Not Just Another Acronym

As EMS providers, in order to safely accomplish our goals of triaging, treating and transporting our patients, we must frequently work with and rely upon other agencies to provide personnel, equipment and other resources and support functions. What if there was a system that allowed this to happen in an organized manner, every time an incident occurred, no matter how large or small, regardless of location or jurisdiction? Science fiction, right? Actually, a system for achieving those goals currently exists. It is called the National Incident Management System (NIMS).

Chances are, if you're not directly affiliated with a fire department or some other government entity, you probably weren't included in the introduction of NIMS by the Department of Homeland Security. Many EMS providers are not fully aware of the requirements, set forth by the federal government, making NIMS the national standard for responding to and managing emergency incidents of all types. NIMS is a new way of doing business. As an EMS provider, it is imperative for you to understand how you and your organization fit into the NIMS framework.

The birth of NIMS
Many of the large-scale events that have occurred in recent history have produced the same lessons learned. Among these have been questions about who was in charge, along with personnel receiving multiple, conflicting orders from more than one "commander," the inability to communicate with others operating at the same incident, and a duplication of effort resulting from an unwillingness to integrate game plans or resources. Other problems included confusion sparked by inconsistent use of terminology and an inability to obtain additional resources when local resources ran out.

Since the early 1990s, public-safety innovators had been working to integrate our procedures for managing major events. Many succeeded in doing so at local or even regional levels. However, after the tragic events of September 11, 2001, a determination was made to integrate our command systems, resources and game plans on a national level.

In February 2003, Homeland Security Presidential Directive #5 (HSPD-5) was issued by President Bush. HSPD-5 deals directly with the concepts of managing domestic incidents. In this directive, Bush charged the Department of Homeland Security (DHS) with developing and administering a National Incident Management System. By March 2004, DHS had implemented NIMS.

The Same Sheet Of Music
All of us should be at least somewhat familiar with the concepts of the Incident Command System (ICS). As EMS providers, we may have varying levels of experience utilizing or operating within incident command structures. Some of us are comfortable with ICS concepts because our systems use them all the time. Others may be the exact opposite, essentially becoming victims of ICS as other entities with which we respond utilize it, while we remain on the outside looking in.

It is important to understand that NIMS is not just another acronym atop the pile of ever-changing monikers for the Incident Command System. NIMS is an all-encompassing system unto itself.

NIMS was developed to provide a practical system to be used by all disciplines (EMS, law enforcement, fire-rescue, public works, hospitals, the private sector and government) for all hazards (any incident you can think of, large or small). It provides a framework that allows all local, state, tribal and federal resources to come together under a unified command structure, essentially working off the same sheet of music. NIMS also creates an ability to integrate all of our resources effectively into the overall effort to safely bring the incident to an end as quickly as possible.

The NIMS Umbrella
NIMS consists of six functioning divisions, each contributing to the management of an emergency environment:

1. Command and Management
2. Preparation
3. Resource Management
4. Communications and Information Management
5. Supporting Technologies
6. Ongoing Management and Maintenance.