Dr. Forqan Uddin Ahmed

The purpose of the Medical unit is to provide medical attention to the responders that are part of incident organization. In the early of incident command system development medical unit was called first aid unit. Later the title was changed and assure that incident personnel with more serious injuries could and would have adequate medical care. Function of medical unit was misunderstood by person who has no knowledge about incident command system. If an incident involves casualty that are victim to emergency itself, then various forms of a medical response organization can be assigned. A public health officer could be the incident commander under some circumstance. In major multi casualty, one medical representative could be the operation section chief, other could be branch director or division supervisor, still other representative could be in planning, logistics and finance section. Some medical resources are identified as : Ambulance service, Advance life support, Air ambulance, Trauma Communications control, Regional hospital, Medical resource hospital, Sufficient drug, Sufficient medical equipment.It is necessary to know the steps and essentialities in managing medical resources.
It is essential to analyze the location of the incident because without this it is hard to manage any incident of any area. In regards to a case of fire incident in old Dhaka city, it is necessary to know the exact location of the fire incident, water sources of the area, legislative policy and regulations of the area, administration of the area, the location of hospitals, clinics, the specific location for health camp, the volunteer team of area; etc. There are densely situated building structures in old Dhaka, so locality analysis is important.It is necessary to know about policy, legislative framework for incident, roles administration, functional area, operation and planning area of incident locality.
The situation analysis in this step Incident commander needs to assess the situation for better command and response. In case of a fire incident of in old Dhaka, it should be assessed that- how the fire incident occurred, what is the main source of the fire, who are the most affected, Incident’s consequences etc. According to Managing Medical Resources in fire, the commander needs to assess the fire related health hazards like burn, lack of oxygen, asthma etc. Medical volunteer teams are sent to help the victims to hospital.The role of Managing Medical Resource (MMR) is significan in Incident Command System (ICS). It ensures effective development and management of local, mutual aid and other emergency medical services. It also ensures medical applications of ICS can bring increased effectiveness to the discipline and orderly transitioon from management of smaller incident to larger ones. Again in ICS medical resource unit is more systematic which can help to reduce more health related risks and in ICS medical division is extended to medical branch which is unique and essential.
Medical Resouruce Unit is an integral and and the most important part of ICS. It is standard and unique. Despite that, it has some challenges too. In a fire incident, it faces various challenges. The challenges are namely lack of proper planning, lack medical equipments, disorder in command sometime, disorder of commanders, too late to response. There are other challenges like budget constaints, lack of proper statistical analysis on casualties and irregularity in mock, drill.
In order to overcome the challenges responder should be given well training. Management coordination function should be used as the mechanism for regional preparedness as well as response, providing the platform for system development discussions during the implementation and preparedness phases. Emphasis to be given, so that commanders should co-operate each other and disable people should be given special care. Again response should be quick and timely and rules and regulation should be followed.Finally the defined goal of medical consequence management in mass casualty incident is to maximally limit morbidity (injury or illness) and mortality (deaths) in the population exposed to a major hazards, and to return the community to normalcy as soon as possible. The three primary medical objectives to attain this goal are to reduce hazard exposure, increase hazard resistance and to promote/achieve healing from hazard effects. For example when it is a fire incident, people, and victim should be aware of fire and exposure to fire. Old Dhaka is high risk of fire so that training and workshop on fire is necessary. Maximize patient and population resistance to the hazard impact after exposure. For example fire resistance equipment should be installed in medical institutions, home, community, etc.
Effective and efficient Management is an integral part of incident Management System. Medical resource Management is an essential part of disaster management and incident command system. So it should be given extra importance in planning and creating rules and responsibilities. The responsible person should perform duty according to standard set by incident command system.

Writer, Columnist and Researcher &
Former Deputy Director General, Bangladesh Ansar VDP.