Emergency Support
Function
Mass Casualty
Office of Emergency Management
Version 3
November 2016
Mass Casualty ESF, Version 3.0 Nov 2016
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Table of Contents
1.0
Introduction ...........................................................................................................................3
1.1.
Purpose ......................................................................................................................................... 3
1.2.
Scope ............................................................................................................................................. 3
2.0
Assumptions ...........................................................................................................................4
3.0
Concept of Operations ............................................................................................................4
3.1.
General .......................................................................................................................................... 4
3.2.
Resources ...................................................................................................................................... 4
4.0
Roles and Responsibilities .......................................................................................................5
4.1.1 Primary / Lead Agency / Division .................................................................................................. 5
4.1.
1 Responsibilities - Toronto Paramedic Services Incident Site ..................................................... 5
4.2.
Joint Area Command ..................................................................................................................... 6
4.3.
Toronto Paramedic Services Divisional Operations Centre .......................................................... 6
5.0
Support Agencies / Divisions ...................................................................................................7
5.1.
Toronto Police Service (TPS) ......................................................................................................... 7
5.2.
Toronto Fire Services .................................................................................................................... 7
5.3.
Office of Emergency Management (OEM) .................................................................................... 8
6.0
Revision History – Mass Casualty ESF .......................................................................................9
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Emergency Support Function
Mass Casualty
Primary / Lead Agency / Division:
Toronto Paramedic Services
Supporting Divisions, Agencies
and Corporations (DACs):
Toronto Police Service
Toronto Fire Services
Office of Emergency Management
1.0 Introduction
A Mass Casualty Incident (MCI) is any event or emergency of varying duration where
the number of victims and/or patients exceeds the immediately available resources,
equipment or facilities.
Toronto Paramedic Services, Toronto Police Service (TPS), and Toronto Fire Services
(TFS) provide coordinated City assistance and resources to respond to mass casualty
needs during an emergency.
Assistance provided under this Emergency Support Function is directed by Toronto
Paramedic Services and is supported by several City divisions and external
organizations.
1.1. Purpose
Toronto Paramedic Services has been designated as the lead division for this Mass
Casualty Emergency Support Function (ESF) and in this capacity coordinates the
response with Toronto Police Service and Toronto Fire Services. The purpose of this
Emergency Support function is to describe the roles and practices in response to
incidents resulting in mass casualties. This ESF provides for the proper coordination of
resources during the response phase.
1.2. Scope
This ESF provides a general overview of Toronto Paramedic Services response to an
MCI and the coordination with other Divisions and allied agencies. The primary concern
of a mass casualty incident is to provide rapid care in a prioritized manner. The plan is
intended to be an all hazards approach to meet the needs of multiple or mass casualty
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incidents regardless of the cause, severity of injury or special circumstances involved in
the incident.
Mass Casualty Incidents that involve mass fatalities will be supported by the procedures
outlined in the Mass Fatality Emergency Support Function.
2.0 Assumptions
1. A Mass Casualty event has the potential to overwhelm local resources;
2. The impact of a MCI on Paramedic Services and allied agencies is variable and
requires a scaled response;
3. All agencies, divisions and allied agencies will operate during an incident under
the Incident Management System; and
4. The Incident Command structure will expand and contract as necessary based
on the size and complexity of the incident.
3.0
Concept of Operations
3.1. General
The concept of operations is intended to provide overall guidance to municipal staff in
areas of responsibility and response to a mass casualty incident.
3.2. Resources
Toronto Paramedic Services personnel includes:
•
Paramedics;
•
Emergency Medical Dispatchers;
•
Administrative and support staff including occupational health and safety and
crisis intervention specialists;
•
Management staff;
•
Emergency Support Units (includes Toronto Paramedic Services Bus);
•
Toronto Paramedic Services Superintendents;
•
Toronto Paramedic Services Operations Commanders; and
•
Tactical EMDs and dedicated radio channels.
Special Operations Team response participation, consultation, and technical assistance
includes:
•
Joint CBRNE (Chemical, Biological, Radiological, Nuclear, Explosive) Team;
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•
HUSAR (Heavy Urban Search and Rescue) Team;
•
ETF (Emergency Task Force);
•
Toronto Paramedic Services ESU (Emergency Support Unit); and
•
Marine Unit.
Incident response including all required command and general staff functions at multiple
levels of support and may include establishing or activating:
•
Joint Area Command;
•
Toronto Paramedic Services Division Operations Centre (DOC); and
•
Toronto Emergency Operations Centre (EOC).
4.0 Roles and Responsibilities
4.1. Primary / Lead Agency / Division
Toronto Paramedic Services
4.1. 1 Responsibilities - Toronto Paramedic Services Incident Site
Toronto Paramedic Services will establish Incident Site response in conjunction with
allied emergency services and other partners. The response priorities of Toronto
Paramedic Services are life safety and incident stabilization. Incident Site response
takes into account the severity of the incident, the availability of resources and the
amount of site management required.
In addition to the Incident Site Command, Toronto Paramedic Services may activate
some or all of the following functions at the emergency site:
•
Triage Officer
Ensures patients are triaged on-scene and designates casualties accordingly.
Patients are sorted into treatment areas based on the Simple Triage and Rapid
Treatment (START) protocols;
•
Treatment Officer
Ensures patients receive appropriate medical and first aid treatment for their
injuries, in priority of acuity, until transported from the Incident Site;
•
Staging Officer
Manages the air and ground ambulance/emergency vehicle staging areas; and
•
Transport Officer
Coordination of patient transport with the Central Ambulance Communication
Centre (CACC), based on patient acuity and specialized treatment requirement.
