TRAINING PACKAGES

FOR HEALTH EMERGENCIES 08\

Health Emergency Response Operations

(HERO)

08/29/22 1
 Module 5: Field Operations
Introduction to MCM, ICS, Incident
Command Planning and overview on
the Management of the Dead and
Missing

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Objectives:
1. Define the following:
– Mass Casualty Management,
– Incident Command System
– Incident Command Planning.
2. Set-up an Incident Command System
3. Facilitate Incident Command Planning
and meetings

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Mass Casualty Incident
• Any event resulting in a
number of victims large enough
to disrupt the normal course of
emergency and health care
services

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Mass Casualty Management
• Management of victims of a mass
casualty event
• Objective is to minimize loss of life
and disabilities

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Different Approaches to MCI
1. Basic Approach
2. Classical Care Approach
3. Mass Casualty Management Approach

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Different Approaches to MCI
1. Basic Approach
•“Scoop and Run” method
•Does not require specific technical
ability from rescuers
•Justified for the management of small
number of victims in certain circumstances
•May just transfer problem from the incident
site to the hospital

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Different Approaches to MCI

2. Classical Care Approach

•First responders are trained (basic triage
and field care)
•Involves two organizations working
independently with weak linkages
•May quickly result to chaos

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Different Approaches to MCI

3. Mass Casualty Management Approach

Most sophisticated approach which includes
pre-established procedures for:
 resource mobilization
 field management
 hospital reception

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Mass Casualty Management
System
• The group of units, organizations
and sectors which work jointly,
through institutionalized procedures,
to minimize disabilities and loss of
life in a mass casualty event through
the efficient use of all existing
resources.

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Mass Casualty Management
System
• Involves field management which
encompasses procedures used to
organize the disaster area in order to
facilitate management of victims.
• Field management has two
components: field organization and
management of victims.

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 FIELD ORGANIZATION

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
ALERTING PROCESS
• Sequence of
activities
implemented to
achieve the efficient
mobilization of
adequate resources
•Includes initial
warning,
assessment of the
situation and
dissemination of
alert messages

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 PRE-IDENTIFICATION OF FIELD AREAS
• This will allow various incoming resources to reach their specific
areas rapidly and efficiently.

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 SAFETY AND SECURITY
• Safety and security measures are implemented to protect victims,
responders and exposed population from immediate and/or potential risk.

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 COMMAND POST
 Multi-sectoral control unit established to:
•Coordinate the various sectors involved in field
management
•Link with back-up systems to provide information and
mobilize necessary resources
•Supervise victim management

 It is the communication/coordination hub of the

pre-hospital organization.

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 COMMAND POST

The main
criterion of an
effective
command post is
radio
communications.

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 MANAGEMENT OF
VICTIMS

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 SEARCH AND RESCUE
• Skilled teams or specialized units will locate and remove
victims from unsafe location, assess victim status, provide first
aid and transfer victims to advance medical post if necessary.

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 FIELD CARE
• Triage – essentially based on urgency (victim
status), likelihood of survival, as well as care
resources available.
• First Aid – can be provided on-site, however,
the most important priority is to transfer acute
victims to the advance medical post as soon as
possible while ensuring key first aid functions.

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 FIELD CARE
• Advance Medical Post – main objective is to provide
effective field stabilization to victims of a mass casualty
event. It uses the three T principle: Tag, Treat and
Transport.

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 TRANSFER ORGANIZATION

•Includes procedures implemented to ensure

that victims of a mass casualty incident will be
safely, quickly and efficiently transferred by
appropriate vehicles to the appropriate and
prepared health care facilities.

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
Health Emergency Response Operations (HERO)
TRAINING
PACKAGES FOR 08\
 Exercise: Learning from the Past
• Recall one major incident that happened in your
region.
• If this situation will happen again and you are to
handle it differently, how would you handle it?
A. One day before the disaster
B. Day one of the disaster
C. Day two of the disaster
D. One week after the disaster
• Try to focus on the organizational structure.

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 OVERVIEW OF INCIDENT
COMMAND SYSTEM

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Incident Command System
• Standard, on-scene, all-hazard incident
management concept
• Allows users to adopt an integrated
organizational structure

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Purpose of ICS
To ensure:

1.Safety of responders and others

2.Achievement of tactical objectives

3.Efficient use of resources

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Primary Management Functions
ICS is built around 5 primary management
functions:

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Management by Objectives
ICS is objective-driven/ managed by objectives.

