ASTM F1288-90(2009)

NOTICE: This standard has either been superseded and replaced by a new version or withdrawn.
Contact ASTM International (www.astm.org) for the latest information
Designation: F1288 − 90 (Reapproved 2009)
Standard Guide for
Planning for and Response to a Multiple Casualty Incident
This standard is issued under the fixed designation F1288; the number immediately following the designation indicates the year of
original adoption or, in the case of revision, the year of last revision. A number in parentheses indicates the year of last reapproval. A
superscript epsilon (´) indicates an editorial change since the last revision or reapproval.
1. Scope 3.1.2 disaster—a sudden calamity, with or without
casualties, so defined by local, county, or state guidelines.
1.1 This guide covers the planning, needs assessment,
3.1.2.1 medical disaster—a type of significant medical in-
training,integration,coordination,mutualaid,implementation,
cidentwhichexceeds,oroverwhelms,orboth,thecapabilityof
provision of resources, and evaluation of the response of a
local resources and of routinely available regional or multi-
local emergency medical service (EMS) organization or
jurisdictional medical mutual aid, and for which extraordinary
agency to a multiple patient producing situation that may or
medical aid from state or federal resources is very likely
may not involve property loss. This guide is limited to the
required for further diagnosis and treatment.
pre-hospital response and mitigation of an incident up to and
3.1.3 EMS control/medical group supervision—the first
including the disposition of patients from the incident scene.
emergency medical services response at the incident scene, or
1.2 This guide addresses the background on planning,
designated by the local response plan or incident command to
scope, structure, application, federal, state, local, voluntary,
be responsible for the overall management of the incident’s
and nongovernmental resources and planning efforts involved
EMS operation.
indeveloping,implementing,andevaluatinganEMSannex,or
3.1.4 extrication management—the function of supervising
component, to the local jurisdiction’s emergency operations
personnel who remove entrapped victims.
plan (EOP) as defined in the Federal Emergency Management
3.1.5 fatality management—the function designated by ex-
Agency (FEMA) publication, Civil Preparedness Guide (CPG)
isting plans, or the EMS control/medical group supervisor, to
1–8.
organize, coordinate, manage, and direct morgue services.
1.3 This standard does not purport to address the safety
3.1.6 incident commander—the individual responsible for
concerns associated with its use. It is the responsibility of the
the overall on-site management and coordination of personnel
user of this standard to establish appropriate safety and health
and resources involved in the incident.
practices and determine the applicability of regulatory limita-
tions prior to use.
3.1.7 logistics resources management—the function respon-
sible for acquiring personnel, equipment (including vehicles),
2. Referenced Documents
facilities, supplies, and services as requested by the incident
2.1 ASTM Standards:
commander.
F1149 Practice for Qualifications, Responsibilities, and Au-
3.1.8 medical communications management—the function
thority of Individuals and Institutions Providing Medical
designated by the incident commander or EMS control/ medi-
Direction of Emergency Medical Services
cal group supervisor to establish, maintain, and coordinate
effective communication between on-site and off-site medical
3. Terminology
personnel and facilities.
3.1 Definitions of Terms Specific to This Standard:
3.1.9 medical supplies management—the function desig-
3.1.1 command post—the physical location from which
nated by the incident commander to manage equipment and
incident command exercises direction over the entire incident.
report to EMS control/medical group supervisor.
3.1.10 mental health coordinator—a qualified mental health
This guide is under the jurisdiction of ASTM Committee F30 on Emergency
professional responsible for coordinating the psychosocial
Medical Services and is the direct responsibility of Subcommittee F30.03 on
assessments and interventions for responders, affected
Organization/Management.
Current edition approved March 1, 2009. Published March 2009. Originally
individuals, and groups.
approved in 1990. Last previous edition approved in 2003 as F1288 – 90 (2003).
3.1.11 multiple casualty incident (MCI)—a type of signifi-
DOI: 10.1520/F1288-90R09.
