Disaster Response

Along with emergency planning, continuity of operations planning, response and recovery programs, efforts to ensure the welfare of employees who are required to remain at a given facility to support of critical operations, must be addressed (7). In addition, identification of safe routes of travel for employees summoned to report for work during times of community emergency must be addressed; this becomes extremely critical during a concurrent community-wide evacuation. Finally, managers of personnel required for incident response and/or support should encourage their employees to complete family planning checklists (8), thereby ensuring their availability to respond in times of need. Through exploration of community resources and an assessment of jurisdictional capabilities, first-response personnel can construct appropriate contingency plans and procedures in advance of a disaster for implementation when need arises.

For example, many large metropolitan areas maintain responders trained to handle emergencies involving building collapse, trench collapse, confined space rescue, elevated rescue, heavy vehicle rescue, machinery extrication, and hazardous material releases or spills. In the absence of local resources, technical teams may need to be summoned to respond and address incidents involving the need for specialized services. Although many areas within the United States possess resources with varied levels of response capability, federal urban search and rescue (USAR) teams exist to support state and local needs through a Governor’s declaration of emergency and subsequent request of federal resources.

Under the Federal Stafford Act (Robert T. Stafford Disaster Relief and Emergency Management Assistance Act, Public Law 93–288, as amended), only the state’s Governor may request federal assistance through the President. With this declaration, channels are opened to localities to receive many types of specialty teams and resources available through federal emergency management authorities. Several examples of specialized medical resources accessible within the National Response Framework (NRF) are found in Table 157.1 (9).


The Incident Commander (IC) should consider employing the concept of unified command. In a unified command, while input from multiple stakeholders is requested and rapidly attained—aiding in the strategic decision-making process—there is only one overall plan and one collective “team” working common objectives in pursuit of a common set of goals.

Establishing a unified command involves managerial representatives from the various agencies, or “stakeholders,” being present at the command post to provide direct input to the IC. In the setting of a terrorist event, law enforcement officials may initially take the command position, as crisis management activities are paramount, with an eventual passing of command to fire rescue, public works, and/or health department managers for consequence management. As the expertise needed to respond to a given phase of an event shifts, the type of IC required may change; with the incident command structure (ICS), such a handoff of responsibility is easily possible. The unified command structure allows for shifting of responsibility to seamlessly take place as the modes of managing the incident progress from crisis to consequence response. Even in the setting of a unified command, there is only one IC in charge of the overall response at any given time.

The primary rules for dealing with a forecasted or real-time disaster include the following.

Meet the needs of the disaster survivors. Those responsible for managing any emergency will benefit greatly from monitoring the needs of those for whom they are attempting to provide direct services, as well as the needs of their responders. The requirement to engage in an ongoing needs analysis is paramount and must consider the following.

  • Basic medical and mental health support
  • Provision of food and water
  • Security presence

Meet the needs of the responders. If forward incident management teams—incident management planning groups traveling ahead of specific resources—have arrived and completed a preliminary damage assessment and identified areas to be searched, the following additional immediate needs should be recognized.

  • Locations and security arrangements for staging areas, base of operations, and USAR missions
  • Emergency fuel and maintenance facilities for equipment and apparatus
  • Sanitation and decontamination facilities

Many specialty resources—for example, USAR teams—deploy into these areas with the capability to be, literally, self-sufficient for a specified period of time (3–7 days). Identification of resource needs in advance of the incident will ease the burden on the Logistics Branch in their effort to ensure availability of needed items.

Resource Typing

Common terminology relating to resource needs is essential to ensure that emergency managers obtain the proper “tool” for the task at hand. A resource typing system (10) database has been included within the framework of the NIMS for this specific purpose. Groups representing specialists from emergency management, EMSs, fire and hazardous materials, law enforcement, health and medical services, public works, search and rescue, and animal health at local, state, and federal levels provide input for the construction of this list of accessible resources.

Within each category, numeric classification (typing) levels are assigned, indicating the general degree of capability that a given resource possesses, with type I being the greatest, followed by type II, type III, and so on. The specific capabilities each asset type offers—the number of personnel, type of apparatus, specific training levels, equipment, personal protective equipment, etc.—are addressed within each category.

