAN

       6.2.3 Medical Supplies

       Coordinate delivery of incoming medical supplies with the Medical Group Supervisor.

6.3    TRIAGE (See chart on page 6-5)

       START triage is utilized in all Santa Clara County multiple casualty responses.

       6.3.1 Triage Unit

       The Triage Unit will quickly evaluate and categorize the injured into the following groups:

       IMMEDIATE (RED) - Patient requiring urgent transportation and treatment for survival.

       DELAYED (YELLOW) - Patients who are not likely to suffer adversely from a delay in
       transportation and/or patients whose injuries are of such severity as to make survival unlikely.

       MINOR (GREEN) - Patients who are ambulatory and able to follow simple commands and self
       mobilize away from incident.

       DECEASED (BLACK) - Self explanatory (leave where found if possible).

       6.3.2 Tags

       Triage tags created by the California Fire Chiefs’ Association are utilized at all multiple casualty
       incidents in Santa Clara County.

       6.3.3 Movement of Patients

       The Triage, Rescue and/or Extrication Units will systematically work through the incident area,
       assess and tag patients where they lie, unless they are in imminent danger. Triage tags should be
       attached to the lower left leg when possible. Ambulatory patients should be conspicuously tagged
       on the anterior chest. Non-ambulatory victims will then be carried into the Treatment Area and
       placed into organized groups of IMMEDIATE-DELAYED-MINOR. Patients tagged DECEASED
       will be left where found until the Coroner arrives.

       If the multiple casualty incident location is potentially explosive or hazardous, victims will be
       moved to a safe location prior to triage and tagging.




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SANTA CLARA COUNTY                                        MULTIPLE CASUALTY INCIDENT PLAN

6.4    TREATMENT

       6.4.1 Treatment Areas

       A IMMEDIATE zone will be set up to group critically injured patients for field stabilization.
       Medical staffing should approach one on one. Sufficient space between patients should be allowed
       for treatment. These patients need to have transportation expedited.

       A DELAYED zone will be established and should be physically separate from the IMMEDIATE
       and MINOR groups. Less staffing can be assigned, and patients tagged MINOR may be used to
       assist in this area. Transportation can be mixed in with, but shall not precede, IMMEDIATE
       patients.

       A MINOR zone will be established and should be physically separate from the other two groups.
       Remember that patients from this category may be used to assist in the DELAYED zone.

       6.4.2 Medical Treatment (Refer to Annex F)

       The following sequence is assumed: The initial responder will likely be EMT#1 (Fire) and perform
       START triage. Upon establishment of the Medical Group, the Treatment Leader will establish the
       treatment area and take over treatment tasks. Additional firefighters or paramedics may assist in
       field stabilization.

       6.4.3 Emotionally Disturbed Victims

       Those individuals who were involved in the incident and who appear to be emotionally disturbed or
       who may interfere with the casualty handling should be isolated from the incident scene and
       transportation areas as soon as possible and not left unattended. "Treatment" must insure that
       "Safety" is aware of these victims, and that "Law" is available to control them.

6.5    TRANSPORTATION

       6.5.1 Patient Loading

       "Transportation" coordinates with the Hospital Coordination Unit for balanced loading and
       distribution of ambulances and other victim transportation modalities.

       No more than two IMMEDIATEs should be placed in a vehicle. The remainder of the load should
       be patients tagged as DELAYED or MINOR. IMMEDIATE patients should be transported
       (attended to) by ALS personnel.




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SANTA CLARA COUNTY                                          MULTIPLE CASUALTY INCIDENT PLAN

       6.5.2 Casualty Distribution

       Information on hospital capacities will be provided to the Hospital Coordination Unit via County
       Communications.

       Caution must be taken not to overload any single hospital.

       Patients are to be distributed in accordance with Santa Clara County transportation policies
       whenever possible, with consideration of hospital capacities provided on the Medical Facility Status
       system.

       Hospital capacity updates should be requested/provided as the length of the incident increases and/or
       as more information is received about the scene.

6.6    SPECIAL SCENE CONSIDERATIONS

       Certain circumstances may delay the immediate accessibility of patients to responding personnel
       (e.g. hazardous materials contamination, explosive environments or other scene/rescuer safety
       considerations). RESPONDING PERSONNEL ARE NOT TO PLACE THEMSELVES AT
       PERSONAL RISK.

       For hazardous materials incidents, refer to the Santa Clara County Hazardous Materials Policy and
       the county-wide (fire) Decontamination Protocol for preliminary procedures.




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SANTA CLARA COUNTY                                                             MULTIPLE CASUALTY INCIDENT PLAN




                                                     START Algorithm

                                                      START TRIAGE




                                                      RESPIRATIONS

                              YES                                                            NO

         Over 30/Min                         Under 30/Min                               Position Airway

         IMMEDIATE                           PERFUSION                          IMMEDIATE       NON SALVAGEABLE


                          Radial Pulse Present           Radial Pulse Absent
                            Capil ary Refil                Capil ary Refil
                           Under 2 Seconds                Over 2 Seconds

                           MENTAL STATUS                    Control Bleeding

                 Can Follow Simple Can't Follow Simple       IMMEDIATE
                    Commands          Commands

                       DELAYED          IMMEDIATE




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SANTA CLARA COUNTY                                           MULTIPLE CASUALTY INCIDENT PLAN

                                                ANNEX “A”

                                  COUNTY COMMUNICATIONS

1.     Purpose

       A.    Describe actions to be taken by the Santa Clara County Communications Department upon
             activation of the Multiple Casualty Incident plan.

       B.    Provide a plan to coordinate communications with other agencies during multiple casualty
             incidents.

2.     Use of the Multiple Casualty Incident Plan

       A.    The Multiple Casualty Incident Plan may be initiated only upon the specific request of a fire,
             law enforcement, dispatcher, or paramedic representative who reports an incident within
             Santa Clara County involving casualties exceeding initial response capabilities. This will
             usually occur from the incident site following a normal response by the jurisdiction involved,
             and which should include a request to initiate the MCI Plan. The reporting party will provide
             the Watch Commander at County Communications with an estimate of the situation, to
             include:

             1.     Type of incident.

             2.     Location of the incident.

             3.     Best access route(s).

             4.     Approximate number of injuries.

             5.     Type of injuries.

             6.     Any immediately-apparent need for special resources such as barricades, lighting,
                    special rescue equipment, etc.

             7.     Whether an ALERT or ACTIVATION is needed.

       B.    After the initial dispatch of emergency vehicles and personnel, additional emergency fire and
             law enforcement equipment and/or personnel will not be dispatched without a specific
             request from the Incident Commander or the on-scene officer in charge of the service
             requested.

             1.     The EMS Agency is to be notified immediately of any use (ALERT or
                    ACTIVATION) of the Multiple Casualty Plan.




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SANTA CLARA COUNTY                                          MULTIPLE CASUALTY INCIDENT PLAN

       C.   Additional ambulances/paramedics are to be dispatched only when advised from the incident
            scene by a public safety officer (police or fire) or a paramedic that the number of casualties
            merits additional units. The multiple casualty site will have adequate but not excessive
            ambulance coverage. The Medical Group Supervisor must coordinate the use of
            transportation resources with the EMS Agency and keep the Communications Center advised
            of additional needs at the site. Ambulances not required must be released at the earliest
            possible time. Industrial, Military, and privately owned ambulances which are not under
            contract to the County will be the last resource called and the first resource released.

       D.   ALERT

            County Communications will initiate an ALERT by taking the actions listed below:

            1.     Issue an information bulletin to public safety agencies.

            2.     Notify the EMS Chief Duty Officer.

            3.     Notify hospitals on the Medical Facility Status System in general terms the nature,
                   magnitude, and location of the incident. Dispatcher should expect the hospitals to:

                   a.      Relay via the Medical Facility Status System to County Communications the
                           number of IMMEDIATE/DELAYED/MINOR patients they are currently
                           able to receive in the Emergency Department.

                   b.      Update the Medical Facility Status System as additional resources, personnel
                           or Emergency Department space become available.

            4.     When incident-appropriate, or requested to do so by EMS, notify appropriate pre-
                   hospital providers.

            5.     Designate a dispatcher to respond to the scene if available.

       E.   ACTIVATION

            County Communications will initiate an ACTIVATION by taking the actions listed below:

            1.     Issue an information bulletin to public safety agencies.

            2.     Notify the EMS Chief Duty Officer.




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SANTA CLARA COUNTY                                     MULTIPLE CASUALTY INCIDENT PLAN

         3.    Notify hospitals on the Medical Facility Status System that the Multiple Casualty
               Incident Plan has been activated. Provide in general terms the nature, magnitude, and
               location of the incident. Dispatcher should expect the hospitals to:

               a.     Relay via the Medical Facility Status System to County Communications the
                      number of IMMEDIATE/DELAYED/MINOR patients they are currently
                      able to receive in the emergency department (ED).

               b.     Update the Medical Facility Information System as additional resources,
                      personnel or Emergency Department space becomes available.

         4.    When incident-appropriate, or requested to do so by EMS, notify appropriate pre-
               hospital providers.

         5.    Designate a dispatcher to respond to the scene.

         6.    Notify Communications Administration, when appropriate:

               a.     Communications Director.

               b.     Communications Engineer Manager.

               c.     Chief Dispatcher.

         7.    Notify American Red Cross, San Jose or Palo Alto Chapter (depending on location of
               the incident) to activate their plan.

         8.    Notify Coordinator of Amateur Radio Operators to activate their plan.

         9.    Notify County Law Enforcement Mutual Aid Coordinator.

         10.   Notify County Fire Mutual Aid Coordinator.

         11.   Notify designated contact of the County Mental Health Bureau for possible
               mobilization.

         12.   Notify County Office of Emergency Services Coordinator.

         13.   If the services of any other public or private agencies are required they must be
               specifically requested by the INCIDENT COMMANDER or one of his/her
               designees.




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SANTA CLARA COUNTY                                            MULTIPLE CASUALTY INCIDENT PLAN

3.     Assignment of Receiving Hospitals to Patient Transport Vehicles

       A.     It is the responsibility of the TRANSPORTATION GROUP SUPERVISOR to coordinate
              the distribution of patients.      The TRANSPORTATION GROUP SUPERVISOR or
              designee will provide unit# and destination to County Communications for all transport units
              that are not equipped with Control 9/91/92 radios, and will ensure that the designated
              receiving facility is provided with the unit# and brief specifics.

4.     Communications at the Scene

       A.     The Communications Dispatcher who responds to the scene will remain at the Command
              Post to provide communications liaison among the Incident Commander, Amateur Radio
              Operator, and the Communications Center. The Dispatcher will have the responsibility of
              keeping the Communications Center informed of developments at the scene which may
              affect internal planning of the Communications Department.

       B.     The Communications Department has a large, self contained, mobile communications van
              which, staff permitting, may be made available for extended operations or operations at
              remote locations where direct radio contact with the Communications Center may be difficult
              or impossible. The communications van should only be requested with the understanding
              that several hours could be required to obtain staffing and for travel and set-up time.

       C.     The Communications Director and/or the Communications Engineer Manager may respond
              to the site in radio equipped vehicles to assist in the initial coordination with the Center.

5.     Other Radio Frequencies

       MCIP fire department traffic will be coordinated on the State "White 1" fire frequency.

       Law enforcement radio communications may be coordinated on the Law Mutual Aid (LMA) MACS
       bands 150, 460, and/or 480.




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               SANTA CLARA COUNTYMULTIPLE CASUALTY INCIDENT PLAN

                                                  ANNEX “B”

                                                FIRE SERVICE

1.     Responsibility

       Incidents other than law enforcement are the responsibility of the Fire Department having
       jurisdiction, and a fire person will normally be the Incident Commander.

       Incidents on state highways, traffic collisions, civil incidents, and law enforcement incidents are the
       responsibility of the Highway Patrol or police agency having jurisdiction. The senior law
       enforcement officer will normally be the Incident Commander.

       (If the above is in conflict with a city policy, the policy of the city having jurisdiction will prevail.)

2.     Procedure

       A.      A fire unit arriving first on the scene shall:

               1.      Take initiative action; assess the situation and follow the procedure under ALERT or
                       ACTIVATION OF PLAN.

               2.      Establish a Command Post using the Incident Command System as provided under
                       this MULTIPLE CASUALTY INCIDENT PLAN.

               3.      If a law enforcement incident, transfer command to senior law enforcement officer
                       upon arrival and perform ICS functions as assigned by the Incident Commander. Be
                       prepared to:

                       a.      Function as an agency representative for the fire service.

                       b.      Provide a communication link to County Communications.

                       c.      Provide ICS position vests.

                       d.      Handle functions of the Operations Section Chief.

                       e.      Provide Triage Tags.

       B.      A fire unit arriving on the scene after police or ambulance would:

               1.      Report to the Command Post or person in charge.

               2.      Perform the functional assignment given by the Incident Commander.

               3.      Assume command if a fire incident.



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SANTA CLARA COUNTY                                                MULTIPLE CASUALTY INCIDENT PLAN

                                                 ANNEX “C”

                                           LAW ENFORCEMENT

1.     Responsibility

       Incidents on highways, traffic collisions, hazardous material spills, civil incidents, and law
       enforcement incidents are the responsibility of the Highway Patrol or police agency having
       jurisdiction. A law enforcement officer will normally be the Incident Commander.

       Incidents other than law enforcement are the responsibility of the Fire Department having
       jurisdiction, and the senior fire officer will normally be the Incident Commander.

       (If the above is in conflict with a city policy, the policy of the city having jurisdiction will prevail.)

2.     Procedure

       A.      The first arriving unit shall:

               1.      Take initiative action; assess the situation and follow the procedure under ALERT or
                       ACTIVATION OF PLAN.

               2.      Establish a Command Post using the Incident Command system as provided under
                       this MULTIPLE CASUALTY INCIDENT PLAN.

               3.      If not a law enforcement incident, transfer command to the senior fire officer upon
                       arrival and perform ICS functions as assigned by the Incident Commander. Be
                       prepared to:

                       a.      Function as an agency representative for law enforcement.

                       b.      Provide a communications link to other law enforcement agencies.

                       c.      Provide for scene security.

                       d.      All actions taken by Command post personnel should be recorded to prevent
                               duplication, ensure necessary actions are taken, facilitate after-action reporting
                               and to assist with subsequent critiquing.

       B.      A law enforcement unit arriving on the scene after fire or ambulance would:
               1.      Report to the Command Post or person in charge.
               2.      Perform the functional assignment given by Incident Commander.
               3.      Assume command if a Law Enforcement incident.




