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EW ZEALAND AMBULANCE MAJOR INCID
New Zealand Ambulance Major Incident 
and Emergency Plan (AMPLANZ)
1982
Act 
The Plan
September 2016
Information 
Official 
the 
under 
Released 

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Acknowledgements
Ambulance New Zealand would like to acknowledge and warmly thank the following organisations for their 
support and contributions towards the completion of the 2011 version and also this review of AMPLANZ:
Members of Ambulance New Zealand especially St John, Wellington Free Ambulance and the Northern 
Emergency Services Trust  for releasing the members of the AMPLANZ review work group: 
 
Tim Chiswell, St John
 
Warren Cornor, Wellington Free Ambulance
 
Kelvin Perriman, St John
 
Bruce MacDonald, St John
 
Peter Turnbull, NEST
 
Andrew Keenan, Wellington Free Ambulance
Ambulance NZ Standards and Accreditation Committee
1982
New Zealand Fire Service
Ambulance Victoria, Specialist Emergency Response Department
NZ Ministry of Health, Emergency Management Team and especially Murray Mills as a member of the 
Act 
Review work group
UK Department of Health, Emergency Preparedness Division 
Thank you to Paul O’Connell (St John Learning Media) for the design of this document.
Thank you also to Catherine Preston, David Wethey, Glenn Cockburn, Matt Ohs, Oz Golan, The Lifeflight Trust 
and Hawke’s Bay Today for the use of their photographs in this document
Foreword
Information 
New Zealand has for a number of years had a national ambulance major incident and emergency plan 
– AMPLANZ. This has ensured that there is a common understanding between ambulance services, 
communications and control centres and our emergency management partners as to how an ambulance will 
respond in a time of crisis.
Official 
This document is the reviewed plan based largely on the 2011 plan, the changes in the sector and its 
experience relating to major incident management. There have also been changes to the New Zealand 
Coordinated Incident Management System (CIMS) as well as a new National Health Emergency Plan (NHEP). 
the 
Developments in CIMS or the NHEP are reflected here. 
Thankfully, unlike before the previous extensive rewrite of AMPLANZ in 2011, New Zealand has not had 
significant local or regional emergencies like the Pike River tragedy and the Canterbury Earthquakes. That 
said, we have seen improvements to our management and an increased awareness of our plans and 
procedures through reviews of incident management and ongoing local and national exercises. Examples 
under 
where significant development has occurred is in the formalisation of Ambulance’s National Crisis 
Coordination Centre run by St John and improvements in the sector’s business continuity management.
AMPLANZ continues to provide the sector with the appropriate guidance for each service to development its 
own detailed major incident and emergency plan. 
Finally there continues to be development of our national understanding of the risks we face and the need 
to ensure that our plans, organisations, people and communities are resilient. AMPLANZ covers all aspects 
of our management in a major incident and enables ambulance services to coordinate effectively with 
Released 
partner agencies.
David Waters 
CEO 
Ambulance New Zealand

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AMPLANZ Part 1:
Introduction to AMPLANZ and Emergency Management for the 
Ambulance Sector
For all staff of New Zealand Ambulance Services
1982
September 2016
Act 
Content
Part 1: Introduction to AMPLANZ and Emergency Management of 
the Ambulance Sector
Information 
1.0 Introduction 
 
4
1.1 What is AMPLANZ? 
 
4
1.2 The Aim of AMPLANZ 
 
4
1.3 Mandate of AMPLANZ 
 
4
1.4 Format of AMPLANZ 
 
4
1.5 The Ambulance Sector 
 
5
Official 
2.0 Frameworks and Concepts of Emergency Management  
  6
2.1 Legislation and National Emergency Management Plans 
  6
2.2 The 5 ‘Rs’ 
 
6
the 
2.3 CIMS (New Zealand Coordinated Incident  
Management System) 
 
7
2.4 Concept of Ambulance Emergency Management   
7
2.4.1 The Responsibilities of Ambulance Services in a  
Major Incident 
 
7
under 
2.4.2 A structured and consistent approach 
8
2.4.3 Whole of Organisation and Sector 
 
8
Part 2: Consistent Operations at the Scene
Part 3: Ambulance Service Approach
Part 4: National Crisis Coordination Centre
Appendices
Released 

---

1.0 Introduction
AMPLANZ is mandated to provide:
“….all Ambulance Services with the nationally 
1.1 What is AMPLANZ?
standardised framework to command, control and co-
ordinate ambulance resources locally, regionally and 
AMPLANZ is a detailed operational framework for 
nationally, for the greatest good of the greatest number 
the New Zealand ambulance sector to provide clear 
of casualties during major incidents”.
guidance for all Ambulance Services in all parts of the 
emergency management cycle. It provides standard 
1.4 Format of AMPLANZ
terminology, structures, and roles. It also provides tools 
to assist an Ambulance Service in its readiness and 
The format of AMPLANZ is one document made up of 
reduction, response and recovery, for example, task 
four parts as noted below.
cards, planning templates, debriefing templates etc.
Specific Ambulance Service Major Incident and 
AMPLANZ – The Plan
1982
Emergency Plans must be developed Ambulance 
Services based on this framework.
 
