RescueRanger
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The tragic train collision at Gotki in the early hours of Monday morning was another stark reminder in the lack of readiness and of a unified command and control in Pakistan’s emergency management system.
Despite 16 years passing since the 2005 earthquake and numerous international experts injecting knowledge and capacity development, there is still a lack of a uniform, coordinated effort when responding to complex rescue operations in Pakistan.
The scenes from Gotki on television were chaotic, there was no sign of any incident commander, no single point of contact for press information, no crowd control and I could not help but feel for the friends and families of the passengers in the ill-fated trains having to watch this — only to add to their mental anguish.
The mismanagement of information, the lack of crowd control and cordons, the lack of leadership all this impacts on public safety, it inhibits the initial rescue operation, the increases the risk of secondary victims due to incidents such as stampedes, the risk of theft and loss of evidence and can create chokepoints restricting access for emergency vehicles.
In the event of a disaster, leadership for emergency management is assumed and maintained by local government officials. However, due to differences between the structures of the many provinces, federal, and other response agencies involved in response and recovery efforts, a standardised system for communication, command, and control is required.
The Incident command system or (ICS) as it is known in emergency management circles was developed in response to many deaths and property damage caused by wildfires in the western United States in the late 1960’s to early 70’s. Studies found that rather than a lack of resources or failure of tactics, ineffective disaster response was more often due to communication and deficiencies in organizational structure.
The Incident Command System (ICS) is a standardised hierarchical structure that allows for a cooperative response by multiple agencies, both within and outside of government, to organise and coordinate response activities without compromising the decision-making authority of local command in Pakistan’s case the Provincial Disaster Management Authority. ICS ensures that the most pressing needs are met, and that precious resources are used without duplication or waste.
A key component of the ICS is the concept of unified command, unified command within the ICS is used when there is a multi-agency response during a large emergency incident. Unified Command allows for the integration of local, state, and federal agencies to operate under one overall management structure with greater authority.
Figure 1 a simplified diagram of the Incident Command System
The Incident Commander is responsible for setting up cordons which are known as Hot, Warm and Cold Zones. Hot zones are where rescue operations are underway, warm zones are for equipment, standby teams, command and control, medical tents and transports, cold zones are for liaison officers such as the PLO.
Beyond these three zones you have holding areas where the press and members of public can be briefed, that way maintaining the integrity of the scene, the safety of the searchers, the victims, any potential evidence and safeguarding against secondary casualties.
Figure 2 example of hot, warm, and cold zone cordons
The IC also sets up a common approach path used to ferry staff, equipment, and victims in/out of the scene.
Why is time so critical in Search operations?
In rescue operations there is a principal known as the “Golden Day”, this is the first 24 hours of the incident. The greatest number of victims will be found on the first day (80/90%) and can be categorised as follows.
The “golden hour” is a well-known term used among trauma surgeons and emergency medical service responders suggesting that an injured person has about 60 minutes—a golden hour—in which traumatic care can improve their survival rate.
Figure 3 diagram of the golden hour
In mass casualty incidents such as the Gotki train collision, the initial responders to the scene can become quickly overwhelmed by the sheer number of causalities and complexity of injuries, it is therefore important that a simplified method of triage is taught and included in the incident command system documentation for national, provincial and district level disaster management plans.
Figure 4 example of a simple triage system
A triage system can help first responders rapidly assess and categorise casualties based on level of injury and urgency of care, helping get the right help to those who are most in need and reducing the impact on limited resources.
Finally, time and time again we see that preventable deaths occur due to mismanagement of the initial response to such tragedies. Government officials and stakeholders should take concrete steps in establishing disaster plans to include the ICS and these plans should be regularly testes and updated. The ICS is an internationally recommended system which should become a part of every organisation helping save lives, protecting property and livelihoods.
Despite 16 years passing since the 2005 earthquake and numerous international experts injecting knowledge and capacity development, there is still a lack of a uniform, coordinated effort when responding to complex rescue operations in Pakistan.
