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ICED: Incident Command Emergency Department: Development of a Simplified Incident Command System for Initial Emergency Department Management in the Case of Mass Casualty Incidnents.Jeffrey Michael Franc Manuela Verde ObjectivesMass Casualty incident often place increased demand on Emergency Medical Resources. Initially, the first encounter with the medical system for many patients will be the Emergency Department (ED). Although Emergency Departments are usually well equiped to deal with severly injured patients, many departments are unable to cope with large numbers of patients simultaneously. Often, EDs lack the ability to proviced a coordinated response. Incident Command System (ICS) is often used by many Emergency Response Systems for organization in large events. Although it is likely that ICS would be helpful for use in the Emergency Department, no simple system has been designed to allow immediate use of ICS in the ED with minimal training. The Incident Command Emergency Department (ICED) package allows EDs to quickly build an organized ICS structure with minimal training. MethodsExisting document from Incident Command System (ICS), Hospital Emergency Incident Command System (HEICS) and Hospital Incident Command (HICS) were reviewed. In addition, literature review using Medline attempted to discover any previous ED specific implementations of ICS. ResultsExisting programs were found to be inadequate for ED use. ICS documents are far to generalized, and require a very good knowledge of ICS implementation to be useful. Conversely, HEICS was found to be more hospital specific, and provided the advantage of specific job action sheets for use in the hospital. However, the job action sheets and organizational structure does not extend fully down to the resource level, and as such, can be difficult to use for those unfamiliar with ICS. Furthermore, the HEICS program has abandoned in favor of HICS. However, HICS is distinctly oriented to hospital administration, and all duties normally performed are condensed into a single supervisory position in the organization. Literature review failed to report any other published ICS programs for ED use. The ICED program was created by the authors as a simple alternative and follows precisely ICS rules and regulations. The program is oriented only to ED care, however, the command position easily fits into existing hospital command structure. The System contains only thirteen positions in the structure, and only five forms, many times smaller than previous hospital based ICS programs. ConclusionsThe Incident Command Emergency Department (ICED) program represents a reasonable alternative to more complex Incident Command System based structures. With only thirteen job positions and five forms, the ICED system can be easily and quickly implemented for Emergency Deparmtent mass casualty incidents |
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