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Plan has been working in Colombia since 1962, helping children access their rights to health, education, livelihoods and protection. We work closely with communities, empowering them to take an active role in organizing and participating in creating sustainable solutions to existing problems.
Plan believes firmly that children and young people have the capacity to improve their quality of life. Many children drop out of school because they’re forced to work or because violence forced their family to move.
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The following definitions are to be utilized in determining AANDC’s roles and responsibilities for emergency management. Assets: Any real or personal property, tangible or intangible, that a company or individual owns that can be given or assigned a monetary value. Awareness: The continual process of collecting, analyzing, and disseminating intelligence, information or knowledge to allow organizations and individuals to anticipate requirements and to respond effectively. Coordinate: Bring (parts, movements, etc) into proper relation, cause to function together or in proper order. Emergency: An emergency is a present or imminent event that requires prompt coordination of actions concerning persons or property to protect the health, safety or welfare of people, or to limit damage to property or the environment. Emergency Operations Centre: A designated facility established by an agency or jurisdiction to coordinate the overall agency or jurisdictional response and support to an emergency response. Incident Command System: A standardized on-scene emergency management concept specifically designed to allow its user(s) to adopt an integrated organizational structure equal to the complexity and demands of single or multiple incidents, without being hindered by jurisdictional boundaries. Issue: An issue is a situation that somehow challenges the public’s sense of appropriateness, tradition, values, safety, security or the integrity of the government. Natural Disaster: A naturally occurring calamitous event bringing great damage, loss, or destruction such as tornadoes, hurricanes, widespread flooding, wildland fires, earthquakes, and related occurrences. Non-Government Organization (NGO): A non-profit organization that is based on the interests of its members, individuals, or institutions that is not created by government, but may work cooperatively with government. Primary Department: A federal department with the legislated mandate related to a key element of an emergency. Recovery: Steps and measures taken after the emergency to repair and restore conditions to an acceptable level that existed prior to the emergency. Search and Recovery: Acts that are carried out to recover an individual or individuals when the first response effort has not proven successful.
Threat: Any potential event or act, deliberate, accidental or natural hazard that could cause injury to employees or assets, and thereby affect service delivery adversely. The most common emergencies affecting First Nations are floods, fires or failure of community infrastructure (i.e. The Aboriginal Affairs and Northern Development Canada (AANDC) National Emergency Management Plan describes the roles and responsibilities of the Department and its partners in emergency management as well as the concept of operations for responding to and managing an emergency situation in First Nations communities. Emergency management planning at AANDC takes into account that there are various funding arrangements or agreements between AANDC and the provinces for the delivery of emergency management services for First Nations communities.
The purpose of the AANDC National Emergency Management Plan is to provide a national framework for the roles and responsibilities of emergency management: mitigation, preparedness, response and recovery activities in First Nations communities across Canada.
The provinces and territories are responsible for activities related to emergency management within their respective jurisdictions. The Emergency Management Act 2007 (EMA) states that each federal minister is responsible for the identification of risks that are within or related to his or her area of responsibility, including those related to critical infrastructure. This Plan is consistent with the Federal Emergency Response Plan (FERP) and is an evergreen document that will evolve over time.
This Plan applies to emergencies that have the potential to threaten the health, safety and security of First Nations communities.
The vast majority of emergency situations for which AANDC would have responsibility as the primary federal government department are emergency situations that arise in First Nations communities.
Nothing in this plan is intended to diminish, alter or impede the authority, roles and responsibilities, or accountability of any region, province or territory. The main responsibility for emergency management rests with provincial and territorial governments.
The AANDC National Emergency Management Plan applies to emergencies that have the potential to threaten the health and safety of First Nations communities and individuals and that exceed the capacity of the local community to address on their own. AANDC enters into collaborative agreements with provincial governments to ensure that First Nations communities have access to comparable emergency assistance services available to other residents in their respective province. In the North, AANDC collaborates with territorial emergency management organizations and other government departments to manage emergencies that have the potential to affect communities, lands, waters and the environment generally.
Four basic pillars of effective emergency management in Canada have been adopted and must be taken into consideration in all aspects of the Department’s emergency management planning and operations. Recovery - Steps and measures taken after the emergency to repair and restore conditions to an acceptable level that existed prior to the emergency. Public Safety Canada’s Federal Emergency Response Plan (FERP) identifies and describes the mechanisms and processes that will be used for emergency management by the Government of Canada. AANDC’s risk environment includes natural or human-induced hazards that may impact First Nations communities. First Nations communities are dispersed across Canada, located in diverse geological and climatic zones and are thus exposed to a wide variety of hazards depending on their locale.
Effective management of AANDC’s risk environment involves the four pillars of emergency management: mitigation, preparedness, response and recovery.
The AANDC National Emergency Management Plan will help to mitigate or reduce the impact of emergencies on the safety, health and security of affected First Nation individuals and property. Traditionally the responsibility to deal with emergencies is placed first on the individual. Key stakeholders and their established roles and responsibilities in relation to this plan are provided below.
Community members should take efforts to protect personal property from the effects of emergencies.
First Nations communities have a responsibility to develop and implement Emergency Management plans as effective emergency management starts at the local level. The responsibility for emergency management rests with provincial and territorial governments; however, the AANDC Minister has accepted responsibility for supporting emergency management in First Nations communities. AANDC regions are responsible for developing, exercising, implementing and maintaining regional emergency management plans. AANDC Headquarters and Regions must work closely together to ensure the timely flow of information during emergencies. Additionally, the Department is committed to search and recovery based on compassionate grounds.
