There was a bus to bus collision along the highway from Himamaylan City going

to Kabankalan City involving more or less 100 victims. You are to set-up an Incident
Command System in the vicinity.

With your knowledge and understanding of the Mass Casualty Incidents and
Mass Casualty Management. You are to organize an Incident Command System
bearing in mind the specific duties and responsibilities of each individual in the ICS
hierarchy, personnel/responders, materials, equipment and transportation needed.
Establish Operation Center and unified referral system involving local government units
and inter-local health zones.

Triage and Categorize patients accordingly. Specify cases.

ICS:
Command Staff- The staff who report directly to the Incident Commander, including the
Public Information Officer, Safety Officer, Liaison Officer, and other positions as required.

Incident commander-Head of the incident command system that is in control of the

entire response operations. Assumption of command to next higher capable personnel will
commence anytime during the incident. Higher capable personnel can either assume as
Incident Commander or may serve as Responsible Person as the need arises.

Liaison Officer- is a conduit of information and assistance between incident personnel

and organizations that are assisting or cooperating with the response.

Public information officer (PIO) - is the individual responsible for communicating with
the public, media, and/or coordinating with other agencies, as necessary, with incident related
information requirements.

Under PIO:
Safety Officer - is an appointed safety adviser who promotes safety onboard by carrying
out inspections, identifying hazards and potential hazards to health, safety and the environment
subject to the agreement of the Master.

Operations- Establishes strategy (Approach Methodology, etc.) and Specific Tactics

(Actions) to accomplish the goals and objectives set by the Command. Coordinates and
executes strategy and tactics to achieve response objectives.
● Branch: The organizational level having functional and/or geographical responsibility for
major aspects of incident operations. A Branch is organizationally situated between the
Section Chief and the Division or Group in the Operations Section, and between the
Section and Units in the Logistics Section. Branches are identified by the use of Roman
numerals or by functional area.
Under BRANCHES
● Division: The organizational level having responsibility for operations within a defined
geographic area. The Division level is organizationally between the Strike Team and the
Branch.
● Group: An organizational subdivision established to divide the incident management
structure into functional areas of operation. Groups are located between Branches
(when activated) and resources (personnel, equipment, teams, supplies, and facilities) in
the Operations Section.
Under DIVISIONS:
● Task Force: Any combination of resources assembled to support a specific mission or
operational need. A Task Force will contain resources of different kinds and types, All
resource elements within a Task Force must have common communications and a
designated leader.
● Strike Team/ Resource Team: A set number of resources of the same kind and type
that have an established minimum number of personnel, common communications, and
a designated leader. In the law enforcement community, Strike Teams are sometimes
referred to as Resource Teams.
● Single Resource: An individual, a piece of equipment and its personnel complement, or
a crew/team of individuals with an identified work supervisor that can be used on an
incident.

Logistics- Supports command and operations in their use of personnel, supplies, and
equipment. Performs technical activities required to maintain the function of operational facilities
and processes
Responsibilities:
● Facilities.
● Transportation.
● Communications.
● Supplies.
● Equipment maintenance and fueling.
● Food services (for responders).
● Medical services (for responders).
● All off-incident resources.

Under Logistics Section:

1. Service Branch- responsible for the management of all service activities at the incident,
including food, communications, and medical support.
● Communications Unit- Plans for and supports effective use of incident communications
equipment. Ensures communications systems are installed and tested. Ensures portable
radios are distributed per IAP and the Incident Radio Communications Plan. Recovers
unused equipment
● Medical Unit- is responsible for ensuring occupational health of all incident personnel,
including planning for and coordinating incident emergency response.
 ● Food Unit- is responsible for supplying the food needs for the entire incident, including
all remote locations, such as Camps and Staging Areas.

2. Support Branch- A Branch within the Logistics Section responsible for providing
personnel, equipment, and supplies to support incident operations.
● Supply Unit- Functional Unit within the Support Branch of the Logistics Section
responsible for ordering equipment and supplies required for incident operations.
● Facilities Unit- provides incident personnel with incident facilities such as a base, camp,
and the Incident Command Post, as well as sleeping and sanitation facilities.
● Ground Support Unit- Provides and maintains transportation for personnel, supplies,
equipment, and food. Develops and implements the Traffic Plan. Arranges and supports
fueling, repair, and maintenance of ground resources. Maintains records and inventory of
support and transportation vehicles. Maintains incident roads.

