Infectious diseases with epidemic potential remain a significant and constant threat to the health and security of populations around the world, requiring robust health emergency preparedness, readiness and response systems and capacities at local and national levels. Emergency Medical Teams (EMTs), the EMT Initiative and its global network focus on establishing common quality standards and recommendations for medical teams to respond to health emergencies rapidly and effectively, as well as strengthening and supporting national capacities through strong collaboration and coordination. This publication defines minimum standards for the establishment of such critical capacities in a predictable and quality assured manner, and will enhance the interoperability between national, regional, and international capacities. This will contribute to the development and classification of respective specialized care teams (SCT) within the EMT framework and will provide guidance to member states, ministries of health, national and international EMTs and other key stakeholders to develop capacities and trainings, preparing for, or responding to outbreaks of highly infectious diseases.

Catastrophic disasters occurring in 2011 in the United States and worldwide-from the tornado in Joplin, Missouri, to the earthquake and tsunami in Japan, to the earthquake in New Zealand-have demonstrated that even prepared communities can be overwhelmed. In 2009, at the height of the influenza A (H1N1) pandemic, the Assistant Secretary for Preparedness and Response at the Department of Health and Human Services, along with the Department of Veterans Affairs and the National Highway Traffic Safety Administration, asked the Institute of Medicine (IOM) to convene a committee of experts to develop national guidance for use by state and local public health officials and health-sector agencies and institutions in establishing and implementing standards of care that should apply in disaster situations-both naturally occurring and man-made-under conditions of scarce resources. Building on the work of phase one (which is described in IOM's 2009 letter report, Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations), the committee developed detailed templates enumerating the functions and tasks of the key stakeholder groups involved in crisis standards of care (CSC) planning, implementation, and public engagement-state and local governments, emergency medical services (EMS), hospitals and acute care facilities, and out-of-hospital and alternate care systems. Crisis Standards of Care provides a framework for a systems approach to the development and implementation of CSC plans, and addresses the legal issues and the ethical, palliative care, and mental health issues that agencies and organizations at each level of a disaster response should address. Please note: this report is not intended to be a detailed guide to emergency preparedness or disaster response. What is described in this report is an extrapolation of existing incident management practices and principles. Crisis Standards of Care is a seven-volume set: Volume 1 provides an overview; Volume 2 pertains to state and local governments; Volume 3 pertains to emergency medical services; Volume 4 pertains to hospitals and acute care facilities; Volume 5 pertains to out-of-hospital care and alternate care systems; Volume 6 contains a public engagement toolkit; and Volume 7 contains appendixes with additional resources.

The care of the sick and injured on wildland fire incidents has expanded over the last 30 years. The mission of Medical Units on wildland fire incidents has evolved into a complex service which provides: (1) stabilization and emergency medical treatment of incident personnel, and (2) occupational health and preventative measures for incident personnel to remain safe and healthy. Wildland firefighting operations require a unique array of services due to the remoteness, terrain, and complexity of utilizing multiple agencies. Medical support is essential because of the inherent risks and exposures associated with these events. The issues of standard of care and legal licensure of providers come into play when emergency medical providers from other jurisdictions cross state lines or other geopolitical boundaries to provide medical care. These situations are further complicated in areas where medical control is sometimes nonexistent or the capabilities of nearby medical facilities may be limited, including the variability of local emergency medical services agency capacities. This document introduces stakeholders to the minimum standards developed by the Incident Emergency Medical Task Group (IEMTG) when a Medical Unit has been established by a National Wildfire Coordinating Group (NWCG) member agency. This document is intended to provide direction regarding medical personnel and equipment assigned to the Medical Unit. The IEMTG recognizes the National EMS Scope of Practice Model as the baseline standard for emergency medical service providers. Therefore, a key component of the minimum standards addresses the recognition of local, state, federal, and tribal jurisdictional authorities and the integration of medical services. Overall, the minimum standards seek to ensure that incident personnel receive quality, timely medical care on wildland fire incidents, which often occur in remote areas.