At the request of a First Nation community, the leading province or AANDC, non-government organizations (i.e. Regions should identify and communicate with non-government organizations located within their area of responsibility to determine what they can offer First Nations during emergencies. Other government agencies, such as neighbouring municipalities, could offer support services like security, the provision of basic services and shelter to an evacuated First Nation, or equipment to prepare for or respond to an emergency. Public Safety Canada is the federal government department responsible for promoting and coordinating the preparation of departmental emergency management plans as well as coordinating the government’s response to an emergency through the Government Operations Centre (GOC). AANDC’s concept of operations, during an emergency, was developed based on the Incident Command System (ICS), a system that defines and establishes clear roles, responsibilities, lines of communication and operating procedures to be assumed by personnel in the management of an emergency situation. The AANDC Emergency Management Governance Structure is consistent with the structure of the Government of Canada as outlined in the Federal Emergency Response Plan, which involves engaging existing governance structures to the greatest extent possible in responding to an emergency. The AANDC Minister is the lead Minister for addressing emergency mitigation, preparedness, response and recovery on all Indian lands across Canada. The Deputy Minister of AANDC sits on the DM National Security Committee which is chaired by the National Security Advisor to the Prime Minister, with the Deputy Minister of Public Safety Canada as vice-chair. The Senior Assistant Deputy Minister (SADM) of Regional Operations at AANDC Headquarters is a member of the ADM’s Emergency Management Committee, co-chaired by the Associate Assistant Deputy Minister of Emergency Management and National Security at Public Safety Canada and the Commander of Canada Command.
The Director of Emergency and Issue Management in Regional Operations is responsible for the development, implementation and maintenance of AANDC’s National Emergency Management Plan.
Regional Directors General are responsible for the overall and effective implementation of the Emergency Management Business Line in their respective regions. The inter-working relations start between the players at the lowest level and then move upwards to the players at the highest level. Moving upwards, the AANDC HQ EM Operations Centre reports to the Director of the Emergency and Issue Management Directorate; and the Government Operations Centre reports to the ADM Emergency Management Committee.
The AANDC Emergency Management Coordination Structure clearly defines the operational lines of reporting between AANDC Headquarters (HQ), AANDC Regions, provincial and territorial emergency management organizations and the Government Operations Centre (administered and operated by Public Safety Canada). At the base of the diagram are Operations, Planning, Administration and Logistics - the four principal emergency management activities of the Incident Command System – which influence the work completed within AANDC’s Coordination Structure. First Nations communities should ideally have a structure that aligns with their provincial or federal emergency management community of practice to deal with localized emergencies.
AANDC Regional EM Operations Centres should ideally mirror the HQ organization but on a smaller scale due to limited staff. The AANDC HQ EM Operations Centre is responsible for coordinating and monitoring emergency management activities impacting First Nations communities from a national perspective and responding to queries from senior officials within the Department, including the offices of the Minister and Deputy Minister (DM). The Government Operations Centre (GOC) is housed within Public Safety Canada on behalf of the Government of Canada. During day to day activities, Operations staff are responsible for monitoring, validating, and providing situational awareness products such as notifications, weekend and weekly summaries, fire and flood reports to senior management, the Government Operations Centre, law enforcement and other agencies on emergencies impacting First Nations communities.
Planning staff are responsible for ensuring that emergency management plans are developed, maintained and promoted. Communications staff are part of emergency operations during an emergency and play a key role in managing external communications by ensuring that media outlets are kept informed and up to date.
Each AANDC region is responsible for working with First Nations communities and Emergency Management Organizations to evaluate the threat and risks associated with emergencies and take steps to mitigate potential emergencies (i.e. Regions and Headquarters are responsible for activities arising from the preparedness phase of emergency planning, including on-going training, exercising and, in the Regions, supporting the development and maintenance of First Nations Emergency Management Plans. Capturing and reporting information regarding emergencies is also an important component of preparedness.
Response includes those actions during or immediately after an emergency in order to manage its consequences to minimize suffering and losses. The declaration of an emergency in a First Nation community involves a shared response amongst the First Nation, the province or territory and AANDC as each have a role to play. The responsibility for identifying and initiating a response to an emergency rests with the local First Nations community and the appropriate provincial Emergency Management Organization (EMO).
Recovery focuses on the reparation or restoration of conditions to an acceptable level through measures taken after the emergency. Returning a community to a state of normalcy, which existed prior to the emergency, is a priority.
Funding for assistance related to emergencies will be in accordance with departmental policies and agreements.
The AANDC National Emergency Management Plan is in a constant state of activation for routine day-to-day departmental activities related to emergency management. In order to assist senior departmental officials with their roles and responsibilities before, during and after an emergency, a Senior Officials Desk Book has been developed. Level 1 is the routine (day-to-day) activities of the Emergency and Issue Management Directorate within the Regional Operations Sector at AANDC HQ as well as the regional emergency management programs. Level 2 is the partial augmentation of the AANDC HQ EM Operations Centre and relevant Regional EM Operations Centre(s). Level 3 is the extensive augmentation of AANDC HQ EM Operations Centre (including the GOC) and relevant Regional EM Operations Centre(s). Headquarters emergency management staff will monitor events and activities with regional emergency management coordinators in order to gather sufficient information to keep records of activities and events, and to be able to provide periodic statistics for senior management and regions. During normal business hours, situation reports are provided through normal reporting mechanisms.
It is important to note that formats for these reports must be identical between HQ and Regions. An emergency management staff contact list has been developed and is updated regularly in order to ensure that all contact information is up-to-date, especially for emergency management duty personnel and for contact purposes during and outside regular business hours. The Department and stakeholders must capitalize on their own and others’ experiences, successes, as well as failures, to continually strive to improve on policies, plans, procedures, processes and operations.
The Lessons Learned and After Action Report is not an audit and is to be considered a learning tool. A draft of the lessons learned and after action report should be completed no later than 30 calendar days after the conclusion of the emergency or operation. Program awareness pertaining to the emergency management plan must be promoted and shared within the Department, especially to those who are directly or indirectly involved with any aspect of emergency management services and activities. The development of training and exercise scenarios must be a common practice for the effective administration of emergency management functions within the Department. Each region is responsible for taking steps from within their annual budgets to mitigate potential emergencies.
Regions shall identify from annual regional budgets, the funds necessary to meet expenditures incurred by activities arising from the preparedness phase of emergency planning. It is important that all First Nations be treated equally and consistently on a national basis as jurisdictions permit regarding the reimbursement of costs associated with emergency management. The Emergency and Issue Management Directorate (EIMD) of the Regional Operations Sector is responsible for the management and maintenance of AANDC’s National Emergency Management Plan. The Plan will undergo a full review by AANDC in consultation with the Regional Directors General and their respective Regional Emergency Management Coordinators and other key stakeholders, a minimum of every three years.
