Mass casualties or high-impact incidents can strain EMS organizations. With the increase in population density the impact of these incidents will increase. One such incident is that of terrorism and criminal activity with major incidents, such as the bombings in Oklahoma City, the New York World Trade Center, and Atlanta. A nationally recognized tool for effective mass casualty and disaster operations is the Incident Management System (IMS). The utilization of the IMS began as a wildfire incident command system and evolved into an urban fire command system. This book is for the responders and planners who confront mass casualties with the intent for EMS agencies and providers to integrate the IMS. To prevent MCIs and disasters from becoming chaotic, they must be managed. The "IMS Toolbox" approach is used throughout the text in order to describe how the IMS expands to match the speed, size, and severity of the event. The book is divided into 12 sections that include: (1) basics of incident management systems; (2) who's in charge; (3) the management staff; (4) EMS operations; (5) EMS operations functions; (6) EMS logistics; (7) communications; (8) the chemical environment; (9) community threat assessment; (10) response agency management systems; (11) training and implementation; and (12) EMS incident management in the real world and appendices on additional accounts of EMS incident management in the real world and incident management forms. Glossary and index