 
 
 
Part 1  
Part 2  
Part 3  
Part 4  
AMPLANZ cannot be arbitrarily changed. There is a 
Introduction 
Consistent 
Ambulance 
National 
Act 
to AMPLANZ 
Operations 
Service 
Crisis 
review process through the Ambulance New Zealand 
and Emergency 
at the 
Approach 
Coordination 
Standards and Accreditation Committee outlined as 
Management for 
Scene 
 
Centre
part of AMPLANZ.
the Ambulance 
 
Sector 
In line with health sector and the emergency 
 
management sectors as a whole, there are a large 
number of specialist terms and abbreviations. To 
Part 1: Introduction to AMPLANZ and Emergency 
assist the reader, there is a Glossary of Terms and 
Management for the Ambulance Sector: This part 
Abbreviations in Appendix 1.
summarises what AMPLANZ is, the sector, and key 
ambulance and emergency management concepts.
Information 
1.2 The Aim of AMPLANZ
Part 2: Consistent Operations at the Scene: This 
The aim of AMPLANZ is to:
Part focuses on the activities to be undertaken by 
responding crews, the duty management and those 
  Ensure the effective and consistent management of 
operational officers directly involved at the scene in 
major incidents at local, service and national levels 
coordination with other responding agencies.
for the benefit of patients
Official 
Part 3: Ambulance Service Approach: This Part focuses 
  Minimise the impact of a major incident or multiple 
on the activities to be undertaken by Ambulance 
major incidents on normal operations 
Service Management in all parts of the emergency 
the 
  Adopt and encourage a whole-sector approach to 
management cycle. It is designed to guide ambulance 
major incident management
managers who are required to support the response 
at the scene, as well as play a role in preparing for or 
  Adopt and encourage a whole-of-organisation 
recovering from a major incident.
approach within services to major incident 
management.
Part 4: National Crisis Coordination Centre: This 
under 
Part provides a framework for the development and 
1.3 Mandate of AMPLANZ
management of National Crisis Coordination Centre to 
ensure that the ambulance sector is able to respond to 
AMPLANZ applies to all Ambulance Services1 in 
a significant regional or national emergency.
New Zealand and it is noted in Section 3.2.7 of 
the Ambulance Standard (NZS 8156:2008) that an 
This is Part 1. 
Ambulance Service “shall be aware of, and where 
appropriate, contribute to, regional and/or national large 
scale contingency planning and be able to operate in 
Released 
accordance with such plans including…. AMPLANZ”.
Ambulance New Zealand has approved policy to clarify:
“…the mandate of AMPLANZ and to ensure that 
Ambulance NZ and Ambulance Services understand their 
roles and responsibilities with regards to the development, 
maintenance, and operationalisation of AMPLANZ”.
1An Ambulance Service is defined in NZS8156:2008 Section 1.5 page 12.
4
NEW ZEALAND AMBULANCE MAJOR INCIDENT AND EMERGENCY PLAN (AMPLANZ)

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1.5 The Ambulance Sector
(ACC)-contracted fixed wing and rotary air ambulance 
Trust. The area of coverage of the land-based services 
The primary role for the ambulance sector is to deliver 
and the bases of the air ambulances are noted in 
pre-hospital health care. This includes triage, treatment 
Figure 1. 
and transport and pre-hospital emergency and non-
acute care. Response to major emergencies is also 
Ambulance communications and clinical control 
considered part of the sector’s primary role. Beyond 
services are managed by the two land based 
the emergency functions, Ambulance Services are 
ambulance services. The services are provided by St 
continuing to develop their role in the primary health 
John Clinical Control Services (CCS) and WFA Central 
care sector. 
Communications. The St John CCS is currently run 
from two Clinical Control Centres in Auckland and 
There are two land-based emergency Ambulance 
Christchurch. The WFA Central Communications is 
Services and 11 Accident Compensation Corporation 
based in Wellington. 
1982
Figure 1
Act 
Information 
Land based ambulance services
  St John
  Wellington Free Ambulance
Air ambulance services
Official 
 Helicopters
 Fixed Wing Aircraft
the 
under 
Released 
PART 1 SEPT 2016 
5

