![\"Illustrative](\"/assets/mci/organization.svg\")
An MCI begins when the patient demand and incident complexity exceed the routine response. Do not wait for an exact count before establishing command, announcing the problem and ordering help. Estimate a range, identify hazards, and update the estimate after the first triage sweep. A small number of critically injured patients can create more pressure than a larger group with minor complaints.
\n“Dispatch, establish [incident name] Command. We have [incident type], approximately [range] patients, with [hazards/access problem]. Declare a provisional Level [number] MCI. Send [specific resources] to [safe staging location and approach]. [Unit] is triage; [unit/person] is establishing Med Com. Patient categories will follow.”
This is a teaching script, not a replacement for agency radio procedures. Avoid guessing an exact count or promising a hospital destination.
An MCI begins when the patient demand and incident complexity exceed the routine response. Do not wait for an exact count before establishing command, announcing the problem and ordering help. Estimate a range, identify hazards, and update the estimate after the first triage sweep. A small number of critically injured patients can create more pressure than a larger group with minor complaints.
\n“Dispatch, establish [incident name] Command. We have [incident type], approximately [range] patients, with [hazards/access problem]. Declare a provisional Level [number] MCI. Send [specific resources] to [safe staging location and approach]. [Unit] is triage; [unit/person] is establishing Med Com. Patient categories will follow.”
This is a teaching script, not a replacement for agency radio procedures. Avoid guessing an exact count or promising a hospital destination.
Use the 2019 Fire Services Operational Area Annex to organize the scene. Use OCEMS Policy 900.00 for the medical-system interface: OCC, base assignment, patient distribution, hospital responsibilities, backup communications and documentation. The current linked policy prints an effective date of January 1, 2026; the OCEMS update page also lists it in the April 2026 implementation cycle. Both dates are past as of this guide’s source check.
\n| Question | Primary reference | What crews should do |
|---|---|---|
| Who runs triage, treatment, staging and loading? | Annex, including Attachment A | Build the field organization around workload and geography; assign clear supervisors and handoffs. |
| Who coordinates hospitals? | 900.00 §IV; annex communications | Use one incident Med Com and the OCC-assigned coordinating base, with OCC assistance when the system expands. |
| How much patient information is sent? | 900.00 Appendix A | Use the report appropriate to incident conditions and level; explain when information is unavailable. |
| Which patients need specialty care? | Applicable specialty policy, including 310.30; 900.00 §IV E | Communicate the specialty need. Base distribution considers both that need and available specialty capacity. |
| Does MCI activation change clinical scope? | Applicable standing orders, procedures and 310.00 | Continue authorized care. An organizational assignment does not grant new medications, procedures or credentials. |
| What if the radio fails? | 900.00 §VII; 330.15 for required medical-control failures | Distinguish destination coordination from permission for an ALS intervention; follow each applicable fallback. |
| What is recorded? | 900.00 §VIII; 300.10; local worksheets | Maintain patient records and tracking as well as incident activity logs. One does not replace the other. |
| Who closes the incident? | 900.00 §V; annex conclusion | Med Com reports scene clearance to base; base closes the hospital MCI notification and records are reconciled. |
Two differences deserve special attention. The older annex lists approximately 3–9 / 10–29 / 30+ patients; current 900.00 Appendix A prints approximately 3–10 / 10–30 / 30+. These overlap and are estimates, not a rigid counting formula. Communicate the declared level and the actual patient burden. Also, the annex’s older base-report wording must be read with current 900.00, which requires worksheet data to be entered into the base hospital’s electronic report/database at the conclusion.
\nThe annex’s historical hospital examples are not a live capacity list. Use assigned destinations and current coordination. In this guide, local requirement means a source-backed OC instruction; teaching example means an illustrative arrangement to adapt through command.
", "sourceRefs": [ [ "annex", "pp. 4, 9–13" ], [ "policy", "§IV–VIII and Appendix A" ], [ "base", "complete policy" ], [ "trauma", "complete policy" ], [ "documentation", "complete policy" ] ], "renderedHtml": "Use the 2019 Fire Services Operational Area Annex to organize the scene. Use OCEMS Policy 900.00 for the medical-system interface: OCC, base assignment, patient distribution, hospital responsibilities, backup communications and documentation. The current linked policy prints an effective date of January 1, 2026; the OCEMS update page also lists it in the April 2026 implementation cycle. Both dates are past as of this guide’s source check.
\n| Question | Primary reference | What crews should do |
|---|---|---|
| Who runs triage, treatment, staging and loading? | Annex, including Attachment A | Build the field organization around workload and geography; assign clear supervisors and handoffs. |
| Who coordinates hospitals? | 900.00 §IV; annex communications | Use one incident Med Com and the OCC-assigned coordinating base, with OCC assistance when the system expands. |
| How much patient information is sent? | 900.00 Appendix A | Use the report appropriate to incident conditions and level; explain when information is unavailable. |
| Which patients need specialty care? | Applicable specialty policy, including 310.30; 900.00 §IV E | Communicate the specialty need. Base distribution considers both that need and available specialty capacity. |
| Does MCI activation change clinical scope? | Applicable standing orders, procedures and 310.00 | Continue authorized care. An organizational assignment does not grant new medications, procedures or credentials. |
| What if the radio fails? | 900.00 §VII; 330.15 for required medical-control failures | Distinguish destination coordination from permission for an ALS intervention; follow each applicable fallback. |
| What is recorded? | 900.00 §VIII; 300.10; local worksheets | Maintain patient records and tracking as well as incident activity logs. One does not replace the other. |
| Who closes the incident? | 900.00 §V; annex conclusion | Med Com reports scene clearance to base; base closes the hospital MCI notification and records are reconciled. |
Two differences deserve special attention. The older annex lists approximately 3–9 / 10–29 / 30+ patients; current 900.00 Appendix A prints approximately 3–10 / 10–30 / 30+. These overlap and are estimates, not a rigid counting formula. Communicate the declared level and the actual patient burden. Also, the annex’s older base-report wording must be read with current 900.00, which requires worksheet data to be entered into the base hospital’s electronic report/database at the conclusion.
\nThe annex’s historical hospital examples are not a live capacity list. Use assigned destinations and current coordination. In this guide, local requirement means a source-backed OC instruction; teaching example means an illustrative arrangement to adapt through command.
" }, { "id": "levels-reports", "heading": "MCI levels and the patient report", "html": "Level describes a system problem as well as a patient count. Acuity, entrapment, distance, pediatric concentration, contamination, hospital capacity and threats can justify escalation. Do not delay a needed request while deciding whether the tenth or thirtieth patient changes a label.
\n| Level | Approximate count | Report when available |
|---|---|---|
| 1 | 3–10 | Tag number’s last three digits; category; specialty need; age; sex/gender field; major injuries; vital signs including BP or pulse quality; destination/specialty request; ambulance identifier. |
| 2 | 10–30 | Tag number’s last three digits; category; destination/specialty request; ambulance identifier; additional information as available. |
| 3 | 30 or more | Level 2 report when possible; destination or specialty-center request. Hazard and urgency may sharply limit the report. |
Preserve the complete tag number in patient records and tracking. The last-three-digit convention is for the specified MCI communications and hospital tracking workflow; it is not a reason to discard the full identifier. Clarify a duplicate or ambiguous abbreviated identifier immediately.
\n“[Incident] Med Com: tag ending 417, Immediate, adult, specialty trauma destination requested, transporting unit Ambulance 12. Additional findings available on request.” Record the assigned destination and read it back. Add age, injuries and vital signs when the level and conditions permit.
OCC notifies the EMS Duty Officer for 20 or more victims under §IV D. That notification threshold is separate from the Level 3 patient-count description. Dispatch notifications and department EOC/FOC activation also follow the annex and agency procedures.
", "sourceRefs": [ [ "policy", "§IV D and Appendix A" ], [ "annex", "pp. 4, 9–12" ] ], "renderedHtml": "Level describes a system problem as well as a patient count. Acuity, entrapment, distance, pediatric concentration, contamination, hospital capacity and threats can justify escalation. Do not delay a needed request while deciding whether the tenth or thirtieth patient changes a label.
\n| Level | Approximate count | Report when available |
|---|---|---|
| 1 | 3–10 | Tag number’s last three digits; category; specialty need; age; sex/gender field; major injuries; vital signs including BP or pulse quality; destination/specialty request; ambulance identifier. |
| 2 | 10–30 | Tag number’s last three digits; category; destination/specialty request; ambulance identifier; additional information as available. |
| 3 | 30 or more | Level 2 report when possible; destination or specialty-center request. Hazard and urgency may sharply limit the report. |
Preserve the complete tag number in patient records and tracking. The last-three-digit convention is for the specified MCI communications and hospital tracking workflow; it is not a reason to discard the full identifier. Clarify a duplicate or ambiguous abbreviated identifier immediately.
\n“[Incident] Med Com: tag ending 417, Immediate, adult, specialty trauma destination requested, transporting unit Ambulance 12. Additional findings available on request.” Record the assigned destination and read it back. Add age, injuries and vital signs when the level and conditions permit.
OCC notifies the EMS Duty Officer for 20 or more victims under §IV D. That notification threshold is separate from the Level 3 patient-count description. Dispatch notifications and department EOC/FOC activation also follow the annex and agency procedures.
" }, { "id": "command-roles", "heading": "Command, supervision and role assignments", "html": "Build only the organization needed to control the work. In the initial response, the IC manages unassigned responsibilities and gives named personnel the critical functions. A reinforced response can add treatment and transportation leaders, safety, air coordination and staffed treatment areas. A distributed incident can require multiple medical groups and a Medical Branch, while patient distribution remains coordinated through one transportation system and one Med Com.