Notwithstanding this departmental review process, the fact remains that emergency management policies, plans and procedures are all operational documents that should be consulted on a routine basis. The Ontario Mass Evacuation Plan is a supporting plan to the Provincial Emergency Response Plan (PERP).
For more information on the legislative framework and authorities, see the PERP available on the EMO website. This plan supports the agreement between the Governments of Ontario and Canada (through the Department of Aboriginal Affairs and Northern Development Canada) to provide emergency response support to First Nation communities in the province. An EMO planning team in consultation with non-governmental organizations, provincial and federal partners developed the plan.
This plan is meant to be used to respond to a request for a partial or complete evacuation from one or more communities to one or more host communities. Provincial coordination will involve the evacuating community, host communities, relevant Ontario ministries, federal departments, non-governmental organizations, and others, as required. This plan is for Ontario’s far north, encompassing municipalities, unorganized territories2 and First Nation communities. This is an overarching plan for carrying out mass evacuations and as such, many aspects are general in nature4. The Far North of Ontario spans the width of the province, from Manitoba in the west, to James Bay and Quebec in the east.
The far north is subject to several hazards covered under Ontario’s Hazard Identification and Risk Assessment.
The geography of the far north may complicate evacuations or efforts to manage or suppress the hazard. Maintain family and community unity, which is integral to maintaining community cohesion and supports. Potential threats to the communities and emergency responders are critical in determining the urgency of the evacuation and for planning resource mobilization. Real-time threat assessment should be ongoing and coordinated among partners, particularly ministries with relevant OIC responsibilities and the community(ies) at risk.
An OIC ministry or the PEOC may recommend evacuation, or that it is safe to return, based on a real-time threat assessment.
The availability, duration, type, and location of host community facilities affect planning for the evacuation. Consideration should be given to maintaining the readiness of host communities for future hosting. Evacuating communities should identify Community Evacuation Liaisons for each host community. The decision to deploy is typically based on requests from impacted communities, the mandate of the organization deploying staff, and staff member’s level of expertise.
Depending on the scale and complexity of the operation, a senior provincial official may be deployed to coordinate the provincial response and to liaise with community and other deployed officials. Situational awareness requires continuous coordination to help collect, collate, evaluate, and disseminate information. When planning for the return of evacuees, the number and location of host communities, and the distance to evacuated communities are key planning considerations.
Roles and responsibilities may pertain to transportation hubs, host communities, support from ministries or the federal government, or responsibilities of evacuating communities.
Determine the financial and legislative roles and responsibilities for the evacuation and comply with applicable policies, agreements, procedures, etc. Emergency information needs to be coordinated among the affected communities, province, and federal government. Once it has been decided that a community needs complete or partial evacuation, the parties involved must establish who the evacuees are, where the host locations are, and what the means of evacuation will be. Following the judgement of the authorized entity that it is safe for evacuees to return, the order of return and the methods of transportation must be established using an inclusive planning process that involves affected communities, provincial and federal partners, and other partners (i.e. Real-time threat assessment is a critical component of evacuation operations and should be ongoing. All responders involved in managing the hazard or participating in the evacuation must regularly communicate situational awareness information to those conducting real-time threat assessments and must report a changing situation as soon as feasible.
OIC ministries are responsible for assessing the threat for the types of emergencies they have been assigned. EMO is responsible for real-time threat assessments for hazards that have not been assigned to an OIC ministry. The PEOC is responsible for assessing the threat based on the real-time threat assessment and characteristics of the community(ies) or region under threat. During routine monitoring, the PEOC duty officer performs the function of real-time threat assessment. OIC ministries routinely monitor conditions in the province according to their assigned type of emergency. Uncertainty in real-time threat assessment is unavoidable, which is why persons with appropriate knowledge of the threat causing the emergency should be involved in the assessment.
During emergencies, the PEOC links with the local community and the OIC ministry acting as provincial lead to coordinate real-time threat assessment information. Emergency managers must understand the makeup of the population who are to be evacuated before they can make key decisions about transportation modes, route selections, hosting destinations, and the many other elements of an evacuation. Medevac is used for those individuals receiving home care or residing in a health-care facility in the evacuating community that qualify for medical transfer as per the Ambulance Act (evacuation by emergency medical services (EMS) or Ornge). This stage is typically orchestrated through the existing health procedures used in the community. This includes persons with disabilities, seniors, children, pregnant women, and those with medical conditions. Among these, some require attendant care, which means both the caregiver and the Stage 1 evacuee they care for should be on the Stage 1 evacuation list.
The designation of evacuees into the different stages will be determined by the First Nation Chief and Council, Head of Council, or appointed person, with the assistance of the on-site health care organization. Different types of hazards may dictate variations in the criteria for these categories (e.g.

The decision to evacuate a community is the responsibility of the First Nation Chief, Head of Council, or appointed person.
For First Nations communities, AANDC and PS approve federal assistance to support an evacuation. The urgency of an evacuation is determined based on the immediacy of the threat to the community (life, safety, health, and welfare), the resilience of the community, and (depending on the nature of the threat) the availability of resources for evacuation or shelter-in-place10.
Evacuations may take place prior to (pre-emptive), during, or after an incident has occurred. Given adequate warning about a hazard, adequate resources, and the likelihood of the threat actually impacting a community, it is advisable to conduct pre-emptive evacuations. If adequate resources are not available to conduct a pre-emptive evacuation, it may still be possible and necessary to carry out an evacuation even while a threat is already affecting a community. If recommending enhanced monitoring or activation of the PEOC, consider what positions must be staffed to conduct the evacuation. Alert PS of the situation and advise them if Government of Canada support may be required to assist. Establish a regular information cycle and contact for evacuating communities, host communities, and other parties assisting with the evacuation. Consider requesting additional host communities stand-by to receive evacuees if the situation appears likely to escalate rapidly. Establish the PEOC Command, and if it is an area or unified command, consider including additional organizations in the command meetings to better inform and coordinate the response. Determine financial accountabilities in consultation with partners and communicate the information.
Determine at the outset of the operations which organization will be responsible for information management and the manner in which information will be shared.