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Ambulance Services are required to comply with the 
Appendix 2 lists the key legislation and plans that 
Ambulance Standard (NZS 8156: 2008). 
guide Ambulance Service emergency planning.
In addition, there are multiple services that provide 
patient transfer services, private hire services, support 
2.2 The 5 ‘Rs’
to public events and specialist operational support to 
The New Zealand integrated approach to emergency 
other emergency services. 
management can be described by the four areas of 
activity, known as the ‘4Rs’ 4.
2.0 Frameworks and Concepts of 
These are
Emergency Management 
  Reduction: identifying and analysing long-term 
risks to human life and property from natural or 
2.1 Legislation and National Emergency 
non-natural hazards; taking steps to eliminate 
these risks if practicable, and, if not, reducing the 
Management Plans
1982
magnitude of their impact and the likelihood of  
The ambulance sector in New Zealand, unlike many 
their occurring 
services internationally, does not have its own 
Act 
  Readiness: developing operational systems and 
legislation that guides and regulates the provision of 
capabilities before an emergency occurs
ambulance services.
  Response: actions taken immediately before, during 
That said, Ambulance Services are health sector 
or directly after an incident or emergency to save 
organisations and therefore have responsibilities 
lives and property, and to help communities recover 
within, for example, the Health Act 1956 and  
New Zealand Public Health and Disability Act 2000.
  Recovery: the coordinated efforts and processes 
used to bring about the immediate, medium-
In the context of emergency management, the 
term and long-term holistic regeneration of an 
ambulance sector must comply with, for example, the 
organisation and community following an emergency. 
Civil Defence Emergency Management Act 2002 and 
Information 
Epidemic Preparedness Act 2006.
For the purposes of AMPLANZ, a ‘5th R’ is identified  
as critical:
Ambulance services shall be aware of their 
responsibilities under these legislations as well as 
  Relationships: the development and maintenance of 
other health, safety and workplace legislation.
communications, coordination and understanding of 
capacity and capability between ambulance service 
There are two key national plans that relate to 
managers and key personnel in health service 
Official 
emergency management. These are the: 
agencies, civil defence and welfare agencies, lifeline 
  National Civil Defence Emergency Management 
organisations and private sector agencies, as well as 
Plan 2015 
traditional emergency service partners.
the 
  National Health Emergency Plan 2015 (NHEP). 
2.3 CIMS (New Zealand Coordinated 
The NHEP, in particular, refers to the requirement of 
Ambulance Services to:
Incident Management System5)
“...provide triage, initial treatment and transportation 
The purpose of CIMS is to provide structure and 
under 
as outlined in the Ambulance Major Incident and 
coordination in the management of incidents with 
Emergency Plan...” (AMPLANZ) 2
the aim of improving efficiency and effectiveness 
in management response. CIMS is New Zealand’s 
And: 
approach to incident management and it provides a 
“...if regional ambulance resources are overwhelmed, 
framework to manage a range of diverse incidents from 
ambulance services will open the National Crisis 
routine incidents to major emergencies.
Coordination Centre (NCCC). The NCCC will coordinate 
CIMS is a seamless approach based on the following 
with the National Health Coordination Centre and other 
Released 
principles across all responding organisations: 
national emergency management structures ... as 
required. The NCCC will also coordinate the (national) 
  Common structures, roles, and responsibilities
ambulance response.” 3
  Common terminology
The Ministry of Health (MoH) is the lead agency 
  Modular and scalable
for national health and disability sector emergency 
planning and response coordination.
2National Health Emergency Plan 2015. Page 23. 
3National Health Emergency Plan 2015. Page 23. 
4http://www.civildefence.govt.nz/cdem-sector/cdem-framework/the-4rs/
6
NEW ZEALAND AMBULANCE MAJOR INCIDENT AND EMERGENCY PLAN (AMPLANZ)

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1982
Act 
  Responsive to community needs
All Ambulance Services are required to be familiar with 
CIMS and have personnel trained to the appropriate 
  Integrated response coordination
level to manage incidents in line with CIMS. CIMS 
  Consolidated action planning 
manuals shall be available to all Ambulance Service 
personnel.
  Integrated information management and 
communications
2.4 Concept of Ambulance Emergency 
  Resource coordination
Management
Information 
  Designated response facilities
  Manageable span of control
2.4.1 The Responsibilities of Ambulance Services in 
To coordinate the effective use of all of the available 
a Major Incident
resources, agencies need a formalised management 
structure that lends consistency, fosters efficiency and 
The role of the ambulance sector in response to a 
Official 
provides direction across the 4Rs. The CIMS structure 
major incident is to deliver and maintain appropriate 
is built on the functions:
pre-hospital clinical care. In a mass casualty incident, 
ambulance will lead the operational health response 
  CONTROL: Coordinates and controls the response
to the incident at the scene/s and manage the triage, 
the 
  INTELLIGENCE: Collects and analyses information 
treatment and transport of patients to appropriate 
and intelligence related to context, impact and 
receiving hospitals or health facilities.  In all 
consequences; also distributes intelligence outputs 
emergencies impacting the health of the communities, 
Ambulance Services will manage and coordinate their 
  PLANNING: Leads planning for response activities 
response with the DHBs and other emergency services 
under 
and resource needs
to manage demands on the healthcare system.
  OPERATIONS: Provides detailed direction, 
Below are key responsibilities of Ambulance Services 
coordination, and supervision of response 
in a major incident. 
elements on behalf of the Control function   
Responsibilities of an Ambulance Service in all 
  LOGISTICS: Provides personnel, equipment, 
emergencies:
supplies, facilities, and services to support 
response activities   
  To save life in conjunction with other Emergency 
Services
Released 
  PUBLIC INFORMATION MANAGEMENT: Develops 
and delivers messages to the public, directly and 
  To notify and liaise with the other Emergency 
through the media, and liaises with the community 
Services
if required
  To initiate and maintain an Ambulance Service 
  WELFARE: Coordinates the delivery of emergency 
Command and Control structure lead by an 
welfare services and resources to affected 
Ambulance Service Controller
individuals, families/whānau, and communities   
5The New Zealand Coordinated Incident Management System (CIMS), 2nd edition. 2014. Safer communities through integrated emergency 
management. Pages 4–6.
PART 1 SEPT 2016 
7