\n{{figure:organization}}\n| Role | Owns | Key handoff |
|---|---|---|
| Incident Commander / Unified Command | Objectives, priorities, safety direction and overall resource allocation. | Give incoming command the hazards, counts, assignments, unmet needs and current transport picture. |
| Medical Branch Director | Medical branch execution of the IAP; coordination across medical groups and transportation. | Report progress and constraints to Operations; prevent competing patient-distribution systems. |
| Medical Group Supervisor | Medical work within the group; locations, leaders, personnel and supply needs. | Connect triage, treatment and transportation; escalate bottlenecks and safety needs. |
| Triage Unit Leader | Triage teams, litter movement from the triage area, counts and triage-area control. | Send category counts and resource needs to the supervisor; coordinate movement with treatment. |
| Treatment Unit Leader | Treatment areas, reassessment, preparation for movement and Patient Loading Coordinator. | Tell transportation which patients are ready and which need a special transport capability. |
| Immediate / Delayed / Minor Area Managers | Care and repeated triage within their assigned area. | Maintain a reliable census and announce deterioration rather than waiting for the next routine report. |
| Patient Transportation Unit Leader (PTUL) | Patient movement off incident, transportation coordination and destination records. | Join patient readiness, assigned destination and an appropriate transport resource. |
| Med Com | Incident-to-base/OCC destination communications and current receiving-capacity picture. | Relay assigned destinations to transportation and crews; maintain one coherent distribution picture. |
| Ground Ambulance Coordinator (GAC) | Ambulance staging, availability, routes and dispatch to loading. | Provide the requested ambulance capability and track when resources become available again. |
| Patient Loading Coordinator | Transfer from treatment to loading; readiness, priority and patient/ambulance matching. | Reports to Treatment; coordinates with PTUL/Med Com and treatment managers. |
| Medical Supply Coordinator | Medical supplies supporting the group. | Translate shortages into specific resource requests; coordinate caches, trailers or DMSU support. |
| Morgue Manager / law enforcement / coroner interface | Designated temporary area and controlled handling under assigned supervision. | Keep identification, scene integrity and access controlled; do not merge this space with minor-patient holding. |
| Air Ambulance Coordinator / Helispot Manager | Patient air-transport coordination / safe helispot management, respectively. | Coordinate with transportation and Air Operations; a landing zone does not independently assign destinations. |
At expansion, say both the position and the person/unit taking it. Hand over the worksheet and radio plan, not just the vest. Identify which responsibilities remain combined. A person tasked with taking care of a patient cannot reliably maintain a large incident’s destination board at the same time.
\nThe ICS Medical Unit supporting responders and their medical plan is distinct from the Medical Group or Branch treating incident victims. Responder rehabilitation, water, relief and an emergency plan for injured personnel must have an owner as the incident grows.
", "sourceRefs": [ [ "annex", "pp. 3, 5–8 and Attachment A, pp. 15–19" ], [ "forms", "ICS 203, 206 and 207" ] ], "renderedHtml": "Build only the organization needed to control the work. In the initial response, the IC manages unassigned responsibilities and gives named personnel the critical functions. A reinforced response can add treatment and transportation leaders, safety, air coordination and staffed treatment areas. A distributed incident can require multiple medical groups and a Medical Branch, while patient distribution remains coordinated through one transportation system and one Med Com.
\n| Role | Owns | Key handoff |
|---|---|---|
| Incident Commander / Unified Command | Objectives, priorities, safety direction and overall resource allocation. | Give incoming command the hazards, counts, assignments, unmet needs and current transport picture. |
| Medical Branch Director | Medical branch execution of the IAP; coordination across medical groups and transportation. | Report progress and constraints to Operations; prevent competing patient-distribution systems. |
| Medical Group Supervisor | Medical work within the group; locations, leaders, personnel and supply needs. | Connect triage, treatment and transportation; escalate bottlenecks and safety needs. |
| Triage Unit Leader | Triage teams, litter movement from the triage area, counts and triage-area control. | Send category counts and resource needs to the supervisor; coordinate movement with treatment. |
| Treatment Unit Leader | Treatment areas, reassessment, preparation for movement and Patient Loading Coordinator. | Tell transportation which patients are ready and which need a special transport capability. |
| Immediate / Delayed / Minor Area Managers | Care and repeated triage within their assigned area. | Maintain a reliable census and announce deterioration rather than waiting for the next routine report. |
| Patient Transportation Unit Leader (PTUL) | Patient movement off incident, transportation coordination and destination records. | Join patient readiness, assigned destination and an appropriate transport resource. |
| Med Com | Incident-to-base/OCC destination communications and current receiving-capacity picture. | Relay assigned destinations to transportation and crews; maintain one coherent distribution picture. |
| Ground Ambulance Coordinator (GAC) | Ambulance staging, availability, routes and dispatch to loading. | Provide the requested ambulance capability and track when resources become available again. |
| Patient Loading Coordinator | Transfer from treatment to loading; readiness, priority and patient/ambulance matching. | Reports to Treatment; coordinates with PTUL/Med Com and treatment managers. |
| Medical Supply Coordinator | Medical supplies supporting the group. | Translate shortages into specific resource requests; coordinate caches, trailers or DMSU support. |
| Morgue Manager / law enforcement / coroner interface | Designated temporary area and controlled handling under assigned supervision. | Keep identification, scene integrity and access controlled; do not merge this space with minor-patient holding. |
| Air Ambulance Coordinator / Helispot Manager | Patient air-transport coordination / safe helispot management, respectively. | Coordinate with transportation and Air Operations; a landing zone does not independently assign destinations. |
At expansion, say both the position and the person/unit taking it. Hand over the worksheet and radio plan, not just the vest. Identify which responsibilities remain combined. A person tasked with taking care of a patient cannot reliably maintain a large incident’s destination board at the same time.
\nThe ICS Medical Unit supporting responders and their medical plan is distinct from the Medical Group or Branch treating incident victims. Responder rehabilitation, water, relief and an emergency plan for injured personnel must have an owner as the incident grows.
" }, { "id": "scene-layout", "heading": "Lay out the scene around patient and vehicle movement", "html": "Choose the loading and traffic arrangement early. A beautiful treatment layout fails if ambulances cannot enter, turn, load and depart. Consider hazard direction, rescue access, terrain, lighting, security, weather, public access and the distance patients must be carried. The diagrams below are conceptual; they do not establish hazard boundaries, isolation distances or approved landing zones.
\n{{figure:patient-flow}}\nReview the layout whenever hazards move, congestion develops, patient numbers change or a new rescue area opens. Moving a tarp requires communicating the change to triage, transport, dispatch and incoming resources; otherwise the old location remains the one everyone drives toward.
", "sourceRefs": [ [ "annex", "pp. 6–8 and Attachment A" ] ], "renderedHtml": "Choose the loading and traffic arrangement early. A beautiful treatment layout fails if ambulances cannot enter, turn, load and depart. Consider hazard direction, rescue access, terrain, lighting, security, weather, public access and the distance patients must be carried. The diagrams below are conceptual; they do not establish hazard boundaries, isolation distances or approved landing zones.
\n![\"Patients](\"/assets/mci/patient-flow.svg\")
Review the layout whenever hazards move, congestion develops, patient numbers change or a new rescue area opens. Moving a tarp requires communicating the change to triage, transport, dispatch and incoming resources; otherwise the old location remains the one everyone drives toward.
" }, { "id": "triage", "heading": "START, JumpSTART and repeated triage", "html": "Triage is a rapid sorting process followed by reassessment. It is not a diagnosis or a guarantee that a patient will remain in the same category. The annex uses ribbons for initial categorization and numbered tags when a treatment team takes responsibility or before the patient leaves the scene. Complete assessment follows team assignment.
\n| Check | Finding | Category / next action |
|---|---|---|
| Walking | Able to walk under the applicable scene instructions | Minor area for further evaluation. The annex modifies this in smaller trauma incidents when spinal precautions and resources are available; do not automatically tell every injured person to stand. |
| Breathing | Not breathing | Open the airway. Breathing resumes: Immediate. Still not breathing: annex black/white category. |
| Respiratory rate | Greater than 30/min | Immediate. Otherwise assess perfusion. |
| Perfusion | Radial pulse absent or capillary refill greater than 2 seconds | Immediate. Otherwise assess ability to follow simple commands. |
| Mental status | Cannot follow simple commands | Immediate. If the preceding checks are adequate and commands are followed: Delayed. |
The annex directs use of JumpSTART when the victim appears to be a child and START when the victim appears to be a young adult. A carried infant or a child who is normally unable to walk needs the nonambulatory assessment; arriving in the green area does not establish a green category.
\nThe source uses “expectant/deceased” together. That triage label is not an independent pronouncement, DNR decision or substitute for applicable clinical policy. Attachment B calls for reassessment of these patients after critical interventions for Immediate and Delayed patients, except where injuries are clearly incompatible with life. Use the official algorithm and current medical direction for actual decisions.
\nReport counts by category and location. Reassess at treatment entry, while waiting, before loading and when condition changes. Record the change so the old category does not remain on the transport request. Place ribbons visibly; use the actual tag’s instructions for category tabs and detachable tracking portions. The patient’s tag must continue with the patient. A location ribbon on a vehicle is not an individual patient record.
\nPlan for language, hearing, cognitive or developmental barriers. Failure to follow a spoken instruction needs context; inability to walk may predate the incident. Use clinical assessment and the applicable algorithm rather than treating a disability as a new injury.
", "sourceRefs": [ [ "annex", "Attachment B, pp. 21–25" ], [ "policy", "definitions and §VIII" ], [ "jumpstart", "airway-positioning branch" ] ], "renderedHtml": "Read with the full triage explanation below. These are OCMedic text-based teaching graphics based on annex Attachment B and the linked HHS CHEMM airway branch, not an independent triage protocol. Categories require reassessment; a triage label is not a death pronouncement.
Triage is a rapid sorting process followed by reassessment. It is not a diagnosis or a guarantee that a patient will remain in the same category. The annex uses ribbons for initial categorization and numbered tags when a treatment team takes responsibility or before the patient leaves the scene. Complete assessment follows team assignment.