Initiating media contacts or directing the appropriate position to do this according to established plans and procedures (e.g. Adopting an extended operational cycle in which extra positions are staffed beyond the normal working day. Alerting other emergency responders in the province, including non-governmental organizations, that they may be requested to provide assistance. Marshalling transportation resources, including the recall of deployed resources in preparation for redeployment. Collecting and analyzing the data necessary to fully understand the potential impact and threat. Weather, resource availability, and the scale of an incident can significantly affect the time required to mobilize resources.
Emergency information is primarily the community’s responsibility, but may be supplemented by the province according to the provisions of the Provincial Emergency Information Plan.
Communications between the field and the PEOC, between the PEOC and partners, and within the PEOC is critical. The PEOC (or other EOC) may request deployments to fulfil specific incident management functions, as needed (e.g.
Where the scale of the incident, evacuation timeline, or availability of staff prevents the physical deployment of staff, relevant incident management functions may be performed remotely using available technology. Information technology in the far north is not universally accessible and may be further compromised by the nature of the emergency. All partners (but with specific reference to PEOC) should recognize the potential limitations to information technology in these regions of the province. The priorities for evacuation will be determined by the Chief and Council (for a First Nation), the Head of Council (for a municipality), or an authorized entity. Transportation planning for the evacuation will be undertaken by a joint planning team as described in Annex 7. The evacuating community should identify community evacuation liaisons at each of the host community sites to support evacuees. If an evacuation involves a First Nation community, the JEMS Service Level Evacuation Standards provides a sample flight manifest.
Service Level Evacuation Standards11 are in place for hosting First Nations community members in the event of an evacuation.
Through the PEOC, EMO works with the evacuating First Nation to identify a host community or communities for its evacuees. The selection and preparation of host facilities should be driven by the needs of the evacuees. Another key consideration is the availability of personnel and other resources to support the host facilities. Potential conflicts with the longer-term use of accommodations in the host community should be considered and mitigated if possible (e.g. The PEOC should begin contingency planning with partners for longer-term evacuations if it appears likely that evacuees will be displaced from their community for longer than the period discussed below.
When evacuees are members of a First Nation, the use of any facility that was used as, or could evoke comparisons to, residential schools should be avoided.
Communities considering acting as a host community during an evacuation should identify emergency shelter facilities. Short-Term Basic Shelter Services: for a period of 1-14 days, in arenas, gymnasiums, recreation halls, etc. Special Accommodations: to address the requirements of medically vulnerable individuals or those with special needs. Host communities may be limited in the types of accommodations that they are able to provide.
Planning for hosting evacuees builds on information already available (typically from the manifest). Host communities are responsible for registering evacuees that are entering into their care. Registration records should only be shared with organizations providing services to the evacuees (e.g. Before the return of evacuees, the evacuated community should be in a safe and ready state. Services have resumed and are sufficient to support returning evacuees – for example, power, water, sanitation, security, food and essential supplies, and medical services.
If a community was completely evacuated it may be advisable to begin the return of evacuees with essential workers to restart systems and assess the readiness of the community to receive other returning evacuees. Once approval has been given for all or a part of the population to return home, community leaders, working with community evacuation liaisons, will develop priorities and manifests for the return flights. Ground transportation arrangements may be made by the host community or the provincial government. The evacuated community will take the lead for communicating re-entry procedures, with assistance from partners as required. What media sources can evacuees use for the most up-to-date information on re-entry procedures? Following a regional evacuation, multiple communities may decide at the same time that they are ready to return evacuees. The PEOC and partners will commence demobilization as host communities are cleared of evacuees.
The Quick Reference Guide is a condensed version of the Ontario Mass Evacuation Plan Part 1: Far North. Triage may also be used for patients arriving at the emergency department, or telephoning medical advice systems, among others.
The term ''triage'' may have originated during the Napoleonic Wars+ from the work of Dominique Jean Larrey+.
For many emergency medical services+ (EMS) systems, a similar model may sometimes still be applied. As medical technology has advanced, so have modern approaches to triage, which are increasingly based on scientific models. Simple triage is usually used in a scene of an accident or "mass-casualty incident+" (MCI), in order to sort patients into those who need critical attention and immediate transport to the hospital and those with less serious injuries. Upon completion of the initial assessment by medical or paramedical personnel, each patient may be labelled which may identify the patient, display assessment findings, and identify the priority of the patient's need for medical treatment and transport from the emergency scene.
In advanced triage, doctors and specially trained nurses may decide that some seriously injured people should not receive advanced care because they are unlikely to survive.
The use of advanced triage may become necessary when medical professionals decide that the medical resources available are not sufficient to treat all the people who need help.
In these extreme situations, any medical care given to people who will die anyway can be considered to be care withdrawn from others who might have survived (or perhaps suffered less severe disability from their injuries) had they been treated instead. If immediate treatment is successful, the patient may improve (although this may be temporary) and this improvement may allow the patient to be categorized to a lower priority in the short term.
Continuous integrated triage+ is an approach to triage in mass casualty situations which is both efficient and sensitive to psychosocial+ and disaster+ behavioral health issues that affect the number of patients seeking care (surge), the manner in which a hospital or healthcare facility deals with that surge (surge capacity) and the overarching medical needs of the event.
Continuous integrated triage combines three forms of triage with progressive specificity to most rapidly identify those patients in greatest need of care while balancing the needs of the individual patients against the available resources and the needs of other patients. For those patients that have a poor prognosis and are expected to die regardless of the medical treatment available, palliative care+ such as painkiller+s may be given to ease suffering before they die.
In the field, triage sets priorities for evacuation+ or relocation to other care facilities. Alternative care facilities are places that are set up for the care of large numbers of patients, or are places that could be so set up. In advanced triage systems, secondary triage is typically implemented by emergency nurses+, skilled paramedic+s, or battlefield medical personnel+ within the emergency departments of hospitals during disasters, injured people are sorted into five categories.
Some crippling injuries, even if not life-threatening, may be elevated in priority based on the available capabilities.
During the early stages of an incident, first responders may be overwhelmed by the scope of patients and injuries.