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The transport officer may also coordinate any helicopters or ambulances
responding from neighbouring services and the staging area.
4.2. Joint Area Command
Toronto Paramedic Services may establish Joint Area Command in conjunction with
allied emergency services and other partners. Toronto Paramedic Services Area
Command provides support and guidance to all Toronto Paramedic Services Incident
Sites.
4.3. Toronto Paramedic Services Divisional Operations Centre
Toronto Paramedic Services may activate the Toronto Paramedic Services Divisional
Operations Centre (DOC). The DOC provides site support and operational oversite to
maintain service delivery for unaffected citizens and visitors of the City of Toronto.
Coordination of support is managed using the IMS model, and will expand or contract in
accordance with the incident demands and impact.
Toronto Paramedic Services may coordinate with support agencies to assist in
providing health and medical services to citizens directly and indirectly affected by the
emergency. This also includes response personnel and others involved in the incident.
Toronto Paramedic Services may coordinate the delivery of health and medical services
with involved federal and provincial organizations including:
•
Local Health Integration Network (LHIN);
•
Community Care Access Centre (CCAC);
•
Ministry of Health and Long-Term Care (MOHLTC),
o
Emergency Health Services Branch (MOHLTC EHSB),
o
Emergency Management Branch (MOHLTC EMB);
•
Ontario Hospital Association (OHA);
•
Health Canada;
•
Coroner's Office; and
•
Others as required.
Toronto Paramedic Services may coordinate with the City's health and medical service
providers, including, Toronto Public Health, the Ontario Hospital Association, hospitals
and health care facilities (including medical and dental facilities)
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5.0 Support Agencies / Divisions
5.1. Toronto Police Service (TPS)
In a mass casualty response the Toronto Police Service will be responsible for all site
security and investigation including the following:
•
Establishing a security and credentialing system;
•
Setting up a security perimeter and establishing staffed entry and egress points;
•
Briefing and debriefing personnel when entering or leaving the staging area;
•
Removing unauthorized personnel from the scene;
•
Acquire, assemble and coordinate all necessary TPS personnel, the materials
required to support those personnel and the functions that will be required of
them;
•
Provide advice and up to date information to the Incident Commander regarding
Toronto Police Services concerns, identifications or requirements of personnel;
•
Apply special skills of officers within the identification processing group where
required during the investigation; and
•
Assist Toronto Paramedic Services as required and/or requested.
5.2. Toronto Fire Services
Toronto Fire Services (TFS) is dedicated to protecting life, property and the environment
from the effects of fires, illness, accidents, natural disasters and other hazards. They
are committed to enhancing fire safety and raising community awareness through
education and involvement. In a mass casualty response Toronto Fire Services is
responsible for:
•
Ensuring the incident site is safe from hazards, both environmental and
structural, for emergency service personnel to enter;
•
Acquire, assemble and coordinate all necessary TFS personnel, the materials
required to support those personnel and the functions that will be required of
them;
•
Provide advice and up to date information to the Incident Commander regarding
TFS concerns or requirements of personnel;
•
Coordinating triage and staging with Toronto Paramedic Services; and
•
Assist Toronto Paramedic Services as required and/or requested.
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5.3. Office of Emergency Management (OEM)
The role of the Office of Emergency Management (OEM) is to strengthen the City's
ability to prepare, respond and recover from major emergencies. The OEM is
responsible for coordinating preparedness, mitigation, response and recovery activities
for any major emergency or disaster (manmade or natural) affecting the City of Toronto.
This is achieved through:
•
Maintaining the City's Emergency Plan;
•
Acting as curator of this Mass Fatality Emergency Support Function;
•
Ensuring that this ESF complies with the City's Emergency Plan and all other
Emergency Support Functions (ESFs), Risk Specific Plans (RSPs) and other relevant
City of Toronto, Provincial and Federal emergency management legislation;
•
Ensuring Emergency Operations Centre readiness;
•
Supporting implementation of the City Incident Management System at both site and
Emergency Operations Centre levels;
•
Conducting Training;
•
Developing a multi-year comprehensive exercise program;
•
Conducting a Hazard Identification and Risk Assessment (HIRA);
•
Delivering Public Education and Outreach; and
•
Assisting Toronto Paramedic Services when updating this ESF based on the City of
Toronto Emergency Plan, emergency management training, exercises and policies.
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6.0 Revision History – Mass Casualty ESF
Revision Name of Contributor
Number
Summary Of Changes
Revision Date
1.0
I. Attard (Toronto
Paramedic Services),
M. Phair (TPS), J.
Smysnuik (OEM), and
M. Noormahamud
(TFS)
•
Complete update of the
document with input
from OEM, TPS, and
TFS
April 2013
2.0
J Smysnuik (OEM)
•
Incorporate change from November 2014
EMS to Toronto
Paramedic Services
Adam Thurston
(Toronto Paramedic
Services)
4.0
Loretta Chandler (OEM) •
Brad Eyre (OEM)
Jennifer Smysnuik
(OEM)
•
Dawn Ainsworth
(Toronto Paramedic
•
Services)
•
5.0
•
6.0
•
3.0
Mass Casualty ESF, Version 3.0 Nov 2016
Significant update to this October 2016
ESF
Approved by EMWG
Nov 28, 2016
Posted to the Website
Nov 30, 2016
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