\n| Check | Finding | Category / next action |
|---|---|---|
| Walking | Able to walk under the applicable scene instructions | Minor area for further evaluation. The annex modifies this in smaller trauma incidents when spinal precautions and resources are available; do not automatically tell every injured person to stand. |
| Breathing | Not breathing | Open the airway. Breathing resumes: Immediate. Still not breathing: annex black/white category. |
| Respiratory rate | Greater than 30/min | Immediate. Otherwise assess perfusion. |
| Perfusion | Radial pulse absent or capillary refill greater than 2 seconds | Immediate. Otherwise assess ability to follow simple commands. |
| Mental status | Cannot follow simple commands | Immediate. If the preceding checks are adequate and commands are followed: Delayed. |
The annex directs use of JumpSTART when the victim appears to be a child and START when the victim appears to be a young adult. A carried infant or a child who is normally unable to walk needs the nonambulatory assessment; arriving in the green area does not establish a green category.
\nThe source uses “expectant/deceased” together. That triage label is not an independent pronouncement, DNR decision or substitute for applicable clinical policy. Attachment B calls for reassessment of these patients after critical interventions for Immediate and Delayed patients, except where injuries are clearly incompatible with life. Use the official algorithm and current medical direction for actual decisions.
\nReport counts by category and location. Reassess at treatment entry, while waiting, before loading and when condition changes. Record the change so the old category does not remain on the transport request. Place ribbons visibly; use the actual tag’s instructions for category tabs and detachable tracking portions. The patient’s tag must continue with the patient. A location ribbon on a vehicle is not an individual patient record.
\nPlan for language, hearing, cognitive or developmental barriers. Failure to follow a spoken instruction needs context; inability to walk may predate the incident. Use clinical assessment and the applicable algorithm rather than treating a disability as a new injury.
" }, { "id": "treatment-transport", "heading": "Treatment, loading and destination assignment", "html": "Treatment should remove the immediate barrier to survival and make transport possible. The annex favors prompt movement when transport is available, with necessary care continuing en route. Contamination, rescue constraints or unavailable transport may require a treatment area and longer holding period. Keep requesting what will shorten that delay.
\nThe annex’s resource planning model assigns a paramedic, an EMT and an ambulance to each Immediate or Delayed patient as resources allow, and at least an EMT for a small group of Minor patients. That model describes demand; it is not a reason to stop movement while waiting for an ideal assignment. Report shortages and use the authorized contingency organization. Consider how separating an ALS ambulance’s clinicians affects both patient care and the remaining vehicle’s capability.
\nSpecialty designation and immediate receiving capacity are different. Policy 900.00 prioritizes specialty placement through field findings, Med Com/base communication and bed availability. Under a large burden, base may need to prioritize which patients benefit most from scarce specialty beds. Do not send every red-tagged patient to the nearest trauma center on the assumption that category alone establishes destination.
\nUnder 900.00, a receiving facility may not divert an assigned declared-MCI patient unless it is closed because of the internal-disruption exception defined in Policy 310.96. Route a change through the coordinating system so the tracking record and receiving notification remain consistent. Do not treat a routine diversion message as permission to improvise a new destination.
\nAir transport, buses, vans and other alternatives need the assigned command/transport coordination and applicable local policy. Do not infer that multiple seats are usable patient positions, that an ambulance has unlimited stretcher capacity, or that a green category removes the need for reassessment and accountability.
", "sourceRefs": [ [ "annex", "pp. 5–8, 11; Attachment A" ], [ "policy", "§IV E–G" ], [ "trauma", "specialty destination criteria" ] ], "renderedHtml": "Treatment should remove the immediate barrier to survival and make transport possible. The annex favors prompt movement when transport is available, with necessary care continuing en route. Contamination, rescue constraints or unavailable transport may require a treatment area and longer holding period. Keep requesting what will shorten that delay.
\nThe annex’s resource planning model assigns a paramedic, an EMT and an ambulance to each Immediate or Delayed patient as resources allow, and at least an EMT for a small group of Minor patients. That model describes demand; it is not a reason to stop movement while waiting for an ideal assignment. Report shortages and use the authorized contingency organization. Consider how separating an ALS ambulance’s clinicians affects both patient care and the remaining vehicle’s capability.
\nSpecialty designation and immediate receiving capacity are different. Policy 900.00 prioritizes specialty placement through field findings, Med Com/base communication and bed availability. Under a large burden, base may need to prioritize which patients benefit most from scarce specialty beds. Do not send every red-tagged patient to the nearest trauma center on the assumption that category alone establishes destination.
\nUnder 900.00, a receiving facility may not divert an assigned declared-MCI patient unless it is closed because of the internal-disruption exception defined in Policy 310.96. Route a change through the coordinating system so the tracking record and receiving notification remain consistent. Do not treat a routine diversion message as permission to improvise a new destination.
\nAir transport, buses, vans and other alternatives need the assigned command/transport coordination and applicable local policy. Do not infer that multiple seats are usable patient positions, that an ambulance has unlimited stretcher capacity, or that a green category removes the need for reassessment and accountability.
" }, { "id": "communications", "heading": "Med Com, base hospitals, OCC and communications failure", "html": "Med Com should be identifiable, stationary enough to maintain records, and near the loading operation without obstructing it. The current Med Com checklist directs initial contact with OCC on 6 Alpha, using “[incident name] Med Com.” OCC assigns the coordinating talk group and base; Policy 900.00 identifies 6-Bravo through 6-Kilo as coordination talk groups. Confirm the actual assignment rather than selecting one from this guide.
\n{{figure:communications}}\nMed Com supplies the incident description, location, estimated count, level and evolving needs. Base initiates the ReddiNet MCI module, polls potential receivers, and at minimum polls all base hospitals. OCC can assist or coordinate destinations directly when the annex’s expanded response requires it. The field still needs a single, reconciled destination record.
\nFor a geographically spread incident, use assigned medical tactical communications between remote transportation/loading personnel and Med Com. Do not create independent hospital-allocation desks at each sector. Transporting ALS crews needing medical direction request an assignment through OCC, normally to the base managing the MCI; OCC can assign an alternative if that base cannot handle the call.
\nThe annex assigns dispatch a staged notification workflow. Level 1 includes affected-department overhead notifications. Level 2 adds regional dispatch, Operational Area overhead and regional ambulance notifications. Level 3 adds North/South Medical Task Force activation, Operational Area MCI trailers/resources and department FOC/EOC activation under department policy. Dispatch should prompt for the level if it was omitted and anticipate additional channels on a complex incident.
OCC notifies the normally assigned base, monitors the incident communications and assists distribution. Base/MICN assesses receiving capacity, maintains the base worksheet, communicates specialty-bed availability and assignments, notifies receivers, and asks for OCC assistance when its workload exceeds capacity. Ambulances monitor the assigned tactical frequency or Med-9 after departure for authorized destination changes. Each function must explicitly hand over its records if responsibility changes.
| Failure | Source-directed route | Keep track of |
|---|---|---|
| ReddiNet unavailable | Base uses telephone or another available system; the attached default PCCI supports initial assignments. | Assignments already made, updated capacity and receiver notification. |
| OCC in FAILSAFE | Med Com uses established FAILSAFE procedures to contact the base normally assigned to the area. | Who is coordinating and the working communications channel. |
| 800 MHz system unavailable | Try OCC by Med-9, landline or cellular phone. | Successful contact path and any message backlog. |
| No OCC or base contact by any alternate means | Med Com uses the default PCCI attached to current 900.00 for destinations. | Every allocation so the same fallback capacity is not reused independently by different sectors. |
The PCCI is a distribution contingency, not a live bed dashboard or a patient-care algorithm. Keep a current copy of 900.00’s PCCI pages 7–8 available through agency procedures. This guide links those tables rather than recreating phone numbers and capacity values that can become stale.
\nA clinical intervention requiring online medical control is a separate question. Follow 330.15 when its communication-failure conditions apply, including the required ePCR questions and subsequent review. Record failed attempts and the actual care provided; an MCI declaration alone does not suspend medical-control requirements.
", "sourceRefs": [ [ "medcom", "checklist, PDF p. 3" ], [ "policy", "§IV D–G and §VII" ], [ "failure", "complete policy" ] ], "renderedHtml": "Med Com should be identifiable, stationary enough to maintain records, and near the loading operation without obstructing it. The current Med Com checklist directs initial contact with OCC on 6 Alpha, using “[incident name] Med Com.” OCC assigns the coordinating talk group and base; Policy 900.00 identifies 6-Bravo through 6-Kilo as coordination talk groups. Confirm the actual assignment rather than selecting one from this guide.
\n![\"The](\"/assets/mci/communications.svg\")
Med Com supplies the incident description, location, estimated count, level and evolving needs. Base initiates the ReddiNet MCI module, polls potential receivers, and at minimum polls all base hospitals. OCC can assist or coordinate destinations directly when the annex’s expanded response requires it. The field still needs a single, reconciled destination record.
\nFor a geographically spread incident, use assigned medical tactical communications between remote transportation/loading personnel and Med Com. Do not create independent hospital-allocation desks at each sector. Transporting ALS crews needing medical direction request an assignment through OCC, normally to the base managing the MCI; OCC can assign an alternative if that base cannot handle the call.
\nThe annex assigns dispatch a staged notification workflow. Level 1 includes affected-department overhead notifications. Level 2 adds regional dispatch, Operational Area overhead and regional ambulance notifications. Level 3 adds North/South Medical Task Force activation, Operational Area MCI trailers/resources and department FOC/EOC activation under department policy. Dispatch should prompt for the level if it was omitted and anticipate additional channels on a complex incident.
OCC notifies the normally assigned base, monitors the incident communications and assists distribution. Base/MICN assesses receiving capacity, maintains the base worksheet, communicates specialty-bed availability and assignments, notifies receivers, and asks for OCC assistance when its workload exceeds capacity. Ambulances monitor the assigned tactical frequency or Med-9 after departure for authorized destination changes. Each function must explicitly hand over its records if responsibility changes.
| Failure | Source-directed route | Keep track of |
|---|---|---|
| ReddiNet unavailable | Base uses telephone or another available system; the attached default PCCI supports initial assignments. | Assignments already made, updated capacity and receiver notification. |
| OCC in FAILSAFE | Med Com uses established FAILSAFE procedures to contact the base normally assigned to the area. | Who is coordinating and the working communications channel. |
| 800 MHz system unavailable | Try OCC by Med-9, landline or cellular phone. | Successful contact path and any message backlog. |
| No OCC or base contact by any alternate means | Med Com uses the default PCCI attached to current 900.00 for destinations. | Every allocation so the same fallback capacity is not reused independently by different sectors. |
The PCCI is a distribution contingency, not a live bed dashboard or a patient-care algorithm. Keep a current copy of 900.00’s PCCI pages 7–8 available through agency procedures. This guide links those tables rather than recreating phone numbers and capacity values that can become stale.
