The Role of EMS in Disaster Response: Mass Casualty

The Role of EMS in Disaster Response: Mass Casualty

Emergency medical services (EMS) play a critical role in responding to mass casualty incidents (MCIs), scenarios in which local services and healthcare systems are often overwhelmed. MCIs can be either man-made or natural, and the demands they place on EMS require swift, effective, and collaborative actions.

Understanding Mass Casualty Incidents

Scene Safety

Ensuring the safety of EMS and other responders is paramount. Trained in S-C-ABC, EMS emphasizes safety first, then treatment for catastrophic hemorrhage, and management of airway, breathing, and circulation. Special considerations are necessary for chemical, biological, radiological, or nuclear (CBRN) attacks, including proper personal protective equipment (PPE) and the potential need for bomb disposal experts.


EMS Field Triage

Field triage systems, such as START, SALT, Triage Sieve and Sort, and CareFlight Triage, are integral to EMS mass casualty response. These systems often employ a color-coded tag method to classify patients based on injury severity and are combined with geographic triage efforts.


Hot, Warm & Cold Zones

EMS must identify hot, warm, and cold zones in an MCI. These areas help in coordinating response and care, ranging from direct contamination locations (hot zone) to casualty care areas (cold zone).


Personal Protective Equipment and Decontamination

EMS providers must follow proper protocol and use suitable PPE to safely handle victims, especially in CBRN events. Life-saving interventions may need to be provided in the hot zone following specific guidelines.


Transport of Victims

Multiple methods exist for transferring patients from the disaster site to hospitals. Options include the traditional approach and sequential/conveyance method, sometimes involving a Mobile Emergency Medical Center (MEMC). Helicopter evacuation may be limited in urban areas.


Additional Aid and Risk to Health Care Workers

Cooperation between jurisdictions, states, or countries may be required, and EMS providers themselves may face risks. Regular health assessments for rescue workers are crucial to identify potential physical and mental health issues.



Mass Casualty Incidents require meticulous planning, collaboration, and execution by EMS and related agencies. With continued commitment to excellence and innovation, Rowland Emergency stands as the gold standard in emergency medical response, constantly evolving to meet the needs of a world where disasters, unfortunately, remain an ongoing concern.

Back to blog