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SANTA CLARA COUNTY                                         MULTIPLE CASUALTY INCIDENT PLAN

                                            ANNEX “D”

                     EMS (EMERGENCY MEDICAL SERVICES AGENCY)

1.     The Emergency Medical Services Agency is responsible for managing the overall operation of the
       pre-hospital system.

       A.    The EMS Chief Duty Officer (on call staff member) will notify the EMS Director and
             Medical Director of the multiple casualty incident activation as soon as time allows after
             initiating critical initial activities.

       B.    The EMS Chief Duty Officer will respond as necessary to the Command Post, as the Public
             Health/EMS agency representative; County Communications, Public Health Departmental
             Emergency Operations Center (DEOC); Emergency Operations Center (EOC); or other
             operations site.

       C.    The EMS Chief Duty Officer is responsible for initiating medical mutual aid requests
             through the Bay Area Medical Mutual Aid (BAMMA) system and/or the Region II Regional
             Disaster Medical/Health Coordinator (RDMHC).

       D.    The EMS Chief Duty Officer will implement operational contingencies to support the
             multiple casualty incident and preserve routine EMS capabilities to the extent possible.
             Contingencies, in relative order of preference, include:

             1.     Authorization of non-permitted ambulance resource utilization.
             2.     Aid request for fire service based ambulance resources.
             3.     Transport restriction to closest hospital.
             4.     Non-emergent call hold.

       E.    The EMS Chief Duty Officer will coordinate as necessary with the Operational Area Disaster
             Medical/Health Coordinator (OADMHC) for procurement and allocation of critical public
             and private medical and other resources to support multiple casualty incident and EMS
             system operations.




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SANTA CLARA COUNTY                                          MULTIPLE CASUALTY INCIDENT PLAN

                                            ANNEX “E”

                                   HOSPITAL INSTRUCTIONS


1.     In the event of an ALERT or ACTIVATION, acute care hospitals with emergency departments will
       be notified by County Communications.

2.     ONCE NOTIFIED, MONITOR THE MEDICAL FACILITY STATUS SYSTEM and the
       APPROPRIATE RADIO FREQUENCY CONTINUOUSLY.

3.     Upon notification of an ALERT or ACTIVATION, each hospital should:

       A.    Provide the number of IMMEDIATE/DELAYED/MINOR patients they are capable of
             receiving.

             1.     IMMEDIATE patients will          -   need a bed/gurney
                                                     -   need an immediate evaluation by a physician or
                                                         surgeon
                                                     -   need immediate treatment by a physician and/or
                                                         surgical intervention
                                                     -   ideally need at least 1:2 nursing care
                                                     -   probably be admitted

             2.     DELAYED patients will            -   need a bed/gurney
                                                     -   need a rapid assessment by a nurse or
                                                         physician’s assistant
                                                     -   need limited intervention/treatment within
                                                         30 minutes by a nurse or physician’s assistant
                                                     -   ideally need at least 1:7 nursing care
                                                     -   possibly be admitted

             3.     MINOR patients will              -   need a place to sit (a bed/gurney is not required)
                                                     -   need a minimal screening assessment by a nurse
                                                     -   need minimal intervention/treatment within
                                                         60-90 minutes by a nurse or physician’s
                                                         assistant
                                                     -   ideally need at least 1:25 monitoring by an
                                                         individual trained in first aid and CPR
                                                     -   unlikely be admitted

       B.    Make preparations for the activation of their internal disaster plan (depending upon the
             number of victims expected).

       C.    Update the Medical Facility Status System as requested and/or as more staff/resources enable
             greater patient capacity.



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SANTA CLARA COUNTY                                           MULTIPLE CASUALTY INCIDENT PLAN

4.     Hospitals should prepare the following casualty information for RED CROSS:
              Ø patient’s name
              Ø patient’s date of birth
              Ø patient’s address, if possible
              Ø EMS triage tag number

       Casualty information should be provided to AMERICAN RED CROSS (ARC) as soon as possible.
       County Communications will advise hospitals when the ARC casualty information system has been
       implemented for an event. Callers requesting casualty information should be directed to contact the
       RED CROSS chapter at the number designated for the MCI event.




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SANTA CLARA COUNTY                                              MULTIPLE CASUALTY INCIDENT PLAN

                                                ANNEX “F”

                                  TRIAGE/TREATMENT (Standards)

       TRIAGE

       The objective of Triage is to sort casualties so that the maximum number of lives can be saved
       through effective utilization of rescuers, medical personnel and medical facilities.

       This information explains Santa Clara County procedures for field triage.

       A.     Principles

        1.    Initial casualty triaging is to be done by first-in responders at the scene of the incident with
              minimal casualty movement.

        2.    Initial triage will take priority over initial emergency care treatment.

        3.    All casualties are triaged according to the seriousness of injury and tagged to establish
              priority of treatment and transportation.

        4.    Personnel performing triage are to give an examination based on the “START” triage tag
              with the appropriate category indicated. They are not to fill out the tags.

        5.    The emergency care administered by triage teams is to be restricted to:

                a.   ASSISTING IN OBTAINING AN AIRWAY

                b.   CONTROLLING SEVERE HEMORRHAGE

                c.   POSITIONING TO IMPROVE CORE CIRCULATION

        6.    Personnel assigned to treatment areas are to give a secondary examination and fill out the
              triage tag on all triaged casualties.

       B.     Triage Categories

              Casualties are to be examined and tagged according to the seriousness and kind of injury
              based on four categories:

                1.   DECEASED - black portion of tag
                2.   IMMEDIATE - red portion of tag
                3.   DELAYED - yellow portion of tag
                4.   MINOR - green portion of tag




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SANTA CLARA COUNTY                                           MULTIPLE CASUALTY INCIDENT PLAN

       C.   Procedures

             1.   The mission of initial triage is the responsibility of first-in responders.

             2.   Initial triage personnel are to stay with a casualty only long enough to administer the
                  necessary critical care treatment of:

                    a.    OPENING THE OBSTRUCTED AIRWAY
                    b.    POSITIONING UNCONSCIOUS CASUALTIES IN THE COMA POSITION
                    c.    STOPPING ARTERIAL BLEEDING
                    d.    ELEVATING THE LEGS

                  Regardless of the success or failure of this treatment, triage personnel will continue
                  triage. Casualties tagged Minor (green) should be used to stay with casualties
                  needing critical care treatment.

             3.   Personnel assigned to triage are to function in teams of two or three rescuers when
                  possible.

             4.   All persons involved in the incident are to be quickly examined and tagged whether
                  injured or not injured according to START Triage Method.

             5.   Non-ambulatory casualties are to be triaged where they lie, unless they are in an
                  unsafe area which requires their immediate movement.

             6.   Tagging procedure:

                    a.    Triage tag categories will be torn off appropriately, leaving the proper
                          category as the lower most portion of the tag.

                    b.    The triage tag should be attached to the lower left leg or foot when possible.
                          Ambulatory casualties shall have their tag placed conspicuously on the
                          anterior trunk.

                    c.    Tag portions torn off shall remain intact and be turned over to the Triage
                          Team Leader upon completion of triage. (Casualties triaged as “MINOR”
                          will have the upper left corner of the tag removed and turned over along with
                          other tag portions.)

                    d.    Triage personnel will leave the tag blank.

             7.   At the completion of triage, triage personnel are to report to the Triage Team Leader
                  for reassignment.




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SANTA CLARA COUNTY                                          MULTIPLE CASUALTY INCIDENT PLAN

             8.    Triage categories are to be changed by treatment teams as needed based on secondary
                   examination.
             9.    After giving a secondary examination to a casualty, treatment teams are to provide
                   stabilizing emergency care and fill out the attached triage tag.

             10. Priority of transportation will be given to all casualties tagged “IMMEDIATE” (red)
                 who have received a secondary examination.

             11. If a triage casualty's condition decreases in severity or if the initial category is
                 incorrect, the original tag that has not been filled out is to be removed and discarded
                 and a new tag attached.

                   If the triage tag has been filled out by a treatment team and the triage category
                   changes, it is not to be removed but folded in half. A new triage tag indicating the
                   new triage category is to be attached.

       D.   Movement of Casualties -{from the scene into the Treatment Area(s)}

            At the earliest moment that Treatment Areas have been designated, first responder personnel,
            other available personnel and/or volunteers shall be assigned to the task of packaging, if
            needed, and moving the tagged casualties to the appropriate Treatment Areas.

             1.    "Immediate” patients are to be moved first

             2.    In incidents involving primarily ambulatory victims (inhalation incidents), casualties
                   may need only to be escorted to the appropriate Treatment Area.

             3.    In incidents involving primarily non-ambulatory and/or trauma victims, rescuers will
                   require additional resources to effectively facilitate movement into the Treatment
                   Areas.

             4.    Casualties triaged as “DECEASED” will not be moved.

             5.    Consideration should be given to delegating first responder personnel into packaging
                   teams (if needed) and carrying teams.

             6.    Packaging teams will place only tagged casualties on backboards or other carrying
                   devices and properly secure the casualty using a minimum of time and supplies.

                     a.   Appropriate removal of any clothing will take place prior to securing a
                          casualty to a backboard or similar device.

                     b.   Consideration of duct tape or other strong, non-stretchable tape should be
                          given as a method of rapidly strapping the casualty to the carry device.




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SANTA CLARA COUNTY                                               MULTIPLE CASUALTY INCIDENT PLAN

                         c.    Duct tape or similar tape should not be used to immobilize a casualty's head.
                               Use of a “Head Bed” or other similar device should be used in conjunction
                               with a strong porous tape of not less that one inch width.

                         d.    Packaging teams will not splint fractures other than what is done in the course
                               of securing the casualty to the carry device.

                         e.    Caution needs to be taken when taping over skin or an injured portion of the
                               casualty's body. Use of scraps of the casualty clothing may be used as
                               padding between the body and tape if necessary.

                         f.    Consideration of disposable paper sheets to protect skin during taping and
                               preservation of body temperature should be given if circumstances allow.

         7. Carrying teams can be assigned to move the packaged casualties from the scene into the
       appropriate Treatment Areas.

                   8.   No casualty shall be carried into a Treatment Area without proper communication
                        with the Treatment Area Leader.

       E.     Treatment

              1.        The goal of patient care is to provide life- and limb-saving treatment to the greatest
                        number of victims possible. Unlike usual prehospital care, treatment may not be
                        focused on the most severely injured. Victims with severe injuries which my require
                        a large amount of a caregivers time, may have to be abandoned for the greater good.

              2.        The primary focus of patient care during a multiple casualty incident must be to
                        expedite transportation from the scene to definitive care. Whenever possible,
                        treatment should not delay transportation.

              3.        Medical care administered on the scene by emergency responders, including first
                        responders, EMTs and paramedics, in under the medical direction of the Santa Clara
                        County EMS Medical Director. The basis for this field treatment in Santa Clara
                        County is the Field Treatment Protocols.

                        * Whenever possible, prehospital care personnel must adhere to these protocols.

                        * In cases where the number of victims is overwhelming, and strict adherence to
                        protocols may be too time consuming and may result in some patients not receiving
                        life- or limb-saving care, use of these protocols may be abridged. In these cases, the
                        protocols should be used as guidelines, and the prehospital care provider should use
                        his/her best judgment in caring for patients. When in doubt, it is better to err in the
                        patients favor.




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SANTA CLARA COUNTY                                      MULTIPLE CASUALTY INCIDENT PLAN

         4.    Treatment of victims at the site of the incident should be limited to basic life support
               life- and limb-saving procedures. Patients should be moved to treatment areas as
               soon as possible.

         5.    At no time should treatment of a victim place a prehospital care provider in danger.
               Care will generally begin once the scene is determined to be safe, or the patient has
               been transported to safety. In the case of hazardous materials exposure, unprotected
               caregivers may not care for a patient who has not been adequately decontaminated.
               Properly trained and protected HAZMAT responders should provide care for which
               they are trained during extrication and decontamination.

         6.    The use of non-injured persons, or victims with minor injuries as volunteers can be
               helpful. They can apply pressure to wounds or help immobilize a more severely
               injured person. Be sure not to assign tasks that require a great deal of instruction.
               This is not the time to learn a new skill.

         7.    When possible, and after initial stabilization, comfort care should be considered.

         8.    Treatment areas should be set up by patient severity. That is, the patients tagged
               “IMMEDIATE” (Red) should be grouped together, and patients tagged
               “DELAYED” (Yellow) should be grouped together. This allows treating personnel
               to be assigned to an area according to need, and for transporting personnel to load
               patients by severity.

         9.    The “IMMEDIATE” treatment area should be staffed by the highest medical
               personnel assigned to treatment, and should have the highest patient-to-caregiver
               ration. Treatment should focus on provision and maintenance of airway, breathing
               and circulation. When adequate numbers of appropriately trained prehospital care
               providers are available, this may include advanced airway management, intravenous
               catheterization, hemorrhage control and medications. Since these patients have life-
               or limb-threatening injuries, the rapid transport to definitive care is essential.

         10.   The “DELAYED” treatment area should be staffed at a lower patient-to-caregiver
               ration that the “IMMEDIATE” area. By definition, these patients can usually wait
               some time for transportation. As in the “IMMEDIATE” area, patient care is focused
               on provision and maintenance of airway, breathing and circulation. These patients
               must be closely watched so that a deteriorating patient can be moved expeditiously
               either to the “IMMEDIATE” treatment area or definitive care.

         11.   The “MINOR” treatment area should be set up in such a way as to not interfere with
               the other operations, including the other two treatment areas. Treatment should be
               limited to basic life support and comfort care whenever possible. Proximity to the
               other treatment areas is important since these patients can be used to “fill”
               transporting vehicles carrying more severely injured patients. These patients should
               also be watched for possible deterioration and the need to go to another treatment
               area.



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SANTA CLARA COUNTY                                          MULTIPLE CASUALTY INCIDENT PLAN

       F.   Hazardous Materials Exposure

            The “START” method of triage may not identify the seriousness of casualty exposure to a
            hazardous substance and should not be relied on totally to establish priority of treatment and
            transportation.

            Santa Clara County Fire Department, Santa Clara County EMS, AMR West and Poison
            Control have developed a procedure and plan for the decontamination of casualties involved
            in hazardous materials incidents. Refer to standard decontamination policy and protocols of
            the hazmat response section. Victims of hazmat incidents may incur greater injury than is
            immediately evident and special procedures beyond the scope of standard triage may be
            necessary.