The scenes from Gotki on television were chaotic, there was no sign of any incident commander, no single point of contact for press information, no crowd control and I could not help but feel for the friends and families of the passengers in the ill-fated trains having to watch this — only to add to their mental anguish.
The mismanagement of information, the lack of crowd control and cordons, the lack of leadership all this impacts on public safety, it inhibits the initial rescue operation, the increases the risk of secondary victims due to incidents such as stampedes, the risk of theft and loss of evidence and can create chokepoints restricting access for emergency vehicles.
In the event of a disaster, leadership for emergency management is assumed and maintained by local government officials. However, due to differences between the structures of the many provinces, federal, and other response agencies involved in response and recovery efforts, a standardised system for communication, command, and control is required.
The Incident command system or (ICS) as it is known in emergency management circles was developed in response to many deaths and property damage caused by wildfires in the western United States in the late 1960’s to early 70’s. Studies found that rather than a lack of resources or failure of tactics, ineffective disaster response was more often due to communication and deficiencies in organizational structure.
The Incident Command System (ICS) is a standardised hierarchical structure that allows for a cooperative response by multiple agencies, both within and outside of government, to organise and coordinate response activities without compromising the decision-making authority of local command in Pakistan’s case the Provincial Disaster Management Authority. ICS ensures that the most pressing needs are met, and that precious resources are used without duplication or waste.
A key component of the ICS is the concept of unified command, unified command within the ICS is used when there is a multi-agency response during a large emergency incident. Unified Command allows for the integration of local, state, and federal agencies to operate under one overall management structure with greater authority.
Figure 1 a simplified diagram of the Incident Command System
The Incident Commander is responsible for setting up cordons which are known as Hot, Warm and Cold Zones. Hot zones are where rescue operations are underway, warm zones are for equipment, standby teams, command and control, medical tents and transports, cold zones are for liaison officers such as the PLO.
Beyond these three zones you have holding areas where the press and members of public can be briefed, that way maintaining the integrity of the scene, the safety of the searchers, the victims, any potential evidence and safeguarding against secondary casualties.
Figure 2 example of hot, warm, and cold zone cordons
The IC also sets up a common approach path used to ferry staff, equipment, and victims in/out of the scene.
Why is time so critical in Search operations?
In rescue operations there is a principal known as the “Golden Day”, this is the first 24 hours of the incident. The greatest number of victims will be found on the first day (80/90%) and can be categorised as follows.
- Injured, not trapped: There also are known as “surface victims” and usually account for about 50% of all victims.
- Non-structural entrapment: These are also known as “light rescue” and usually account for 30% of all victims.
- Structural entrapment/entombed victims: These are victims of the collapse that have been heavily trapped or entombed in the collapse, this type of rescue is extremely complicated and requires specialist teams that are able to stabilise the collapsed structure, utilise specialist search equipment and use tools to cut, breach, break or burn through the structure to access voids where the victim may be located. These types of rescue operations are almost always carried out by Heavy Urban Search and Rescue Teams.
The “golden hour” is a well-known term used among trauma surgeons and emergency medical service responders suggesting that an injured person has about 60 minutes—a golden hour—in which traumatic care can improve their survival rate.
Figure 3 diagram of the golden hour
In mass casualty incidents such as the Gotki train collision, the initial responders to the scene can become quickly overwhelmed by the sheer number of causalities and complexity of injuries, it is therefore important that a simplified method of triage is taught and included in the incident command system documentation for national, provincial and district level disaster management plans.
Figure 4 example of a simple triage system
A triage system can help first responders rapidly assess and categorise casualties based on level of injury and urgency of care, helping get the right help to those who are most in need and reducing the impact on limited resources.
Finally, time and time again we see that preventable deaths occur due to mismanagement of the initial response to such tragedies. Government officials and stakeholders should take concrete steps in establishing disaster plans to include the ICS and these plans should be regularly testes and updated. The ICS is an internationally recommended system which should become a part of every organisation helping save lives, protecting property and livelihoods.