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  To protect the health, safety and welfare of all 
  To assume responsibility for casualty 
ambulance staff generally, and all health workers 
decontamination, in conjunction with the Fire 
on the scene. Also ensure that the actions of 
Service
Ambulance and health staff do not put others  
  To provide the Fire Service with clinical advice and 
at risk.
assistance to support on-site decontamination
  To supply sufficient ambulances and staff for  
  To maintain adequate emergency ambulance cover 
the incident
throughout the Ambulance Service’s operational 
  To provide a communications system between 
area for the duration of the major incident
ambulance and DHBs (including hospitals)
  To progressively release activated hospital(s) and 
  To provide Ambulance Liaison Officer/s to the 
health facilities and ultimately issue a message 
partner agencies as appropriate for the incident
indicating the completion of casualty evacuation.
  To reduce to a minimum, the disruption of the 
1982
normal work of the Service by implementing 
2.4.2 A structured and consistent approach
Business Continuity Plans, as appropriate,  
AMPLANZ is aligned with CIMS, important  
ensuring the restoration of normality at the  
New Zealand emergency management concepts and 
Act 
earliest opportunity.
with key national emergency plans.
Responsibilities of an Ambulance Service for Mass 
AMPLANZ also notes that to effectively manage large 
Casualty Incidents in particular:
and complex incidents, the processes and procedures 
used by ambulance services need to be established 
  To provide a structure to support the triage, 
and understood within the services and also by partner 
treatment and transport of casualties from the 
agencies.
scene by establishing an Ambulance Control  
Point, Casualty Clearing Point and Ambulance 
Major incidents, such as mass casualty events, are 
Loading Point
infrequent and consequently any procedures required 
Information 
to manage such incidents shall follow the same basic 
  To provide a Senior Ambulance Officer at the scene 
processes as for smaller and less complex incidents. 
to act as Ambulance Commander (AC)
Therefore essential processes, such as assigning 
  To be part of the Scene Incident Management Team 
initial response roles and responsibilities, incident 
(IMT) to ensure a coordinated response to the 
escalation, notifications, situation reports, triage etc 
incident
are the same no matter what the size or complexity of 
the incident.
Official 
  To identify, notify and communicate with appropriate 
receiving hospital(s), health facilities and DHBs 
of the prevailing situation and the categories and 
2.4.3 Whole of Organisation and Sector
the 
estimated times of arrival of casualties
AMPLANZ is designed to ensure that all parts of the 
  To triage all patients prior to evacuation from  
ambulance sector and the individual services are 
the scene
involved in the response, recovery and development of 
readiness of the sector. This will then contribute to the 
  To manage all medical resources deployed to the 
resilience of the health sector.
scene for the treatment and care of casualties
under 
Within an Ambulance Service there are roles and 
  To determine the priorities for the evacuation 
responsibilities of first-responding crews, for ambulance 
of casualties, ensuring even and simultaneous 
service management and also for key support staff in 
dispatch to the receiving hospital(s) and health 
non- operational or core support positions.
facilities
Across the sector, guidance is given to further integrate 
  To organise transportation for casualties to the 
the individual service’s response and planning at 
receiving hospital(s) and health facilities, and any 
the tactical and operational levels and also in the 
necessary secondary transfers between hospital
coordination of all ambulance services with national 
Released 
  To acquire additional ambulance resources, as 
agencies, such as MoH.
necessary through the use of the Ambulance 
Service’s national coordination mechanisms
  To forward to the receiving hospital(s) and health 
facilities, Medical Officer(s) of Health and DHB(s), 
any information acquired at the scene relating to 
chemical, biological or radiation (CBR) hazards and 
possible contamination of casualties or rescuers 
and advise of the potential for self-presenting 
patients
8
NEW ZEALAND AMBULANCE MAJOR INCIDENT AND EMERGENCY PLAN (AMPLANZ)

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AMPLANZ Part 2:
Consistent Operations at the Scene
For all Ambulance Services staff working directly at or with the scene
September 2016
1982
Act 
Content
Information 
Part 1: Introduction to AMPLANZ and Emergency Management for the 
Ambulance Sector
Part 2: Consistent Operations at the Scene
1.0 Introduction 
 
10
3.6 Summary of scene roles and responsibilities 
 
21
Official 
2.0 Readiness and Reduction   
10
3.7 Site Set up 
 
22
2.1 Planning and development   
10
3.8 Coordination with Health, Emergency Services and  
2.2 Training and education 
 
10
other Agencies  
 
25
3.8.1 Health  
 
25
the 
3.0 Response 
 
10
3.8.2 Emergency Services and other Agencies 
 
25
3.1 Activations, Level of Response, and Notifications   
10
3.9  Media  
25
3.1.1 Escalation 
 
11
3.10 Resources and Equipment  
 
26
3.1.2 Definition and Types of Incident 
 
12
3.1.3 Response Matrix Tool 
 
13
3.10.1 Major Incident Vests 
 
26
3.1.4 Risk Assessment and Response 
 
13
3.11 Specialist Operations 
 
26
under 
3.2 Role of the First Crew 
 
14
3.11.1 Activation of Ambulance Specialist Operations   
27
3.11.2 Pre-hospital Responses by DHBs and other organisations   
27
3.3 Triage  
14
3.11.3 Activation of Responses by DHBs and other organisations  
3.4 Communications and information management   
16
 27
3.4.1 On-scene communications  
 