Available from FEMA, 500 C St., SW, Washington, DC 20472.
cant medical incident that may fall into the following catego-
For referenced ASTM standards, visit the ASTM website, www.astm.org, or
ries:
contact ASTM Customer Service at service@astm.org. For Annual Book of ASTM
3.1.11.1 extended—an incident for which local medical
Standards volume information, refer to the standard’s Document Summary page on
the ASTM website. resources are available and adequate to provide for field
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959. United States
F1288 − 90 (2009)
medical triage and stabilization, and for which appropriate 3.1.25 triage management—the function that is responsible
local facilities are available and adequate for further diagnosis for triage and preliminary treatment of casualties.
and treatment.
4. Summary of Guide
3.1.11.2 major—an incident producing large numbers of
casualties, for which routinely available regional or multi-
4.1 This guide is based upon a body of knowledge on the
jurisdictional medical mutual aid is necessary and adequate for
planning, implementation, and evaluation of the emergency
further diagnosis and treatment.
medical components of the local pre-hospital response to
3.1.12 mutual aid—the coordination of resources, including
multiple casualty incidents.
butnotlimitedtofacilities,personnel,vehicles,equipment,and
4.2 Thebodyofknowledgeonwhichtheguideisbasedwas
services, pursuant to an agreement between jurisdictions pro-
drawn from a wide variety of sources, including individual
viding for such interchange on a reciprocal basis in responding
authors, academic institutions, and federal, state, regional, and
to a disaster or emergency.
local organizations.
3.1.13 needs assessment—a preliminary survey of real or
4.3 This guide is organized in such a way as to provide
potential hazards in a specific geographic area.
those responsible for planning, implementing, and evaluating
3.1.14 operations offıcer—individual who assists the inci-
the emergency medical components of the local pre-hospital
dent commander on issues relating to the operations of the
response to multiple casualty incidents with information they
incident.
can readily use to ensure that their response is as expedient and
appropriate as is reasonably possible.
3.1.15 public information—a function designated by the
incidentcommanderforthedisseminationoffactualandtimely
4.4 The guide was created to organize, collate, and distrib-
reports to the news media.
uterelatedinformationinsuchawayastobereadilyaccessible
to people in the fields of emergency medical services and
3.1.16 safety management—the function that identifies real
emergency management.
or potential hazards, unsafe environment or procedures at the
incident scene, and recommends the appropriate corrective or
4.5 This guide should not be perceived as an inflexible rule
preventive actions under the authority of the incident
or standard but as a guide that should be adapted to the needs
commander, to ensure the safety of all personnel at the incident
of the individual community, and should be refined and
scene.
improved as the body of knowledge on which it is based
increases.
3.1.17 sector offıcers (group supervisors/leaders/
managers)—qualified personnel who control a specific area or
5. Significance and Use
task assignment.
5.1 This guide is intended to assist the management of the
3.1.18 staging area—the location where responding emer-
local EMS agencies or organizations in the design, planning,
gency services equipment and personnel assemble for assign-
and response of their jurisdiction’s resources to multiple
ment.
casualty incidents (MCIs).
3.1.19 staging management—the function designated by the
5.2 This guide does not address all of the necessary plan-
incident commander that is responsible for the orderly assem-
ning and response of pre-hospital care agencies to an incident
bly and utilization of resources in a designated area.
that involves the total destruction of community services and
3.1.20 transportation management—the function desig-
systems.
nated by the EMS control/medical group supervisor that is
5.3 This guide does not address the necessary design,
responsible for the transportation of the patients from the
planning, and response to be undertaken by a medical care
incident scene and for coordination with EMS control/ medical
facility to an internal or external event that necessitates the
group supervisor, communications, and the incident com-
activation of the facility’s disaster plan.
mander.
5.4 This guide provides procedures to coordinate and pro-
3.1.21 treatment area—the site at or near the incident for
vide a systematic and standardized response by responsible
emergency medical treatment prior to transport.
parties, including the local elected officials, emergency man-
3.1.22 treatment management—the function that is respon-
agement officials, public safety officials, medical care officials
sible for the definitive on-scene medical treatment of patients.