\nA clinical intervention requiring online medical control is a separate question. Follow 330.15 when its communication-failure conditions apply, including the required ePCR questions and subsequent review. Record failed attempts and the actual care provided; an MCI declaration alone does not suspend medical-control requirements.
" }, { "id": "tracking", "heading": "Patient tracking, records and reconciliation", "html": "Maintain one patient identity across the treatment area, transportation worksheet, ambulance record and receiving facility. The most consequential administrative error is often a patient who has physically left but still appears on the scene count, or a departure with no recorded destination.
\nUse an explicit status such as “awaiting transport,” “assigned,” “departed,” “arrival confirmed” or “unresolved” in a teaching or agency-approved tracking method. Do not equate a destination assignment with actual departure. Reconcile treatment-area totals with transportation departures at regular briefings and before closure.
\nInclude people who decline care, leave before completion, self-transport or are handed to another authorized resource in the appropriate agency workflow. Do not silently erase them from the count. Apply the relevant assessment, refusal and documentation policies; a green tag is not a discharge order.
\nRetain tags with patients for the hospital medical record. Protect patient details in approved systems; general incident activity logs do not need full patient narratives, personal identifiers or medical histories. Record operational events and refer to the authorized clinical/tracking record where necessary.
\nThe base worksheet and Med Com worksheet are complementary. Base transfers its worksheet data into the required electronic record. Hospitals update received-casualty information and retain tags. Scene clearance therefore starts a reconciliation process; it does not eliminate the receiving system’s remaining work.
", "sourceRefs": [ [ "policy", "§IV E–G, §V and §VIII" ], [ "documentation", "complete policy" ], [ "medcom", "worksheet" ], [ "baseform", "worksheet" ] ], "renderedHtml": "![\"Patient](\"/assets/mci/tracking.svg\"){kind=tracking}
Maintain one patient identity across the treatment area, transportation worksheet, ambulance record and receiving facility. The most consequential administrative error is often a patient who has physically left but still appears on the scene count, or a departure with no recorded destination.
\nUse an explicit status such as “awaiting transport,” “assigned,” “departed,” “arrival confirmed” or “unresolved” in a teaching or agency-approved tracking method. Do not equate a destination assignment with actual departure. Reconcile treatment-area totals with transportation departures at regular briefings and before closure.
\nInclude people who decline care, leave before completion, self-transport or are handed to another authorized resource in the appropriate agency workflow. Do not silently erase them from the count. Apply the relevant assessment, refusal and documentation policies; a green tag is not a discharge order.
\nRetain tags with patients for the hospital medical record. Protect patient details in approved systems; general incident activity logs do not need full patient narratives, personal identifiers or medical histories. Record operational events and refer to the authorized clinical/tracking record where necessary.
\nThe base worksheet and Med Com worksheet are complementary. Base transfers its worksheet data into the required electronic record. Hospitals update received-casualty information and retain tags. Scene clearance therefore starts a reconciliation process; it does not eliminate the receiving system’s remaining work.
" }, { "id": "hazmat-safety", "heading": "HazMat awareness and the clean patient-care boundary", "html": "At a suspected release, protect the medical system from becoming part of the exposure. Recognize warning signs from a safe location, withdraw or stay out as appropriate, notify command and request trained HazMat resources. Do not approach a placard, container or patient simply to improve identification when doing so exposes the crew.
\nAwareness-level training does not qualify a crew to enter a hazard area, perform decontamination or manage contaminated patients. OSHA’s EMS interpretation distinguishes care after removal from danger and thorough decontamination from duties involving contaminated or only superficially decontaminated victims. Required training, PPE and employer authorization depend on the assigned duty.
\nIn an MCI layout, make the transition from hazardous/contaminated operations to clean medical operations explicit. HazMat/command determines zones and the decontamination process. Ambulance loading, supplies and ordinary treatment should not become a bypass around that control point. Tell Med Com about the agent or exposure concern, decontamination status and special receiving needs when known. Do not label a patient “clean” merely because clothing was removed or a quick rinse occurred.
\nPlan a separate way to identify and redirect self-presenting contaminated people without drawing them through treatment or loading. Recheck wind, runoff, vehicle movement and changing conditions through command. No fixed distance in a teaching diagram establishes a safe location.
\nFor training, use FEMA CDP AWR-358 dL and the Cal OES/CSTI First Responder Awareness pathway, with employer confirmation of acceptance. The training section also links FEMA IS-5.A, clearly labeled as an introduction that does not meet the cited HAZWOPER response-training requirement.
", "sourceRefs": [ [ "osha", "EMS training interpretation" ], [ "hazmat", "course overview" ], [ "csti", "training pathway" ], [ "annex", "decontamination responsibilities" ] ], "renderedHtml": "At a suspected release, protect the medical system from becoming part of the exposure. Recognize warning signs from a safe location, withdraw or stay out as appropriate, notify command and request trained HazMat resources. Do not approach a placard, container or patient simply to improve identification when doing so exposes the crew.
\nAwareness-level training does not qualify a crew to enter a hazard area, perform decontamination or manage contaminated patients. OSHA’s EMS interpretation distinguishes care after removal from danger and thorough decontamination from duties involving contaminated or only superficially decontaminated victims. Required training, PPE and employer authorization depend on the assigned duty.
\nIn an MCI layout, make the transition from hazardous/contaminated operations to clean medical operations explicit. HazMat/command determines zones and the decontamination process. Ambulance loading, supplies and ordinary treatment should not become a bypass around that control point. Tell Med Com about the agent or exposure concern, decontamination status and special receiving needs when known. Do not label a patient “clean” merely because clothing was removed or a quick rinse occurred.
\nPlan a separate way to identify and redirect self-presenting contaminated people without drawing them through treatment or loading. Recheck wind, runoff, vehicle movement and changing conditions through command. No fixed distance in a teaching diagram establishes a safe location.
\nFor training, use FEMA CDP AWR-358 dL and the Cal OES/CSTI First Responder Awareness pathway, with employer confirmation of acceptance. The training section also links FEMA IS-5.A, clearly labeled as an introduction that does not meet the cited HAZWOPER response-training requirement.
" }, { "id": "ambulance-strike-teams", "heading": "Ambulance strike teams: what to request and how they fit", "html": "An ambulance strike team packages transport resources under a leader so command can supervise a coherent capability. It is not simply every ambulance parked together. The California public manual describes five similarly capable transport vehicles, a leader with a vehicle and compatible communications. FEMA’s April 2024 ALS and BLS definitions use five or more ambulances of the same type, common communications and a leader in a separate command vehicle; their minimum configuration lists five ambulances and one command vehicle.
\n{{figure:strike-team}}\nSpecify ALS or BLS capability, quantity, staffing and mission in the request. Do not rely on “Type 1” or “Type 2” alone: the older California manual’s numbering shorthand and current national single-type ALS/BLS definitions are different frameworks. Confirm the resource package actually ordered, including pediatric, bariatric, wheelchair, critical-care or other needs.
\nA medical/ambulance task force is a mission-designed mix rather than a homogeneous ambulance team. It may solve a different problem, such as moving patients with mixed clinical and mobility requirements. A Disaster Medical Support Unit or cache supports operations but is not an extra transport ambulance. A request for the wrong label can deliver resources that cannot do the intended work.
\nDescribe the incident, task, quantity and level of care, required arrival time, reporting location, safe route, contact, communications, expected duration and logistics. Route requests through command, dispatch and the applicable medical-health mutual-aid process. Out-of-area assistance involves the Operational Area/MHOAC and regional coordination as applicable. Do not self-dispatch or promise another jurisdiction’s resources.
\nAt the incident, the team leader receives a specific assignment and supervisor. The leader retains personnel accountability and communicates readiness or limitations. GAC controls the ambulance staging/dispatch function; PTUL and Med Com control the patient-distribution interface. The AST leader does not establish a competing hospital allocation system merely because the team arrived as one package.
\n“Request one ALS ambulance strike team for transport from the east loading point. Confirm five staffed ALS ambulances, an AST leader/command vehicle and interoperable communications. Report through incident staging by the requested time. Anticipated assignment is six hours; confirm fuel, relief, meals, oxygen resupply and destination coordination. Pediatric patients are present; advise any limitations.” This is request wording, not confirmation of availability or a binding resource order.
The linked California manual is dated April 2010 even though its public file was uploaded in 2021. Use it for system background, and verify current California deployment, credentialing, reimbursement and mission-specific requirements with the responsible program. Do not treat its historical contact addresses, fees or training rules as current instructions.
", "sourceRefs": [ [ "ast", "§§200–400 and glossary" ], [ "astals", "2024 resource definition" ], [ "astbls", "2024 resource definition" ], [ "astleader", "2025 position definition" ] ], "renderedHtml": "An ambulance strike team packages transport resources under a leader so command can supervise a coherent capability. It is not simply every ambulance parked together. The California public manual describes five similarly capable transport vehicles, a leader with a vehicle and compatible communications. FEMA’s April 2024 ALS and BLS definitions use five or more ambulances of the same type, common communications and a leader in a separate command vehicle; their minimum configuration lists five ambulances and one command vehicle.
\n![\"A](\"/assets/mci/strike-team.svg\")
Specify ALS or BLS capability, quantity, staffing and mission in the request. Do not rely on “Type 1” or “Type 2” alone: the older California manual’s numbering shorthand and current national single-type ALS/BLS definitions are different frameworks. Confirm the resource package actually ordered, including pediatric, bariatric, wheelchair, critical-care or other needs.
