scope:

GENERAL

1.It is essential that the same principles with respect to the response to the incident apply in both cases with the exception that the categorization as T4 (details given in Para. 2.4 (5)) is implemented in MASCAL situations only. The use of Triage category T4 can only be authorised by the Theatre Medical Director. Hence, in a MASCAL situation the principles of treatment at the onset of the medical response may change from one based on the individual needs of each patient to the greatest good for the greatest number.

2. The standardization of principles concerning preparatory planning, personnel training, gear interoperability, categorization, treatment, and evacuation of patients will help considerably in ensuring inter-allied and mutual assistance.

3. In a Major Incident/MASCAL situation a coordinated response of all staffs and agencies (including. civilian resources) involved is required, and management of a Major Incident/MASCAL situation is a Commander's responsibility. Any Major Incident/MASCAL situation should have the total focus of the commander, especially in a humanitarian and disaster response situation and/or medical stability operation.

4. If the medical/health service anticipates increased numbers of casualties are likely to exceed the planned medical capability deployed to support the incident, the Medical Incident Officer (MIO) or Senior Medical Officer (SMO) may declare a MASCAL situation. The Joint Operations Centre (JOC) is to inform all personnel that a MASCAL situation has been declared. As referred in AJP- 4.10(B) the Patient Evacuation Coordination Centre (PECC) - if implemented - is collocated with or integrated in the Ops-Centre (Tactical Operations Centre (TOC), Joint Operations Centre (JOC) or Combined Joint Operations Centre (CJOC) and is likely to have the best overview of available medical capabilities and hospital capacity. Therefore the coordination of the medical evacuation is a responsibility of the PECC.

5. Force Protection Measures and other support operations, e.g. air support and Explosive Ordnance Disposal (EOD) and CBRN require a rapid, efficient and coordinated response to Major Incident/MASCAL situations.

6. The need for medical material in support of medical aid to a Major Incident/MASCAL situation is high in quantity but low in diversity.