16
4.0 Recovery 
 
27
3.4.2 METHANE 
 
16
4.1 Ambulance Debrief Processes and Tools 
 
28
3.4.3 Notifications to Health Partners 
 
18
4.1.1 Debrief aims and requirements 
 
28
3.4.4 Information Management tools 
 
18
4.1.2 Debrief and Reporting tools 
 
28
3.4.5 Integration with the Incident Management Team   
19
Part 3: Ambulance Service Approach
Released 
3.5 Command Structure and Scene Management  
 
19
3.5.1 Simple Command Structure 
 
19
Part 4: National Crisis Coordination Centre
3.5.2 Comprehensive Command Structure   
19
Appendices

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1.0 Introduction
complete CIMS 2 training, with refresher training 
every five years
AMPLANZ is divided into four parts plus an overview 
document. This is Part 2 and focuses on the activities 
  All ambulance operations managers, CCCS 
to be undertaken by responding crews, the duty 
managers and relief managers to complete CIMS 4 
management, the CCCS and those operational officers 
training with refresher training every five years 
directly involved at the scene, in coordination with 
  Senior ambulance managers and officers (District 
other responding agencies.
Operations Managers, Territory Managers etc.) who 
This document should be read in conjunction with 
will be required to fill Ambulance Commander or 
Part 1: Introduction to AMPLANZ and Emergency 
Operations Manager roles to complete ‘Ambulance 
Management for the Ambulance Sector.
Critical Incident Management’ training or similar (to 
be developed)
Appendix 1 has a Glossary of Terms and Abbreviations.
  Emergency Management Continuing Clinical 
1982
2.0 Readiness and Reduction
Education Modules for ambulance officers shall be 
developed and maintained to develop skills and 
competencies in key aspects of the Ambulance 
2.1 Planning and development 
Act 
Service major incident readiness and response
The Ambulance Service is responsible for the 
  Ambulance and Communications staff effectively 
development and maintenance of: 
practice their skills in ambulance and multi-agency 
  Relationships with other emergency services, 
major incident or emergency exercises 
including the DHBs, civil defence and key public 
  Operational Staff who are required to undertake 
and private sector agencies that may require an 
Specialist Operations will receive appropriate 
ambulance major incident response or will impact 
specific training. There shall be a national 
an ambulance response
alignment, in conjunction with partner agencies, to 
  Business Continuity Management will be integrated 
ensure consistent training in all specialist areas.
Information 
into the service; from station level through to core 
Training needs analysis is required to further enhance 
support departments, such as IT or Finance
the appropriateness of emergency management 
  Risk analysis processes in their area to ensure 
training and education within an Ambulance Service.
priority operational risks are mitigated 
Training and education in emergency management 
  Predetermined or tactical response plans including 
for Ambulance Services shall also align appropriately 
their integration with other emergency services 
with competency frameworks and guidelines of other 
Official 
and partner agencies. This will include the timely 
emergency service partners, as well as with Civil 
communication of these plans from the CCCS to 
Defence and Emergency Management Agencies.
responding ambulance officers and management
the 
  The provision of appropriate and consistent 
3.0 Response
equipment and materials required for responding to 
a major incident. These will be in the form of kits 
3.1 Activations, Level of Response1, and 
and caches of materials and equipment.
Notifications
under 
It is also an Ambulance Service responsibility to 
develop its own exercises and / or to take part in 
This section outlines the Ambulance activation 
multi-agency exercises that clearly test aspects of 
mechanisms and levels of response required for an 
the service’s major incident response procedures and 
incident in the community that may require escalation 
plans and enables review and learning to be reflected 
to the national level.
in modifications of these procedures. See Part 3 
Section 2 for further details.
The aim is to ensure that every major incident is 
managed appropriately as early as possible in the 
2.2 Training and education
response. This will improve patient outcomes and will 
Released 
All operational ambulance staff shall have a basic 
ensure that the responding ambulance officers are 
level of emergency management training from 
supported quickly and effectively.
their primary qualifications. To further enhance an 
The classification of the type of incident is essential to 
Ambulance Service emergency response, ambulance 
ensure that appropriate activations and notifications 
officers and managers shall have the appropriate 
occur. Once an incident has been classified it triggers 
level of training for the role they may be required to 
certain actions that must be taken by the affected 
undertake at the scene of a major incident. Such 
training should include, but is not limited to:
Ambulance Service. This will enable quick decision-
making to determine the level of coordination required.
  All emergency ambulance staff and CCCS staff to 
 1This section draws on Ambulance Victoria (AV) Emergency Response Plan 2009. AV’s generous support is acknowledged.
10
NEW ZEALAND AMBULANCE MAJOR INCIDENT AND EMERGENCY PLAN (AMPLANZ)