Planning - Coordinates support activities for incident planning as well as contingency,

long-range. and demobilization planning. Supports Command and Operations in processing
incident information. Coordinates information activities across the response system.
Collects situation and resources status information, evaluates it, and processes the
information for use in developing action plans. Dissemination of information can be in the form
of the IAP, in formal briefings, or through map and status board displays.
Responsibilities:
● Collect and manage all incident-relevant operational data.
● Supervise preparation of the IAP.
● Provide input to the IC and Operations in preparing the IAP.
● Incorporate Traffic, Medical, and Communications Plans and other supporting
materials into the IAP.
● Conduct and facilitate planning meetings.
● Reassign personnel within the ICS organization.
● Compile and display incident status information.
● Establish information requirements and reporting schedules for units (e.g.,
Resources and Situation Units).
● Determine need for specialized resources.
● Assemble and disassemble Task Forces and Strike Teams (or law enforcement
Resource Teams) not assigned to Operations.
● Establish specialized data collection systems as necessary (e.g., weather).
● Assemble information on alternative strategies.
● Provide periodic predictions on incident potential.
● Report significant changes in incident status.
● Oversee preparation of the Demobilization Plan.

Under Planning Section:

● Resource Unit- Responsible for all check-in activity and for maintaining the status of all
personnel and equipment resources assigned to the incident.
 ● Demobilization Unit- On large, complex incidents, assists in ensuring that an orderly,
safe, and cost-effective movement of personnel is made when they are no longer
required at the incident.
● Situation Unit- Collects and processes information on the current situation, prepares
situation displays and situation summaries, and develops maps and projections.
● Documentation Unit- Prepares the Incident Action Plan, maintains all incident-related
documentation, and provides duplication services.

Admin/Finance - Supports Command and Operations with administrative issues as well

as tracking and process- ing incident expenses. Includes such issues as licensure
requirements, regulatory compliance, and financial accounting
Responsibilities:
● Manage all financial aspects of an incident.
● Provide financial and cost analysis information as requested.
● Ensure compensation and claims functions are being addressed relative to the
incident.
● Gather pertinent information from briefings with responsible agencies.
● Develop an operating plan for the Finance/Administration Section and fill Section
supply and support needs.
● Determine the need to set up and operate an incident commissary.
● Meet with assisting and cooperating agency representatives as needed.
● Maintain daily contact with agency(s) headquarters on finance matters.
● Ensure that personnel time records are completed accurately and transmitted to
home agencies.
● Ensure that all obligation documents initiated at the incident are properly
prepared and completed.
● Brief agency administrative personnel on all incident-related financial issues
needing attention or followup.
● Provide input to the IAP.

Under Finance Section:

● Time Unit- Track, record and report all on-duty time for personnel working during the
Emergency. Ensure that personnel time records, travel expense claims and other forms
are prepared and submitted to budget and payroll.
● Cost Unit- Responsible for collecting cost information, performing cost-effectiveness
analyzes and providing cost estimates and cost savings recommendations.
● Compensation Claims Unit- Oversee the investigation of injuries and property/
equipment damage claims arising out of the emergency. Complete all forms required by
the worker's compensation program. Maintain a file of injuries and illnesses associated
with the emergency which may include results of an investigation.
● Procurement Unit- Coordinate vendor contracts not previously addressed by existing
approved vendor lists. Coordinate with the Supply Unit on all matters involving the need
to exceed established purchase order limits.
IDENTIFIED PATIENTS:

Green: (20)
Patient 1: A 7 year-old female, crying with an apparent wound on her left hand.

Patient 2: A 30 year-old female, complaining of pain due to a wound on her arm, walking at the
scene.

Patient 3: A 28 year old male, complaining of neck pain walking at the scene, with a respiratory
rate of 23, pulse of 95, and an intact mental status.

Patient 4: A 23 year old male, conscious and responsive and has skin abrasions on arms and
legs.

Patient 5: A 35 year old factory worker has 3 cm laceration on right palm cut with a utility
knife, vital signs normal (guys, need ta basi mag base sa scenario nga bus to bus accident
heheh)

Patient 6: A 28 year old found ambulatory on scene trying to help driver out of the car

Patient 7: A 9 year old boy, crying, able to walk and has minor abrasions on left arm

Patient 8: a 3 year old child, crying, now found wandering around the area, calling out parent’s
names

Patient 9: a 33 year old male, able to walk with minor lacerations on right arm and leg due to
small glass shards.

