11. Appendix B: Function Cards

Function Cards for Mass Casualty Incident Response

PAHO has created a number of function cards that define in detail the basic activities of the professionals involved in the coordination and the care of victims in a MCI.

1. Operator - dispatch center

  • Receives initial call or warning message concerning the event
  • Establishes: caller’s name and telephone number - nature of event - exact location of event - time of occurrence - approximate number of victims
  • Verifies information (if an unqualified observer)
  • Mobilizes and sends a dispatch team to site for initial assessment
  • Alerts potential responders (stand by)
  • Receives report of initial assessment
  • Dispatches necessary resources

2. Initial assessment team

  • Travel to site expeditiously
  • Identify a leader
  • Establishes: precise location of the event time of the event - type of incident
  • Estimates: number of casualties - added potential risk - exposed population
  • Team Leader reports initial information to dispatch center
  • Draws a single map of the area indicating:
    • main topographical features
    • potential risk areas
    • victims
    • access roads various field areas
    • limits of restricted areas
    • compass rose
    • wind direction
  • Directs resources arriving in the field until the arrival of a high ranking officer
  • Hands over the map and briefs first arriving officer of rank
  • Reports to reassigned station

3. Fire services

The Fire Services will be responsible for:

  • Safety
  • Search and rescue
  • Risk reduction
  • Definition of restricted areas
  • Providing a senior officer as a staff member of the Command Post
  • Providing the Advanced Medical Post (AMP) with a Transport Officer

4. Search and rescue team

  • Locates victims
  • Removes victims from unsafe locations to collection point if necessary
  • Conducts initial triage of victims (acute/ nonacute)
  • Provides essential first aid
  • Transfers victims to Advance Medical Post

5. Search and rescue officer

Coordinates search and rescue activities by:

  • identifying and assigning teams supervising team functioning
  • establishing a collection point when necessary coordinating the transfer of patients from the collection point to the Advance Medical Post communicating with Command Post for resource reinforcement
  • ensuring safety and welfare of search and rescue teams

6. Coordinator of the command post

  • Performs overall coordination of the field operations
  • Receives reports from the other officers in the Command Post
  • Continuously assesses the general situation
  • Coordinates requests between sectors in the field
  • Ensures links between sectors
  • Ensures the welfare of all staff involved in field operations
  • Liaises with central headquarters, (e.g., EOCs)
  • Authorizes releases to the media
  • Acts as link between field operations and backup system
  • Acts as link between field operations and backup system

7. Fire officer in command post

  • Coordinates activities of the Fire Service in the field (ensures safety, search and rescue)
  • Assists in transport organization
  • Manages fire staff resource needs by:
    • continuous assessment
    • requests for backup
    • timely rotation of staff withdrawal of staff no longer needed
  • Reports to the coordinator of the Command Post

8. Police officer in command post

  • Ensures that radio communication is established and maintained
  • Implements security measures to:
    • maintain restricted areas
    • provide crowd and traffic control
  • Manage field police resources by:
    • continuous assessment of needs
    • redeployment of police officers
    • requests for backup
    • ensure adequate supply of necessary equipment
  • This officer is generally the coordinator of the Command Post

9. Health officer in command post

  • Supervises the field care of victims
  • Provides the link between the health/ medical backup system
  • Ensures the adequate supply of manpower and equipment
  • Receives reports from the manager of the Advance Medical Post (acute treatment manager)
  • Deploys and manages health staff resources
  • Reports to the coordinator of the Command Post

10. Acute treatment manager (manager of advance medical post)

  • Supervises triage and stabilization of victims in AMP
  • Establishes the internal organization of the AMP
  • Manages the staff of the AMP
  • Ensures that effective victim flow is maintained
  • Ensures adequate equipment and supplies are available in each treatment area
  • Organizes the transfer of patients to health care facilities in collaboration with the Transport Officer, the Health Officer in the Command Post and receiving Health Care facility
  • Decides on the transfer order of victims, the mode of transport, escort and destination
  • Ensures staff welfare
  • Reports to the Health Officer in the Command Post

11. Medical triage officer

  • Receives victims at the entrance of the AMP
  • Examines and assesses the condition of each victim
  • Categorizes and tags patients as follows
    • Red-immediate stabilization necessary
    • Yellow-close monitoring, care can be delayed
    • Green-minor delayed treatment or no treatment
    • Black-deaths
  • Directs victim to appropriate treatment area
  • Reports to the manager of the AMP

12. Red team leader

  • Receives patient from medical triage
  • Examines and assesses the medical condition of the victim
  • Institutes measures to stabilize the victim
  • Continuously monitors victim’s condition
  • Reassesses and transfers victims to other treatment areas
  • Prioritizes victims for evacuation
  • Requests evacuation in accordance with priority list
  • Reports to the manager of the AMP

13. Evacuation officer

  • Receives victims for evacuation
  • Assesses the victim’s stability
  • Assesses the security of any equipment attached to victims and corrects deficiencies
  • Ensures that immobilization is adequate
  • Ensures that the tag is safely and clearly attached
  • Maintains observation of victims until transported
  • Supervises loading and ensure escort is briefed
  • Reports to manager of AMP

14. Transport officer

  • Coordinates and supervises the transportation of victims
  • Identifies access routes and communicates traffic flow to drivers
  • Supervises all available ambulance drivers and drivers of assigned vehicles
  • Receives requests for transportation
  • Assigns appropriate vehicle tasks in accordance with specific needs
  • Maintains a log of the whereabouts of all vehicles under his control
  • Reports to the manager of the AMP

15. Administration clerk - triage area

  • Maintains a register of all victims admitted to medical triage
  • Records
    • name or identification number
    • age when possible
    • sex
    • time of arrival
    • injury category assigned
  • Reports to Triage Officer

16. Administration clerk evacuation area

  • Maintains a register of all victims leaving the AMP
  • Records
    • victim name/number
    • injury category
    • time of departure
    • mode of departure (vehicle) and escort destination
  • Reports to the evacuation office

17. Ambulance driver

  • Remains in the vehicle at all times
  • Responds promptly to directives from Transport Officer
  • Ensures that vehicle is parked in designated area and is ready to move
  • Transports patients in accordance with safety rules and instructions
  • Reports to Transport Officer