EMS SUPPORTEMS SUPPORTtoto

HIGH-RISEHIGH-RISEFIREFIGHTING FIREFIGHTING OPERATIONSOPERATIONS

Wake County EMS SystemWake County EMS System

City of Raleigh Fire City of Raleigh Fire DepartmentDepartment

OUR SINGLE OVERRIDING OBJECTIVEOUR SINGLE OVERRIDING OBJECTIVE

Prompt,Prompt,Compassionate,Compassionate,

Clinically excellent Clinically excellent patient care……patient care……

…… …… whenever and whenever and wherever needed.wherever needed.

The Changing Raleigh The Changing Raleigh SkylineSkyline

One Meridian PlazaOne Meridian PlazaPhiladelphia, PA - February 23, 1991Philadelphia, PA - February 23, 1991

EMS High Rise Fire Support EMS High Rise Fire Support

ô Policy corresponds to RFD High Rise Policy corresponds to RFD High Rise Fire Operations policyFire Operations policy

ô Prepared in cooperation with RFDPrepared in cooperation with RFDô RFD principal point of contact – RFD principal point of contact –

Battalion Chief Rob JohnsonBattalion Chief Rob Johnsonô Policy effective September 1, 2008Policy effective September 1, 2008

What is a high-rise What is a high-rise building?building?

ô Portions are beyond the reach of the Portions are beyond the reach of the fire department’s aerial equipment.fire department’s aerial equipment.

ô Potential for stack effect, reverse Potential for stack effect, reverse stack effect, or stratification.stack effect, or stratification.

ô An unreasonable evacuation time An unreasonable evacuation time may be expected.may be expected.

ô Greater dependency on internal fire Greater dependency on internal fire protection systems will be required.protection systems will be required.

Strict ICS ComplianceStrict ICS Compliance

ô Safe, effective mitigation of the Safe, effective mitigation of the incident.incident.

ô Minimizing risk to responders.Minimizing risk to responders.ô Free-lancing and operation outside Free-lancing and operation outside

the ICS is strictly prohibited.the ICS is strictly prohibited.

DispatchDispatchRFD High-Rise Box AssignmentRFD High-Rise Box Assignment

EMS EMS First AlarmFirst Alarm Assignment Assignment

ô 2 District Chiefs2 District Chiefsô 3 EMS units3 EMS unitsô EMS T-1EMS T-1ô Notification of Command Staff and Notification of Command Staff and

Logistics OfficerLogistics Officer

DispatchDispatchRFD Working Fire in a High RFD Working Fire in a High

RiseRiseEMS EMS Second AlarmSecond Alarm Assignment Assignmentô 3 EMS units3 EMS unitsô Command Duty Officer (on-call chief)Command Duty Officer (on-call chief)ô EMS Command StaffEMS Command Staffô MD-1, MD-2MD-1, MD-2

INCIDENT COMMAND POSTINCIDENT COMMAND POSTGround Floor, LobbyGround Floor, Lobby

ô RFD Division Chief RFD Division Chief (Shift Commander) is the (Shift Commander) is the ICIC..

      

First Arriving EMS UnitFirst Arriving EMS Unit

ô Report to the Command PostReport to the Command Postô Full turnout gearFull turnout gearô ALS response compliment includingALS response compliment including

StretcherStretcher Stair chairStair chair Oxygen plus one spare bottleOxygen plus one spare bottle Primary responsibility is the welfare of Primary responsibility is the welfare of

firefighting personnel. This unit will firefighting personnel. This unit will become the become the Medical/Rehab GroupMedical/Rehab Group..

First Arriving District ChiefFirst Arriving District Chief

ô Reports to ICP in full turnouts, with Reports to ICP in full turnouts, with ALS carry gear and ICS gear ALS carry gear and ICS gear (command board, etc.).(command board, etc.).

ô Assumes position of Assumes position of Medical Medical Branch DirectorBranch Director at the ICP. at the ICP.

Second Arriving EMS UnitSecond Arriving EMS Unit

ô Report to the Command PostReport to the Command Postô Full turnout gearFull turnout gearô ALS response compliment includingALS response compliment including

StretcherStretcher Stair chairStair chair Oxygen plus one spare bottleOxygen plus one spare bottle

ô Primary responsibility is Primary responsibility is Lobby Triage Lobby Triage and Treatmentand Treatment (firefighters plus (firefighters plus civilians).civilians).

Second Arriving District Second Arriving District ChiefChief

ô Reports to ICP in full turnouts, with Reports to ICP in full turnouts, with ALS carry gear and ICS gear ALS carry gear and ICS gear (command board, etc.).(command board, etc.).

ô Prepares to serve as Prepares to serve as Medical/Rehab Medical/Rehab Group SupervisorGroup Supervisor..

Third-Arriving EMS UnitThird-Arriving EMS Unit

ô Leave unit at designated Leave unit at designated BASEBASE location locationô Bring full ALS response complimentBring full ALS response complimentô Report to ICP report in full turnout gear Report to ICP report in full turnout gear

to Medical Branch Directorto Medical Branch Director One serves as AIDE/SCRIBE or as directed.One serves as AIDE/SCRIBE or as directed. One serves as EMS LOGISTICS officer.One serves as EMS LOGISTICS officer.