Within the hospital system, the first stage on arrival at the emergency room is assessment by the hospital triage nurse. For a typical inpatient hospital triage system, a triage nurse or physician will either field requests for admission from the ER physician on patients needing admission or from physicians taking care of patients from other floors who can be transferred because they no longer need that level of care (i.e. The ''Australasian Triage Scale'' (abbreviated ''ATS'' and formally known as the ''National Triage Scale'') is a triage system that is implemented in both Australia+ and New Zealand+. In the mid-1980s, The Victoria General Hospital+, in Halifax, Nova Scotia+, Canada+, introduced paramedic triage in its Emergency Department. For routine emergencies, many locales in Canada now employ the Canadian Triage and Acuity Scale (CTAS) for all incoming patients. Triage at an accident scene is performed by a paramedic+ or an emergency physician+, using the four-level scale of   Can wait, Has to wait, Cannot wait, and Lost. In the emergency room of a hospital, the triage is performed by a physician called MAO–''medecin d'accueil et d'orientation'' (reception and orientation physician), and a nurse called IOA–'' infirmiere d'organisation et d'accueil'' (organisation and reception nurse). France has also a Phone Triage system for Medical Emergencies Phone Demands in its Samu Medical Regulation Centers through the 15 medical free national hot line.
Preliminary assessment of injuries is usually done by the first ambulance+ crew on scene, with this role being assumed by the first Notarzt arriving at the scene. The German triage system also uses four, sometimes five colour codes to denote the urgency of treatment. In Hong Kong+, triage in Accident and Emergency Departments is performed by experienced registered nurse+s, patients are divided into five triage categories: ''Critical'', ''Emergency'', ''Urgent'', ''Semi-urgent'' and ''Non-urgent''. In the UK+, the commonly used triage system is the Smart Incident Command System, taught on the MIMMS (Major Incident Medical Management (and) Support) training program.
Triage in a multi-scale destruction, disaster, catastrophic, casualty event, such as following a tornado or an explosion in a populated area, first responders follow a similar triage category scale as the US military.
A battlefield situation, however, requires medic+s and corpsmen+ to rank casualties for precedence in MEDEVAC+ or CASEVAC+. In a "naval combat situation", the triage officer must weigh the tactical situation with supplies on hand and the realistic capacity of the medical personnel.
Notions of mass casualty triage as an efficient rationing process of determining priority based upon injury severity are not supported by research, evaluation and testing of current triage practices, which lack scientific and methodological bases. Research indicates there are wide ranges and overlaps of survival probabilities of the Immediate and Delayed categories, and other START limitations. Poor assessments, invalid categories, no objective methodology and tools for prioritizing casualties and allocating resources, and a protocol of worst first triage provide some challenges for emergency and disaster preparedness and response.
Because treatment is intentionally delayed or withheld from patients, advanced triage has ethical+ implications. Bioethical concerns have historically played an important role in triage decisions, such as the allocation of iron lung+s during the polio+ epidemics of the 1940s and of dialysis machines+ during the 1960s. Research continues into alternative care, and various centers propose medical decision-support models for such situations. A few days a month I open the forum up to paid registration, when you purchase a membership ($10.00), you will receive instant access, with a membership for yourself, as well as a free invite for a friend.
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The Plan International Canada, Because I am a Girl, and Spread the Net names, associated trade marks and logos, and the logo are trade marks of Plan International Canada Inc. Preparedness activities consist of all hazard planning for response and recovery during emergencies as well as training and exercising of the plans.
However, Section 91(24) of the Constitution Act 1867 prescribes the legislative authority of the Government of Canada for "Indians, and Lands reserved for the Indians".
The Program structure recognizes that the provinces and territories have constitutional jurisdiction for emergency management, while the federal government has jurisdiction for Indians and lands reserved for Indians. The intent is to harmonize AANDC’s policies, plans and procedures with those of provinces, territories and other federal departments to contribute to a coordinated Government of Canada response to emergencies impacting First Nations communities.
However, under the EMA, each federal minister is responsible for identifying risks that are within or related to their area of responsibility and developing appropriate emergency management plans in respect of those risks.
In this context, it would be consistent with Canada’s risk environment which includes the traditional spectrum of natural and human-induced hazards such as wildland and urban interface fires, floods, hazardous material spills, transportation accidents, earthquakes, hurricanes, tornadoes, disease outbreaks or pandemics, major power outages, and cyber incidents as well as the risk of terrorism. Therefore, it is important to ensure that the roles and responsibilities of all stakeholders are clearly defined and understood by all.
As the capacity of the individual to cope with the emergency diminishes, the responsibility then shifts to successive levels of government, as the resources and expertise of each are needed. As such, through negotiated agreements with AANDC, provinces may respond to emergencies in First Nations communities in support of stated objectives in exchange for the reimbursement of eligible expenses. It is important that all First Nations have comparable emergency management services to nearby non-aboriginal communities. Red Cross), other government departments or agencies, and Aboriginal organizations may support the management of an emergency. Once identified, these should be grouped and documented within regional emergency management plans for practical and reference purposes, along with contact information. The Director of Operations and Implementation from the Regional Operations Sector is the Committee Secretary. The Director of Emergency and Issue Management reports to the Senior ADM of Regional Operations. AANDC HQ and Regions must work closely together to ensure the timely flow of information on emergencies and issues that could lead to emergencies.
The AANDC Coordination Structure clearly defines the operational lines of reporting between AANDC Headquarters (HQ), AANDC Regions, provincial and territorial emergency management organizations and the Government Operations Centre (administered and operated by Public Safety Canada). Some of these EMOs have negotiated funding agreements with AANDC for the provision of response functions to emergencies in First Nations communities. Response activities include emergency public communication, search and rescue, emergency medical assistance and evacuation. It is important that all First Nations be treated equally and consistently on a national basis as jurisdictions permit regarding the reimbursement of eligible costs associated with emergencies. Once a situation or event is terminated, it is a good business practice to regroup key staff and stakeholders as soon as possible to conduct a formal debrief to identify areas for improvement and to identify key lessons learned.