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The major variables that govern the type of response 
To allow the identification of correct response levels, 
from an Ambulance Service include: 
two tools have been developed: 
  Time to respond to the incident (travel, triage, treat 
  An Escalation Flow Chart that notes the actions of 
and transport)
all ambulance parties in the initial escalation
  The complexity of the incident
  A Response Matrix to be used by the CCCS.
  The number of patients.
3.1.1 Escalation
There are four levels of response: 
The Escalation Flow Chart – Figure 1 – provides an 
  Normal Operations
overview of the actions by the CCCS and the Ambulance 
Duty Operational Manager2 in the initial stages of a 
  Level 1: medium impact on normal operations
major incident. This outlines when to use the Response 
  Level 2: high impact on normal operations
Matrix and the initial assessment, as well as clearly 
  Level 3: severe impact on normal operations.
defining the actions to be undertaken by the CCCS and 
Duty Manager, based on the level of incident.1982
Figure 1: Escalation Flow Chart 
Duty Operations Manager
Communicator and/or Dispatcher
CCCS Duty Manager
Act 
(or Ops Management Team/AMb Service Exec on-call)
Use Response Matrix to establish 
Duty Ops Manager with  
initial estimated response level
CCCS DM:
Incident 
received
  Undertake initial assessment
  Review initial resourcing / initial 
response plan
  Decide if declaration required 
Possible or Actual 
and at what Level
Incident identified as possibly  
Major Incident or 
  Ensure Amb Service Exec is 
outside of normal operations
Emergency?
informed
  Call appropriate Ops 
Management Teleconf with 
YES
Information 
agenda to
  Brief management team and
Escalate to CCCS Duty Manager
YES
  To develop Ambulance Action 
Plan
Escalate to Duty Ops 
  Request a Major Incident page 
Manager – Is He/She 
be sent to DHBs if appropriate
contactable?
Immediately dispatch appropriate 
resources as per SOP
NO
Official 
Page appropriate Ambulance Service 
Management Team group 
Request and receive a  
“Possible Major Incident” Message to 
YES
METHANE Report
initiate Teleconference
the 
CCCS DM must call the Service  
NO
Exec on-call
under 
LEVEL 1
Major Incident Declared?
Managed by Duty Ops Manager
YES
LEVEL 2
Page “Declared Major Incident”  
Managed by Duty Ops Manager
Level 1, 2 or 3 to appropriate  
unless otherwise advised by Amb 
NO
Major Incident (MI) Paging Group
Service Exec
Normal Operations
LEVEL 3
Released 
Managed by Duty Ops Manager unless 
otherwise advised by Amb Service Exec
Continual reassessments based  
Page incident updates to 
on SITREPS 
appropriate MI Group as required
Support the incident via EOC, 
CCCS, NCCC etc
NO
Page “Stand Down” to  
YES
Stand-down issued?
appropriate MI Paging Group
2Duty Operational Manager is a generic position title that covers a number of positions used across the sector such as Operations Team 
Manager, Shift Supervisor, Duty District Manager etc.
PART 2 SEPT 2016
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3.1.2 Definition and Types of Incident
A major incident or emergency for ambulance is defined as:
Any occurrence that presents serious threat to the health of the community, disruption to the service or 
causes (or is likely to cause) such numbers or types of casualties as to require special arrangements to 
be implemented by appropriate responding agencies including: 
  Ambulance Services 
  District Health Boards (including, for example, hospitals, primary care, and public health)
  The Ministry of Health.
AMPLANZ has adopted a set of descriptors for types of incidents applicable to all hazards. These incident 
1982
descriptors relate to the ability to access patients, involvement of a lead agency or a comprehensive CIMS 
structure and the complexity of the response and its impact on normal services.
Act 
Time to respond, triage, treat and transport is another factor that will impact on patient care and normal service 
delivery. Therefore this will need to be taken into account in the decision-making process.
Figure 2: Types of Incidents
Type of Incident Description
Complex 
Incident that is not routine or it is an infrequently used procedure (e.g. CBR, Airport 
emergency, major Civil Defence Emergency Management (CDEM) event (tsunami))
Information 
Controlled
Incident that has a lead agency (e.g. Police, Fire, Health, CDEM etc) or comprehensive 
CIMS structure in place or  a large number of personnel are deployed
Official 
Restricted
Where access to patients is difficult owing to hazardous, environmental or security 
factors
the 
Open
Where there are no issues regarding the access to or egress from patients
Simple
Incident where normal or routine Ambulance procedures apply
under 
Released 
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3.1.3 Response Matrix Tool
The initial assessment of an incident is the responsibility of the CCCS Duty Manager using the response matrix 
below in Figure 3.
Figure 3: Response Matrix
>21
Level 2
Level 2
Level 2
Level 3
Level 3
11–20
Level 2
Level 2
Level 2
Level 3
Level 3
1982
6–10
Level 1
Level 1
Level 2
Level 2
Level 2
Act 
Normal 
3–5
Level 1
Level 1
Level 2
Level 2
Operations
Normal 
Normal 
0–2
Level 1
Level 1
Level 2
Operations
Operations
Numbers of  
Simple/ 
Simple/ 
Simple/ 
Complex/ 
Patients
Restricted/ 
Type of 
Open
Restricted
Controlled
Information 
Controlled
Incident
Time
<1hr
1–2hr
2–4hr
4–8hr
>8hr
Official 
How to use the Response Matrix
1.  Estimate the total likely ‘Time’ or duration of the incident for ambulance (travel, triage, treatment and transport) 
and plot on the Response Matrix
the 
2.  Determine the ‘Type of Incident’ from Figure 2 and plot it on the Response Matrix
3.  Determine the Severity of the Incident by comparing the time estimate to the Type of Incident, and select the 
greater (i.e. further to the right of the matrix)
4.  Determine the likely number of patients and plot against the Severity of the Incident on the Response Matrix
under 
5.  The Duty Operational Manager  will be informed and will respond according to approved Standard Operating 
Procedures. If the local Duty Operations Manager is not available then CCCS Duty Manager will contact the 
Local Operations Management Team and the Ambulance Service Exec to escalate the incident.
3.1.4 Risk Assessment and Response
Once an incident has been classified using the Response Matrix Tool and determined to be outside of normal 
business, the CCCS will inform the Ambulance Service Duty Operational Manager. 
Released 
Ambulance Service Duty Operational Manager, in consultation with the CCCS Manager, will then be required to 
confirm that a major incident has occurred and will declare a major incident for ambulance at the appropriate 
level. This will be done using information from the incident scene, the CCCS, partner agencies and other reliable 
sources. To assist with decision-making the Ambulance Service Duty Operational Manager will need to consider: 
  The type of incident
  The possible time for ambulance to respond (travel, triage, treat and transport) and therefore for patients to 
reach definitive care
  The location of the incident, relative to ambulance resources and health facilities
PART 2 SEPT 2016
13