Patient 10: A 17-year old girl, walks over to you and has an obvious broken arm. Respirations
are 22, Pulse is 124 (Radial), she is awake, alert, and crying

Patient 11: a 17 year old female, ambulatory by hopping on left foot due to a twisted ankle on
right foot, complaining of pain on right leg.

Patient 12: 22 years female old with abdominal tenderness and minor penetrating trauma,
ambulating, RR 24, Strong radial pulse

Patient 13: An 8 years old male, screaming due to minor lacerations, blood in his ears, RR 30,
moving all extremities

Patient 14: 12 years old female with minor lacs, crying, ambulatory, RR 24

Patient 15: 18 year old male conscious with dislocated left ankle.
Patient 16: A 2 year old male, standing at the side and crying due to minor laceration on his left
ear.

Patient 17: A 25 year old female, screaming for help with minor abrasions on her left upper
extremities.

Patient 18: 23 year old male, sitting on the side of the sidewalk with a minor cut on left hand.

Patient 19: A 42 year old female, helping her son out of the bus with minor laceration on her
face and right arm.

Patient 20: A 7 year old male crying with abrasions in the left arm.

Yellow : (20)
Patient 1: A 15 year old male passenger with a large bleeding laceration on his right arm.

Patient 2: A 17 year old male, complaining of left leg pain with obvious deformity of the leg with
tibia and fibula exposed.

Patient 3: A 33 year old female with bruising on the abdomen, walking at the scene with
complaints of abdominal pain.

Patient 4: A 24 year old male with penetrating trauma on the arm, conscious, claiming of pain,
and facial grimace noted.

Patient 5: 30 year old male states he can’t move or feel his legs. Respirations are 26, Pulse is
110 (Radial), He is awake and oriented

Patient 6: 48 year old male, unable to ambulate, complaints of pain around the abdomen and
when pressed moans loudly, breathing is normal but respirations are 24 cycles per minute.

Patient 7: 44 year old female, unable to ambulate, normal breathing with respiration of 24 per
min, normal circulation < 2s, normal mental status even with headache

Patient 8: 22 year old female, large bleeding laceration on right thigh respiratory rate of 21,
pulse rate of 68

Patient 9 : 33 year old male with fractured tibia, pulse rate is 79 and respiration of 26

Patient 10: Crying 18 year old female, fractured left leg with respiration of 23 and heart rate of
89.
Patient 11: 44 year old male, mental status is intact, unable to walk with respiratory rate of 26
and capillary refill of 1 sec, cardiac rate of 74 bpm.
Patient 12: 35 year old male with bruising on the abdomen, heart rate of 110, respiratory rate of
26.
Patient 13: A 78 year old male, unable to ambulate, dislocated right ankle with pulse rate of 80

Patient 14: 65 year old female with chest pains starting shortly after the accident. Normal
breathing, but respirations are 28 and she feel slightly short of breath Normal circulation with
cap refill <2sec. But clammy. Normal mental status

Patient 15: A 30 year old female, hysterical with bruised right forearm, small laceration on her
right knee, and dislocated left ankle, unable to walk, RR: 25, BP: 120/80 and Pulse Rate: 85

Patient 16: A 25 year old male,unable to walk or move because his arms and legs were fallen
by bagages and boxes that were heavy, normal breathing but respriations are 24 and is
coughing.

Patient 17 : 23 year old female, screaming with small laceration on forehead, pulse rate is: 24,
Heart rate is 110 bpm.

Patient 18: Unable to walk due to dislocated left knee, normal breathing and respirations are
28, normal circulation with cap refill of <2s, normal mental status, is able to follow command but
crying and cannot exactly tell where it is hurting

Patient 19: Male, 38 years old. Unable to ambulate or move because is in shock, normal
breathing, no complaints but he has laceration on his forearm.

Patient 20: Female, 15 years old, unable to ambulate due to her left leg trapped by 2 heavy
boxes, normal breathing and mental status

Red: (16)
Patient 1: A 30 year old male, claiming of severe back pain, weakness and with tingling
sensation felt on both legs.

Patient 2: A 50 year old male, complaining of chest pain with a respiratory rate of 40 cpm, pulse
rate of 120, and an intact mental status.

Patient 3 : 45 years old, conscious with large hematoma on the chest area, Respiratory rate is
36 cpm and pulse rate of 120 bpm.