\nA medical/ambulance task force is a mission-designed mix rather than a homogeneous ambulance team. It may solve a different problem, such as moving patients with mixed clinical and mobility requirements. A Disaster Medical Support Unit or cache supports operations but is not an extra transport ambulance. A request for the wrong label can deliver resources that cannot do the intended work.
\nDescribe the incident, task, quantity and level of care, required arrival time, reporting location, safe route, contact, communications, expected duration and logistics. Route requests through command, dispatch and the applicable medical-health mutual-aid process. Out-of-area assistance involves the Operational Area/MHOAC and regional coordination as applicable. Do not self-dispatch or promise another jurisdiction’s resources.
\nAt the incident, the team leader receives a specific assignment and supervisor. The leader retains personnel accountability and communicates readiness or limitations. GAC controls the ambulance staging/dispatch function; PTUL and Med Com control the patient-distribution interface. The AST leader does not establish a competing hospital allocation system merely because the team arrived as one package.
\n“Request one ALS ambulance strike team for transport from the east loading point. Confirm five staffed ALS ambulances, an AST leader/command vehicle and interoperable communications. Report through incident staging by the requested time. Anticipated assignment is six hours; confirm fuel, relief, meals, oxygen resupply and destination coordination. Pediatric patients are present; advise any limitations.” This is request wording, not confirmation of availability or a binding resource order.
The linked California manual is dated April 2010 even though its public file was uploaded in 2021. Use it for system background, and verify current California deployment, credentialing, reimbursement and mission-specific requirements with the responsible program. Do not treat its historical contact addresses, fees or training rules as current instructions.
" }, { "id": "strike-team-leader", "heading": "AST leader and crew deployment checklists", "html": "Track actual unit states: staged, assigned, loading, transporting, at hospital, returning, resting or out of service. Record the reason for a lost capability and notify the supervisor before another patient is committed to that unit. Ask about offload delay, resupply and crew fatigue; “at hospital” does not mean available.
\nKeep unit crews connected to the team leader. If command changes the team’s assignment or separates resources, clarify who supervises each resource, whether the resource order changes, and how accountability and logs will continue. Escalate immediate safety concerns promptly rather than waiting for a scheduled briefing.
\nFive available ambulances carrying one suitable patient each with a 60-minute total cycle produce a theoretical five patients per hour. If travel, handoff, cleaning and return increase the cycle to 90 minutes, the theoretical rate falls to about 3.3 per hour. This arithmetic is an OCMedic teaching estimate, not a capacity guarantee. Patient needs, crew relief, vehicle availability and receiving delays can reduce it further; do not use it to justify overloading a vehicle.
Obtain formal release and the demobilization instructions. Complete required checkout, reconcile logs and patient movements, document equipment or exposure issues, replenish for safe travel and brief the return route. Notify the designated coordination point and home agency of release and arrival. No unit leaves merely because its latest transport is complete.
", "sourceRefs": [ [ "ast", "§§307–313 and Appendix 701" ], [ "astleader", "duties and logistics" ], [ "forms", "ICS 211, 214 and 221" ] ], "renderedHtml": "![\"Mobilize](\"/assets/mci/ast-lifecycle.svg\")
Track actual unit states: staged, assigned, loading, transporting, at hospital, returning, resting or out of service. Record the reason for a lost capability and notify the supervisor before another patient is committed to that unit. Ask about offload delay, resupply and crew fatigue; “at hospital” does not mean available.
\nKeep unit crews connected to the team leader. If command changes the team’s assignment or separates resources, clarify who supervises each resource, whether the resource order changes, and how accountability and logs will continue. Escalate immediate safety concerns promptly rather than waiting for a scheduled briefing.
\nFive available ambulances carrying one suitable patient each with a 60-minute total cycle produce a theoretical five patients per hour. If travel, handoff, cleaning and return increase the cycle to 90 minutes, the theoretical rate falls to about 3.3 per hour. This arithmetic is an OCMedic teaching estimate, not a capacity guarantee. Patient needs, crew relief, vehicle availability and receiving delays can reduce it further; do not use it to justify overloading a vehicle.
Obtain formal release and the demobilization instructions. Complete required checkout, reconcile logs and patient movements, document equipment or exposure issues, replenish for safe travel and brief the return route. Notify the designated coordination point and home agency of release and arrival. No unit leaves merely because its latest transport is complete.
" }, { "id": "forms", "heading": "ICS forms and OCEMS worksheets: use the right record", "html": "Start with the records needed to run the incident. As complexity grows, Planning and the assigned supervisors organize an Incident Action Plan and supporting forms. A crew should know which forms it supplies and which it receives; it should not invent a second planning process.
\n{{forms-table}}\nICS 206 is the incident personnel medical plan. It is not a patient-by-patient destination sheet. Similarly, ICS 214 records operational activity; it does not replace an ePCR, a triage tag, the Med Com worksheet or required time/cost records. Use the current incident-approved versions and submission process.
\nFor OC-specific patient distribution, open the Med Com MCI worksheet and checklist and the Base Hospital MCI worksheet. The county index labels the Med Com attachment October 2025, while the downloaded form footer says revised April 9, 2025; these are publication/index and form revision labels, not two interchangeable versions.
\nDirect FEMA PDF links are provided alongside the official forms directory. If a direct file is blocked by a browser or agency network, use the directory to obtain the current official copy. Do not substitute an unofficial answer-key or form-download site.
", "sourceRefs": [ [ "forms", "official forms and instructions" ], [ "medcom", "all three pages" ], [ "baseform", "worksheet" ] ], "renderedHtml": "Start with the records needed to run the incident. As complexity grows, Planning and the assigned supervisors organize an Incident Action Plan and supporting forms. A crew should know which forms it supplies and which it receives; it should not invent a second planning process.
\n| Form / PDF | Use on an MCI or strike team |
|---|---|
| ICS 201 — Incident Briefing | Snapshot for initial briefing and transfer of command. |
| ICS 202 — Incident Objectives | Objectives for the operational period. |
| ICS 203 — Organization Assignment List | Who is assigned to the incident organization. |
| ICS 204 — Assignment List | Resource assignments and instructions for the period. |
| ICS 205 — Incident Radio Communications Plan | Assigned radio functions and channels. |
| ICS 205A — Communications List | Contact methods for assigned personnel/functions. |
| ICS 206 — Medical Plan | Medical support and emergency procedures for incident personnel. |
| ICS 207 — Incident Organization Chart | Wall chart showing the incident organization and assigned personnel. |
| ICS 208 — Safety Message-Plan | Incident safety message and precautions. |
| ICS 211 — Incident Check-In List | Accountability at arrival and check-in. |
| ICS 213 — General Message | Documented message and reply. |
| ICS 213RR — Resource Request Message | Resource need and request tracking; use the approved local medical-health request process. |
| ICS 214 — Activity Log | Notable activities for a unit, leader or other assigned resource. |
| ICS 221 — demobilization check-out | Authorized checkout before departure. |
ICS 206 is the incident personnel medical plan. It is not a patient-by-patient destination sheet. Similarly, ICS 214 records operational activity; it does not replace an ePCR, a triage tag, the Med Com worksheet or required time/cost records. Use the current incident-approved versions and submission process.
\nFor OC-specific patient distribution, open the Med Com MCI worksheet and checklist and the Base Hospital MCI worksheet. The county index labels the Med Com attachment October 2025, while the downloaded form footer says revised April 9, 2025; these are publication/index and form revision labels, not two interchangeable versions.
\nDirect FEMA PDF links are provided alongside the official forms directory. If a direct file is blocked by a browser or agency network, use the directory to obtain the current official copy. Do not substitute an unofficial answer-key or form-download site.
" }, { "id": "ics-214", "heading": "How to complete ICS 214: activity log with a worked example", "html": "Use the incident-assigned name and operational period, not a personal shift nickname. A unit log should let the next supervisor understand what was assigned, what happened, what remains unresolved and who was told.
\n| Block | Enter |
|---|---|
| 1 — Incident Name | The official incident name. |
| 2 — Operational Period | Start and end dates/times for the period covered; use the 24-hour clock and clarify the incident’s time-zone convention. |
| 3 — Name | Organizational unit or resource designator, such as the assigned strike-team identifier. |
| 4 — ICS Position | Name and ICS position of the person in charge of that unit/resource. |
| 5 — Home Agency (and Unit) | The preparer’s agency and applicable unit. |
| 6 — Resources Assigned | Assigned people/resources, their ICS positions and home agencies/units. |
| 7 — Activity Log | Date/time and concise notable activities: assignment, action, change, problem, notification and result. |
| 8 — Prepared by | Preparer’s name, position/title, signature and preparation date/time; identify continuation pages. |
Resource: Training AST Alpha. Operational period: October 2, 2026, 0800–2000, local time; the example continues across the leader relief documented at 1125. All identifiers and events below are invented for instruction.
\n| Time | Notable activity |
|---|---|
| 0805 | Received exercise assignment to east staging from Transportation Supervisor; confirmed five ambulances and leader vehicle. |
| 0820 | Completed check-in; briefed crews on the assigned radio plan, safe approach, loading location and responder emergency procedure. |
| 0842 | Unit A3 reported low oxygen reserve after transport; marked unavailable for new assignments and requested replacement through Logistics. |
| 0855 | Transportation Supervisor notified of reduced team availability; remaining units held to current assignment. |
| 0918 | Unit A3 confirmed replenishment and crew readiness; updated Transportation Supervisor and resource status. |
| 1125 | Relief briefing completed; passed unit status, unresolved requests and log copies to incoming leader. |
| 1320 | Received authorized release, completed required checkout and notified home coordination of return ETA. |
A useful entry is specific enough to explain the decision: “A3 unavailable, supervisor notified, oxygen requested.” “Busy with patients” cannot support a handoff or later reconstruction. Use dates when an operational period crosses midnight; distinguish an event time from a later documentation time.
\nFEMA routes completed logs through supervisors to the Documentation Unit and recommends retaining a copy. Follow the incident’s record-handling process. Keep patient identifiers and clinical narratives in the approved patient records rather than this general activity log.