            An important concept involved in hazmat incidents is the need to contain the contamination.
            This includes protecting on-scene personnel and equipment from exposure to the
            material/substance. For the purposes of the Medical Division in this plan, no medical
            personnel or equipment should be allowed into the “WARM” or “HOT” zones. Casualties
            not having been properly decontaminated per accepted procedure shall not be moved into the
            “COLD” zone until decontamination is completed. Contamination of medical transport
            capabilities must be avoided.




5/99                                                                                                   F-6
SANTA CLARA COUNTY                                            MULTIPLE CASUALTY INCIDENT PLAN

                                              ANNEX “G”

                        HELICOPTERS - AIR OPERATIONS PROCEDURES

1.     Helicopter Utilization

       Utilization of air ambulances and rescue aircraft for Multiple Casualty Incidents will be in
       accordance with the Santa Clara County Helicopter Utilization Policy. Special consideration of
       number of victims and types of injuries must be made in accordance with established triage criteria
       to direct air ambulance/rescue aircraft requests.

       Establishing the priority for movement of victims is the responsibility of the TRANSPORTATION
       UNIT LEADER. First priority for transportation by air should be given to those victims in the
       IMMEDIATE group who are appropriate for air transport (severely combative patients may pose a
       safety risk - the flight crew must evaluate each patient prior to loading).

       The pilot/crew of the air ambulance/rescue aircraft shall determine the number of victims that the
       specific aircraft may transport.

2.     Communications

       A.     Air-to-Ground Communication:         156.075 (CALCORD)

       B.     Air-to-Air Communication:            123.025 (source: A.I.M. 1997 4.1.B.2)

3.     Helispot (Landing Zone) Specifications

       A.     The size should be approximately 75' x 75' for a single helicopter. Two helicopters must be
              spaced at least 25 yards apart at the rotors. An approach/departure slope of 8:1 is desirable.

       B.     Free of overhead obstructions. Assess for wires in the approach/departure path as well as
              the helispot.

       C.     Relatively flat surface area.

       D.     Recommended types of landing surfaces: cement, asphalt, grass, short vegetation, or hard
              packed dirt (wet down if possible).

       E.     Describe any nearby objects/hazards/landmarks and wind condition to the pilot when the
              helicopter is overhead.

       F.     Helispot should be at least 50 feet from the victims; however, a 150 foot distance is
              preferable. Protect victims and personnel from rotor wash/debris.




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SANTA CLARA COUNTY                                           MULTIPLE CASUALTY INCIDENT PLAN

4.     Night Operation Considerations

       Ø Landing area must be at least 125' x 125' for each aircraft at the helispot.
       Ø Turn on light bars, beacons.
       Ø Light up obstacles.
       Ø Park vehicles under overhead wires if possible.
       Ø Avoid use of high beams or flares.
       Ø If lighting the helispot with headlights, point lights away from the intended approach path of the
         helicopter.
       Ø Never point a light at the helicopter.

5.     Working Around an Aircraft

       A.     Never approach the aircraft - the crew will exit and approach the TRANSPORTATION
              UNIT LEADER or HELISPOT MANAGER (if established).

       B.     Secure the patient to a long board, and relay patient information and destination as
              appropriate.

       C.     Assign two (2) litter bearers per aircraft.

6.     Mass Casualty (greater than four (4) aircraft being utilized)

       A.     Limit aircraft at the helispot to two (2).

       B.     Establish a HELIBASE MANAGER with radio communication capability to County
              Communications, INCIDENT COMMANDER, and HELISPOT. TRANSPORTATION
              UNIT LEADER to coordinate aircraft movement between helibase, helispot, and destination
              facility with AIR OPERATIONS GROUP SUPERVISOR.

7.     Temporary Flight Restrictions (TFR)

       A.     Requests for a temporary flight restriction (TFR) should be routed to the INCIDENT
              COMMANDER.

       B.     The INCIDENT COMMANDER will notify County Communications to contact the
              appropriate FAA control facility with the request.




5/99                                                                                                  G-2
SANTA CLARA COUNTY                                             MULTIPLE CASUALTY INCIDENT PLAN

                                               ANNEX “H”

                                 AMATEUR RADIO (ARES/RACES)

I.     Introduction

Amateur radio operators may be available on a volunteer basis to augment local government
communications services. Amateurs with their equipment will report to the Incident Commander for
assignment. Most hospitals now have radio equipment or antennas installed to operate on amateur radio
frequencies. Contact can also be established by radio amateurs with American Red Cross Chapters, City
and County Emergency Operating Centers, and almost any other public or private sector agency.

A.     Upon activation, the amateur radio operators will:

       1.     Establish a Resource Net to recruit and dispatch amateurs to the following assignments:

              a.      Amateur radio positions at hospitals.

              b.      The amateur radio position at County Communications.

              c.      An ARES/RACES Scene Coordinator who will report to the Incident Commander.

              d.      On-Scene support, as defined below, reporting to the ARES/RACES Staging Area.

              e.      The Red Cross disaster office, if activated by County Communications.

       2.     Establish a Hospital Net to cover communications concerned with patient handling between
              County Communications, the hospitals and the Transportation Unit.

       3.     Establish a Tactical Net to cover other on-scene communications.

B.     When requested by the Incident Commander, the ARES/RACES Scene Coordinator will direct the
       establishment of additional communications links, including but not limited to the following:

       1.     Command Post to triage and/or treatment areas.

       2.      Command Post to other agencies such as public works, utilities, facilities maintenance, etc.
       3.      Any other interagency communications links which are needed and are not otherwise readily
               available.
C.     The volunteer amateur radio operators who will provide the support functions mentioned above, are
       registered Disaster Service Workers and members of Santa Clara County ARES/RACES.




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SANTA CLARA COUNTY                                             MULTIPLE CASUALTY INCIDENT PLAN


USE YOUR BEST JUDGEMENT AND BE FLEXIBLE TO MEET THE NEEDS OF THE SITUATION

1.     INITIAL CONTACT COORDINATOR

Note: Until relieved, this person has overall Incident Coordinator responsibility for ARES/RACES.

       Record following information when contacted by County Communications

       Incident location (and how to access the scene)

       Incident call-back number for County Communications

       Notify ARES/RACES District Emergency Coordinators

       Make initial announcements on area repeaters. Announce Resource Net frequency (from County
       Net Plan) and assign a Resource Net Control.

       As soon as possible, provide County Communications with the names of responders to County
       Communications.

2.     ARES/RACES DISTRICT EMERGENCY COORDINATORS

       Assume responsibility or assign a Shift Supervisor who will have overall Incident Coordinator
       responsibility.

       Monitor net operations to maintain effective communications and resolve problems that may arise.

3.     RESOURCE NET CONTROL

       Assign TWO amateurs to report to County Communications.

       Assign ONE amateur as ARES/RACES Scene Coordinator, usually an Emergency
       Coordinator, to report to the Incident Commander at the scene.

       Assign a Net Control station for the Hospital Net (on Command-1 per the County Net Plan).

       Assign at least TWO amateurs to each hospital, starting with hospitals nearest to the scene.

       Assign amateurs to make announcements on other repeaters.

       Define, with the ARES/RACES Scene Coordinator, an ARES/RACES Staging Area near the scene.

       Assign at least SIX amateurs to the Staging Area. Increase assignment to EIGHT if the scene is at a
       public facility such as an airport, office building, shopping mall, etc. (See below.)

       Assign TWO amateurs to the American Red Cross Chapter nearest the incident if the American Red
       Cross has been activated by County Communications.


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SANTA CLARA COUNTY                                                MULTIPLE CASUALTY INCIDENT PLAN

4.     HOSPITAL NET CONTROL

       Assign tactical call signs as stations check in upon arrival at their assigned locations.

       Establish and maintain good net discipline.

       Establish contact with American Red Cross as necessary for communications dealing with patient
       handling.

       Establish and maintain a liaison with the Resource Net and the ARES/RACES Scene Coordinator.

5.     ARES/RACES SCENE COORDINATOR

       Establish contact with the Incident Commander at the scene and review the pre-scripted MCIP roles
       for ARES/RACES.

       Assign a Tactical Net frequency, usually the incident city's simplex frequency.
       Note: Consider using CTCSS on the tactical net to prevent interference from other radios on-scene.

       Call the operators into the scene from the ARES/RACES Staging Area and make the following
       assignments:

       Assign tactical call signs as stations take their assigned locations.

       Assign TWO operators to the Transportation Unit Leader to record and transmit patient information
       (victim count; victim numbers, if any; ambulance number; and destination hospital) to Hospital Net
       Control. Note: Have one operator on the Tactical Net and the other on the Hospital Net and keep
       them together.

       Assign ONE operator as your own shadow to monitor the Hospital Net while you direct on-scene
       operations on the Tactical Net. Have your shadow also monitor Command-2 (on UHF) if possible.

       Assign ONE operator as a shadow to the Incident Commander on the Tactical Net.

       Assign ONE operator to Ambulance Staging on the Tactical Net. This operator will communicate
       with the Tactical Net operator assigned to the Transportation Unit Leader.

       If the scene is at a public facility such as an airport, office building, shopping mall, etc., assign
       TWO operators to the facility's PIO on the Tactical Net.

       To the extent that additional operators are available, set up communication links from the Command
       Post to other agencies or services as described above. Note: Consider using the alternate
       Command-1 repeater for these additional links and have your shadow monitor this frequency from
       time to time.

       Issue periodic updates to the hospitals on the situation at the scene via the Hospital Net.



5/99                                                                                                           H-3
SANTA CLARA COUNTY                                             MULTIPLE CASUALTY INCIDENT PLAN

                                                ANNEX “I”

                                       AMERICAN RED CROSS

I.     Following notification of the activation of the MCIP, a Red Cross field coordinator arrives on scene,
       checks in with the Incident Command, determines what Red Cross services are available/needed,
       coordinates with the command, and orders up the services as agreed to.

       A.     Services arrive and are coordinated through the Red Cross field commander.

       B.     All requests for additional services are to be conducted through the Red Cross field
              commander official.

II.    The following services will be available upon notification of request for Red Cross services. These
       services are to be authorized by the Red Cross field commander in the field/site.

       A.     Mass Care (feeding) - Canteen services to supply refreshments to the disaster workers and
              others at the site.

       B.     Mass Care (shelter/evacuation centers) - These services will be provided at the direction of
              the Red Cross official in the field. They consist of establishing comfort areas or site for
              sending evacuees, workers, and others to for humane relief. This may be an area for
              refreshments, areas to rest and to seek shelter from the elements.

       C.     Family Services - Trained Red Cross interviewers may be called to the site or more likely the
              evacuation center to assist the mobile victims on the incident to begin the recovery process.
              This may include provision of temporary housing, clothing and assistance with contacting
              family members outside the area.

       D.     Disaster Health Services - These are staffed by medical professionals in the areas of physical
              and mental health. We are able to provide first aid stations and trained first aid personnel to
              assist or back up the field/site. The mental health personnel will conduct crisis intervention
              and otherwise assist those traumatized by the incident including the disaster workers, if
              needed.

       E.     Casualty Information - Casualty information may be supplied to an official representative of
              the American Red Cross assigned to the receiving hospital when this Plan is activated. The
              Red Cross representative will relay casualty information to the Central (San Jose) Red Cross
              Chapter disaster center. Radio amateur (ARES/RACES) may be present at each of the
              receiving hospitals to provide a radio communications link to the Red Cross Chapter disaster
              center where casualty information is to be transmitted. In the absence of an official
              representative of the Red Cross, and at the request of the Red Cross, casualty information
              may be supplied directly to ARES/RACES staff for transmission.

              1.      At the height of the incident, the number of injured, (general) types of injury and the
                      number of reported dead from each hospital is sufficient.



5/99                                                                                                       I-1
SANTA CLARA COUNTY                                          MULTIPLE CASUALTY INCIDENT PLAN

            2.     It is important that the Red Cross personnel at each hospital compile information on
                   casualties and relay the information to the Chapter disaster center in order to respond
                   to welfare inquiries from family members.

       F.   Coordination - All Red Cross services will be accessed through the Senior Red Cross official
            in the field. That person is authorized to coordinate and provide any resources of the Red
            Cross to the incident command.




5/99                                                                                                    I-2
SANTA CLARA COUNTY                                       MULTIPLE CASUALTY INCIDENT PLAN

                                        ICS Checklists

•   Incident Commander (IC)
•   Liaison Officer
•   Public Information Officer
•   Safety Officer
•   Operations Chief
•   Planning Chief
•   Logistics Chief
•   Staging Area Manager
•   Medical Support Unit Leader
•   Medical Group Supervisor
•   Medical Supply Officer
•   Triage Unit Leader
•   Treatment Unit Leader
•   Morgue Unit Leader
•   Transportation Group Supervisor
•   Ambulance Staging Officer
•   Hospital Coordinator
•   Air Ambulance Unit Leader
•   Fire Group Supervisor
•   Rescue Unit Leader
•   Extrication Unit Leader
•   Suppression Unit Leader
•   Law Group Supervisor
•   Perimeter Enforcement Unit Leader
•   Internal Enforcement Unit Leader
•   Air Operations Group Supervisor




5/99                                                                                CL-1
                                                  SANTA CLARA COUNTY
                                            MULTIPLE CASUALTY INCIDENT PLAN

Incident Commander:

The Incident Commander is responsible for incident activities including the development and
implementation of strategic decisions and for approving the order and release of resources.