Patient 4: 68 year old female, complains of severe substernal chest pain, radiating up to
anterior neck, shortness of breath, increased work of breathing, RR 30, HR 86, BP 120/90
mmhg, O2 Sat 91% and Pain Scale 9/10

Patient 5: 25 year old male, complaining of abdominal pain, RR: 37 cpm and pulse rate of 125
bpm, confuse with blood pressure of 100/80
Patient 6: 30 year old male, with large laceration across his left arm with profuse bleeding.

Patient 7: 10 year old girl, complaining of severe pain on her right thigh which is pumping bright
red blood everywhere. Breathing and respiration are 24/min. No palpable pulse on her left thigh
and is cool to touch.

Patient 8: Patient has an open head wound, bleeding controlled. Respirations are 16, Pulse is
88 (Radial), He is unconscious.

Patient 9: unidentified female, with HR of 150bpm, RR is 37 and a bp of 90/70 complaining of

chest pain.

Patient 10: A boy cannot catch a breath while standing up, breathing is irregular, cannot stop
coughing and nose and mouth are covered in snoot

Patient 11: A 45 year old asthmatic, unable to walk and breathing is fast due to panic, 40 bpm,
complaints of tightness in throat

Patient 12: 28 year old male with chest pain, SOB, no trauma noted, RR 34, shallow, weak
radial pulse

Patient 13: 56 year old female, arterial bleed from leg, responsive to pain, RR 34, no radial
pulse, carotid 130/min

Patient 14: 60 yo male complaining of chest pain, Respirations: 40, Pulse: 190, Mental Status:
Intact

Patient 15: A 50 year old male, tachypneic, confused, increased pulse rate with GCS scale of
9/15, presence of multiple right digitals fracture.

Patient 16: 25 year old pregnant woman, with facial grimace and guarding the abdomen, she
has multiple lacerations on the face, RR is 8 cpm and Heart rate is 145 bpm.

Black: (20)
Patient 1. 45 year old bus driver with obvious head injury, brain matter protruding with clear
liquid coming out from ears

Patient 2: A 40 year-old male who is unresponsive with bleeding from his ears, absence of
respiration and impalpable central pulse

Patient 3: a 25 year old female with head injury, unresponsive, and bleeding coming from her
nose.
Patient 4: 32 year old male, unresponsive with penetrating trauma on abdominal, pupils are
dilated and nonreactive.

Patient 5 : 5 year old female, unresponsive with prominent skull fractures, gray matter found
around the surrounding area

Patient 6: A 69 year old male, complains of severe chest pain and shortness of breath, vital
signs absent

Patient 7: a 10 year old boy, with severe bleeding in the head, unresponsive with eyes bulging
on his face noted.

Patient 8: a 65 year old female, with severe bleeding. Respiratory rate- 9 cpm, pulse rate- 130
bpm, mental status- unresponsive

Patient 9: A 4 year old, unable to walk and Is unresponsive, canno breath, no return of
respiration after airway opening, after 15s of CPR still no respiration return

Patient 10: 21 year old female, unresponsive, unable to walk, no spontaneous respirations, just
the sound of moaning once in a while and ceases ( apnea), no return of spontaneous respiration
of airway opening.

Patient 11: 54 year old female, gurgles but can’t maintain an open airway and is not breathing.
Weak Carotid Pulse and is unresponsive

Patient 12: 6 years old child, cyanotic from nipple line up, apneic

Patient 13: A 22 year old male , unresponsive bleeding from the ears.

Patient 14: 27 year old male, detached right leg, profuse bleeding, no pulse,no Respiration.

Patient 15: A 4 year old girl, penetrating steel tube through the neck, no pulse, no breathing,
skin pallor is evident.

Patient 16: Male, 21 year old, open wound on the abdomen, dilated pupil and nonreactive,
pallor, cold and clammy skin, no pulse no breathing

Patient 17: 44 year old male with multiple fractures and lacerations, leaking blood from the
ears, no pulse, no breathing.

Patient 18: 68 year old female, unresponsive, pale, piercing glass shards on the face, apneic
and with cold and clammy skin.
Patient 19: 12 year old boy, detached left arm, unresponsive, pale, cold and clammy skin,
nonreactive and dilated pupil.

Patient 20: 30 years old with severe head injury, no pulse, no breathing, cold and clammy skin.