(pre-hospital and hospital), local EMS agencies/organizations
3.1.23 triage—the process of sorting and prioritizing emer- and others with objectives and tasks for the pre-hospital
gency medical care of the sick and injured on the basis of management of a significant incident.
urgency and type of condition present, and the number of
5.5 This guide provides for the establishment of an incident
patients and resources available in order to properly treat and
command system with position descriptions that identify
transport them to medical facilities appropriately situated and
mission, functions, and responsibilities of the command struc-
equipped for their care.
ture to be used at a MCI. The incident command functions
3.1.24 triage area—a location near the incident site to include but are not limited to staging, logistics, rescue/
which injured persons should be brought, triaged, and taken extrication, triage, treatment, transportation (air, land, and
directly to the treatment area. water), communications, and fatality management.
F1288 − 90 (2009)
5.6 This guide provides examples and other management 6.4.1.5 It creates an awareness of new hazards.
tools that can assist in providing training objectives and 6.4.2 When the needs assessment is complete, the jurisdic-
decision making models for dispatch, response, triage,
tion should be able to make the following decisions:
treatment, and transportation for local jurisdictions experienc-
6.4.2.1 The type of planning desired,
ing multiple casualty incidents.
6.4.2.2 What types of response to emphasize,
6.4.2.3 What resources will be needed to fulfill that
PLANNING
response, and
6.4.2.4 The type and quantity of mutual aid and support
6. Planning
services that might be required outside the normal jurisdic-
6.1 Purpose—Planning should be a cooperative effort be-
tional services.
tween local EMS providers and the jurisdiction in which they
6.4.3 Components—There are three basic parts to a needs
deliver services. The plan should be written to establish the
assessment:
emergency organization, basic policies, responsibilities, and
6.4.3.1 Consideration of the potential for specific incidents,
actions required for support of local operations of emergency
6.4.3.2 Evaluation of the potential harm resulting from the
medical/health plans. Plans should ensure rapid medical assis-
incident, and
tance to persons requiring aid due to an incident. Plans should
6.4.3.3 Evaluation of the resources required to respond to
describe a system for coordination of alerting, dispatching, and
the incident.
uses of medical personnel and resources whenever a local
6.4.4 Approach—The following are suggested approaches
emergency medical health agency requires assistance from
to completing a needs assessment:
another EMS agency/jurisdiction. The plan should be designed
6.4.4.1 Form a team to identify the potential hazards, risks,
to be an extension of day to day service, facilities, and
and impact relating to potential MCIs.
resources.
6.4.4.2 Consult the local or state civil defense/emergency
6.2 Goal—The plan ensures adequate and coordinated ef-
preparedness offices for assessment information.
forts that will minimize loss of life, disabling injuries, and
6.4.4.3 After identifying potential MCIs, evaluate them for
human suffering by providing effective medical assistance
their potential hazards, risks, and impact.
through efficient use of medical and other resources in the
6.4.4.4 Evaluate the area’s resources.
event of emergencies resulting in multiple casualty incidents.
6.4.5 Resources Assessment—Consider the personnel re-
6.3 Objectives—The primary objectives of a plan should
quired for performing such tasks as emergency medical
include a process whereby:
services, firefighting, and rescue. Inventory equipment for the
6.3.1 Each EMS agency/jurisdiction should have a plan to
job and evaluate its ability to perform the task. Prepare a
meet its own needs within its capabilities.
written description of what potential incidents exist, and the
6.3.2 Each EMS agency/jurisdiction should enter into mu-
ability to respond to these incidents.
tual aid agreements with other local or regional jurisdictions
6.4.6 Once complete, the needs assessment becomes part of
which can be invoked when local capability to manage a
the plan.
situation has been exceeded. Each jurisdictional plan should
6.5 Plan Components—The plan should include provision
facilitate the access and utilization of local and state resources.
for the following:
6.3.3 The EMS agency/jurisdiction’s plan should conform
6.5.1 Organizational Structure for Response:
to appropriate regional and state plans.
6.5.1.1 The plan should define an overall incident organiza-
6.3.4 Each EMS agency/jurisdiction should define training
tion based on a strategy of efficient and effective utilization of
requirements, and develop and utilize a training program based
resources.
on the needs assessment of the community.
6.5.1.2 The plan should address chain of command, includ-
6.3.5 The plan should be a coordinated interagency effort.
ing transfer of authority of any officer or position.
Responsible agencies should have regular interaction in order
to facilitate working relations during an incident. 6.5.2 Organization of Manpowe
...