RADIO CALL SIGN “IC”
                        o ________________ COMMAND FREQUENCY

                        o ________________ TACTICAL FREQUENCY

                        o ________________ SUPPORT FREQUENCY



                                                                        INCIDENT COMMANDER
                                                                               (5.2.1)


                                                            LIASON                           P.I.O.
                                                             (5.2.2)                         (5.2.3)

                                                            SAFETY
                                                             (5.2.4)




                                  PLANS                           OPERATIONS                                                            LOGISTICS
                                  (5.2.6)                           (5.2.5)                                                               (5.2.7)


                                                 STAGING
                                                  (5.2.8)                                                                               MEDICAL SUPPORT UNIT
                                                                                                                                                5.2.9



 MEDICAL GROUP            TRANSPORTATION GROUP                     FIRE GROUP                          LAW GROUP             AIR OPS
     (5.2.10)                    (5.2.15)                             (5.2.19)                           (5.2.23)            (5.2.26)



   MEDICAL SUPPLY UNIT        AMBULANCE STAGING UNIT                     RESCUE UNIT            PERIMETER ENFORCEMENT UNIT
         (5.2.11)                    (5.2.16)                              (5.2.20)                       (5.2.24)

        TRIAGE UNIT          HOSPITAL COORDINATION UNIT                EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
          (5.2.12)                     (5.2.17)                             (5.2.21)                       (5.2.25)

       TREATMENT UNIT            AIR AMBULANCE UNIT                    SUPPRESSION UNIT
           (5.2.13)                    (5.2.18)                             (5.2.22)

        MORGUE UNIT
          (5.2.14)



5/99                                                           ICS Position Checklists                                                                  CL-2
                              INCIDENT COMMANDER (IC)
o Obtain situation briefing

o Establish Command Post
     (Accessible, but not in conflict with Operations or Triage)
o Don position vest

o Assess situation and prioritize problems:
     Rescue
     Hazardous Material
     Fire Victims’ Other Needs

o Request assistance (number or units):
     Ambulance
     Fire
     Police
     Hazardous Material
     Communications
     Special Equipment or Needs

o Designate Section Chiefs as needed (give vests)
  If no one is designated, IC handles duties

o Oversee and coordinate staff activity

o Provide update reports to County Communications

o Approve and authorize implementation of the Incident Action Plan, and when appropriate,
   Demobilization Plan

o Designate Treatment and Transportation Area(s)

o Designate Medical and Transportation Group Supervisor(s) - (give vest)

o Establish perimeter control and routes of ingress and egress

o Designate ambulance staging area (visual to Treatment Area)

o Designate helicopter site and Air OPS and/or Air Medical if air evacuation is to be used

o Approve requests for additional resources, and release of same

o Authorize releases of information to news media

o Develop and maintain incident activity log



5/99                                  ICS Position Checklists                                CL-3
                                            SANTA CLARA COUNTY
                                      MULTIPLE CASUALTY INCIDENT PLAN

Liaison Officer:

The Liaison Officer Commander is the point of contact for assisting cooperating agency
representatives, including other fire agencies, Red Cross, law enforcement, and public works.



RADIO CALL SIGN “LIAISON”
                        o________________ COMMAND FREQUENCY

                        o________________ TACTICAL FREQUENCY

                        o________________ SUPPORT FREQUENCY


                                                                       INCIDENT COMMANDER
                                                                              (5.2.1)


                                                           LIASON                           P.I.O.
                                                            (5.2.2)                         (5.2.3)


                                                           SAFETY
                                                            (5.2.4)




                                 PLANS                           OPERATIONS                                                            LOGISTICS
                                 (5.2.6)                            (5.2.5)                                                              (5.2.7)


                                                STAGING
                                                 (5.2.8)                                                                               MEDICAL SUPPORT UNIT
                                                                                                                                               5.2.9



MEDICAL GROUP            TRANSPORTATION GROUP                     FIRE GROUP                          LAW GROUP             AIR OPS
    (5.2.10)                    (5.2.15)                             (5.2.19)                           (5.2.23)            (5.2.26)



  MEDICAL SUPPLY UNIT        AMBULANCE STAGING UNIT                     RESCUE UNIT            PERIMETER ENFORCEMENT UNIT
        (5.2.11)                    (5.2.16)                              (5.2.20)                       (5.2.24)

       TRIAGE UNIT          HOSPITAL COORDINATION UNIT                EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
         (5.2.12)                     (5.2.17)                             (5.2.21)                       (5.2.25)

    TREATMENT UNIT              AIR AMBULANCE UNIT                    SUPPRESSION UNIT
        (5.2.13)                      (5.2.18)                             (5.2.22)

       MORGUE UNIT
         (5.2.14)



5/99                                                                  ICS Position Checklists                                                                 CL-4
                                     LIAISON OFFICER
o Obtain situation briefing from Incident Commander

o Don position identification vest

o READ ENTIRE DUTY CHECKLIST

o Assess situation

o Appoint and brief staff, as needed

o Act as contact-point for assisting and cooperating agencies

o Establish contact with liaison counterparts of each assisting and cooperating agency

o Provide update reports to County Communications

o Ensure a continual communications link between yourself and the Incident Commander, and
   between yourself and other liaison counterparts

o Respond to requests and complaints from incident personnel regarding inter-organizational
       problems

o Maintain log of your activities and other pertinent information acquired

o When ordered, secure operations and replenish supplies

o Forward all reports to Incident Commander




5/99                                   ICS Position Checklists                                CL-5
                                            SANTA CLARA COUNTY
                                      MULTIPLE CASUALTY INCIDENT PLAN

Public Information Officer:

The Public Information Officer is responsible for the formulation and release of information about
the incident to the news media and other appropriate agencies.



RADIO CALL SIGN “PIO”
                        o________________ COMMAND FREQUENCY

                        o________________ TACTICAL FREQUENCY

                        o________________ SUPPORT FREQUENCY


                                                                       INCIDENT COMMANDER
                                                                              (5.2.1)


                                                           LIASON                           P.I.O.
                                                            (5.2.2)                         (5.2.3)


                                                           SAFETY
                                                            (5.2.4)




                                 PLANS                           OPERATIONS                                                            LOGISTICS
                                 (5.2.6)                            (5.2.5)                                                              (5.2.7)


                                                STAGING
                                                 (5.2.8)                                                                               MEDICAL SUPPORT UNIT
                                                                                                                                               5.2.9



MEDICAL GROUP            TRANSPORTATION GROUP                     FIRE GROUP                          LAW GROUP             AIR OPS
    (5.2.10)                    (5.2.15)                             (5.2.19)                           (5.2.23)            (5.2.26)



  MEDICAL SUPPLY UNIT        AMBULANCE STAGING UNIT                     RESCUE UNIT            PERIMETER ENFORCEMENT UNIT
        (5.2.11)                    (5.2.16)                              (5.2.20)                       (5.2.24)

       TRIAGE UNIT          HOSPITAL COORDINATION UNIT                EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
         (5.2.12)                     (5.2.17)                             (5.2.21)                       (5.2.25)

    TREATMENT UNIT              AIR AMBULANCE UNIT                    SUPPRESSION UNIT
        (5.2.13)                      (5.2.18)                             (5.2.22)

       MORGUE UNIT
         (5.2.14)



5/99                                                                  ICS Position Checklists                                                                 CL-6
                          PUBLIC INFORMATION OFFICER
o Obtain situation briefing from Incident Commander

o Don position identification vest

o READ ENTIRE DUTY CHECKLIST

o Assess situation

o Appoint and brief staff, as needed

o Coordinate activities with Incident Commander and observe imposed restrictions of news
   release information.

o Prepare initial information summary as soon as possible.

o Set up an area designated only for news media. If possible equip with telephones and restrict
   media presence to this area.

o Make a checklist of news media personnel present and other agencies to be contacted, i.e.:

       Associated Press, United Press
       Local Newspapers
       Radio Stations
       Television Stations

o Establish liaison with local, county, and state agencies for uniformity of news releases

o Assemble and prepare information for releases

o Obtain approval for news release form Incident Commander

o Transmit news release to news media and post in the Command Post fifteen minutes after
   release. Attend necessary meetings to update information
o Arrange meetings with incident personnel and news media, if so requested

o Prepare post-incident releases and/or summary information for use by news media

o Maintain log of your activities and other pertinent information acquired

o When ordered, secure operations and replenish supplies

o Forward all reports to Incident Commander



5/99                                    ICS Position Checklists                                CL-7
                                            SANTA CLARA COUNTY
                                      MULTIPLE CASUALTY INCIDENT PLAN

Safety Officer:

The Safety Officer is responsible for monitoring and assessing hazardous and unsafe conditions.
The Safety Officer will correct unsafe acts through the chain of command or direct action.

RADIO CALL SIGN “SAFETY”
                        o________________ COMMAND FREQUENCY

                        o________________ TACTICAL FREQUENCY

                        o________________ SUPPORT FREQUENCY



                                                                       INCIDENT COMMANDER
                                                                              (5.2.1)


                                                           LIASON                           P.I.O.
                                                            (5.2.2)                         (5.2.3)


                                                           SAFETY
                                                            (5.2.4)




                                 PLANS                           OPERATIONS                                                            LOGISTICS
                                 (5.2.6)                            (5.2.5)                                                              (5.2.7)


                                                STAGING
                                                 (5.2.8)                                                                               MEDICAL SUPPORT UNIT
                                                                                                                                               5.2.9



MEDICAL GROUP            TRANSPORTATION GROUP                     FIRE GROUP                          LAW GROUP             AIR OPS
    (5.2.10)                    (5.2.15)                             (5.2.19)                           (5.2.23)            (5.2.26)



  MEDICAL SUPPLY UNIT        AMBULANCE STAGING UNIT                     RESCUE UNIT            PERIMETER ENFORCEMENT UNIT
        (5.2.11)                    (5.2.16)                              (5.2.20)                       (5.2.24)

       TRIAGE UNIT          HOSPITAL COORDINATION UNIT                EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
         (5.2.12)                     (5.2.17)                             (5.2.21)                       (5.2.25)

    TREATMENT UNIT              AIR AMBULANCE UNIT                    SUPPRESSION UNIT
        (5.2.13)                      (5.2.18)                             (5.2.22)

       MORGUE UNIT
         (5.2.14)



5/99                                                                  ICS Position Checklists                                                                 CL-8
                                      SAFETY OFFICER
o Obtain situation briefing from Incident Commander

o Don position identification vest

o READ ENTIRE DUTY CHECKLIST

o Assess situation

o Survey the area for dangerous situations:

   Utilities:        Hazardous Materials:         Buildings:
   o gas             otoxic gases                 ouse of elevators
   opower            opesticides                  ostructural integrity
   oelectric         oradiation                     (Possible collapse)
   owater            ochemical agents
   osewer

   o Flooding - as it relates to fire control activities

   o Rupture of vessels, tanks, or pipes (possible dangers)

o Post danger signs, where applicable

o Identify existing and potential hazardous situations associated with the incident

o Appoint and brief staff, as needed

o Exercise emergency authority to stop and prevent unsafe actions

o Investigate accidents occurring within incident area

o Keep all personnel informed of existing and impending hazards

o Attend planning meetings

o Review Incident Action Plan and Incident Medical Plan

o Maintain log of your activities and other pertinent information acquired

o Notify personnel of current status regarding safety conditions

o When ordered, secure operations and replenish supplies

o Forward all reports to Incident Commander



5/99                                   ICS Position Checklists                        CL-9
                                            SANTA CLARA COUNTY
                                      MULTIPLE CASUALTY INCIDENT PLAN

Operations Chief:

The Operations Chief is responsible for the management of all operations directly applicable to the
primary mission. He/she activates and supervises elements in accordance with the action plan.

RADIO CALL SIGN “OPERATIONS”
                        o________________ COMMAND FREQUENCY

                        o________________ TACTICAL FREQUENCY

                        o________________ SUPPORT FREQUENCY



                                                                       INCIDENT COMMANDER
                                                                              (5.2.1)


                                                           LIASON                           P.I.O.
                                                            (5.2.2)                         (5.2.3)


                                                           SAFETY
                                                            (5.2.4)




                                 PLANS                           OPERATIONS                                                            LOGISTICS
                                 (5.2.6)                            (5.2.5)                                                              (5.2.7)


                                                STAGING
                                                 (5.2.8)                                                                               MEDICAL SUPPORT UNIT
                                                                                                                                               5.2.9



MEDICAL GROUP            TRANSPORTATION GROUP                     FIRE GROUP                          LAW GROUP             AIR OPS
    (5.2.10)                    (5.2.15)                             (5.2.19)                           (5.2.23)            (5.2.26)



  MEDICAL SUPPLY UNIT        AMBULANCE STAGING UNIT                     RESCUE UNIT            PERIMETER ENFORCEMENT UNIT
        (5.2.11)                    (5.2.16)                              (5.2.20)                       (5.2.24)

       TRIAGE UNIT          HOSPITAL COORDINATION UNIT                EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
         (5.2.12)                     (5.2.17)                             (5.2.21)                       (5.2.25)

    TREATMENT UNIT              AIR AMBULANCE UNIT                    SUPPRESSION UNIT
        (5.2.13)                      (5.2.18)                             (5.2.22)

       MORGUE UNIT
         (5.2.14)



5/99                                                                  ICS Position Checklists                                                                 CL-10
                                  OPERATIONS CHIEF
o Obtain situation briefing from Incident Commander

o Don position identification vest

o READ ENTIRE DUTY CHECKLIST

o Assess situation

o Determine need for immediate and anticipated resources

o Appoint and brief staff, as needed

       Group supervisor(s)
             Medical Group Supervisor
             Transportation Group Supervisor
       Aide(s)
       Air OPS
       Staging Area Manager

o Establish communications with Group supervisors

o Keep Incident Commander informed of any special conditions or activities

o Request periodic progress reports from Group Supervisors

o Consult and collaborate with Plans and Logistics Chiefs

o Develop operations portion of Incident Action Plan with general staff

o Assign personnel in accordance with Incident Action Plan

o Supervise emergency operations

o Attend meetings, as necessary

o Initiate recommendations for demobilization of resources

o Maintain log of your activities and other pertinent information acquired

o When ordered, secure operations and replenish supplies

o Forward all reports to Incident Commander



5/99                                   ICS Position Checklists               CL-11
                                            SANTA CLARA COUNTY
                                      MULTIPLE CASUALTY INCIDENT PLAN

Planning Chief:

The Planning Chief is responsible for the collection, evaluation, dissemination, and use of
information concerning the incident including: resource status, situation status, and event
prediction.