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  The number and status of patients 
  Coordinate the deployment of resources at the 
scene
  The availability of ambulance resources
  Provide Sitreps using the METHANE format.
  Environmental factors, such as weather and time of day
Summary of Triage Officer Role
  Health and safety of responding ambulance resources
  Assess and triage the number and type of patients
  The need to coordinate with other services and the 
impact of their operations, in particular, the health 
  Obtain triage tags and apply triage tags
services.
  Inform Ambulance Operations Manager (AOM) of 
numbers and status of patients
  Begin to coordinate the removal of triaged patients 
3.2 Role of the First Crew
to the Casualty Clearing Point(s) (when set up)
1982
The actions of the first-arriving ambulance crew at 
  Begin to allocate the clinical priority for patients 
an incident are crucial to establishing an appropriate 
until a Treatment Officer is appointed. (See Section 
response to an incident. These are summarised below.
3.6 for role description of the Treatment Officer)
Act 
Primary Roles 
For full task cards for the members of the first crew – 
see Appendix 4.
  Ensure the scene is safe. Use ‘STEP 1, 2, 3’ as 
appropriate. See Appendix 3
All ambulances will carry Ambulance Major Incident 
Folders to assist the first crew. See Part 2 Section 
  Complete a scene ‘walk around / size up’ 
3.4.4.
  Provide an immediate and initial Incident Situation 
Report (Sitrep) utilising the following METHANE3 
3.3 Triage
format to the CCCS
The aims of triage, wherever it is done, are not only 
  Identify and make contact with the Officers in 
to deliver the right patient to the right place at the 
Information 
Charge of other responding services and begin the 
right time so that they receive the optimum treatment 
coordination process 
but also to ‘do the most for the most’, accepting that 
  Adopt Operations Manager and Triage Officer roles 
valuable medical resources are directed to those with 
and put on the appropriate Major Incident vests
the greatest clinical need.
  Conduct initial triage of the scene 
The principles of triage shall be used whenever: 
Official 
  Provide further and regular Sitreps following the 
“The number of casualties exceeds the number of 
METHANE format to the CCCS 
skilled rescuers available”.
  Meet, brief and allocate roles to incoming 
The first triage decision will be made at the scene, 
the 
ambulance crews
likely where the patient is found. This will be done 
using a primary triage process as outlined in Figure 5. 
  Provide a handover to a more senior Officer when/if 
This is a process performed by the designated triage 
requested.
officer at the scene. The Triage Officer should be the 
Summary of Operations Manager Role
highest clinically qualified officer available.
under 
  Ensure scene safety
The process is rapid, taking seconds to complete. 
Triage enables the Triage Officer to prioritise patient 
  Complete scene assessment and reconnaissance
treatment and transport. Patients will be labelled and, 
  Establish appropriate sites and roles for scene 
where appropriate, grouped according to their status.
management
  Maintain liaison with responding agencies 
Released 
3 METHANE is a pneumonic for a standard situation report. See AMPLANZ Part 2 Section 3.4.2 and Figure 5
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Figure 5: Primary Triage Algorithm
YES
MOBILE?
Delayed
Green T3
NO
Dead
Black T0
1982
NO Act 
NO
BREATHING?
OPEN 
BREATHING?
AIRWAY
YES
YES
Information 
DIFFICULTY 
YES
BREATHING?
NO
Official 
RADIAL 
No
Immediate
PULSE PRESENT?
the 
Red T1
Yes
under 
OBEYS 
No
Urgent
COMMANDS?
Yes
Yellow T2
Figure 4 notes a casualty category of ‘Mobile’. This is defined as a person with minor injuries who is able to  
walk or be moved without assistance from medical personnel to a designated ‘green’ triage area, where they  
Released 
will be reassessed.
It is the responsibility of the Triage Officer to ensure that the appropriate label or tag (black, red, yellow or green) is 
attached to the patient and that patients are directed to the appropriate location.
The triage tools, including tags, to be used by all Ambulance Services are outlined in Appendix 5. (Note the triage 
tags are under review.)
Triage is an ongoing and dynamic process. Following the primary triage, further triage decisions at the scene are 
taken at the Casualty Clearing Point (secondary triage). It is also important to recognise that changing clinical 
conditions may require re-labelling and further documentation. Ambulance Personnel will use best endeavors to 
access all health information available at the scene including personal medical information adjuncts while noting 
the time and resource challenges of triaging and treating in a major incident.
PART 2 SEPT 2016
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3.4 Communications and information 
When communicating, all sections are used in the 
report. Where information is unknown, that section is 
management
stated as being unknown or that an estimate is being 
The most significant factor that will contribute to 
provided. 
successful command and control of an incident is 
‘Number of patients unknown, but is estimated to be 
effectiveness of the communications systems and 
approximately 50’
protocols. These include: 
‘Hazard identification has not yet been completed, but 
  On-scene communications within the Ambulance 
heavy rain looks imminent’.
Service and within the Incident Management Team
If any section of the report is missing, the receiver 
