A 3-Ringed Circus

Savvy ICs use relationships to delegate tasks at the extrication scene

Multitasking is a term we use to indicate increased efficiency, but it only has a positive connotation when you’re referring to simple tasks, like making a phone call while walking the dog. Emergency responders, however, are tasked with getting things done at emergency scenes, where every second and every action can be critical. No incident commander (IC) can possibly do it all, and that’s why we must shift the focus from multitasking to delegation. And nowhere is that more important than at the scene of an extrication.

We can all remember watching ICs lose their cool and get upset on scene. This usually happens when they’re pulled out of their comfort zone and tasked with trying to accomplish too much by themselves. Similarly, we’ve all heard the term “delegating responsibility.” It’s really not as bad as it sounds. The three-ring circus that is an extrication scene can overwhelm the best ICs. A smart IC, then, will get trusted people to work for and with them in each of these “rings” to accomplish the rescue.

Ring 1
Ring 1 is law enforcement. Years, months or weeks prior to the crash, the relationship should be made with the local and state law enforcement agencies. Fire chiefs and police chiefs must meet to discuss their department’s differing incident priorities.

Example: Fire departments usually don’t care about shutting down the road indefinitely. They might assume that police can easily redirect traffic to a secondary road. But police departments know that if you’re dealing with a crash on the interstate or the turnpike, it’s a different situation. How many times have you seen people too busy for their own good driving down the emergency lane just to become the cork in the bottleneck? Chain-reaction crashes are common 2–3 miles behind the crash. They’re usually more serious than the one that shut down the road, and they can create problems for emergency vehicles needing to access the original crash site.

Every couple of months, we read another account of a police department and a fire department getting into a disagreement because of apparatus placement at an extrication scene. We must always protect ourselves from the rubbernecking, cell-phone-talking, texting-while-driving public, whom we serve. The bottom line: We must establish a relationship with law enforcement ahead of time so we don’t end up in a “blue-vs.-red” spat that makes us all look bad and leaves us with bad feelings.

Ring 2
Ring 2 is EMS. If your fire department also provides your EMS, then you’re lucky—but that’s not the average department, according to national statistics. Most communities have an EMS system that’s volunteer or run by the local hospital or ambulance service. And so this is another group you must partner with ahead of time to ensure smooth operations on scene.

Most of what you discuss with law enforcement applies to EMS, with a couple of differences. Coordination doesn’t come easy. It starts with establishing agreements to provide a certain level of protection for those on scene and to operate within the National Incident Management System (NIMS), for incidents large and small.

Communication is paramount; it’s always the first thing we complain about after the call, but not the first thing we work on. Cross training will help both sides understand each other’s difficulties and also help facilitate the call. If all agencies know where key equipment is stored, they can help when personnel are busy with other tasks.

Ring 3
Ring 3 is the media. They’re coming to the party, so you better have a good seat for them. Let’s face it, they can make you look good or bad on the same call, depending on how the reporter wants to report the story, and how the cameraperson shoots the scene. Keeping them at a respectable distance but giving them accurate information that doesn’t violate the patients’ rights or dignity is a good way to do business.

A Final Word
When relationships are made before the call, it takes pressure and work off the IC, freeing them up to manage the scene. It ensures the patients will receive the best, fastest care, and the family members and the media will receive timely, informative, respectful updates on the operation. In short, delegation makes a bad rescue scene very manageable. And that’s the key to incident command.

Brad Havrilla is a 19-year veteran with Palm Beach County Fire Rescue, where he is currently assigned to the training division. Havrilla is an international extrication judge and the past vice-chairman of the Transportation Emergency Rescue Committee. He was the recipient of the Harvey Grant Excellence in Rescue Award in 2004.