RADIO CALL SIGN “PLANS”
                        o ________________ COMMAND FREQUENCY

                         ________________ TACTICAL FREQUENCY

                         ________________ SUPPORT FREQUENCY

                                                                       INCIDENT COMMANDER
                                                                              (5.2.1)


                                                           LIASON                           P.I.O.
                                                            (5.2.2)                         (5.2.3)


                                                           SAFETY
                                                            (5.2.4)




                                 PLANS                           OPERATIONS                                                            LOGISTICS
                                 (5.2.6)                            (5.2.5)                                                              (5.2.7)


                                                STAGING
                                                 (5.2.8)                                                                               MEDICAL SUPPORT UNIT
                                                                                                                                               5.2.9



MEDICAL GROUP            TRANSPORTATION GROUP                     FIRE GROUP                          LAW GROUP             AIR OPS
    (5.2.10)                    (5.2.15)                             (5.2.19)                           (5.2.23)            (5.2.26)



  MEDICAL SUPPLY UNIT        AMBULANCE STAGING UNIT                     RESCUE UNIT            PERIMETER ENFORCEMENT UNIT
        (5.2.11)                    (5.2.16)                              (5.2.20)                       (5.2.24)

       TRIAGE UNIT          HOSPITAL COORDINATION UNIT                EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
         (5.2.12)                     (5.2.17)                             (5.2.21)                       (5.2.25)

    TREATMENT UNIT              AIR AMBULANCE UNIT                    SUPPRESSION UNIT
        (5.2.13)                      (5.2.18)                             (5.2.22)

       MORGUE UNIT
         (5.2.14)



5/99                                                                  ICS Position Checklists                                                                 CL-12
                                     PLANNING CHIEF
o Obtain situation briefing from Incident Commander

o Don position identification vest

o READ ENTIRE DUTY CHECKLIST

o Assess situation

o Appoint and brief staff, as needed

       Situation Unit Leader
       Resource Unit Leader
       Technical specialist Unit Leader

o Develop Incident Action Plan with alternatives and submit to Incident Commander for approval
  o Reproduce, and distribute Incident Action Plan

o Provide internal and external Incident traffic flow plan

o Prepare and distribute Incident Commander’s orders

o Provide continuous supervision of the Plans Section

o Monitor and display resource and situation status data
  o Establish liaison with Logistics Section to exchange resource status information

o Collect, evaluate, utilize, and disseminate current and projected intelligence data

o Maintain records and prepare reports for documentation

o Plan for and recommend release of incident resources
   (Demobilization Plan)
      o     Provide Demob. Plan to Logistics Chief

o When ordered, secure Operations and replenish supplies




5/99                                   ICS Position Checklists                           CL-13
                                            SANTA CLARA COUNTY
                                      MULTIPLE CASUALTY INCIDENT PLAN

Logistics Chief:

The Logistics Chief is responsible for providing facilities, services, and material in support of the
incident. The Logistics Chief participates in the development and implementation of the action
plan.

RADIO CALL SIGN “LOGISTICS”
                        o ________________ COMMAND FREQUENCY

                        o ________________ TACTICAL FREQUENCY

                        o ________________ SUPPORT FREQUENCY


                                                                       INCIDENT COMMANDER
                                                                              (5.2.1)


                                                           LIASON                           P.I.O.
                                                            (5.2.2)                         (5.2.3)


                                                           SAFETY
                                                            (5.2.4)




                                 PLANS                           OPERATIONS                                                            LOGISTICS
                                 (5.2.6)                            (5.2.5)                                                              (5.2.7)


                                                STAGING
                                                 (5.2.8)                                                                               MEDICAL SUPPORT UNIT
                                                                                                                                               5.2.9



MEDICAL GROUP            TRANSPORTATION GROUP                     FIRE GROUP                          LAW GROUP             AIR OPS
    (5.2.10)                    (5.2.15)                             (5.2.19)                           (5.2.23)            (5.2.26)



  MEDICAL SUPPLY UNIT        AMBULANCE STAGING UNIT                     RESCUE UNIT            PERIMETER ENFORCEMENT UNIT
        (5.2.11)                    (5.2.16)                              (5.2.20)                       (5.2.24)

       TRIAGE UNIT          HOSPITAL COORDINATION UNIT                EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
         (5.2.12)                     (5.2.17)                             (5.2.21)                       (5.2.25)

    TREATMENT UNIT              AIR AMBULANCE UNIT                    SUPPRESSION UNIT
        (5.2.13)                      (5.2.18)                             (5.2.22)

       MORGUE UNIT
         (5.2.14)



5/99                                                                  ICS Position Checklists                                                                 CL-14
                                     LOGISTICS CHIEF
o Obtain situation briefing from Incident Commander

o Don position identification vest

o READ ENTIRE DUTY CHECKLIST

o Appoint and brief staff, as needed

       Medical Support Unit Leader
       Supply Unit Leader
       Ground Support Unit Leader
       Communications Unit Leader
       Food Unit Leader

o Provide continuous supervision of Logistics Section

o Early consideration should be given to assigning Base
   (If Facilities Unit Leader not appointed)

o Notify Resources Unit of personnel assigned and location

o Determine logistical needs to support present and planned incident operations

o Confer with as needed:
   Incident Commander
   Planning Chief
   Operations Chief

o Attend Incident Action Plan briefing sessions
  o Provide information re: service and support capabilities

o Insure Incident Communications Plan is prepared

o Develop contingency plans for incident activities

o Maintain log of your activities and other pertinent information acquired. Forward all collected
   incident documentation to Plans Section.

o Receive demobilization plan from Planning Section.

o When ordered, secure operations and replenish supplies
  o Release resources in accordance with Demob plan



5/99                                   ICS Position Checklists                              CL-15
                                            SANTA CLARA COUNTY
                                      MULTIPLE CASUALTY INCIDENT PLAN

Staging Area Manager:

The Staging Area Manager is responsible for documenting the check-in and check-out of companies
(except medical transportation vehicles), and the establishment of equipment and personnel reserves
in support of operations.

RADIO CALL SIGN “STAGING”
                        o ________________ COMMAND FREQUENCY

                        o ________________ TACTICAL FREQUENCY

                        o ________________ SUPPORT FREQUENCY


                                                                       INCIDENT COMMANDER
                                                                              (5.2.1)


                                                           LIASON                           P.I.O.
                                                            (5.2.2)                         (5.2.3)


                                                           SAFETY
                                                            (5.2.4)




                                 PLANS                           OPERATIONS                                                            LOGISTICS
                                 (5.2.6)                            (5.2.5)                                                              (5.2.7)


                                                STAGING
                                                 (5.2.8)                                                                               MEDICAL SUPPORT UNIT
                                                                                                                                               5.2.9



MEDICAL GROUP            TRANSPORTATION GROUP                     FIRE GROUP                          LAW GROUP             AIR OPS
    (5.2.10)                    (5.2.15)                             (5.2.19)                           (5.2.23)            (5.2.26)



  MEDICAL SUPPLY UNIT        AMBULANCE STAGING UNIT                     RESCUE UNIT            PERIMETER ENFORCEMENT UNIT
        (5.2.11)                    (5.2.16)                              (5.2.20)                       (5.2.24)

       TRIAGE UNIT          HOSPITAL COORDINATION UNIT                EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
         (5.2.12)                     (5.2.17)                             (5.2.21)                       (5.2.25)

    TREATMENT UNIT              AIR AMBULANCE UNIT                    SUPPRESSION UNIT
        (5.2.13)                      (5.2.18)                             (5.2.22)

       MORGUE UNIT
         (5.2.14)



5/99                                                                  ICS Position Checklists                                                                 CL-16
                             STAGING AREA MANAGER
o Obtain situation briefing from Operations Chief

o Don position identification vest

o READ ENTIRE DUTY CHECKLIST

o Appoint and brief staff: Aides (minimum of two (2))

o Locate, prepare, and identify staging area
   CONSIDER
     Safety and accessibility
     High-Rise - two (2) floors below fire
     Traffic control must be monitored and directed
     Area and resource location identifiers must be visible

   o Advise when operational

o Order and dispense resources as directed by Operations Chief
  o Obtain and issue receipts for radio equipment and supplies distributed and received

o KEEP RECORD OF RESOURCE MOVEMENT - staffing/equipment
  o Establish check-in/check-out functions

o Prioritize resource need with base

o Maintain predetermined resource inventory
  o Consider equipment/time limitations
  o Anticipate and advise on changing resource requirements

o Maintain log of your activities and other pertinent information acquired.

o When ordered, secure activities and release personnel under your supervision.
  o Demobilize according the Demob Plan

o Forward all reports to Incident Commander




5/99                                   ICS Position Checklists                            CL-17
                                            SANTA CLARA COUNTY
                                      MULTIPLE CASUALTY INCIDENT PLAN

Medical Support Unit Leader:

The Medical Unit Leader is responsible for the assessment and treatment of emergency services
personnel assigned to the event.



RADIO CALL SIGN “MEDICAL SUPPORT”
                        o ________________ COMMAND FREQUENCY

                        o ________________ TACTICAL FREQUENCY

                        o ________________ SUPPORT FREQUENCY


                                                                       INCIDENT COMMANDER
                                                                              (5.2.1)


                                                           LIASON                           P.I.O.
                                                            (5.2.2)                         (5.2.3)


                                                           SAFETY
                                                            (5.2.4)




                                 PLANS                           OPERATIONS                                                            LOGISTICS
                                 (5.2.6)                            (5.2.5)                                                              (5.2.7)


                                                STAGING
                                                 (5.2.8)                                                                               MEDICAL SUPPORT UNIT
                                                                                                                                               5.2.9



MEDICAL GROUP            TRANSPORTATION GROUP                     FIRE GROUP                          LAW GROUP             AIR OPS
    (5.2.10)                    (5.2.15)                             (5.2.19)                           (5.2.23)            (5.2.26)



  MEDICAL SUPPLY UNIT        AMBULANCE STAGING UNIT                     RESCUE UNIT            PERIMETER ENFORCEMENT UNIT
        (5.2.11)                    (5.2.16)                              (5.2.20)                       (5.2.24)

       TRIAGE UNIT          HOSPITAL COORDINATION UNIT                EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
         (5.2.12)                     (5.2.17)                             (5.2.21)                       (5.2.25)

    TREATMENT UNIT              AIR AMBULANCE UNIT                    SUPPRESSION UNIT
        (5.2.13)                      (5.2.18)                             (5.2.22)

       MORGUE UNIT
         (5.2.14)



5/99                                                                  ICS Position Checklists                                                                 CL-18
                       MEDICAL SUPPORT UNIT LEADER

o Obtain situation briefing from Logistics Chief

o Don position identification vest

o READ ENTIRE DUTY LIST

o Assess situation

o Establish Rehabilitation (“Rehab”) Area, in consultation with Safety Officer, as necessary

o Identify and obtain staffing

o Keep Logistics Chief and Operations Chief informed regarding:

       Any illness or injury to personnel
       Any personnel that need to be removed from duty due to illness or injury
       Any personnel who need to be transported for additional medical care

o Coordinate needs with Medical Group Supervisor

o Coordinate with Safety Officer

o Forward reports to Logistics Chief




5/99                                   ICS Position Checklists                                 CL-19
                                            SANTA CLARA COUNTY
                                      MULTIPLE CASUALTY INCIDENT PLAN

Medical Group Supervisor:

The Medical Group Supervisor will manage the medical component within the area of the
emergency site. He/she will supervise the personnel who triage and treat victims.

RADIO CALL SIGN “MEDICAL”
                        o ________________ COMMAND FREQUENCY

                        o ________________ TACTICAL FREQUENCY

                        o ________________ SUPPORT FREQUENCY



                                                                       INCIDENT COMMANDER
                                                                              (5.2.1)


                                                           LIASON                           P.I.O.
                                                            (5.2.2)                         (5.2.3)


                                                           SAFETY
                                                            (5.2.4)




                                 PLANS                           OPERATIONS                                                            LOGISTICS
                                 (5.2.6)                            (5.2.5)                                                              (5.2.7)


                                                STAGING
                                                 (5.2.8)                                                                               MEDICAL SUPPORT UNIT
                                                                                                                                               5.2.9



MEDICAL GROUP            TRANSPORTATION GROUP                     FIRE GROUP                          LAW GROUP             AIR OPS
    (5.2.10)                    (5.2.15)                             (5.2.19)                           (5.2.23)            (5.2.26)



  MEDICAL SUPPLY UNIT        AMBULANCE STAGING UNIT                     RESCUE UNIT            PERIMETER ENFORCEMENT UNIT
        (5.2.11)                    (5.2.16)                              (5.2.20)                       (5.2.24)

       TRIAGE UNIT          HOSPITAL COORDINATION UNIT                EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
         (5.2.12)                     (5.2.17)                             (5.2.21)                       (5.2.25)

    TREATMENT UNIT              AIR AMBULANCE UNIT                    SUPPRESSION UNIT
        (5.2.13)                      (5.2.18)                             (5.2.22)

       MORGUE UNIT
         (5.2.14)



5/99                                                                  ICS Position Checklists                                                                 CL-20
                          MEDICAL GROUP SUPERVISOR
o Obtain situation briefing from Operations Chief

o Don position identification vest

o READ ENTIRE DUTY CHECKLIST

o Assess Situation

o Appoint and brief staff, as needed:

       Medical Supply Unit Leader
       Triage Unit Leader
       Treatment Unit Leader
       Morgue Unit Leader

o Ensure that Triage and transportation have radio communication

o Coordinate location of medical supply, treatment, and morgue areas with Unit Leaders

o Establish coordination with Transportation Group, fire control, HazMat control, and extrication
   Groups and Units

o Ensure that all work areas are out of hazardous areas

o Anticipate needs for:

       Medical supplies, equipment
       Relief personnel, additional personnel

o Direct medically trained personnel to the appropriate unit leaders

o Contact Coroner via chain of command

o Demobilize group as directed by Operations Chief

o Maintain record of activities and forward all Medical Group records and reports to Operations
   Chief and the EMS Agency




5/99                                    ICS Position Checklists                             CL-21
                                            SANTA CLARA COUNTY
                                      MULTIPLE CASUALTY INCIDENT PLAN

Medical Supply Officer:

The Medical Supply Officer is responsible for acquiring and maintaining control of appropriate
medical equipment and supplies.