", "sourceRefs": [ [ "forms", "ICS 214 v3.1 and instructions" ], [ "ast", "§603 and Appendix 701" ] ], "renderedHtml": "![\"A](\"/assets/mci/ics-214-map.svg\")
Use the incident-assigned name and operational period, not a personal shift nickname. A unit log should let the next supervisor understand what was assigned, what happened, what remains unresolved and who was told.
\n| Block | Enter |
|---|---|
| 1 — Incident Name | The official incident name. |
| 2 — Operational Period | Start and end dates/times for the period covered; use the 24-hour clock and clarify the incident’s time-zone convention. |
| 3 — Name | Organizational unit or resource designator, such as the assigned strike-team identifier. |
| 4 — ICS Position | Name and ICS position of the person in charge of that unit/resource. |
| 5 — Home Agency (and Unit) | The preparer’s agency and applicable unit. |
| 6 — Resources Assigned | Assigned people/resources, their ICS positions and home agencies/units. |
| 7 — Activity Log | Date/time and concise notable activities: assignment, action, change, problem, notification and result. |
| 8 — Prepared by | Preparer’s name, position/title, signature and preparation date/time; identify continuation pages. |
Resource: Training AST Alpha. Operational period: October 2, 2026, 0800–2000, local time; the example continues across the leader relief documented at 1125. All identifiers and events below are invented for instruction.
\n| Time | Notable activity |
|---|---|
| 0805 | Received exercise assignment to east staging from Transportation Supervisor; confirmed five ambulances and leader vehicle. |
| 0820 | Completed check-in; briefed crews on the assigned radio plan, safe approach, loading location and responder emergency procedure. |
| 0842 | Unit A3 reported low oxygen reserve after transport; marked unavailable for new assignments and requested replacement through Logistics. |
| 0855 | Transportation Supervisor notified of reduced team availability; remaining units held to current assignment. |
| 0918 | Unit A3 confirmed replenishment and crew readiness; updated Transportation Supervisor and resource status. |
| 1125 | Relief briefing completed; passed unit status, unresolved requests and log copies to incoming leader. |
| 1320 | Received authorized release, completed required checkout and notified home coordination of return ETA. |
A useful entry is specific enough to explain the decision: “A3 unavailable, supervisor notified, oxygen requested.” “Busy with patients” cannot support a handoff or later reconstruction. Use dates when an operational period crosses midnight; distinguish an event time from a later documentation time.
\nFEMA routes completed logs through supervisors to the Documentation Unit and recommends retaining a copy. Follow the incident’s record-handling process. Keep patient identifiers and clinical narratives in the approved patient records rather than this general activity log.
" }, { "id": "incident-setups", "heading": "Six incident setups for tabletop discussion", "html": "The following are OCMedic teaching examples, not predetermined dispatch packages, staffing standards, hazard distances or hospital allocations. The IC adapts them to actual hazards, access, patient burden and available personnel. Arrows show patient or information movement, not an instruction to enter an unsafe area.
\nProblem: several patients, live traffic, limited shoulder space and one possible entrapment. Begin with command, triage, Med Com and an ambulance coordination function. Establish traffic protection and rescue access through the appropriate agencies before positioning the medical operation.
Setup: use a protected treatment/loading location with clear ambulance ingress and egress. Patients ready for movement can go directly to an assigned ambulance when appropriate; do not create a distant tarp area merely to make the incident resemble a diagram. Keep walking patients supervised and accounted for.
Expand when: extrication delays, additional patients, multiple critical injuries or traffic geometry exceed the combined assignments. Exercise question: who still owns triage when the first officer transfers command, and how is the last transported patient reconciled?
\nProblem: mixed adult/pediatric patients, some separated from caregivers, and a transport queue. Establish a Medical Group with dedicated triage, treatment and transportation supervision as resources arrive. Request pediatric equipment and sufficient personnel for movement and repeated assessment.
Setup: maintain identified treatment areas, a supervised minor-patient area and a separate family/reunification interface through command. Preserve each child’s identifier during movement and handoff; do not assume an adult accompanying a child is the responsible caregiver. The transport record must reflect who accompanied the patient.
Expand when: specialty/pediatric capacity or transport turnaround limits movement. An AST can add a supervised transport package, but it does not solve an unidentified-patient or receiving-capacity problem. Exercise question: how will a carried, nonambulatory child arriving in the minor area get an appropriate primary assessment?
\nProblem: multiple casualty locations and changing access/security. Law-enforcement and fire/EMS command coordinate the safety framework and authorized medical access. This guide does not provide tactical entry procedures. Ordinary ambulance staging remains in the location assigned as safe for its role.
Setup: separate authorized casualty-transfer points feed identified medical sectors. Give each loading point a clear name. Use one Med Com and a transportation function capable of reconciling requests from all sectors. Route resources using current command instructions, not the shortest route on a map.
Expand when: concentrated critical injuries saturate specialty care even below 30 patients. Request logistical and hospital-system support early. Exercise question: how will two sectors avoid using the same reported hospital capacity twice?
\nProblem: exposed people may contaminate rescuers, treatment areas, ambulances and hospitals. Establish awareness-level recognition/notification and wait for the assigned hazard-control organization; only qualified, equipped personnel perform their authorized hazard-zone tasks.
Setup: HazMat/command manages the contaminated side and the decontamination boundary. An identified handoff feeds clean triage/treatment, then loading. Keep ambulances, replacement supplies and uninvolved people from crossing into the contaminated stream. Record the exposure concern and decontamination information needed for receiving coordination.
Expand when: ambulatory arrivals bypass control, symptoms evolve, or contaminated vehicles need removal from service. Exercise question: who can confirm the handoff conditions, and where is a self-presenting person redirected without contaminating clean operations?
\nProblem: blocked routes, prolonged rescue, infrastructure loss and several medical sites. Expand through Operations into rescue and medical functions with safety and logistics support. The Medical Branch may supervise several Medical Groups while transportation coordination remains unified.
Setup: name the sector treatment/loading points and identify usable transport corridors. Plan repeated communications checks, backup recordkeeping, medical supplies, responder relief and alternate receiving coordination. Request capabilities for the actual mission, including air resources only through the assigned air/transport system.
Expand when: local coverage is depleted or turnaround makes the ambulance queue unsustainable. Use the medical-health mutual-aid request process, documenting what is requested, accepted and still outstanding. Exercise question: how does the transport picture change if the principal route closes or communications fail for one sector?
\nProblem: patients with different mobility, monitoring and ongoing-care needs must leave a facility. Coordinate facility command, receiving arrangements and the appropriate medical-health system. An evacuation does not automatically make every resident a START trauma patient or every requested vehicle an ALS ambulance.
Setup: facility staff identify patients, destination arrangements, care needs, equipment, medications and accompanying records. A controlled loading point matches the verified transport capability to the patient. Separate ambulatory transport planning from stretcher or specialized transport, and preserve belongings and identification through handoff.
Expand when: receiving placement, equipment, oxygen, staff or route capacity blocks evacuation. A mission-tailored task force may be more appropriate than a homogeneous AST. Exercise question: what prevents a patient with a higher care need from being assigned to a vehicle based only on the order in which it arrives?
", "sourceRefs": [ [ "annex", "modular organization, movement and communications" ], [ "policy", "destination coordination and documentation" ], [ "tactical", "training and role boundaries" ], [ "astals", "mission/logistics specifications" ], [ "osha", "HazMat EMS role limitations" ] ], "renderedHtml": "The following are OCMedic teaching examples, not predetermined dispatch packages, staffing standards, hazard distances or hospital allocations. The IC adapts them to actual hazards, access, patient burden and available personnel. Arrows show patient or information movement, not an instruction to enter an unsafe area.
\n![\"Traffic-controlled](\"/assets/mci/road.svg\")
Problem: several patients, live traffic, limited shoulder space and one possible entrapment. Begin with command, triage, Med Com and an ambulance coordination function. Establish traffic protection and rescue access through the appropriate agencies before positioning the medical operation.
Setup: use a protected treatment/loading location with clear ambulance ingress and egress. Patients ready for movement can go directly to an assigned ambulance when appropriate; do not create a distant tarp area merely to make the incident resemble a diagram. Keep walking patients supervised and accounted for.
Expand when: extrication delays, additional patients, multiple critical injuries or traffic geometry exceed the combined assignments. Exercise question: who still owns triage when the first officer transfers command, and how is the last transported patient reconciled?
\n![\"Bus](\"/assets/mci/bus.svg\")
Problem: mixed adult/pediatric patients, some separated from caregivers, and a transport queue. Establish a Medical Group with dedicated triage, treatment and transportation supervision as resources arrive. Request pediatric equipment and sufficient personnel for movement and repeated assessment.
Setup: maintain identified treatment areas, a supervised minor-patient area and a separate family/reunification interface through command. Preserve each child’s identifier during movement and handoff; do not assume an adult accompanying a child is the responsible caregiver. The transport record must reflect who accompanied the patient.
Expand when: specialty/pediatric capacity or transport turnaround limits movement. An AST can add a supervised transport package, but it does not solve an unidentified-patient or receiving-capacity problem. Exercise question: how will a carried, nonambulatory child arriving in the minor area get an appropriate primary assessment?
\n![\"Site](\"/assets/mci/distributed.svg\")
Problem: multiple casualty locations and changing access/security. Law-enforcement and fire/EMS command coordinate the safety framework and authorized medical access. This guide does not provide tactical entry procedures. Ordinary ambulance staging remains in the location assigned as safe for its role.
Setup: separate authorized casualty-transfer points feed identified medical sectors. Give each loading point a clear name. Use one Med Com and a transportation function capable of reconciling requests from all sectors. Route resources using current command instructions, not the shortest route on a map.
Expand when: concentrated critical injuries saturate specialty care even below 30 patients. Request logistical and hospital-system support early. Exercise question: how will two sectors avoid using the same reported hospital capacity twice?
