Please explain the sign Medical Branch on the left front of E 44.
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EMS automatically assigned on all 10-75 and when the box is loaded up due to quality and quantity of call received by the Borough Communications Office. A Medical Branch is established at all Mass Casualty Incidents not just fire.
In general and upon arrival of EMS resources The "Medical Branch" is established to facilitate and manage EMS related activities and to be part of the "unified command structure" that in this situation involves a fire. The "Fire Branch" by its very nature would execute all duties required to mitigate the "fire" part of the event. If the specific needs of the event required one, a "Law Enforcement Branch" (think active shooter or something like that) would also be established and staffed by the NYPD. Each "Branch" of the operation would perform duties aligned to their specific discipline in order to bring the event to a successful conclusion.
That might sound cumbersome but it's actually very smooth and occurs many times a day in the city (not the active shooter part). Maybe not to the Level depicted in the photo that was referenced and admittedly occasionally a little extra coordination is required to get things where they need to be the system works as intended and those charged with its implementation and execution are top notch at doing so.
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That’s a great explanation. In theory every emergency in the country is run exactly as you laid it out. Some areas are better than other areas.
Question: In New York City, how is an MCI managed that is 100% a medical situation? Example: A kids’ camp serves 100 kids and they all come down with food poisoning. Many are suffering vomiting, diarrhea, dehydration and have to go to the hospital. In this case, I would assume FDNY CFR engines along with the battalion & perhaps division chiefs would be assigned. At that point who is in command? (I understand they work together) Does the ranking EMS chief take command and okays the Incident Action Plan? Does he or she decide to send some patients by ambulance and some by bus and which resources to request? Perhaps decides on staging area, traffic plan, treatment areas, etc, or does everything still go through the FD ranking Chief on scene?
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I have had it both ways. Some assignments its all EMS and some its overseen by a Fire Battalion, Deputy or Staff Chief. I believe the CFR-D manual still designates the Fire officer as the incident commander so on a normal EMS run where the Engine is operating with the Ambulance the Fire Officer is in command. In those situations my experience has been that the Fire Officer will defer all things EMS to the EMS members once the arrive. The Engine will work collaboratively with the EMS unit and the officer will oversee the general goings on. You will have CFR-D Engines involved in treatment and they may accompany the EMS unit to the hospital to assist in care when needed. With regard to staging we keep EMS and Fire separate. It just works better logistically and permits the Ambulances easier, faster access / egress. Mode of Transportation, Treatment areas (except in Hi Rise) and Patient destination is an EMS decision. In addition to a significant number of ambulances in their fleet the FDNY has large busses (MERV, MRTU and METU) that can treat and move large numbers of patients a one time.
In NYC the situation you described you would almost surely have a Chief Fire Officer in command using an EMS Officer / Chief as the subject matter expert allowing pretty much free a hand as it relates to EMS resource allocation, patient care and transportation. The big question would be what caused all the kids to get sick. Is it Haz Mat, Chem, Bio ?. The Fire I/C would be trying to get to the bottom of that also. The incident action plan on smaller events is usually a quick, comprehensive conversation between The Fire and EMS Chief Officers where a plan is formulated / tweaked , needs are addressed with control measures defined and implemented. Sometimes it's just a nod between the two as an acknowledgement that "you got it" because hands are full and you both just focus on your duties. On Larger protracted events regular briefings will occur at specific times and at really protracted events an actual written Incident Action Plan is produced by the FDNY Incident Management Team. The IMT brings very experienced high level planners and decision makers to the table and provides for a very methodical detailed approach and management environment that keeps mitigation activities supported and on track.
In the end the FDNY is one department and the Fire Officer / Chief responsible for the incident has to be kept well informed. The EMS Officer / Chief is expected to be able to stand on their own two feet and effectively run the Medical Branch with or without Fire Officer involvement. In a rapidly expanding fire incident with multiple victims (10-45's) there is little time for anything other than checking in at the command post and getting an assignment and getting to work. If you need resources outside of additional EMS units you have to speak up. Your request just might require a second or third alarm Fire response just to manage the medical needs of the incident. And let's not forget someone still has to put the fire out ! In NYC we are very lucky to have a resource rich environment. I have never asked for something and have been told no or we don't have anymore. They always just sent the help. While I was not involved in this incident, a good example of this was the twin parks fire apartment building fire at 333 East 181 Street in The Bronx on January 9, 2022. Bottom line, regardless of who's in charge keep the ego in check with the expectation being "know your job and do your job".
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HFN01
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JoinedJan 14, 2022Messages80FDNY's EMS units respond to fires and set up a medical branch for the incident. The flag I believe indicates where at the incident the medical branch resources are located in terms of their physical location. If you watch any of the SkylerFire or Majestrium videos of fire scenes, particularly multiple alarms, you will see an incident command board with the fire chiefs, aides, field comm, etc, then a separate command board and staging for the medical branch which will have EMS Chiefs / Captains and crews standing by to assist both civilians and FFs as needed. Others can probably add some detail to this, for example, I am not sure what level incident causes the medical branch resources to get assigned, whether they come on the 10-75 or if it depends on the details, etc, but you certainly see a medical branch at all the larger scenes.