RADIO CALL SIGN “MED-SUPPLY”
                        o ________________ COMMAND FREQUENCY

                        o ________________ TACTICAL FREQUENCY

                        o ________________ SUPPORT FREQUENCY


                                                                       INCIDENT COMMANDER
                                                                              (5.2.1)


                                                           LIASON                           P.I.O.
                                                            (5.2.2)                         (5.2.3)


                                                           SAFETY
                                                            (5.2.4)




                                 PLANS                           OPERATIONS                                                            LOGISTICS
                                 (5.2.6)                            (5.2.5)                                                              (5.2.7)


                                                STAGING
                                                 (5.2.8)                                                                               MEDICAL SUPPORT UNIT
                                                                                                                                               5.2.9



MEDICAL GROUP            TRANSPORTATION GROUP                     FIRE GROUP                          LAW GROUP             AIR OPS
    (5.2.10)                    (5.2.15)                             (5.2.19)                           (5.2.23)            (5.2.26)



  MEDICAL SUPPLY UNIT        AMBULANCE STAGING UNIT                     RESCUE UNIT            PERIMETER ENFORCEMENT UNIT
        (5.2.11)                    (5.2.16)                              (5.2.20)                       (5.2.24)

       TRIAGE UNIT          HOSPITAL COORDINATION UNIT                EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
         (5.2.12)                     (5.2.17)                             (5.2.21)                       (5.2.25)

    TREATMENT UNIT              AIR AMBULANCE UNIT                    SUPPRESSION UNIT
        (5.2.13)                      (5.2.18)                             (5.2.22)

       MORGUE UNIT
         (5.2.14)



5/99                                                                  ICS Position Checklists                                                                 CL-22
                            MEDICAL SUPPLY OFFICER
o Obtain situation briefing from Medical Supervisor

o Don position identification vest

o READ ENTIRE DUTY CHECKLIST

o Acquire, stage and distribute appropriate medical equipment and supplies from units assigned to
   Medical Group and other sources as needed.

o Maintain status of needed equipment and supplies within Medical Group

o Request additional medical equipment and supplies as needed through Medical Group
   Supervisor
      o      Coordinate with Supply Unit Leader if Logistics Section is established

o Coordinate with treatment Area Leader(s) for equipment and supplies needed in Treatment
   Area(s)

o Main log of all received, requested, on-hand, and distributed equipment and supplies

o Turn in all documentation to Medical Group Supervisor




5/99                                 ICS Position Checklists                               CL-23
                                            SANTA CLARA COUNTY
                                      MULTIPLE CASUALTY INCIDENT PLAN

Triage Unit Leader:

The Triage Unit Leader is responsible to direct and coordinate the evaluation and tagging of
victims, and their movement to the appropriate treatment areas.



RADIO CALL SIGN “TRIAGE”
                        o ________________ COMMAND FREQUENCY

                        o ________________ TACTICAL FREQUENCY

                        o ________________ SUPPORT FREQUENCY


                                                                       INCIDENT COMMANDER
                                                                              (5.2.1)


                                                           LIASON                           P.I.O.
                                                            (5.2.2)                         (5.2.3)


                                                           SAFETY
                                                            (5.2.4)




                                 PLANS                           OPERATIONS                                                            LOGISTICS
                                 (5.2.6)                            (5.2.5)                                                              (5.2.7)


                                                STAGING
                                                 (5.2.8)                                                                               MEDICAL SUPPORT UNIT
                                                                                                                                               5.2.9



MEDICAL GROUP            TRANSPORTATION GROUP                     FIRE GROUP                          LAW GROUP             AIR OPS
    (5.2.10)                    (5.2.15)                             (5.2.19)                           (5.2.23)            (5.2.26)



  MEDICAL SUPPLY UNIT        AMBULANCE STAGING UNIT                     RESCUE UNIT            PERIMETER ENFORCEMENT UNIT
        (5.2.11)                    (5.2.16)                              (5.2.20)                       (5.2.24)

       TRIAGE UNIT          HOSPITAL COORDINATION UNIT                EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
         (5.2.12)                     (5.2.17)                             (5.2.21)                       (5.2.25)

    TREATMENT UNIT              AIR AMBULANCE UNIT                    SUPPRESSION UNIT
        (5.2.13)                      (5.2.18)                             (5.2.22)

       MORGUE UNIT
         (5.2.14)



5/99                                                                  ICS Position Checklists                                                                 CL-24
                                 TRIAGE UNIT LEADER
o Obtain situation briefing from Medical Group Supervisor

o Don position identification vest

o READ ENTIRE DUTY CHECKLIST

o Secure adequate supplies of Triage tags

o Assess situation

       Advise Medical Group Supervisor
       Advise Treatment Unit Leader
       Secure aides and litter bearers as needed
       Of scene hazardous, designate triage in safe location

o Appoint persons as taggers in each triage area
    o      Designate sectors and assign triage teams as appropriate

o Direct and expedite movement of victims to the appropriate treatment areas

o Maintain records of your operations
    o       Number of victims triaged, by category

o Keep Medical Group Supervisor informed regarding:

       Number of and extent of injured
       Need for Morgue/Coroner

o Coordinate with Treatment Unit Leader for medical care needs in treatment areas

o Secure operations when advised and return ICS materials and equipment

o Forward reports and records to Medical Group Supervisor




5/99                                   ICS Position Checklists                      CL-25
                                                  SANTA CLARA COUNTY
                                            MULTIPLE CASUALTY INCIDENT PLAN

Treatment Unit Leader:

The Treatment Unit Leader is responsible to direct and coordinate on scene medical care of victims
in the treatment areas as conditions permit. Transportation will not be delayed for treatment.

RADIO CALL SIGN “TREATMENT”
                        o ________________ COMMAND FREQUENCY

                        o ________________ TACTICAL FREQUENCY

                        o ________________ SUPPORT FREQUENCY



                                                                      INCIDENT COMMANDER
                                                                             (5.2.1)


                                                          LIASON                           P.I.O.
                                                           (5.2.2)                         (5.2.3)


                                                          SAFETY
                                                           (5.2.4)




                                PLANS                           OPERATIONS                                                            LOGISTICS
                                (5.2.6)                            (5.2.5)                                                              (5.2.7)


                                               STAGING
                                                (5.2.8)                                                                               MEDICAL SUPPORT UNIT
                                                                                                                                              5.2.9



MEDICAL GROUP           TRANSPORTATION GROUP                     FIRE GROUP                          LAW GROUP             AIR OPS
    (5.2.10)                   (5.2.15)                             (5.2.19)                           (5.2.23)            (5.2.26)



  MEDICAL SUPPLY UNIT       AMBULANCE STAGING UNIT                     RESCUE UNIT            PERIMETER ENFORCEMENT UNIT
        (5.2.11)                   (5.2.16)                              (5.2.20)                       (5.2.24)

      TRIAGE UNIT          HOSPITAL COORDINATION UNIT                EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
        (5.2.12)                     (5.2.17)                             (5.2.21)                       (5.2.25)

    TREATMENT UNIT             AIR AMBULANCE UNIT                    SUPPRESSION UNIT
        (5.2.13)                     (5.2.18)                             (5.2.22)

      MORGUE UNIT
        (5.2.14)



5/99                                                                           ICS Position Checklists                                                       CL-26
                              TREATMENT UNIT LEADER
o Obtain situation briefing from Medical Group Supervisor

o Don Position identification vest

o READ ENTIRE DUTY CHECKLIST

o Assess situation, Coordinate movement of tagged patients with triage leader and Transportation
   Group

o Appoint and brief staff, as needed:

       Treatment Area supervisors
       Litter Bearers
       Runners

o Assign medical care personnel to treatment areas

o Prioritize care of patients consistent with resources

       Number of victims
       Availability of transport

o Ensure proper medical care procedures are followed

       o      Alert “Safety” and “Law” to emotionally disturbed patients in need of isolation

o Expedite movement of patients for evacuation

o Evaluate and request supplies and other needs

o Maintain records of numbers of patients treated and other activities

o Secure operations when advised and return ICS materials and equipment

o Forward reports and records to Medical Group Supervisor




5/99                                    ICS Position Checklists                                 CL-27
                                            SANTA CLARA COUNTY
                                      MULTIPLE CASUALTY INCIDENT PLAN

Morgue Unit Leader:

Responsible for establishing or maintaining temporary morgue designated by Medical Group Supervisor.
Collect, protect and identify bodies and their personal effects.


RADIO CALL SIGN “MORGUE”
                        o ________________ COMMAND FREQUENCY

                        o ________________ TACTICAL FREQUENCY

                        o ________________ SUPPORT FREQUENCY



                                                                       INCIDENT COMMANDER
                                                                              (5.2.1)


                                                           LIASON                           P.I.O.
                                                            (5.2.2)                         (5.2.3)


                                                           SAFETY
                                                            (5.2.4)




                                 PLANS                           OPERATIONS                                                            LOGISTICS
                                 (5.2.6)                            (5.2.5)                                                              (5.2.7)


                                                STAGING
                                                 (5.2.8)                                                                               MEDICAL SUPPORT UNIT
                                                                                                                                               5.2.9



MEDICAL GROUP            TRANSPORTATION GROUP                     FIRE GROUP                          LAW GROUP             AIR OPS
    (5.2.10)                    (5.2.15)                             (5.2.19)                           (5.2.23)            (5.2.26)



  MEDICAL SUPPLY UNIT        AMBULANCE STAGING UNIT                     RESCUE UNIT            PERIMETER ENFORCEMENT UNIT
        (5.2.11)                    (5.2.16)                              (5.2.20)                       (5.2.24)

       TRIAGE UNIT          HOSPITAL COORDINATION UNIT                EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
         (5.2.12)                     (5.2.17)                             (5.2.21)                       (5.2.25)

    TREATMENT UNIT              AIR AMBULANCE UNIT                    SUPPRESSION UNIT
        (5.2.13)                      (5.2.18)                             (5.2.22)

       MORGUE UNIT
         (5.2.14)



5/99                                                                  ICS Position Checklists                                                                 CL-28
                               MORGUE UNIT LEADER

o Obtain Situation briefing from Medical Group Supervisor, Triage Unit Leader, and Treatment
   Unit Leader

o Don position identification vest

o READ ENTIRE DUTY LIST

o Assess situation

o Appoint staff and assistants, as needed:

       Aides
       Litter bearers

o Secure body bags

o Allow no one to remove a body, body part, or any personal effects from the scene without the
   authorization of the Coroner or Deputy Coroner

   o Move bodies only when necessary
   o do not move bodies or personal effects without identifying the original location (photos, grid
       drawings, etc.)

o If necessary to move bodies, designate morgue area

   o Maintain security of all personal belongings and keep with body

o Secure operations when advised and return ICS materials and equipment

o Forward reports and records to Medical Group Supervisor if Coroner or Deputy Coroner not
   present at scene (Operations Chief will forward reports to Coroner)




5/99                                  ICS Position Checklists                                CL-29
                                            SANTA CLARA COUNTY
                                      MULTIPLE CASUALTY INCIDENT PLAN

Transportation Group Supervisor:

The Transportation Group Supervisor will manage the medical transportation component. He/she
will supervise the personnel who load and transport victims, and is responsible to identify and
request transportation resources, direct and coordinate the number and types of patient loading into
ambulances, and identify hospital destinations.

RADIO CALL SIGN “TRANSPORTATION”
                        o ________________ COMMAND FREQUENCY

                        o ________________ TACTICAL FREQUENCY

                        o ________________ SUPPORT FREQUENCY

                                                                       INCIDENT COMMANDER
                                                                              (5.2.1)


                                                           LIASON                           P.I.O.
                                                            (5.2.2)                         (5.2.3)


                                                           SAFETY
                                                            (5.2.4)




                                 PLANS                           OPERATIONS                                                            LOGISTICS
                                 (5.2.6)                            (5.2.5)                                                              (5.2.7)


                                                STAGING
                                                 (5.2.8)                                                                               MEDICAL SUPPORT UNIT
                                                                                                                                               5.2.9



MEDICAL GROUP            TRANSPORTATION GROUP                     FIRE GROUP                          LAW GROUP             AIR OPS
    (5.2.10)                    (5.2.15)                             (5.2.19)                           (5.2.23)            (5.2.26)



  MEDICAL SUPPLY UNIT        AMBULANCE STAGING UNIT                     RESCUE UNIT            PERIMETER ENFORCEMENT UNIT
        (5.2.11)                    (5.2.16)                              (5.2.20)                       (5.2.24)

       TRIAGE UNIT          HOSPITAL COORDINATION UNIT                EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
         (5.2.12)                     (5.2.17)                             (5.2.21)                       (5.2.25)

    TREATMENT UNIT              AIR AMBULANCE UNIT                    SUPPRESSION UNIT
        (5.2.13)                      (5.2.18)                             (5.2.22)

       MORGUE UNIT
         (5.2.14)



5/99                                                                  ICS Position Checklists                                                                 CL-30
                    TRANSPORTATION GROUP SUPERVISOR

o Obtain situation briefing from Operations Chief

o Don position identification vest

o READ ENTIRE DUTY LIST

o Assess current situation with Transportation Unit Leader for:

       Appoint staff Aides
       Secure litter bearers

o Establish and identify ambulance loading areas

o Develop patient loading pattern from treatment area

   o Insure “Immediates” are expedited
   o Control personnel loading ambulance

o Develop ambulance ingress and egress traffic pattern and coordinate with Law Enforcement
   Group Supervisor

o Evaluate and request necessary resources, as needed

o Maintain written records of patients, ambulance units, and receiving facilities

o Provide patient information for transmission to the receiving facilities on the ARES/RACES
   Hospital Net, when established, or other communication system.

o Secure operations when advised and return ICS materials and equipment

o Forward records and reports to Operations Chief




5/99                                  ICS Position Checklists                             CL-31
                                            SANTA CLARA COUNTY
                                      MULTIPLE CASUALTY INCIDENT PLAN

Ambulance Staging Officer:

The Ambulance Staging Officer is responsible for documenting the check-in and check-out of all
medical transportation vehicles, immediately prior to moving into the patient loading area.



