Command Structure?

[Free-B-EMT]

This question is for the volunteers out there.

I was a volunteer firefighter for 20 years before moving to a new town where I joined the volunteer first aid squad. Since the fire dept I belonged to was very much into command and control at the scene, I was very surprised to find out that my new squad has little to no command structure. The bylaws state that the "Duty Crew" is in charge of the scene. I have questioned how this is supposed to work at a larger incident when the Duty Crew would be handling patient care. Who would be making decisions on what is needed as far as additional equipment, manpower, etc? I have yet to get a definitive answer and the overall attitude seems to be "it's never been a problem before so why worry about it?"

My question is this. Is this common among volunteer squads? Do any volunteer squads out there have a solid command structure that can be put in place when needed? How about MCI preplans, mutual aid agreements with other towns or updated lists of available equipment in the area? Any comments would be appreciated. I'm just trying to find out if I'm alone in being concerned about this.

 

[Vizior]

Do you have officers that will respond to a larger incident, something such as a car wreck, bus wreck, toxic gas leak, etc? If so, it is the first unit due's responsibility to begin triage and make the appropriate call for further resources. You can't get sucked into the mind set that when you get on scene, to find a patient to start treating.

It all goes back to the same old scene safety, BSI, and then what further resources are needed.

 

[Free-B-EMT]

No we do not have officers that respond to any incident, except if they happen to be on duty at that time. The fact that they are an officer gives them no more authority than any other member. The officer positions on my squad are more of an administrative position than anything else.

 

[Vizior]

Well, then when you arrive on-scene you need to establish command yourself. The first due unit should establish incident command in that case, and begin triage.

Does your agency do anything with NIMS?

 

[Clibby]

I work for a volunteer squad and we have a solid command structure. The fire department takes command at mvcs and mcis; but we take command before they arrive, even if police are on scene. We usually have two trucks out, so the medic, if we have two, or the senior basic usually triage so the medics and other basics can work. (We usually have either 2 medics or 1 medic and 2 basics on an ALS truck) We also have mutual aid agreements with the surrounding 6 or 7 communities both in state and out of state. I guess it just depends on your department and where your located.

 

[Free-B-EMT]

Vizior

I agree with you. The first due unit should take IC until further help arrives. All of our members have been required to take ICS 100 & 300 so they have a basic concept of what the incident management is all about. The problem seems to be that, since we have no real line officers, no one seems to think any of it is truely important. They don't picture themseleves as ever having to be the one calling the shots. My biggest fear is that at a larger seen the first due rig will call for help then grab the nearest patient and go to work with no thought of organizing the rest of the response.

 

[Free-B-EMT]

Clibby,

Sounds like a nice set up. I'm in NJ where as volunteers we are BLS only. ALS is run out of the local hospitals by request from our dispatchers to a central ALS dispatch.
As far as on scene command, my squad does not even have as much as a crew cheif for each crew out there. No one is in charge at any scene as far as EMS is concerned. The fire dept. will take overall command if they are dispatched but they are hands off as far as EMS goes.

 

[BossyCow]

We have a rural volly squad. We run into the same issue of never knowing who's going to be available for any given call. But we do have a very solid command structure.

First on scene establishes command. They are to give a short report to all incoming units. As responders arrive, if a more senior member arrives, command is transferred to that member.

It is extremely important to follow a command structure to avoid the cluster :censored: situation. I think its very important in the small vollie departments because of the lack of experience. MVAs are one of the most dangerous scenes for Emergency workers. Having someone in command that does an over-all view of the scene is crucial to personnel safety.