The need to use common terminology becomes apparent when considering disaster response management on a global level. For example, when fire agencies in the eastern part of the United States have requested tanker support, they have, historically, received a truck capable of ferrying hundreds of gallons of water to the scene. On the other hand, when the same request is made by an agency on the West Coast, the result may be the deployment of an aircraft carrying thousands of gallons of fire retardant. Similar concern has arisen in EMS where, in one area of the country, a request for a “rescue unit” has resulted in the provision of an ambulance, whereas in a different geographic region that same request resulted in the provision of a nontransport capable unit equipped with extrication and basic medical equipment. Within the public works services, without capability and resource typing, a piece of heavy equipment might be requested and arrive being either too small or too large for the desired task at hand. The requirement to specifically identify and relay the precise needs of those overseeing the response is critical to the cohesive overall management of the incident and deployment of available resources.


In March, 2004, within the United States, Presidential Directive No. 5 (11) was promulgated that established the NIMS (12) as the model for effectively commanding and controlling the response to significant emergencies or disasters. This model identifies organizational branches that an IC may employ to coordinate emergency response.

The Incident Command Structure (ICS) has been likened to a tool box containing organizational tools used to manage an incident regardless of level of complexity or size. The IC maintains the responsibility of ensuring that all elements are addressed to achieve an effective response. Through the use of the ICS, an incident can be managed by a group of individuals overseeing resources within a reasonable span of control. The NIMS may be used by any level of authority, be it the on-scene commander, a municipal, county, or state emergency manager, or federal agencies providing additional resources and assistance. In fact, the organizational concepts are not limited to the management of emergencies.

Incident Command Structure

The command structure begins with the IC and his/her Command Staff consisting of the Safety Officer, Liaison Officer, and Public Information Officer. Beneath this oversight and coordination group are the General Staff Branches, composed of Operations, Planning, Finance, and Logistics. The roles of each position and the manner in which delegated tasks may be organized are identified below.

Incident Commander and Command Staff

The IC is responsible for establishing incident priorities, strategies, and objectives along with overall coordination of resources to address the emergency event. The IC may also create Command Staff positions that could include the following.

  • A Liaison Officer whose job is to aid in coordinating activities with outside agencies.
  • A Safety Officer who monitors and anticipates hazardous conditions or unsafe situations, developing and recommending measures for ensuring responder safety.
  • A Public Information Officer who manages media responding to the event and, under direction from the IC, releases information regarding the event.

The IC then organizes his or her General Staff to implement the tactics necessary to accomplish the objectives established within the IAP in support of the overall management strategy. Positions within the General Staff include; the Operations Branch, the Planning Branch, the Finance Branch, and the Logistics Branch.

Operations Branch

The Operations Branch is responsible for coordinating the tactics of the response so that the strategic initiatives are accomplished. Functioning under the Operations Branch, one may find branches such as public works, health, fire, USAR, hazardous materials, and/or law enforcement. There may also be multijurisdictional branches such as local, state, or federal, or geographic branches such as Division 1/Division 2, or East/West.

Reporting to these branches are the specific groups assembled to carry out the strategic initiatives established with the IAP. Examples include, but are certainly not limited to, suppression, search, triage, treatment, surveillance, debris removal, perimeter control, and so on.

Planning Branch

The Planning Branch, perhaps obviously, is responsible for developing the IAP from incident-specific information in support of the IC’s strategic initiatives. For example, the IAP may add detail to the IC’s outline of goals and objectives by analyzing damage assessment data, situational reports, resource availability, weather conditions, safety considerations, etc. Reporting to the Planning Branch are functional groups, such as those listed below.

  • The Resource Unit, which ensures that all assigned personnel and resources at an incident are categorized by capability and that their status is tracked.
  • The Situation Unit collects, processes, and organizes situation information, prepares situation summaries, forecasts, and develops projections of future events related to the incident.
  • The Demobilization Unit develops the demobilization plan, including specific instructions for all personnel and resources released from the incident.
  • The Documentation Unit maintains complete files of the incident, including a record of all important decisions taken to resolve the incident for legal, analytic, and historical purposes.
  • Technical Specialists or subject matter experts may be required to provide technically specific information to aid mitigation efforts.

The IAP is defined as a written plan containing general objectives reflecting the overall strategy for management of the incident. It may include identification of operational resources and assignments, along with specific direction and key information for the management of the incident for one or more operational periods. Common examples of IAP components include the following.

