Exclusives, Major Incidents, Mass Casualty Incidents

Preplanned EMS Role in Emergency Management

In this day and age of varying potential disasters ranging from natural to manmade, it’s important that each EMS agency have a set of preplans. Not only with their own agency, but also with other departments in their area. Too often, history has shown that EMS hasn’t improved when it comes to preparing for disasters in the respective areas they serve.

Why is this? Naturally, EMS has the mindset of thinking reactionary rather than planning. Our mindset is that when anything occurs, we will rise to the occasion and take care of it. However, we need to keep in mind that some incidents can be a lot bigger than the resources we may currently have.

Why & Who?

“Preparedness is best thought of as a process—a continuing sequence of analyses, plan development, and the acquisition of individual and team performance skills achieved through training, drills, exercises, and critiques.”1 The practice of EMS planning varies considerably among communities. More and more we are seeing a steady increase not only in mass casualty incidents, but also natural disasters.

For example, since 1990, natural disasters have affected about 217 million people every year. Geophysical disasters include earthquakes, volcanoes, dry rockfalls, landslides and avalanches. Climate-related disasters include hydrological events such as floods, storm surge and coastal flooding, while meteorological events include storms, tropical cyclones, local storms, heat/cold waves, drought and wildfires.2

In order to effectively serve patients and the community EMS leaders need to understand the area they are serving. That being said, it takes more than an EMS agency to understand the risks that are potential threats to a community.

To have an effective preplan and understand the risks in your community, you need to utilize the ideas and expertise of all the departments in the community. Many communities have multiple departments ranging from EMS, fire, emergency managers, police, public works and, most importantly, elected city officials.

Having the input and buy-in from community leaders will help create a “big picture” on the potential risks your community faces from disasters, as well as understanding the resources your community can provide to your agency.

How to Preplan

So now that you know what disasters face your community, plan for it in your agency. For example, if you serve in a large community how many ambulances do you have for transport? Do you have a written agreement with other ambulance agencies to assist? What’s your plan for first responders that may not show up if a disaster strikes? These are just a few of some important questions your agency leaders need to ask themselves.

Unsure how to set up a preplan of any size? Look to the Federal Emergency Management Agency (FEMA) Comprehensive Preparedness Guide (CPG) 101, which provides guidance on the fundamentals of planning and developing emergency operations plans (EOPs). CPG 101 shows that EOPs are connected to planning efforts in the areas of prevention, protection, response, recovery and mitigation.

CPG 101 provides guidelines on developing emergency operations plans (EOP). It promotes a common understanding of the fundamentals of risk-informed planning and decision making to help planners examine a hazard or threat and produce integrated, coordinated, and synchronized plans. The goal of CPG 101 is to make the planning process routine across all phases of emergency management and for all homeland security mission areas.3

Funding Preplanning

Preplanning for disasters in the EMS isn’t free. The NASEMSO report of January 2015 on EMS domestic preparedness notes that EMS receives a mere 4% of federal disaster preparedness funds from the U.S. Department of Homeland Security and the Department of Health and Human Services. In addition, there’s no mandate of minimum funding of EMS required for other organizational recipients of these grant programs.4

Funding is best received from the community you serve, but how do you accomplish that? The answer is through elected officials. Like mentioned previously, involving local officials in the disaster planning process can show your agencies abilities and how vital you are to the area you serve. Having the elected official understand what it is your agency may lack may be an opportunity for funding.


Preplanning is something we all are aware of in EMS, but we often never do it. We owe it to the community we serve to always be ready. Being ready means understanding that EMS is only one aspect of the bigger picture of disaster preparedness. Get out there, talk to your community leaders, understand the risks, the resources and be prepared.


1. Dynes RR. Disaster reduction: The importance of adequate assumptions about social organization. Sociological Spectrum. 1993;13(1):175–192.

2. Guha-Sapir D, Vos F, Below R. (2012.) Annual disaster statistical review 2011: The numbers and trends. Center for Research on the Epidemiology of Disasters. Retrieved Aug. 9, 2018, from ble on www.cred.be/sites/default/files/ADSR_2011.pdf.

3. Developing and Maintaining Emergency Operations Plans. (November 2010.) Federal Emergency Management Agency. Retrieved March 1, 2018, from www.fema.gov/media-library-data/20130726-1828-25045-0014/cpg_101_comprehensive_preparedness_guide_developing_and_maintaining_emergency_operations_plans_2010.pdf.

4. National Association of State EMS Officials. (January 2015.) Emergency Medical Services Domestic Preparedness Improvement Strategy, National Association of State EMS Officials. Retrieved Aug. 9, 2018, from www.nasemso.org/Projects/DomesticPreparedness/documents/NASEMSO-EMS-Domestic-Preparedness-Improvement-Strategy-FINAL-Jan2015.pdf.