Take COMMAND of all ambulance (including voluntary) assets; make key appointments
Wear the tabard to identify yourself as the SILVER AMBULANCE COMMANDER and remain near emergency services control vehicles as much as possible
Start a log of your actions, noting the time for each entry; use a scribe when available
SAFETY
Take responsibility for the safety of all health service personnel at scene, or delegate this to SAFETY OFFICER (action card 9)
COMMUNICATIONS
LIAISE REGULARLY with SILVER MEDICAL, POLICE and FIRE COMMANDERS
BRIEF all health service staff for duty on arrival
• Delegate briefing of doctors and nurses to SILVER MEDICAL COMMANDER
UPDATE ambulance GOLD regularly; pass information for hospitals through GOLD rather than direct to hospitals
Consider how you will communicate with fixed points at the scene (for example, CCS, ambulance parking, ambulance loading): radio, mobile phone, field telephone, runner may be used
Provide media brief when requested
• Ensure any media briefings at scene are with knowledge of SILVER POLICE COMMANDER AND SILVER AMBULANCE COMMANDER
ASSESSMENT
Identify areas for ambulance parking and CCS; establish an ambulance circuit (liaise with POLICE)
Identify helicopter landing site and ensure is marked
Assess developing hazards to health service staff
Assess need for additional ambulance and medical personnel and equipment resources; liaise with SILVER MEDICAL COMMANDER for number and type of medical resources
Assess need to rest or relieve staff at scene
TRIAGE
Ensure triage is being carried out at point of contact (primary triage) and at CCS (secondary triage); SECTORISE incident and appoint multiple primary triage officers; priorities for evacuation may differ from priorities for treatment at the scene
Determine the use of the EXPECTANT category, in conjunction with SILVER MEDICAL COMMANDER
TREATMENT
Establish a casualty clearing station; delegate running of CCS to doctor when available
Provide ambulance personnel to treat patients at point of first contact; bring forward medical personnel from CCS for specific tasks. Otherwise concentrate medical personnel at CCS
Aim to achieve best practice standards, but accept compromise when resources are overwhelmed
TRANSPORT
Select appropriate transport for individual patients; liaise with LOADING OFFICER and SILVER MEDICAL COMMANDER to identify needs
Wear the tabard to identify yourself as the BRONZE AMBULANCE COMMANDER
Start a log of your actions, noting the time for each entry; use a scribe when available
SAFETY
Safety of all personnel inside the BRONZE area is a responsibility of the BRONZE FIRE COMMANDER
Staff may be tagged on entering BRONZE area, when hazard is existent
COMMUNICATIONS
LIAISE REGULARLY with BRONZE MEDICAL, POLICE and FIRE COMMANDERS
BRIEF all health service staff sent forward for specific tasks
UPDATE SILVER AMBULANCE COMMANDER regularly
Consider how you will communicate with SILVER AMBULANCE COMMANDER, and other BRONZE COMMANDERS: face-to-face, radio, mobile phone, field telephone, runner may be used
ASSESSMENT
Assess developing hazards to health service staff and liaise with BRONZE FIRE COMMANDER
Assess need for additional ambulance and/or medical personnel and equipment resources; liaise with SILVER AMBULANCE COMMANDER for resources
Assess need to rest or relieve staff at scene
TRIAGE
Ensure triage is being carried out at point of contact (primary triage); SECTORISE incident and use multiple PRIMARY TRIAGE OFFICERS
Implement the use of the EXPECTANT category at the discretion of SILVER AMBULANCE COMMANDER
TREATMENT
Oversee CCS at discretion of SILVER AMBULANCE COMMANDER (not appropriate in all incidents); delegate running of CCS to doctor when available
Direct ambulance personnel to treat patients at point of first contact; request medical and nursing personnel to come forward from CCS for specific tasks
Aim to achieve best practice standards, but accept compromise when resources are overwhelmed
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