It is to be shared nationally and on a constructive basis to enhance the Department’s emergency management capabilities. Responsibility to fund emergency management rests with AANDC regions through the fiscal budgetary allocation process and will be in accordance with departmental policies and agreements. AANDC Regions manage response and recovery financial support in conjunction with Headquarters. EIMD will work collaboratively with regional counterparts, Communications Branch, and other stakeholders to update this plan and the annexes, as required by changes in policy, legislation or to incorporate lessons learned from exercises and actual emergencies.
In addition, this plan references the Service Level Evacuation Standards1 developed by the Joint Emergency Management Steering (JEMS) Committee. Updates to the plan will be undertaken as required based on lessons learned from exercises and incident responses.
It is a provincial coordination plan outlining how Ontario would coordinate its response and collaborate with federal and municipal governments, First Nations, non-governmental organizations, and ministry partners. It is not intended for internal evacuations of one part of a community to another part of the same community.
This plan does not replace a community’s own emergency response plans, which should contain provisions for evacuations if they consider evacuations likely. A detailed action plan that addresses the specific scenario, hazard, and threat will still be required.
Evacuations are most frequently caused by forest fires and flooding (most often from spring break-up along the James Bay coast). Communities in the far north may be located significant distances from communities with road access or from regional centres where services may be available (e.g. Damage to property or the environment may also trigger an evacuation if it poses a risk to the safety, health, and welfare of people. It also dictates what level of activation, and how many and what type of resources will be required for the evacuation. If the evacuation is for one or a few communities, planning may be restricted to movements within the same general geographic area. Therefore, planning should include post-hosting needs, such as financial reconciliation, demobilization support, and reports on issues to be resolved before hosting evacuees in the future. This allows the incident management team, and all partners, to take informed, effective and consistent actions in a timely manner. However, as the level of activation increases, the PEOC duty officer transfers this function to a technical specialist or team, if available. These ministries have processes in place for transferring the responsibility for real-time threat assessment to specialists within their ministry when required. All activities and efforts should be focused on moving these people from the at-risk area to places of safety in a timely manner. This list should contain the names of persons needed to restart systems that must be in place before evacuees can return home (e.g. If an authorized entity decides on a partial or complete community evacuation, the community should declare an emergency.
A pre-emptive evacuation may be undertaken when it is clear that if delayed, conditions (weather or other hazard) would impede evacuation. Evacuations of this nature are done when life safety is at extreme risk and a rescue becomes essential. For example, evacuations of large populations to one or more host communities may require logistics support to secure modes of transportation from a receiving aerodrome or transportation hub to the host community. Communities are encouraged to make the decision to evacuate as soon as a significant or imminent threat is identified. In widespread evacuations, emergency information may need to be coordinated amongst all involved partners. To assist with streamlining communications, an operational cycle should be established and communicated by the PEOC to partners so they know when they are expected to provide updates on the situation from their perspective.
Partners should have back-up technologies available, particularly for their deployed staff.

It is preferable to host community members together, even if it means hosting them farther away from their home community. Evacuation liaisons represent the needs of evacuees when attending meetings with the host community and other agencies.
If the information is not collected on the manifest, registration services can collect and provide this more detailed information. Depending on the scale of the incident, and the numbers and locations of persons to be evacuated, the needs may exceed the capacity of available resources. The Standards provide guidance on allowable expenditures, hosting arrangements, health services, emergency social services, etc. If requested, the PEOC could assist other communities in identifying potential host communities. It is worth noting that community health services and hospitals in the host community may experience an increased demand for their services. Representatives from provincial (through the PEOC) and federal organizations may be available to assist a host community in providing services to evacuees. It is generally understood that time of year may affect the host community’s ability to provide accommodations during an evacuation.
This allows the host community to better coordinate services and seek reimbursement for expenses incurred due to hosting. The recommendation and the decision to return should be based on the results of the ongoing real-time threat assessment, plus a determination that the home community is ready to support the returning evacuees. This may involve the coordination of an advance team that is given sufficient time and other resources to return the community to a pre-evacuation state. It is critical that at the end of an evacuation, there is a full accounting of the operation in the form of after-action and financial reports.
This ration+s patient treatment efficiently when resources are insufficient for all to be treated immediately. It is used to divert scarce resources away from patients with little chance of survival in order to increase the chances for others with higher likelihoods.
The treatment being prioritized can include the time spent on medical care, or drugs or other limited resources.
It becomes the task of the disaster medical authorities to set aside some victims as hopeless, to avoid trying to save one life at the expense of several others.
Triage should be a continuous process and categories should be checked regularly to ensure that the priority remains correct given the patient's condition. Examples include schools, sports stadiums, and large camps that can be prepared and used for the care, feeding, and holding of large numbers of victims of a mass casualty or other type of event.
Unlike all other centres in North America+ that employ physician and primarily nurse triage models, this hospital began the practice of employing Primary Care level paramedics to perform triage upon entry to the Emergency Department. This triage is usually performed at the field hospital+ (PMA–''poste medical avance'', i.e. Typically, every ambulance is equipped with a folder or bag with coloured ribbons or triage tags.
Their injuries are minor, usually scrapes, cuts, and bruising with normal capillary refill. Individuals in this category may have cuts, bruises, lacerations, some confusion, minor fractures, and a capillary refill between 4 and 7 seconds(sometimes longer in cold environments).
A person with a severe head injury, multiple fractures to the skeletal system, fractures in delicate areas such as the spinal cord, massive confusion, in-cohesive, unable to answer simple questions, unresponsive but with vital signs, arterial bleeding, internal bleeding, or capillary refill exceeding 7 seconds is classified red. The casualties are then transported to a higher level of care, either a Forward Surgical Team+ or Combat Support Hospital+ and re-triaged by a nurse or doctor. Any compromise to the casualty's respiration, hemorrhage control, or shock control could be fatal. Injuries are potentially life-threatening, but can wait until the Immediate casualties are stabilized and evacuated.
Care should not be abandoned, spare any remaining time and resources after Immediate and Delayed patients have been treated.
START and START-like (START) triage that use color-coded categories to prioritize provide poor assessments of injury severitySacco, W, Navin, M, Fiedler, K, et al. The same physiologic measures can have markedly different survival probabilities for blunt and penetrating injuries. These are clear obstacles for efficient triage and resource rationing, for maximizing savings of lives, for best practices and National Incident Management System (NIMS) compatibilities,US Department of Homeland Security.