• Assist with establishment of Lobby Assist with establishment of Lobby Triage/Treatment area.Triage/Treatment area.

• Assemble supplies as requested for movement Assemble supplies as requested for movement to MEDICAL/REHAB.to MEDICAL/REHAB.

EMS TRUCK-1EMS TRUCK-1

ô Position unit at designated Position unit at designated BASE BASE or in an or in an appropriate location outside of the collapse appropriate location outside of the collapse zone (at least ½ block away).zone (at least ½ block away).

ô Outside Medical Ops - prepare to establishOutside Medical Ops - prepare to establish TRIAGETRIAGE TREATMENTTREATMENT TRANSPORTATIONTRANSPORTATION

ô Establish pathwaysEstablish pathways ambulance ingress/egress routes AND ambulance ingress/egress routes AND patient movement pathway from lobby to TRIAGEpatient movement pathway from lobby to TRIAGE Use cones, barrier tape, etc.Use cones, barrier tape, etc.

Additional EMS UnitsAdditional EMS Units

ô Primary function is TRANSPORT unless Primary function is TRANSPORT unless otherwise directed.otherwise directed.

ô If assigned non-transport function, leave If assigned non-transport function, leave vehicle at BASE location.vehicle at BASE location.

ô Bring PPE, stretcher, patient care Bring PPE, stretcher, patient care equipment to Outside Medical group equipment to Outside Medical group location.location.

ô Await assignment. Outside Medical Group Await assignment. Outside Medical Group supervisor is responsible for outside supervisor is responsible for outside accountability.accountability.

Inside OperationsInside OperationsMEDICAL/REHAB GROUPMEDICAL/REHAB GROUP

Fire Floor

Lobby

Operations/Staging

Medical/Rehab

Command PostLobby Triage/Treatment

Medical/Rehab may be located with Operations

Medical/Rehab GroupMedical/Rehab Group(inside)(inside)

ô When/as directed by IC and Medical Branch When/as directed by IC and Medical Branch Director, move to an area near OPERATIONS – Director, move to an area near OPERATIONS – adjacent to or one floor below, as directed.adjacent to or one floor below, as directed.

ô Take all necessary equipment and supplies.Take all necessary equipment and supplies.ô Set up in locations that will not impede traffic Set up in locations that will not impede traffic

(not in stairwells).(not in stairwells).ô All movement up and down in the fire building is All movement up and down in the fire building is

strictly controlled by the IC.strictly controlled by the IC.ô EMS personnel will typically be escorted by fire EMS personnel will typically be escorted by fire

suppression personnel.suppression personnel.ô Accountability at both LOBBY and OPERATIONS Accountability at both LOBBY and OPERATIONS

(level 3 accountability)(level 3 accountability)

Medical/Rehab GroupMedical/Rehab Group

ô Conduct rehab operations per Conduct rehab operations per protocol.protocol.

ô Provide medical aid as needed.Provide medical aid as needed.ô Inform OPERATIONS if personnel Inform OPERATIONS if personnel

should not return to firefighting should not return to firefighting operations.operations.

ô Medical/Rehab Supervisor – maintain Medical/Rehab Supervisor – maintain communications with Medical Branch communications with Medical Branch Director.Director.

Outside OperationsOutside Operations

Outside Medical OperationsOutside Medical Operations

ô Receive casualties Receive casualties From inside fire buildingFrom inside fire building Walk-up self-evacuatedWalk-up self-evacuated

ô Perform Triage, Treatment, Perform Triage, Treatment, Transportation, Medical Transportation, Medical CommunicationsCommunications

ô Perform initial and periodic hospital Perform initial and periodic hospital notificationsnotifications

BASE

AmbulanceIngress

AmbulanceEgress

PatientMovementCorridor

TRUCK-1Outside Medical

Fire Building

Additional OperationsAdditional Operations

ô One EMS chief officer to RWECC to One EMS chief officer to RWECC to supervise county coverage and supervise county coverage and mutual aidmutual aid

ô Medical Branch Director augment Medical Branch Director augment groups as per the needs of the groups as per the needs of the situationsituation

ô Utilize physician assets at Outside Utilize physician assets at Outside MedicalMedical

COMMUNICATIONCOMMUNICATION

ô ICS positions require two radiosICS positions require two radios Medical Branch DirectorMedical Branch Director Medical/Rehab Group supervisorMedical/Rehab Group supervisor Lobby Triage supervisorLobby Triage supervisor Outside Medical Ops supervisorOutside Medical Ops supervisor Medical Communications coordinatorMedical Communications coordinator

ô Radio FrequenciesRadio Frequencies One to assigned TAC channel – on command, One to assigned TAC channel – on command,

switch to VEH RPTR channel per IC instructions.switch to VEH RPTR channel per IC instructions. Designated channel for EMS operationsDesignated channel for EMS operations Adapt as necessaryAdapt as necessary Monitor diligentlyMonitor diligently

Be Safe!Be Safe!REMEMBERREMEMBER

Everybody goes home Everybody goes home alive!alive!