\n![\"HOT](\"/assets/mci/hazmat.svg\")
Problem: exposed people may contaminate rescuers, treatment areas, ambulances and hospitals. Establish awareness-level recognition/notification and wait for the assigned hazard-control organization; only qualified, equipped personnel perform their authorized hazard-zone tasks.
Setup: HazMat/command manages the contaminated side and the decontamination boundary. An identified handoff feeds clean triage/treatment, then loading. Keep ambulances, replacement supplies and uninvolved people from crossing into the contaminated stream. Record the exposure concern and decontamination information needed for receiving coordination.
Expand when: ambulatory arrivals bypass control, symptoms evolve, or contaminated vehicles need removal from service. Exercise question: who can confirm the handoff conditions, and where is a self-presenting person redirected without contaminating clean operations?
\n![\"Rescue](\"/assets/mci/collapse.svg\")
Problem: blocked routes, prolonged rescue, infrastructure loss and several medical sites. Expand through Operations into rescue and medical functions with safety and logistics support. The Medical Branch may supervise several Medical Groups while transportation coordination remains unified.
Setup: name the sector treatment/loading points and identify usable transport corridors. Plan repeated communications checks, backup recordkeeping, medical supplies, responder relief and alternate receiving coordination. Request capabilities for the actual mission, including air resources only through the assigned air/transport system.
Expand when: local coverage is depleted or turnaround makes the ambulance queue unsustainable. Use the medical-health mutual-aid request process, documenting what is requested, accepted and still outstanding. Exercise question: how does the transport picture change if the principal route closes or communications fail for one sector?
\n![\"Originating](\"/assets/mci/evacuation.svg\")
Problem: patients with different mobility, monitoring and ongoing-care needs must leave a facility. Coordinate facility command, receiving arrangements and the appropriate medical-health system. An evacuation does not automatically make every resident a START trauma patient or every requested vehicle an ALS ambulance.
Setup: facility staff identify patients, destination arrangements, care needs, equipment, medications and accompanying records. A controlled loading point matches the verified transport capability to the patient. Separate ambulatory transport planning from stretcher or specialized transport, and preserve belongings and identification through handoff.
Expand when: receiving placement, equipment, oxygen, staff or route capacity blocks evacuation. A mission-tailored task force may be more appropriate than a homogeneous AST. Exercise question: what prevents a patient with a higher care need from being assigned to a vehicle based only on the order in which it arrives?
" }, { "id": "demobilization", "heading": "Close the scene, support the hospitals and improve the next response", "html": "Before releasing the medical organization, reconcile the patient count with documented transports and other dispositions. Resolve unknown destinations and missing identifiers through the assigned channels. Med Com notifies base when the scene is clear; base communicates closure to the involved hospitals. Clinical care, hospital tracking and documentation continue after the last ambulance leaves.
\nThe annex specifically recognizes that Level 2 and 3 incidents can leave receiving hospitals under pressure. Command should assess that continued need through the authorized hospital/dispatch interface and consider requested support. Anticipate people who self-present outside the coordinated ambulance stream; those arrivals can change the receiving system’s burden.
\nFor a drill, measure observable actions: time to command and Med Com, first useful resource request, reliable category count, assigned destination readback, first departure, patient-record reconciliation, and a successful backup-communications test. These are proposed exercise measures, not official OCEMS time standards.
\nPolicy 900.00 calls for annual MCI-readiness disaster drills by system participants and base-coordinator review of MCI reports. Use the after-action process to test whether the next revision fixes the observed problem, such as a duplicate destination assignment or an untracked ambulance departure.
", "sourceRefs": [ [ "annex", "conclusion, pp. 12–13" ], [ "policy", "§V–VI" ], [ "ast", "§313" ] ], "renderedHtml": "Before releasing the medical organization, reconcile the patient count with documented transports and other dispositions. Resolve unknown destinations and missing identifiers through the assigned channels. Med Com notifies base when the scene is clear; base communicates closure to the involved hospitals. Clinical care, hospital tracking and documentation continue after the last ambulance leaves.
\nThe annex specifically recognizes that Level 2 and 3 incidents can leave receiving hospitals under pressure. Command should assess that continued need through the authorized hospital/dispatch interface and consider requested support. Anticipate people who self-present outside the coordinated ambulance stream; those arrivals can change the receiving system’s burden.
\nFor a drill, measure observable actions: time to command and Med Com, first useful resource request, reliable category count, assigned destination readback, first departure, patient-record reconciliation, and a successful backup-communications test. These are proposed exercise measures, not official OCEMS time standards.
\nPolicy 900.00 calls for annual MCI-readiness disaster drills by system participants and base-coordinator review of MCI reports. Use the after-action process to test whether the next revision fixes the observed problem, such as a duplicate destination assignment or an untracked ambulance departure.
" }, { "id": "training", "heading": "FEMA ICS courses and HazMat awareness training", "html": "Use these official course pages for enrollment details and current versions. The five requested ICS/NIMS courses are also listed in FEMA’s September 2025 Ambulance Strike Team Leader qualification document. Course completion alone does not establish position qualification, agency authorization or California AST leader credentialing.
\n{{training-table}}\nICS-300 is instructor-led. Use FEMA’s course information and your state/local training provider for an offering; it is not an independent-study “IS-300” course with the same online exam workflow as IS-100. Confirm prerequisites and the accepted delivery format with the host.
\nThe agency must match training, competency, PPE and authorization to actual duties. A completion certificate does not authorize hot-zone entry, decontamination, contaminated-patient handling or technical rescue. Use the OSHA EMS training interpretation with the employer’s applicable requirements to distinguish awareness from operations-level duties.
", "sourceRefs": [ [ "training", "course progression" ], [ "astleader", "training requirements" ], [ "hazmat", "course listing" ], [ "csti", "official program" ], [ "osha", "EMS training interpretation" ] ], "renderedHtml": "Use these official course pages for enrollment details and current versions. The five requested ICS/NIMS courses are also listed in FEMA’s September 2025 Ambulance Strike Team Leader qualification document. Course completion alone does not establish position qualification, agency authorization or California AST leader credentialing.
\n| Course | Delivery | Why it matters |
|---|---|---|
| IS-100.C — Introduction to the Incident Command System, ICS 100 | Online independent study | Common terms, roles and the basic organization. |
| IS-200.C — Basic Incident Command System for Initial Response, ICS-200 | Online independent study | Initial-response supervision and transfer of command. |
| ICS-300 / E/L/G0300 — Intermediate ICS for Expanding Incidents | Instructor-led; locate a state/local offering | Expanding organization, planning and resource management. |
| IS-700.B — An Introduction to the National Incident Management System | Online independent study | How NIMS supports coordinated incident management. |
| IS-800.D — National Response Framework, An Introduction | Online independent study | How the broader national response framework fits together. |
ICS-300 is instructor-led. Use FEMA’s course information and your state/local training provider for an offering; it is not an independent-study “IS-300” course with the same online exam workflow as IS-100. Confirm prerequisites and the accepted delivery format with the host.
\nThe agency must match training, competency, PPE and authorization to actual duties. A completion certificate does not authorize hot-zone entry, decontamination, contaminated-patient handling or technical rescue. Use the OSHA EMS training interpretation with the employer’s applicable requirements to distinguish awareness from operations-level duties.
" }, { "id": "coverage", "heading": "Annex coverage and source-version notes", "html": "This crosswalk makes the scope inspectable. The guide addresses every main annex topic and both attachments; examples and worksheets supplement that explanation. It does not reproduce the complete official plan or authorize deviations from it.
\n{{coverage-table}}\nSource check: October 2, 2026. The county policy directory still links the January 2019 annex and the January 2026 900.00 PDF. Current policy controls the hospital interface where older annex wording differs. Training pages and FEMA form versions were checked against their official listings. The California AST manual is an older background source; current mission orders and responsible program guidance govern deployment details.
\nReview status: published educational guide. The explanations, scenario diagrams and fictional logs are original teaching material. No independent clinical or incident-command review is claimed. Review the complete sources before operational use.
", "sourceRefs": [ [ "index", "current links" ], [ "annex", "complete plan" ], [ "policy", "complete policy" ], [ "ast", "version on title page" ] ], "renderedHtml": "This crosswalk makes the scope inspectable. The guide addresses every main annex topic and both attachments; examples and worksheets supplement that explanation. It does not reproduce the complete official plan or authorize deviations from it.
\nSource check: October 2, 2026. The county policy directory still links the January 2019 annex and the January 2026 900.00 PDF. Current policy controls the hospital interface where older annex wording differs. Training pages and FEMA form versions were checked against their official listings. The California AST manual is an older background source; current mission orders and responsible program guidance govern deployment details.
\nReview status: published educational guide. The explanations, scenario diagrams and fictional logs are original teaching material. No independent clinical or incident-command review is claimed. Review the complete sources before operational use.