As many health care systems in the developed world continue to plan for an expected influenza pandemic+, bioethical+ issues regarding the triage of patients and the rationing of care continue to evolve. CRA Charity Registration Number: 11892 8993 RR0001 *The Standards Program Trustmark is a mark of Imagine Canada used under licence by Plan International Canada. It consists of identifying the vulnerabilities and in taking proactive measures to mitigate the situation. The response will require a complex level of coordination of operations and communications depending on the nature of the emergency.
As per the Government of Canada’s Federal Emergency Response Plan, AANDC’s National Emergency Management Plan adopts an all-hazards approach to emergency management. In AANDC’s case, the Minister of AANDC has accepted responsibility for supporting on-reserve First Nations communities in the four pillars of emergency management: mitigation, preparedness, response and recovery.
AANDC’s National Emergency Management Plan is consistent with the Federal Emergency Response Plan. This recognizes that when an emergency occurs, people will see to their own safety to the greatest extent possible. Therefore, to avoid any confusion or problems during an emergency, formal emergency management agreements must be negotiated by the AANDC regions. Bilateral discussions and maintaining contact on a pre-determined basis are good business practices in establishing and maintaining partnerships with these groups.
The Operations Committee has the authority to review and provide direction on emergency management issues requiring the attention of the Deputy Minister, including committing money for emergency management that might impact other program budgets. The Senior ADM of Regional Operations sits on the Operations Committee and the ADM Emergency Management Committee. The AANDC Regional EM Operations Centres liaise with Support Organizations, Public Safety Canada and the AANDC HQ EM Operations Centre. Managers are authorized to approve spending in accordance with AANDC financial authority levels. Costs will be tracked and identified on an annual basis by both the AANDC Regions and Headquarters. As many of the communities in the far north are First Nations, coordination with the federal government is crucial. Two communities falling within the focus area have road access (Mishkeegogamang and Pickle Lake) and there is a rail link to one municipality (Moosonee).
However, the evacuation of multiple communities due to an area-wide emergency is likely to require out-of-area movements for hosting, particularly when the goal is to keep families and communities together.
The size and demographics of the population are significant factors in determining how to conduct an evacuation. This would include: scheduling such that staff do not become overly fatigued by the operation and providing as much advance notice of scheduling as is possible given the nature of the incident.
In addition, up-to-date contact lists should be maintained by all organizations for use in an emergency.
Alternate technologies that may be utilized in an evacuation include satellite phones and amateur radio.
They should also be identified to the host community as resources that may be called upon to assist evacuees.
This mitigates the risk of families being separated and makes the return of evacuees less complicated. Evacuation liaisons also assist with creating manifests and determining the order of the return of evacuees in consultation with the Chief, Head of Council, or appointed person from the home community. Once a flight manifest is prepared, it should be sent to the PEOC, which can in turn forward it to other organizations that require the information.
Receiving the information in advance can help ensure that needed services are delivered quickly. In this situation, evacuations may need to be prioritized and contingency plans implemented. While the Standards provide guidance on hosting First Nations, they may also be applied to municipal or unorganized territory evacuations as they pertain to hosting arrangements. While agreements may exist between EMO and a host community, the community retains the option of not hosting during a particular evacuation.
Emergency planners should assess proposed facilities based on location, capabilities, capacity, accessibility, and resources, as well as how they would route evacuee traffic.
Municipal departments involved in the development of the host facility plan may be able to provide resources to support the set-up and operation of a host facility. Registration involves creating a municipal record, which is covered under municipal privacy legislation. Since the degree of damage will likely vary within the affected area, it might be beneficial to initiate a phased re-entry process. In most instances, people are returned in the reverse order of when they were evacuated (i.e. As with the initial evacuation, numerous resources, especially personnel and transportation related resources will be required to return evacuees to their home community. It also shows the various partners likely to be involved in an evacuation, broadly reflecting the actions that fall within their jurisdiction.
Triage tag+ A Triage Tag is a tool first responders and medical personnel use during a mass casualty incident. This has happened in disasters+ such as terrorist attacks+, mass shootings+, volcanic eruptions+, earthquakes+, tornadoes+, thunderstorms+, and rail accidents+. A trauma score is invariably taken when the victim first comes into hospital and subsequent trauma scores are taken to account for any changes in the victim's physiological parameters. The triage hospitalist must determine, in conjunction with a hospital's "bed control" and admitting team, what beds are available for optimal utilization of resources in order to provide safe care to all patients. The scale consists of 5 levels, with 1 being the most critical (resuscitation), and 5 being the least critical (nonurgent).
In 1997, following the amalgamation of two of the city's largest hospitals, the Emergency Department at the Victoria General closed. This grades casualties from Priority 1 (needs immediate treatment) to Priority 3 (can wait for delayed treatment).
They can walk, function freely without assistance, are cognizant, and able to respond accurately to questioning. Immediate aid is applied to stop external arterial bleeding and airways are adjusted to ensure un-obstruction as they are carefully moved to a medical staging area, usually with the aid of those marked green or unable to provide medical assistance.
In low scale disaster with few victims involved, immediate CPR is started in attempt to revive the vital signs. In a combat situation, the triage system is based solely on resources and ability to save the maximum number of lives within the means of the hospital supplies and personnel.
For example, a START Delayed (second priority) can have a survival probability of 63% for blunt trauma and a survival probability of 32% for penetrating trauma with the same physiological measures – both with expected rapid deterioration, while a START Immediate (first priority) can have survival probabilities that extend to above 95% with expected slow deterioration. There have been no cost-benefit analyses of the costs and mitigation of triage inefficiencies embedded in the healthcare system. Similar issues may occur for paramedics in the field in the earliest stages of mass casualty incidents when large numbers of potentially serious or critical patients may be combined with extremely limited staffing and treatment resources. If you do not have an invite, you can get one from someone you know who is a member of the site. Individuals then seek outside assistance from local, provincial or territorial authorities if necessary. Such agreements must be reviewed and amended on a scheduled basis in consultation with the Regional Operations Sector in AANDC’s Headquarters.