  • Incident name
  • Operational period and mitigation strategy
  • Identification of ICS organization
  • Resources on scene
  • Strike team or unit leaders and staff
  • Communications plan and assignments
  • Special instructions (weather, hazards, and so on)
  • Plan author and approving authority

Finance Branch

The Finance Branch is responsible for the facilitation of contractual agreements and documentation of allocated resources to ensure reimbursement for supplies and services required to execute the IAP. Reporting to this group are functional groups such as the following.

  • The Compensation/Claims Unit handles injury compensation and claims.
  • The Procurement Unit handles all financial matters pertaining to vendor contracts, identifies sources for equipment, and executes equipment rental agreements and supply contracts.
  • The Cost Unit maintains and provides cost analysis data for the incident.
  • The Time Unit is responsible for recording of personnel time of all relevant agencies.

Logistics Branch

Again, as one might expect from the name given this branch, it is responsible for the acquisition of needed equipment and supplies to support the IAP. The Logistics Branch is essentially the backbone of the response as the strategic initiatives are greatly dependent on having the necessary tools, supplies, equipment, and resources to implement the IAP. Reporting to this group may be functional groups such as the following.

  • The Supply Unit is responsible for ordering, receiving, storing, and processing all incident-related resources, personnel, and supplies.
  • The Ground Support Unit is responsible for maintaining primary tactical apparatus and vehicles, fuel supplies, provision of transportation, usage documentation of all ground equipment, and development of the incident traffic plan.
  • The Facilities Unit assembles, maintains, and, ultimately, demobilizes all facilities used to support incident operations.
  • The Communications Unit assembles and tests all communications equipment; operates the incident communications center; distributes, repairs, and recovers communications equipment assigned to incident personnel; and develops the incident communications plan for effective use of deployed communications equipment.
  • The Medical Unit is responsible for development of the incident medical plan, identifying procedures for managing medical emergencies, and planning for continuity of medical care, including vaccinations, vector control, occupational health, prophylaxis, and mental health services for incident personnel.
  • The Food Unit is responsible for supplying the food needs for the entire incident, including all remote locations (e.g., camps, staging areas), as well as food for personnel unable to leave tactical field assignments.

The basic ICS model identifying the IC and Command Staff is presented in Fig. 157.1, with an expanded operations multijurisdictional ICS model identifying the potential for build-out of managerial branches shown in Figure 157.2. The strength of the ICS is its expandability. Any incident, regardless of type, can be effectively managed by augmenting managerial and support positions, as required. Although many day-to-day operations are managed with one IC absorbing all previously discussed roles, the ability to expand the management structure as the incident grows in size and/or complexity, while using a uniform system, is critical to achieving a successful outcome.

FIGURE 157.1 The basic incident command system (ICS) model. (Developed by Donald Sessions.)


As previously mentioned, the main elements for managing an emergency or disaster begin with an analysis of the hazards that may affect a given area, the vulnerabilities that exist within that area, the frequency of occurrence of specific hazards, and the anticipated consequences of those hazards in the specific area.

Goals for Managing Disaster Response

The responsibility to manage any incident begins with defining pre-established goals that will lead to the successful handling of the emergency, resolution of consequences, and mitigation of the incident itself. The following basic goals outline the steps to surviving the first 72 hours of a disaster.

Establish Communication with Areas Affected

Communication with the EOC in the impacted area should occur within 1 hour. This includes the ability to speak with those overseeing emergency management in the impacted area, as well as being able to reach them physically. There may be times when, because of the level of damage and/or destruction of infrastructure, one is limited to verbal communication with those in the impacted area, and resources cannot get to those in need.

Secure the Area

Security in the impacted area must be such that the general safety of first responders and disaster workers can be reasonably ensured within the first 12 hours of the event. One of the most recent examples of situations that prevented emergency crews from deploying to target areas was seen associated with the response into some of the areas of New Orleans immediately after Hurricane Katrina. The need for establishing a secured presence also aids in calming surviving populations.

FIGURE 157.2 The expanded operations branch multijurisdictional incident command system (MICS) model. (Developed by Donald Sessions.)

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Feb 26, 2020 | Posted by in CRITICAL CARE | Comments Off on Disaster Response

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