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Single Command
• Based on first arriving emergency
units
• Incident Commander is solely
responsible in establishing incident
management objectives and
strategies
• Most useful in smaller, single-
jurisdictional incidents
Health Emergency Response Operations (HERO)
TRAINING
PACKAGES FOR 08\
 Basic Command Structure
Single Command

INCIDENT
COMMANDER

RESCUE/
TRIAGE TREATMENT TRANSPORT
EXTRICATION

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
Health Emergency Response Operations (HERO)
TRAINING
PACKAGES FOR 08\
 Unity of Command and
Chain of Command

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Organizational Flexibility
• ICS organization is flexible and modular

• “Form follows function”: only functions/

positions necessary for the incident will be
filled or activated

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 PRIMARY ICS MANAGEMENT
FUNCTIONS
FUNCTIONS DESCRIPTION
COMMAND Overall management
OPERATIONS Direct tactical actions
PLANNING Collect data and prepare
action plan
LOGISTICS Provide needed resources
FINANCE/ADMINISTRATION Procure resources and
maintain accountability

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 RESPONSIBLE OFFICIAL
• Chairperson of the DRRMC
– Local chief executive
– Head of Agency/Organization/Office
– Senior officials with decision making functions

• Provides overall policy direction, guidance and

priorities
• Serves as link to other higher authorities

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Incident Commander (IC)
• Receives authority from the RO
• Establishes objectives based on the overall
guidance and priorities of the RO
• Establishes the Incident Management Team and
leads the tactical/on-scene response operations

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Notes
The IC is accountable to the RO.

The RO only gives priorities. The IC implements on behalf

of the RO.

All other responders will work under the supervision of the

designated IC.

The chain of command between the IC and RO must NOT

be bypassed by any responder or official.

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Delegation of Authority

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Incident Commander

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Command Staff

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 General Staff

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Incident Management Team

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Who does what?

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
Health Emergency Response Operations (HERO)
TRAINING
PACKAGES FOR 08\
 INCIDENT ACTION PLAN

Health Emergency Response Operations (HERO)

TRAINING
46
PACKAGES FOR 08\
 What is an Incident Action Plan?
• IAP is the “strategic and tactical plan”
that we develop on the spot (after having
activated the response plan) to manage
the activities during the emergency
phase. IAP must be revised as the
situation evolves.

Health Emergency Response Operations (HERO)

TRAINING
47
PACKAGES FOR 08\
 Incident Action Plan
• Used to communicate response goals,
operational objectives and support
activities throughout the ICS
organization.
• Developed for each operational period
(typically 12 to 24 hours)
• May be oral or written

Health Emergency Response Operations (HERO)

TRAINING
48
PACKAGES FOR 08\
 It is accepted practice to prepare written
action plans:
•When the emergency event is large and
involves the full or partial activation of an off-
site EOC to support the response
•When the event extends beyond the first
operational period

Health Emergency Response Operations (HERO)

TRAINING
49
PACKAGES FOR 08\
 Group Work
Scenario:
•24 hours post- disaster, your EOC received a report from the
Field Commander:
o Another 50 survivors with various injuries newly rescued
and need to be transferred to tertiary care hospitals;
hundreds of dead bodies recovered and aligned on the
street.
o Needs: air transport, medicines, immobilization supplies
and equipment, medical teams, body bags, mortuary
services, and experts to manage the dead

Q: What are your actions to be done? Illustrate the flow of

your response actions. Prepare your 24-hour Incident
Action Plan.
Health Emergency Response Operations (HERO)
TRAINING
PACKAGES FOR 08\
 Elements of an Action Plan
An action plan, either oral or written will usually contain the
following:
•A statement of objectives, appropriate to the entire event
•Identification of the functional elements of the EOC that will be
activated for the current and estimated future operational periods
•Resource assignments to accomplish the objectives, with the
intended strategies and tactics, for each organizational element
•Supporting materials such as a map of the event area;
communications plan, patient transportation plan, traffic
management plan, etc.

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Emergency Operations Center
Operational Planning Period
Planning Cycle

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Management of dead and
missing (MDM) persons
during disasters

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Role of DOH in MDM
• Formulate standards/specifications of
cadaver bags and PPEs to be used in the SRR
of the dead
• Include in the licensing requirements of
morticians the training on MDM
• Develop protocols to prevent contamination
of the environment while the burial of the
dead

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Role of DOH in MDM
• Provide technical inputs in establishing
temporary morgue and burial sites
• Provide technical oversight to the local
health office to participate in the
management of the dead
• Provide psychosocial services to the
responders and bereaved families together
with DSWD, PRC and DILG

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Management of the Dead
• Right to be found, identified and buried
• Right to privacy at all times
• Handling must be in a sanitary manner
• Protection and safety of the responders
• Death due to naturals disasters do not pose a
risk of epidemic
• Provision of psychosocial services

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\
 Reporting Scheme
• DOH Hospitals to
• DOH Regional Office to
• DOH Central Office to
• NDRRMC

Health Emergency Response Operations (HERO)

TRAINING
PACKAGES FOR 08\