The Operations Committee and the Senior ADM of Regional Operations report to the Deputy Minister and the ADM Emergency Management Committee reports to the DM National Security Committee. The Liaison Officer and Communications Branch (which are distinguished from the rest because they hold an indirect role in AANDC’s Coordination Structure) support the AANDC HQ EM Operations Centre. Guidelines for eligible and non-eligible expenses will be developed to ensure comparability with their respective provincial or territorial disaster assistance program. This plan supports the activities being undertaken related to mass evacuation planning for ministry and community emergency management programs. There are two municipalities that fall within the focus area (Moosonee and Pickle Lake) plus more than 30 First Nation communities. This is facilitated through liaison that may be in place between OIC ministries and federal departments - for example, between the Ministry of Health and Long-Term Care, Health Canada and Local Health Integration Networks (LHIN).
Alternatively, the Chief of the First Nation, Head of Council, or an appointed person may decide to conduct a complete or partial evacuation based on an assessment of the threat to area residents. This approach minimizes potentially having people in harm’s way and enables a more controlled evacuation and optimization of resources. Where possible, identify the positions, rather than individuals who may be involved in the operation. Notwithstanding this recommended practice, a host community’s capacity may be such that it is unable to accommodate an entire community.
In the event that the list of potential host communities is insufficient for the size of evacuation pending, the PEOC will solicit additional host communities. Details on the set-up and operation of the shelter should be provided in the community’s emergency response plan. Each municipality has the responsibility for managing the record in accordance with the applicable legislation and their municipal policies. The Chief of a First Nation, Head of Council of a municipality, or appointed person, will decide when to allow evacuees to return to the community. With the aide of the triage tags, the first-arriving personnel are able to effectively and efficiently distribute the limited resources and provide the necessary immediate care for the victims until more help arrives. Triage may result in determining the order and priority of emergency treatment, the order and priority of emergency transport, or the transport destination for the patient. In these cases some percentage of patients will die regardless of medical care because of the severity of their injuries. If a record is maintained, the receiving hospital doctor can see a trauma score time series+ from the start of the incident, which may allow definitive treatment earlier. A typical surgical+ team will have their own system of triage for trauma and general surgery patients. The paramedic triage system was moved to the city's only remaining adult emergency department, located at the New Halifax Infirmary.
The absolute urgencies are usually treated onsite (the PMA has an operating room) or evacuated to a hospital. These individuals will sometimes be asked to assist the responder with transport and applying direct aid to other victims. Fractures are stabilized and individuals listed as green will be asked to assist with collection of yellow individuals for transport to the medical staging area. In larger events with more victims, the head is positioned to open the airway, the body is rolled onto its side and the responder will move on to the next victim. Such analyses are often required for healthcare grants funded by taxpayers, and represent normal engineering and management science practice. Provincial and territorial governments will in turn request federal support if an emergency moves beyond their capacity. It draws linkages to various hazard management plans and procedures developed by ministries. The exact population at any one time is difficult to report as people who are recorded in the census may be away from the community and some who are not recorded may be in the community.
Unorganized territories, fly-in lodges and camps, and mining operations also fall into the plan area.
The seasonal roads cannot be relied on for evacuation operations given the short and sometimes unpredictable length of time that they are available. Local populations often provide the best information on the threat to their community and the region. Emergency responders may require personal protective equipment, as responder safety will be critical. Where an entire community may not be hosted together in close proximity to the home community, and if the situation allows, the community’s preference should be discussed with the Head of Council, First Nation Chief, or appointed person.
The primary reason for returning the most vulnerable people last is to help ensure that support services are in place when they return.
In 2006, a triage protocol on whom to exclude from treatment during a flu pandemic was written by a team of critical-care doctors at the behest of the Ontario+ government. They could be police, fire rescue, paramedics, or community individuals with disaster training (CERT certified+).
The positioning is done so if the body's vitals return, vomiting will not be as likely to choke the victim.
For example, a geriatric patient with a penetrating injury in the Delayed category can have an 8% survival probability, and a pediatric patient in the Immediate category can have a 98% survival probability. The sale of invites and memberships is the only method in which this site gains needed revenue for it's survival.
Nothing in this section is intended to diminish, alter or impede the authority, roles and responsibilities, or accountability of any one program manager or policy centre.
In most cases, the Department assumes responsibility for 100% of the eligible cost of emergency assistance activities carried out exclusively in First Nations communities. The Deputy Minister reports to the Minister and the DM National Security Committee reports to the Cabinet Operations Committee. For example, there may be people staying at fly-in lodges that do not report year-round population. Triage-Lavoir de Peronnes+ Triage-Lavoir de Peronnes is a former coal washing facility that was built with the help of the Marshall Plan in 1954. The overall goal of triage, in this system, is to both determine if a patient is appropriate for a given level of care and to ensure that hospital resources are utilized effectively.
The involved are addressed to another structure called the CUMP–''Cellule d'urgence medico-psychologique'' (medical-psychological urgency cell); this is a resting zone, with food and possibly temporary lodging, and a psychologist+ to take care of the brief reactive psychosis+ and avoid post-traumatic stress disorder+.
They are trained to perform first aid, basic life saving and rescue techniques while performing the greatest good, for the greatest number of people. The bodies will not be collected until all surviving individuals have been removed from the immediate disaster area. The intent is to ensure that prior to an emergency, the groups identified below are prepared to cope with the emergency in the best way possible. If the activities address situations that are not restricted to First Nations communities (e.g.
Similarly, there may be community events that draw tourist and other visitors to the community. It was built for the demand of the coal industry to process the coal coming from the mines of Peronnes, Ressaix and Trivieres. They will rapidly classify victims and sort them into 4 categories, treating quickly as they go.
This system is intended to rapidly identify and classify victims for arriving transport or advanced care medical personnel such as doctors and nurses. The local National Guard and other military units responding would be using the military system+ of triage rather than civilian. Triage focuses on the psychological effects of war on the photo journalist protagonist, Mark. FEMA Letter to Dino Villani, former State of Florida EMS Director, summarizing FEMA Evaluation and Testing Program of STM NIMS compatibilities and operational effectiveness and suitability.

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