This guide is intended to assist the management of the local EMS agencies or organizations in the design, planning, and response of their jurisdiction’resources to multiple casualty incidents (MCIs).

This guide does not address all of the necessary planning and response of pre-hospital care agencies to an incident that involves the total destruction of community services and systems.

This guide does not address the necessary design, planning, and response to be undertaken by a medical care facility to an internal or external event that necessitates the activation of the facility’disaster plan.

This guide provides procedures to coordinate and provide a systematic and standardized response by responsible parties, including the local elected officials, emergency management officials, public safety officials, medical care officials (pre-hospital and hospital), local EMS agencies/organizations and others with objectives and tasks for the pre-hospital management of a significant incident.

This guide provides for the establishment of an incident command system with position descriptions that identify mission, functions, and responsibilities of the command structure to be used at a MCI. The incident command functions include but are not limited to staging, logistics, rescue/extrication, triage, treatment, transportation (air, land, and water), communications, and fatality management.

This guide provides examples and other management tools that can assist in providing training objectives and decision making models for dispatch, response, triage, treatment, and transportation for local jurisdictions experiencing multiple casualty incidents.

1.1 This guide covers the planning, needs assessment, training, integration, coordination, mutual aid, implementation, provision of resources, and evaluation of the response of a local emergency medical service (EMS) organization or agency to a multiple patient producing situation that may or may not involve property loss. This guide is limited to the pre-hospital response and mitigation of an incident up to and including the disposition of patients from the incident scene.

1.2 This guide addresses the background on planning, scope, structure, application, federal, state, local, voluntary, and nongovernmental resources and planning efforts involved in developing, implementing, and evaluating an EMS annex, or component, to the local jurisdiction's emergency operations plan (EOP) as defined in the Federal Emergency Management Agency (FEMA) publication, Civil Preparedness Guide (CPG) 1-8.

1.3 This standard does not purport to address the safety concerns associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use.