Author Archives: Dulcie Long

MCICS-100: The First Five Minutes

MCICS-100 was held May 24 and 25 at the new St. Anthony Hospital, Pre-hospital Services building, in Lakewood.  Unlike many courses, both days were very busy with instructor presentations and hands-on exercises.  The course was presented by the Operational Consulting Group comprised of Robert Marlin, John Putt, Matt Swindon and Demetri Zannis, all of whom are paramedics.  It was sponsored by COTrain.

This course was extremely valuable in teaching the theoretical and hands-on skills necessary for responding to a mass casualty incident.  What constitutes a mass casualty incident, you ask?  It’s any incident involving more victims than emergency responders can easily manage.  One ‘trigger point’ mentioned was an incident requiring three or more ambulances for transport, though in a rural area even one ambulance may take a long time to arrive.  It’s necessary to honestly assess the available resource during an incident and it’s generally wise to opt for the mass casualty ICS structure rather than assuming that resources will be freely available.

One concept that is gradually filtering through the law enforcement, firefighter and EMS communities is that the real ‘first responders’ are often the lay people in the immediate area of the incident.  While the Medical Response Corps was present near the finish line of the Boston Marathon, many ‘ordinary’ folks were the ones applying tourniquets to the limbs of victims, saving their lives.  For this reason, this type of training is invaluable not only for the ‘professionals’, but almost anyone who has the interest, desire and time to invest in the course.


Mass Casualty Incident Command System 10-4 exercise. Photo by J Scott.

The classroom portion of the course was both theory and examples of past mass casualty events with an analysis of what went right and what went wrong.  Saturday’s 10-4 exercise involved moving four patients onto backboards and moving them from one area to another.  My team consisted of five women and we worked exceptionally well with one another.  We took advantage of being the last team to perform the 10-4 exercise and so earned the very best time of three minutes flat.  We were thereafter dubbed the “Broad-Squad”.

The final exercise on Sunday was extremely demanding and difficult.  We each had to take on an MCICS role and I was elected to Transportation Chief.  All I can say is that communicating with a dispatcher via radio with chaos all around me was very challenging.  I was very fortunate that my partner/scribe and I had worked together on Saturday, so we communicated very well, which made the patient flow smoother.  Still, there were times that I had to close my eyes to concentrate exclusively on the radio transmissions in order to keep focused.  In the early stages of the final exercise, Robert had to yell at me several times to keep me from surging forward too quickly or getting distracted by a minor detail.  He also had to coach me on the proper radio ‘lingo’ for dispatch.

I can’t emphasize enough the value of this course.  MCICS-100 is also a prerequisite for other MCICS courses, such as MCICS-400, Hospital Evacuation and Surge Capacity (Operational Track) and MCICS-200 Active Shooter.  Learning from the gentlemen of the Operational Consulting Group was a very rewarding experience and helped me to develop that ‘muscle memory’ that we often talk about.

ICS-300: Intermediate ICS for Expanding Incidents

Incident Command System

Incident Command System – stock photo

I think we all know how dry Incident Command System courses can be, yet we complete them because they are important and necessary.  When I enrolled in ICS-300 through the Colorado Department of Public Safety, I expected more of the same.  However, instructor Jim Krugman led our class through interesting discussions and exercises and provided an enriching experience.  Mr. Krugman is the Training and Exercise Coordinator for the Denver Office of Emergency Management and Homeland Security.  He previously spent 36 years with the USDA Forest Service, largely with Fire Operations.  This course was conducted over two days, May 11 and 12, at Front Range Airport.

Attendees were assigned to one of five teams, each with a similar mix of genders, agencies and backgrounds.  This proved invaluable when working through the tabletop exercises as each team member brought a different perspective and set of priorities to the exercise.  I was assigned to team five and when we began the first tabletop exercise, one gentleman was very insistent that the railroad be given a spot in the incident command structure.  This caused Mr. Krugman some frustration and none of us knew until the second day (when introductions were done) that my fellow team member was an employee of one of the railroads.  The resulting discussion was lively and extremely informative, however.   We learned that railroads take their right-of-ways very seriously and, strictly speaking, consider themselves the only valid authority for any event that occurs in their jurisdiction.  The takeaway from this discussion is that any incident that involves or is in proximity to a railway will need to consider the railroad authority in some capacity.  For example, Incident Command would need the cooperation of the railroad to move railcars out of danger during a fire.

Saturday, we reviewed ICS fundamentals, Unified Command and Assessment of an incident or event and establishing objectives.  The lectures were broken up with group exercises and presentation of each team’s assessment or approach to the incident.  While some of the assessments were quite similar there were others that were creative and unique.  Generally speaking, every team provided valuable insight into some of the challenges and weaknesses in others.  By the end of the course on Sunday, it was clear that many of the teams incorporated some ideas presented by other teams.  This type of learning experience is extremely valuable because it reminds all of us that none of us has all the answers.  It is through collaboration and careful listening that the best solutions of all are found.

I also highly recommend Jim Krugman as an instructor.  His approach to ICS course material keeps it fresh and interesting for his students.  His many years of experience in the field also enable him to provide practical examples throughout the course.