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Elmerj
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JoinedMay 6, 2021Messages28EMS automatically assigned on all 10-75 and when the box is loaded up due to quality and quantity of call received by the Borough Communications Office. A Medical Branch is established at all Mass Casualty Incidents not just fire.
In general and upon arrival of EMS resources The "Medical Branch" is established to facilitate and manage EMS related activities and to be part of the "unified command structure" that in this situation involves a fire. The "Fire Branch" by its very nature would execute all duties required to mitigate the "fire" part of the event. If the specific needs of the event required one, a "Law Enforcement Branch" (think active shooter or something like that) would also be established and staffed by the NYPD. Each "Branch" of the operation would perform duties aligned to their specific discipline in order to bring the event to a successful conclusion.
That might sound cumbersome but it's actually very smooth and occurs many times a day in the city (not the active shooter part). Maybe not to the Level depicted in the photo that was referenced and admittedly occasionally a little extra coordination is required to get things where they need to be the system works as intended and those charged with its implementation and execution are top notch at doing so.
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Extra One & One
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JoinedMay 11, 2021Messages248That’s a great explanation. In theory every emergency in the country is run exactly as you laid it out. Some areas are better than other areas.
Question: In New York City, how is an MCI managed that is 100% a medical situation? Example: A kids’ camp serves 100 kids and they all come down with food poisoning. Many are suffering vomiting, diarrhea, dehydration and have to go to the hospital. In this case, I would assume FDNY CFR engines along with the battalion & perhaps division chiefs would be assigned. At that point who is in command? (I understand they work together) Does the ranking EMS chief take command and okays the Incident Action Plan? Does he or she decide to send some patients by ambulance and some by bus and which resources to request? Perhaps decides on staging area, traffic plan, treatment areas, etc, or does everything still go through the FD ranking Chief on scene?
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Elmerj
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JoinedMay 6, 2021Messages28I have had it both ways. Some assignments its all EMS and some its overseen by a Fire Battalion, Deputy or Staff Chief. I believe the CFR-D manual still designates the Fire officer as the incident commander so on a normal EMS run where the Engine is operating with the Ambulance the Fire Officer is in command. In those situations my experience has been that the Fire Officer will defer all things EMS to the EMS members once the arrive. The Engine will work collaboratively with the EMS unit and the officer will oversee the general goings on. You will have CFR-D Engines involved in treatment and they may accompany the EMS unit to the hospital to assist in care when needed. With regard to staging we keep EMS and Fire separate. It just works better logistically and permits the Ambulances easier, faster access / egress. Mode of Transportation, Treatment areas (except in Hi Rise) and Patient destination is an EMS decision. In addition to a significant number of ambulances in their fleet the FDNY has large busses (MERV, MRTU and METU) that can treat and move large numbers of patients a one time.
In NYC the situation you described you would almost surely have a Chief Fire Officer in command using an EMS Officer / Chief as the subject matter expert allowing pretty much free a hand as it relates to EMS resource allocation, patient care and transportation. The big question would be what caused all the kids to get sick. Is it Haz Mat, Chem, Bio ?. The Fire I/C would be trying to get to the bottom of that also. The incident action plan on smaller events is usually a quick, comprehensive conversation between The Fire and EMS Chief Officers where a plan is formulated / tweaked , needs are addressed with control measures defined and implemented. Sometimes it's just a nod between the two as an acknowledgement that "you got it" because hands are full and you both just focus on your duties. On Larger protracted events regular briefings will occur at specific times and at really protracted events an actual written Incident Action Plan is produced by the FDNY Incident Management Team. The IMT brings very experienced high level planners and decision makers to the table and provides for a very methodical detailed approach and management environment that keeps mitigation activities supported and on track.
In the end the FDNY is one department and the Fire Officer / Chief responsible for the incident has to be kept well informed. The EMS Officer / Chief is expected to be able to stand on their own two feet and effectively run the Medical Branch with or without Fire Officer involvement. In a rapidly expanding fire incident with multiple victims (10-45's) there is little time for anything other than checking in at the command post and getting an assignment and getting to work. If you need resources outside of additional EMS units you have to speak up. Your request just might require a second or third alarm Fire response just to manage the medical needs of the incident. And let's not forget someone still has to put the fire out ! In NYC we are very lucky to have a resource rich environment. I have never asked for something and have been told no or we don't have anymore. They always just sent the help. While I was not involved in this incident, a good example of this was the twin parks fire apartment building fire at 333 East 181 Street in The Bronx on January 9, 2022. Bottom line, regardless of who's in charge keep the ego in check with the expectation being "know your job and do your job".
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