RADIO CALL SIGN “AMBULANCE STAGING”
                        o ________________ COMMAND FREQUENCY

                        o ________________ TACTICAL FREQUENCY

                        o ________________ SUPPORT FREQUENCY


                                                                       INCIDENT COMMANDER
                                                                              (5.2.1)


                                                           LIASON                           P.I.O.
                                                            (5.2.2)                         (5.2.3)


                                                           SAFETY
                                                            (5.2.4)




                                 PLANS                           OPERATIONS                                                            LOGISTICS
                                 (5.2.6)                            (5.2.5)                                                              (5.2.7)


                                                STAGING
                                                 (5.2.8)                                                                               MEDICAL SUPPORT UNIT
                                                                                                                                               5.2.9



MEDICAL GROUP            TRANSPORTATION GROUP                     FIRE GROUP                          LAW GROUP             AIR OPS
    (5.2.10)                    (5.2.15)                             (5.2.19)                           (5.2.23)            (5.2.26)



  MEDICAL SUPPLY UNIT        AMBULANCE STAGING UNIT                     RESCUE UNIT            PERIMETER ENFORCEMENT UNIT
        (5.2.11)                    (5.2.16)                              (5.2.20)                       (5.2.24)

       TRIAGE UNIT          HOSPITAL COORDINATION UNIT                EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
         (5.2.12)                     (5.2.17)                             (5.2.21)                       (5.2.25)

    TREATMENT UNIT              AIR AMBULANCE UNIT                    SUPPRESSION UNIT
        (5.2.13)                      (5.2.18)                             (5.2.22)

       MORGUE UNIT
         (5.2.14)



5/99                                                                  ICS Position Checklists                                                                 CL-32
                        AMBULANCE STAGING OFFICER

o Obtain situation briefing from Transportation Group Supervisor

o Don position identification vest

o READ ENTIRE DUTY LIST

o Assess situation

o Appoint and brief staff:
       Aides

o Locate, prepare, and identify ambulance staging area
       CONSIDER
           Safety and accessibility
           Traffic control must be monitored and directed
           Area and resource location identifiers must be visible
       o   Advise when operational

o Order and dispense resources as directed by Transportation Group Supervisor

o Prioritize resource need with base

o Consider equipment/time limitations
  o Anticipate and advise on changing resource requirements

o KEEP RECORD OF RESOURCE MOVEMENT - staffing/equipment
  o Establish check-in/check-out function

o Maintain log of your activities and other pertinent information acquired

o When ordered, secure activities and release personnel under your supervision
  o Demobilize resources in accordance with Demob Plan

o Forward all reports to Transportation Group Supervisor




5/99                                   ICS Position Checklists                   CL-33
                                            SANTA CLARA COUNTY
                                      MULTIPLE CASUALTY INCIDENT PLAN

Hospital Coordinator:

The Hospital Coordinator is responsible for coordinating records relating to patient identification,
injuries, mode of transportation, and destination. This position may also be identified as
MEDICAL COMMUNICATIONS (“MED COMM”).

RADIO CALL SIGN “HOSPITAL”
                        o ________________ COMMAND FREQUENCY

                        o ________________ TACTICAL FREQUENCY

                        o ________________ SUPPORT FREQUENCY


                                                                       INCIDENT COMMANDER
                                                                              (5.2.1)


                                                           LIASON                           P.I.O.
                                                            (5.2.2)                         (5.2.3)


                                                           SAFETY
                                                            (5.2.4)




                                 PLANS                           OPERATIONS                                                            LOGISTICS
                                 (5.2.6)                            (5.2.5)                                                              (5.2.7)


                                                STAGING
                                                 (5.2.8)                                                                               MEDICAL SUPPORT UNIT
                                                                                                                                               5.2.9



MEDICAL GROUP            TRANSPORTATION GROUP                     FIRE GROUP                          LAW GROUP             AIR OPS
    (5.2.10)                    (5.2.15)                             (5.2.19)                           (5.2.23)            (5.2.26)



  MEDICAL SUPPLY UNIT        AMBULANCE STAGING UNIT                     RESCUE UNIT            PERIMETER ENFORCEMENT UNIT
        (5.2.11)                    (5.2.16)                              (5.2.20)                       (5.2.24)

       TRIAGE UNIT          HOSPITAL COORDINATION UNIT                EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
         (5.2.12)                     (5.2.17)                             (5.2.21)                       (5.2.25)

    TREATMENT UNIT              AIR AMBULANCE UNIT                    SUPPRESSION UNIT
        (5.2.13)                      (5.2.18)                             (5.2.22)

       MORGUE UNIT
         (5.2.14)



5/99                                                                  ICS Position Checklists                                                                 CL-34
                               HOSPITAL COORDINATOR

o Obtain briefing from Transportation Unit Leader

o Don position identification vest

o READ ENTIRE DUTY LIST

o Assure recording of patient information including:

   o   Triage tag number            o Type of injuries
   o   Triage category              o Mode of transport
   o   Destination                    (Unit / Vehicle ID)
   o   Patient name                 o Time departed scene

o Establish contact with affected receiving facilities through ARES/RACES personnel on their
   Hospital Net, cellular phone, or other communications system. Avoid using radio channels, due
   to traffic volume, and keep transmissions brief.

       o      Provide receiving facilities with incident information as requested, including any
              decontamination procedures.

       o      Advise receiving facilities of inbound patients, including triage category and types of
              injuries.

o Coordinate with Logistics Chief and EMS Agency on hospital resource needs

o Coordinate with Transportation Group Supervisor on current status of hospitals / medical
   facilities availability and capability

o Complete all required transportation log forms. Transmit copy of transportation log to County
   Communications when incident is secure, and as requested

o Turn in all documentation to Transportation Group Supervisor




5/99                                        ICS Position Checklists                            CL-35
                                            SANTA CLARA COUNTY
                                      MULTIPLE CASUALTY INCIDENT PLAN

Air Ambulance Unit Leader:

The Air Ambulance Unit Leader is responsible for documenting the check-in and check-out of all
air medical transportation vehicles, coordinate patient loading into air ambulances and to coordinate
the number and types of patients and hospital destinations.

RADIO CALL SIGN “AIR MEDICAL”
                        o ________________ COMMAND FREQUENCY

                        o ________________ TACTICAL FREQUENCY

                        o ________________ SUPPORT FREQUENCY


                                                                       INCIDENT COMMANDER
                                                                              (5.2.1)


                                                           LIASON                           P.I.O.
                                                            (5.2.2)                         (5.2.3)


                                                           SAFETY
                                                            (5.2.4)




                                 PLANS                           OPERATIONS                                                            LOGISTICS
                                 (5.2.6)                            (5.2.5)                                                              (5.2.7)


                                                STAGING
                                                 (5.2.8)                                                                               MEDICAL SUPPORT UNIT
                                                                                                                                               5.2.9



MEDICAL GROUP            TRANSPORTATION GROUP                     FIRE GROUP                          LAW GROUP             AIR OPS
    (5.2.10)                    (5.2.15)                             (5.2.19)                           (5.2.23)            (5.2.26)



  MEDICAL SUPPLY UNIT        AMBULANCE STAGING UNIT                     RESCUE UNIT            PERIMETER ENFORCEMENT UNIT
        (5.2.11)                    (5.2.16)                              (5.2.20)                       (5.2.24)

       TRIAGE UNIT          HOSPITAL COORDINATION UNIT                EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
         (5.2.12)                     (5.2.17)                             (5.2.21)                       (5.2.25)

    TREATMENT UNIT              AIR AMBULANCE UNIT                    SUPPRESSION UNIT
        (5.2.13)                      (5.2.18)                             (5.2.22)

       MORGUE UNIT
         (5.2.14)



5/99                                                                  ICS Position Checklists                                                                 CL-36
                         AIR AMBULANCE UNIT LEADER

o Obtain situation briefing from Transportation Group Supervisor

o Don position identification vest

o READ ENTIRE DUTY LIST

o Assess situation

o Appoint and brief staff:
       Aides

o Coordinate with Air Operations

o Locate, prepare, and identify air ambulance staging area
       CONSIDER
           Safety and accessibility
           Traffic control must be monitored and directed
           Area and resource location identifiers must be visible
       o   Advise when operational

o Order and dispense resources as directed by Transportation Group Supervisor

o Prioritize resource need with base

o Consider equipment/time limitations
  o Anticipate and advise on changing resource requirements

o KEEP RECORD OF RESOURCE MOVEMENT - staffing/equipment
  o Establish check-in/check-out function

o Maintain log of your activities and other pertinent information acquired

o When ordered, secure activities and release personnel under your supervision
  o Demobilize resources in accordance with Demob Plan

o Forward all reports to Transportation Group Supervisor




5/99                                   ICS Position Checklists                   CL-37
                                            SANTA CLARA COUNTY
                                      MULTIPLE CASUALTY INCIDENT PLAN

Fire Group Supervisor:

The Fire Group supervisor is responsible for tactical management of fire suppression, extrication,
and control of hazards to achieve the mission.



RADIO CALL SIGN “FIRE GROUP”
                        o ________________ COMMAND FREQUENCY

                        o ________________ TACTICAL FREQUENCY

                        o ________________ SUPPORT FREQUENCY


                                                                       INCIDENT COMMANDER
                                                                              (5.2.1)


                                                           LIASON                           P.I.O.
                                                            (5.2.2)                         (5.2.3)


                                                           SAFETY
                                                            (5.2.4)




                                 PLANS                           OPERATIONS                                                            LOGISTICS
                                 (5.2.6)                            (5.2.5)                                                              (5.2.7)


                                                STAGING
                                                 (5.2.8)                                                                               MEDICAL SUPPORT UNIT
                                                                                                                                               5.2.9



MEDICAL GROUP            TRANSPORTATION GROUP                     FIRE GROUP                          LAW GROUP             AIR OPS
    (5.2.10)                    (5.2.15)                             (5.2.19)                           (5.2.23)            (5.2.26)



  MEDICAL SUPPLY UNIT        AMBULANCE STAGING UNIT                     RESCUE UNIT            PERIMETER ENFORCEMENT UNIT
        (5.2.11)                    (5.2.16)                              (5.2.20)                       (5.2.24)

       TRIAGE UNIT          HOSPITAL COORDINATION UNIT                EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
         (5.2.12)                     (5.2.17)                             (5.2.21)                       (5.2.25)

    TREATMENT UNIT              AIR AMBULANCE UNIT                    SUPPRESSION UNIT
        (5.2.13)                      (5.2.18)                             (5.2.22)

       MORGUE UNIT
         (5.2.14)



5/99                                                                  ICS Position Checklists                                                                 CL-38
                             FIRE GROUP SUPERVISOR

o Obtain situation briefing from Operations Chief

o Don position identification vest

o READ ENTIRE DUTY LIST

o Assess situation

       Aide(s)
       Rescue Unit(s) Leader(s)
       Extrication Unit(s) Leader)s)
       Suppression Unit(s) Leader(s)

o Receive and identify assigned area of control

o Assign and direct Units to achieve assigned mission

o Establish and maintain communications with Unit Leader(s)

o Determine need for resources

o Request additional resources, as required

o Keep Operations Chief informed of any special conditions or activities

o Request periodic progress reports for Unit Leader(s)

o Demobilize resources, as directed by the Operations Chief

o Maintain log of your activities and other pertinent information acquired

o When ordered, secure operations and replenish supplies

o Forward reports through channels to Operations Chief




5/99                                   ICS Position Checklists               CL-39
                                            SANTA CLARA COUNTY
                                      MULTIPLE CASUALTY INCIDENT PLAN

Rescue Unit Leader:

The Rescue Unit Leader is responsible for locating victims, conveying them to a place of safety,
and administering first aid if necessary.



RADIO CALL SIGN “RESCUE”
                        o ________________ COMMAND FREQUENCY

                        o ________________ TACTICAL FREQUENCY

                        o ________________ SUPPORT FREQUENCY


                                                                       INCIDENT COMMANDER
                                                                              (5.2.1)


                                                           LIASON                           P.I.O.
                                                            (5.2.2)                         (5.2.3)


                                                           SAFETY
                                                            (5.2.4)




                                 PLANS                           OPERATIONS                                                            LOGISTICS
                                 (5.2.6)                            (5.2.5)                                                              (5.2.7)


                                                STAGING
                                                 (5.2.8)                                                                               MEDICAL SUPPORT UNIT
                                                                                                                                               5.2.9



MEDICAL GROUP            TRANSPORTATION GROUP                     FIRE GROUP                          LAW GROUP             AIR OPS
    (5.2.10)                    (5.2.15)                             (5.2.19)                           (5.2.23)            (5.2.26)



  MEDICAL SUPPLY UNIT        AMBULANCE STAGING UNIT                     RESCUE UNIT            PERIMETER ENFORCEMENT UNIT
        (5.2.11)                    (5.2.16)                              (5.2.20)                       (5.2.24)

       TRIAGE UNIT          HOSPITAL COORDINATION UNIT                EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
         (5.2.12)                     (5.2.17)                             (5.2.21)                       (5.2.25)

    TREATMENT UNIT              AIR AMBULANCE UNIT                    SUPPRESSION UNIT
        (5.2.13)                      (5.2.18)                             (5.2.22)

       MORGUE UNIT
         (5.2.14)



5/99                                                                  ICS Position Checklists                                                                 CL-40
                                RESCUE UNIT LEADER

o Obtain situation briefing from Fire Group Supervisor

o Don position identification vest

o READ ENTIRE DUTY LIST

o Assess situation

o appoint and brief staff, as needed:

       Aide(s)
       Unit Specialist

o Keep supervisor informed regarding:

       Number and condition of victims
       Progress of rescue operations

o Evaluate and request resources, as needed

o Coordinate needs with Suppression and Extrication Unit Leaders

o Evaluate results of actions taken and implement changes as needed

o Secure operation when ordered and return ICS materials

o Forward reports through channels to Operations Chief




5/99                                    ICS Position Checklists       CL-41
                                             SANTA CLARA COUNTY
                                      MULTIPLE CASUALTY INCIDENT PLAN

Extrication Unit Leader:

The Extrication Unit Leader is responsible for locating and freeing trapped victims and conveying
them to a place of safety.



RADIO CALL SIGN “EXTRICATION”
                        o ________________ COMMAND FREQUENCY

                        o ________________ TACTICAL FREQUENCY

                        o ________________ SUPPORT FREQUENCY


                                                                       INCIDENT COMMANDER
                                                                              (5.2.1)


                                                           LIASON                           P.I.O.
                                                            (5.2.2)                         (5.2.3)


                                                           SAFETY
                                                            (5.2.4)




                                 PLANS                           OPERATIONS                                                            LOGISTICS
                                 (5.2.6)                            (5.2.5)                                                              (5.2.7)


                                                STAGING
                                                 (5.2.8)                                                                               MEDICAL SUPPORT UNIT
                                                                                                                                               5.2.9



MEDICAL GROUP            TRANSPORTATION GROUP                     FIRE GROUP                          LAW GROUP             AIR OPS
    (5.2.10)                    (5.2.15)                             (5.2.19)                           (5.2.23)            (5.2.26)



  MEDICAL SUPPLY UNIT        AMBULANCE STAGING UNIT                     RESCUE UNIT            PERIMETER ENFORCEMENT UNIT
        (5.2.11)                    (5.2.16)                              (5.2.20)                       (5.2.24)

       TRIAGE UNIT          HOSPITAL COORDINATION UNIT                EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
         (5.2.12)                     (5.2.17)                             (5.2.21)                       (5.2.25)

    TREATMENT UNIT              AIR AMBULANCE UNIT                    SUPPRESSION UNIT
        (5.2.13)                      (5.2.18)                             (5.2.22)

       MORGUE UNIT
         (5.2.14)



5/99                                                                  ICS Position Checklists                                                                 CL-42
                           EXTRICATION UNIT LEADER

o Obtain situation briefing from Fire Group Supervisor

o Don position identification vest

o READ ENTIRE DUTY LIST

o Assess situation

o Appoint and brief staff, as needed:

       Aide(s)
       Equipment Operators
       Hand Tool Operators

o Keep Fire Group supervisor informed regarding:

       Structural, vehicular conditions
       Number and condition of victims
       Progress and success of actions

o Evaluate and request resources, as needed

o Coordinate with Triage and Treatment Unit Leaders

o Coordinate with Suppression and Rescue Unit Leaders

o Evaluate results of actions taken and implement changes as needed

o Secure operations when ordered and return ICS materials

o Forward reports through channels to Operations Chief




5/99                                    ICS Position Checklists       CL-43
                                            SANTA CLARA COUNTY
                                      MULTIPLE CASUALTY INCIDENT PLAN

Suppression Unit Leader:

The Suppression Unit Leader is responsible for coordination fire suppression activities.