" } ], "sources": { "annex": { "title": "Orange County Fire Chiefs Association - MCI Plan 2019", "url": "https://www.ochealthinfo.com/sites/healthcare/files/2023-04/OC%20Fire%20Chiefs%20Assoc.MCI%20Plan.2019%20%28attachment%20to%20900.00%29.pdf" }, "policy": { "title": "Multi-Casualty Incident (MCI) Response Plan", "url": "https://www.ochealthinfo.com/sites/healthcare/files/2026-01/900.00%20MCI%20%2812-30-2025%29.pdf" }, "medcom": { "title": "MCI Worksheet Attachment 2 - Mass Casualty Incident Response Plan - Med Com", "url": "https://www.ochealthinfo.com/sites/healthcare/files/2025-11/900.00%20MCI%20Worksheet%20Attachment%202%2010-2025.pdf" }, "baseform": { "title": "MCI Worksheet Attachment 1 - Mass Casualty Incident Response Plan - BH", "url": "https://www.ochealthinfo.com/sites/healthcare/files/2023-05/900.00%20Attachment%201%20%285-2023%29.pdf" }, "base": { "title": "9-1-1 Advanced Life Support Base Contact, Standing Order, and Transport Criteria", "url": "https://www.ochealthinfo.com/sites/healthcare/files/2025-03/310.00%20ALS%20Base%20Contact%204-2025.pdf" }, "failure": { "title": "Treatment Without Base Contact Communication Failure", "url": "https://www.ochealthinfo.com/sites/hca/files/2021-05/330.15%20ALS%20Treatment%20without%20Base%20Hospital%20Contact%20%2804-01-2021%29.pdf" }, "trauma": { "title": "Trauma Triage", "url": "https://www.ochealthinfo.com/sites/healthcare/files/2024-05/310.30%20Trauma%20Triage%20%285-24%29.pdf" }, "documentation": { "title": "OC-MEDS - Clinical Document Standards", "url": "https://www.ochealthinfo.com/sites/healthcare/files/2024-10/300.10%20OC-MEDS%20clin%20Doc%20Stand%2010-2024.pdf" }, "tactical": { "title": "Tactical Casualty Care", "url": "https://www.ochealthinfo.com/sites/hca/files/import/data/files/85126.pdf" }, "jumpstart": { "title": "HHS CHEMM — JumpSTART pediatric triage algorithm", "url": "https://chemm.hhs.gov/incident-primer/triage/jumpstart-triage" }, "ast": { "title": "California EMSA AST/MTF System Manual — April 2010, public PDF uploaded 2021", "url": "https://emsa.ca.gov/wp-content/uploads/sites/71/2021/11/Ambulance-Strike-Team-Medical-Task-Force-System-Manual-2021-11-02.pdf" }, "astals": { "title": "FEMA ALS Ambulance Strike Team — April 2024", "url": "https://rtlt.preptoolkit.fema.gov/Public/Resource/ViewFile/3-508-1294?type=Pdf" }, "astbls": { "title": "FEMA BLS Ambulance Strike Team — April 2024", "url": "https://rtlt.preptoolkit.fema.gov/Public/Resource/ViewFile/3-508-1295?type=Pdf" }, "astleader": { "title": "FEMA Ambulance Strike Team Leader — September 2025", "url": "https://rtlt.preptoolkit.fema.gov/Public/Position/ViewFile/3-509-1224?type=Pdf" }, "forms": { "title": "FEMA ICS Forms Resource Center", "url": "https://training.fema.gov/emiweb/is/icsresource/icsforms/" }, "training": { "title": "FEMA ICS training progression and ICS-300 information", "url": "https://training.fema.gov/programs/nims-ics-position-specific/icstraining.aspx" }, "hazmat": { "title": "FEMA CDP Hazardous Materials Awareness Distance Learning — AWR-358 dL", "url": "https://cdp.dhs.gov/training/course/AWR-358%20dL" }, "csti": { "title": "Cal OES / CSTI Hazardous Materials Outreach Program", "url": "https://www.caloes.ca.gov/office-of-the-director/operations/planning-preparedness-prevention/california-specialized-training-institute/hazardous-materials-program/hazmat-outreach-program/" }, "osha": { "title": "OSHA: HazMat training requirements for EMS personnel", "url": "https://www.osha.gov/laws-regs/standardinterpretations/2017-03-31" }, "index": { "title": "OCEMS current policy directory", "url": "https://www.ochealthinfo.com/providers-partners/emergency-medical-services/ems-policies-procedures-standing-orders/ems-policies" } }, "forms": [ { "number": "201", "title": "Incident Briefing", "version": "v3", "url": "https://training.fema.gov/EMIWeb/IS/ICSResource/assets/ICS%20Forms//ICS%20Form%20201%2C%20Incident%20Briefing%20%28v3%29.pdf", "use": "Snapshot for initial briefing and transfer of command." }, { "number": "202", "title": "Incident Objectives", "version": "v3.1", "url": "https://training.fema.gov/EMIWeb/IS/ICSResource/assets/ICS%20Forms//ICS%20Form%20202%2C%20Incident%20Objectives%20%28v3.1%29.pdf", "use": "Objectives for the operational period." }, { "number": "203", "title": "Organization Assignment List", "version": "v3", "url": "https://training.fema.gov/EMIWeb/IS/ICSResource/assets/ICS%20Forms//ICS%20Form%20203%2C%20Organization%20Assignment%20List%20%28v3%29.pdf", "use": "Who is assigned to the incident organization." }, { "number": "204", "title": "Assignment List", "version": "v3.1", "url": "https://training.fema.gov/EMIWeb/IS/ICSResource/assets/ICS%20Forms//ICS%20Form%20204%2C%20Assignment%20List%20%28v3.1%29.pdf", "use": "Resource assignments and instructions for the period." }, { "number": "205", "title": "Incident Radio Communications Plan", "version": "v3.1", "url": "https://training.fema.gov/EMIWeb/IS/ICSResource/assets/ICS%20Forms//ICS%20Form%20205%2C%20Incident%20Radio%20Communications%20Plan%20%28v3.1%29.pdf", "use": "Assigned radio functions and channels." }, { "number": "205A", "title": "Communications List", "version": "v3", "url": "https://training.fema.gov/EMIWeb/IS/ICSResource/assets/ICS%20Forms//ICS%20Form%20205A%2C%20Communications%20List%20%28v3%29.pdf", "use": "Contact methods for assigned personnel/functions." }, { "number": "206", "title": "Medical Plan", "version": "v3", "url": "https://training.fema.gov/EMIWeb/IS/ICSResource/assets/ICS%20Forms//ICS%20Form%20206%2C%20Medical%20Plan%20%28v3%29.pdf", "use": "Medical support and emergency procedures for incident personnel." }, { "number": "207", "title": "Incident Organization Chart", "version": "v3", "url": "https://training.fema.gov/EMIWeb/IS/ICSResource/assets/ICS%20Forms//ICS%20Form%20207%2C%20Incident%20Organization%20Chart%20%28v3%29.pdf", "use": "Wall chart showing the incident organization and assigned personnel." }, { "number": "208", "title": "Safety Message-Plan", "version": "v3.1", "url": "https://training.fema.gov/EMIWeb/IS/ICSResource/assets/ICS%20Forms//ICS%20Form%20208%2C%20Safety%20Message-Plan%20%28v3.1%29.pdf", "use": "Incident safety message and precautions." }, { "number": "211", "title": "Incident Check-In List", "version": "v3.1", "url": "https://training.fema.gov/EMIWeb/IS/ICSResource/assets/ICS%20Forms//ICS%20Form%20211%2C%20Incident%20Check-In%20List%20%28v3.1%29.pdf", "use": "Accountability at arrival and check-in." }, { "number": "213", "title": "General Message", "version": "v3", "url": "https://training.fema.gov/EMIWeb/IS/ICSResource/assets/ICS%20Forms//ICS%20Form%20213%2C%20General%20Message%20%28v3%29.pdf", "use": "Documented message and reply." }, { "number": "213RR", "title": "Resource Request Message", "version": "v3", "url": "https://training.fema.gov/EMIWeb/IS/ICSResource/assets/ICS%20Forms//ICS%20Form%20213RR%2C%20Resource%20Request%20Message%20%28v3%29.pdf", "use": "Resource need and request tracking; use the approved local medical-health request process." }, { "number": "214", "title": "Activity Log", "version": "v3.1", "url": "https://training.fema.gov/EMIWeb/IS/ICSResource/assets/ICS%20Forms//ICS%20Form%20214%2C%20Activity%20Log%20%28v3.1%29.pdf", "use": "Notable activities for a unit, leader or other assigned resource." }, { "number": "221", "title": "demobilization check-out", "version": "v3.1", "url": "https://training.fema.gov/EMIWeb/IS/ICSResource/assets/ICS%20Forms//ics%20form%20221%2C%20demobilization%20check-out%20%28v3.1%29.pdf", "use": "Authorized checkout before departure." } ], "training": [ { "code": "IS-100.C", "title": "Introduction to the Incident Command System, ICS 100", "format": "Online independent study", "use": "Common terms, roles and the basic organization.", "url": "https://training.fema.gov/programs/independent-study/courseoverview.aspx?code=IS-100.c&lang=en" }, { "code": "IS-200.C", "title": "Basic Incident Command System for Initial Response, ICS-200", "format": "Online independent study", "use": "Initial-response supervision and transfer of command.", "url": "https://training.fema.gov/programs/independent-study/courseoverview.aspx?code=IS-200.c&lang=en" }, { "code": "ICS-300 / E/L/G0300", "title": "Intermediate ICS for Expanding Incidents", "format": "Instructor-led; locate a state/local offering", "use": "Expanding organization, planning and resource management.", "url": "https://training.fema.gov/programs/nims-ics-position-specific/icstraining.aspx" }, { "code": "IS-700.B", "title": "An Introduction to the National Incident Management System", "format": "Online independent study", "use": "How NIMS supports coordinated incident management.", "url": "https://training.fema.gov/programs/independent-study/courseoverview.aspx?code=IS-700.b&lang=en" }, { "code": "IS-800.D", "title": "National Response Framework, An Introduction", "format": "Online independent study", "use": "How the broader national response framework fits together.", "url": "https://training.fema.gov/programs/independent-study/courseoverview.aspx?code=IS-800.d&lang=en" } ], "coverage": [ [ "Intent and definitions", "pp. 2–3", "policy-integration" ], [ "Basic considerations and four response organizations", "p. 3", "command-roles" ], [ "MCI levels", "p. 4", "levels-reports" ], [ "Command and resource needs", "pp. 5–6", "first-actions" ], [ "Triage", "p. 6", "triage" ], [ "Treatment and transportation", "p. 7", "treatment-transport" ], [ "Med Com and report examples", "pp. 8–10", "communications" ], [ "Fire, OCC, base, ambulance and dispatch procedures", "pp. 10–12", "communications" ], [ "Documentation", "p. 12", "tracking" ], [ "Conclusion and hospital support", "pp. 12–13", "demobilization" ], [ "Attachment A: ICS positions", "pp. 14–19", "command-roles" ], [ "Attachment B: ribbons, tags, litter teams, START and JumpSTART", "pp. 20–25", "triage" ] ], "datePublished": "2026-10-02", "dateModified": "2026-10-02" }