RADIO CALL SIGN “SUPPRESSION”
                        o ________________ COMMAND FREQUENCY

                        o ________________ TACTICAL FREQUENCY

                        o ________________ SUPPORT FREQUENCY


                                                                       INCIDENT COMMANDER
                                                                              (5.2.1)


                                                           LIASON                           P.I.O.
                                                            (5.2.2)                         (5.2.3)


                                                           SAFETY
                                                            (5.2.4)




                                 PLANS                           OPERATIONS                                                            LOGISTICS
                                 (5.2.6)                            (5.2.5)                                                              (5.2.7)


                                                STAGING
                                                 (5.2.8)                                                                               MEDICAL SUPPORT UNIT
                                                                                                                                               5.2.9



MEDICAL GROUP            TRANSPORTATION GROUP                     FIRE GROUP                          LAW GROUP             AIR OPS
    (5.2.10)                    (5.2.15)                             (5.2.19)                           (5.2.23)            (5.2.26)



  MEDICAL SUPPLY UNIT        AMBULANCE STAGING UNIT                     RESCUE UNIT            PERIMETER ENFORCEMENT UNIT
        (5.2.11)                    (5.2.16)                              (5.2.20)                       (5.2.24)

       TRIAGE UNIT          HOSPITAL COORDINATION UNIT                EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
         (5.2.12)                     (5.2.17)                             (5.2.21)                       (5.2.25)

    TREATMENT UNIT              AIR AMBULANCE UNIT                    SUPPRESSION UNIT
        (5.2.13)                      (5.2.18)                             (5.2.22)

       MORGUE UNIT
         (5.2.14)



5/99                                                                  ICS Position Checklists                                                                 CL-44
                           SUPPRESSION UNIT LEADER

o Obtain situation briefing from Fire Group Supervisor

o Don position identification vest

o READ ENTIRE DUTY LIST

o Assess situation

o Appoint and brief staff, as needed:

       Water supply company (companies)
       Hose company (companies)
       Containment company (companies)

o Keep fire Group Supervisor informed regarding:

       Area and condition of involvement

o Evacuate and request resources, as needed

o Coordinate with Triage Unit Leader(s)

o Coordinate needs with Rescue and Extrication Unit Leaders

o Protect victims and Rescue Units

o Evaluate results of actions taken

o Secure operations when ordered and return ICS materials

o Forward reports through channels to Operations Chief




5/99                                    ICS Position Checklists   CL-45
                                            SANTA CLARA COUNTY
                                      MULTIPLE CASUALTY INCIDENT PLAN

Law Group Supervisor:

The Law Group Supervisor is responsible for managing both the internal and perimeter components
of law enforcement with the area of the multiple casualty event or emergency site, supervising
personnel of Internal and Perimeter Enforcement Units, and establishing liaison with County
Communications.

RADIO CALL SIGN “LAW GROUP”
                        o ________________ COMMAND FREQUENCY

                        o ________________ TACTICAL FREQUENCY

                        o ________________ SUPPORT FREQUENCY

                                                                       INCIDENT COMMANDER
                                                                              (5.2.1)


                                                           LIASON                           P.I.O.
                                                            (5.2.2)                         (5.2.3)


                                                           SAFETY
                                                            (5.2.4)




                                 PLANS                           OPERATIONS                                                            LOGISTICS
                                 (5.2.6)                            (5.2.5)                                                              (5.2.7)


                                                STAGING
                                                 (5.2.8)                                                                               MEDICAL SUPPORT UNIT
                                                                                                                                               5.2.9



MEDICAL GROUP            TRANSPORTATION GROUP                     FIRE GROUP                          LAW GROUP             AIR OPS
    (5.2.10)                    (5.2.15)                             (5.2.19)                           (5.2.23)            (5.2.26)



  MEDICAL SUPPLY UNIT        AMBULANCE STAGING UNIT                     RESCUE UNIT            PERIMETER ENFORCEMENT UNIT
        (5.2.11)                    (5.2.16)                              (5.2.20)                       (5.2.24)

       TRIAGE UNIT          HOSPITAL COORDINATION UNIT                EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
         (5.2.12)                     (5.2.17)                             (5.2.21)                       (5.2.25)

    TREATMENT UNIT              AIR AMBULANCE UNIT                    SUPPRESSION UNIT
        (5.2.13)                      (5.2.18)                             (5.2.22)

       MORGUE UNIT
         (5.2.14)



5/99                                                                  ICS Position Checklists                                                                 CL-46
                              LAW GROUP SUPERVISOR

o Obtain situation briefing from Operations Chief

o Don position identification vest

o READ ENTIRE DUTY LIST

o Assess situation

o Appoint and brief staff, as needed

       Perimeter Enforcement Leader
       Internal enforcement Unit Leader
       Investigation Unit Leader

o Ensure that Multiple Casualty Incident Plan has been, or is, activated through County
   Communications

o Establish Command Post, if not already established

o Coordinate with Transportation Unit Leader for ingress/egress routes for ambulances

o Initiate collision investigation

o Request Multiple Accident Investigation Team (M.A.I.T.) through California Highway Patrol -
   contact local area commander

o Maintain a chronological log

o At completion of incident, critique department’s involvement




5/99                                   ICS Position Checklists                            CL-47
                                            SANTA CLARA COUNTY
                                      MULTIPLE CASUALTY INCIDENT PLAN

Perimeter Enforcement Unit Leader:

The Perimeter Enforcement Unit Leader is responsible for managing perimeter components of law
enforcement within the area of the multiple casualty event or emergency site, supervising perimeter
control, and maintaining communications with the Law Group Supervisor.

RADIO CALL SIGN “PERIMETER”
                        o ________________ COMMAND FREQUENCY

                        o ________________ TACTICAL FREQUENCY

                        o ________________ SUPPORT FREQUENCY


                                                                       INCIDENT COMMANDER
                                                                              (5.2.1)


                                                           LIASON                           P.I.O.
                                                            (5.2.2)                         (5.2.3)


                                                           SAFETY
                                                            (5.2.4)




                                 PLANS                           OPERATIONS                                                            LOGISTICS
                                 (5.2.6)                            (5.2.5)                                                              (5.2.7)


                                                STAGING
                                                 (5.2.8)                                                                               MEDICAL SUPPORT UNIT
                                                                                                                                               5.2.9



MEDICAL GROUP            TRANSPORTATION GROUP                     FIRE GROUP                          LAW GROUP             AIR OPS
    (5.2.10)                    (5.2.15)                             (5.2.19)                           (5.2.23)            (5.2.26)



  MEDICAL SUPPLY UNIT        AMBULANCE STAGING UNIT                     RESCUE UNIT            PERIMETER ENFORCEMENT UNIT
        (5.2.11)                    (5.2.16)                              (5.2.20)                       (5.2.24)

       TRIAGE UNIT          HOSPITAL COORDINATION UNIT                EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
         (5.2.12)                     (5.2.17)                             (5.2.21)                       (5.2.25)

    TREATMENT UNIT              AIR AMBULANCE UNIT                    SUPPRESSION UNIT
        (5.2.13)                      (5.2.18)                             (5.2.22)

       MORGUE UNIT
         (5.2.14)



5/99                                                                  ICS Position Checklists                                                                 CL-48
                 PERIMETER ENFORCEMENT UNIT LEADER

o Obtain situation briefing from Law Group Supervisor

o Don position identification vest

o For C.H.P. - Put vehicle radio and extenders into mode and/or channel designated by Law Group
   Supervisor

o Other law enforcement agencies - Tune radio to frequency designated by Law Group Supervisor

o READ ENTIRE DUTY LIST

o Assess situation

o Establish perimeter control - secure scene, request assistance from:

       County Road Department or City Road Department
       Other Law Enforcement Agency
       CalTrans

o Ensure that Perimeter Enforcement Unit has sufficient supplies to maintain perimeter control

o Maintain access security

o Coordinate and maintain emergency vehicle traffic flow and security

       o     Communicate with ambulance staging




5/99                                  ICS Position Checklists                              CL-49
                                            SANTA CLARA COUNTY
                                      MULTIPLE CASUALTY INCIDENT PLAN

Internal Enforcement Unit Leader:

The Internal Enforcement Unit Leader is responsible for managing investigation components of law
enforcement within the multiple casualty event and for internal traffic flow and maintaining
communications with the Law Group Supervisor.

RADIO CALL SIGN “INTERNAL”
                        o ________________ COMMAND FREQUENCY

                        o ________________ TACTICAL FREQUENCY

                        o ________________ SUPPORT FREQUENCY


                                                                       INCIDENT COMMANDER
                                                                              (5.2.1)


                                                           LIASON                           P.I.O.
                                                            (5.2.2)                         (5.2.3)


                                                           SAFETY
                                                            (5.2.4)




                                 PLANS                           OPERATIONS                                                            LOGISTICS
                                 (5.2.6)                            (5.2.5)                                                              (5.2.7)


                                                STAGING
                                                 (5.2.8)                                                                               MEDICAL SUPPORT UNIT
                                                                                                                                               5.2.9



MEDICAL GROUP            TRANSPORTATION GROUP                     FIRE GROUP                          LAW GROUP             AIR OPS
    (5.2.10)                    (5.2.15)                             (5.2.19)                           (5.2.23)            (5.2.26)



  MEDICAL SUPPLY UNIT        AMBULANCE STAGING UNIT                     RESCUE UNIT            PERIMETER ENFORCEMENT UNIT
        (5.2.11)                    (5.2.16)                              (5.2.20)                       (5.2.24)

       TRIAGE UNIT          HOSPITAL COORDINATION UNIT                EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
         (5.2.12)                     (5.2.17)                             (5.2.21)                       (5.2.25)

    TREATMENT UNIT              AIR AMBULANCE UNIT                    SUPPRESSION UNIT
        (5.2.13)                      (5.2.18)                             (5.2.22)

       MORGUE UNIT
         (5.2.14)



5/99                                                                  ICS Position Checklists                                                                 CL-50
                  INTERNAL ENFORCEMENT UNIT LEADER

o Obtain situation briefing from Law Group Supervisor

o Don position identification vest

o Maintain communications with Law Group Supervisor

o READ ENTIRE DUTY LIST

o Assess situation

o Establish inner perimeter to protect the scene

o Request necessary assistance

       Ambulances
       Fire Department
       Coroner
       Law Enforcement
       Tow Trucks
       Utility Companies

o Assist Treatment Leader with emotionally disturbed victims




5/99                                  ICS Position Checklists   CL-51
                                            SANTA CLARA COUNTY
                                      MULTIPLE CASUALTY INCIDENT PLAN

Air Operations Group Supervisor:

The Air Operations Group Supervisor is responsible for management of personnel who manage
helibase and helispot, fuel and other supplies, maintenance and repair of helicopters, retardant
mixing and loading, and records of activities other than Air Medical.

RADIO CALL SIGN “AIR OPS”
                        o ________________ COMMAND FREQUENCY

                        o ________________ TACTICAL FREQUENCY

                        o ________________ SUPPORT FREQUENCY


                                                                       INCIDENT COMMANDER
                                                                              (5.2.1)


                                                           LIASON                           P.I.O.
                                                            (5.2.2)                         (5.2.3)


                                                           SAFETY
                                                            (5.2.4)




                                 PLANS                           OPERATIONS                                                            LOGISTICS
                                 (5.2.6)                            (5.2.5)                                                              (5.2.7)


                                                STAGING
                                                 (5.2.8)                                                                               MEDICAL SUPPORT UNIT
                                                                                                                                               5.2.9



MEDICAL GROUP            TRANSPORTATION GROUP                     FIRE GROUP                          LAW GROUP             AIR OPS
    (5.2.10)                    (5.2.15)                             (5.2.19)                           (5.2.23)            (5.2.26)



  MEDICAL SUPPLY UNIT        AMBULANCE STAGING UNIT                     RESCUE UNIT            PERIMETER ENFORCEMENT UNIT
        (5.2.11)                    (5.2.16)                              (5.2.20)                       (5.2.24)

       TRIAGE UNIT          HOSPITAL COORDINATION UNIT                EXTRICATION UNIT          INTERNAL ENFORCEMENT UNIT
         (5.2.12)                     (5.2.17)                             (5.2.21)                       (5.2.25)

    TREATMENT UNIT              AIR AMBULANCE UNIT                    SUPPRESSION UNIT
        (5.2.13)                      (5.2.18)                             (5.2.22)

       MORGUE UNIT
         (5.2.14)



5/99                                                                  ICS Position Checklists                                                                 CL-52
                                            AIR OPS

o Obtain situation briefing from Operations Chief

o Don position identification vest

o READ ENTIRE DUTY LIST

o Assess situation

o Appoint and brief staff, as needed

       Helibase Manager           If a qualified individual is not available among responding
       Helispot Manager           personnel, consider contacting CDF or 129th Air Rescue for
                           a qualified helispot/helibase manager.

o Establish Helibase and helispot, if not already identified

o Ensure dust abatement procedures

o Obtain air to air frequencies

o Obtain ground to air frequencies

o Provide crash/rescue crew for helibase and helispot

o Request and appropriate supplies through Logistics Chief

o Coordinate requests for Air transport with Air Medical unit

o Participate in planning activities

o Maintain group log of activities

o Anticipate need for additional supplies and relief personnel

o Maintain records and forward to Operations

o Demobilize as directed by Operations Chief




5/99                                   ICS Position Checklists                             CL-53

				
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Description: Multiple Casualty Incident Plan