  Communications between the responding crews, 
requests the information from the originator.
the Ambulance Commander and the CCCS
The recognised status changes affected are:
  The detail and timeliness of information given to the 
1982
Incident Controller, to the CCCS and to health partners
  Standby notification (warning of a Possible, 
unconfirmed Major Incident)
  The tools available to the Ambulance Commander 
and CCCS to manage the information, including 
  Declaration (Confirmed Major Incident or “Not” a 
Act 
sitreps, action planning and resource requests.
Major Incident)
  Update to Major Incident Level (A level or 
3.4.1 On-scene communications 
information change)
On-scene communications will initially be from the first 
  Stand-down (Notification that an Agency can stand 
arriving ambulance, until a specialised communications 
down or that the ‘whole of incident’ stand-down is 
vehicle or a senior officer’s car is on scene and able to 
given.
act as an Ambulance Command Point.
Standby: The First Crew arriving at the incident is 
The on-scene communications point must establish 
required to  provide an initial sitrep as soon as possible 
Information 
immediate communications with the CCCS. Continuous 
(within 5mins of arriving at scene). This can be an 
communications must be maintained at all times. 
incomplete METHANE report to the CCCS and the “M” 
The principal radio communications system on-site 
may be a “Standby” if the situation is unclear. 
is the ambulance radio network, through the site 
As soon as possible a full sitrep shall then be 
communications point.  A Communications Officer shall 
communicated using the METHANE Report and clearly 
be appointed by the Ambulance Commander in complex 
stating at the beginning:
Official 
incidents. All communications from the scene to the 
CCCS will be managed by the Communication Officer.
Declaration4: Major Incident Declarations are 
communicated using a METHANE report. The 
All responding crews and management must switch to 
declaration starts the report with words clearly stating, 
the 
the on-site communications network (for example, VHF 
for Example: ‘Major Incident Declared’.
simplex or UHF) on arrival at the incident scene.
Or, if it is NOT a major incident and a declaration is NOT 
Incident and Ambulance Action Plans should 
required at scene, then clearly state “M. This is not a 
include the establishment of command, control 
major incident”. The rest of the METHANE report should 
and local operational networks: for both radio and 
be used.
under 
telephone communications; on-site and off site. It is 
recommended that provision be made for ground to air 
Updates and changes: These are communicated using 
communication capability.
a METHANE report providing the up-to-date information. 
It is not necessary to repeat all previously stated 
Ambulances may only communicate with the CCCS 
information during an update. Where there has been 
once they have left the site, with the exception of the 
no change state, for example “M., E., T., H., A., all no 
break down of the communications system on-site.
change. N. Number of casualties has increased to 15, 
all Triage Green. E., no change.” Declared”.
Released 
3.4.2 METHANE
Ambulance Stand-down: It is important that these are 
Standardised communications are required around any 
also communicated using a METHANE report to provide 
notification or status change of major incidents. These 
a clear understanding of the situation and prevent 
communications need to be readily understood and 
confusion. For instance, it would cause great confusion 
meet the needs of all agencies. A METHANE report is 
to a receiving hospital to receive a stand-down message 
the internationally recognised tool for this and is utilised 
while patients were still in transit. In-transit patients are 
in this plan. See Figure 5.
4Note: Any Ambulance Officer is able to ‘Declare’ a Major Incident based on a thorough scene assessment and / or validated information from 
the Public and / or Emergency Services Partners.
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covered in the numbers section. Examples of an inclusion in a stand-down METHANE report from the scene: “All 
patients have departed the scene for Hospital” Or “35 patients have departed the scene for Hospital. 25 non-injured 
have been moved by bus to the Rembrandt Motel by Police”.
Figure 5: METHANE Report  
M
Major incident status. Standby / declared / confirmed / stand-down
It is important that each phase or change is communicated immdediately 
through the command and communication chain
1982
Act 
E
Exact location of the incident
GPS / grid references and / or known landmarks can be helpful 
to other parties and agencies
T
Type of incident involved
Information 
H
Official 
Hazards that have been identified or the potential for them
the 
A
Access and egress pathway to the scene is advised
under  This should also apply for a Safe Forward Point, Staging Area, 
or Assembly Area.
N
Number and approximate status of patients
Released 
E
Emergency Services already present, and those needed
Extra Ambulance resources needed
PART 2 SEPT 2016
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3.4.3 Notifications to Health Partners
  1 set of triage tags / labels
The Ambulance Services are required to communicate 
  1 Ambulance Operations Manager vest
and coordinate with the local, regional and national 
  1 Triage Officer vest
health services regarding the transport of patients 
  Appropriate ambulance tactical plans for the local 
to the most appropriate health facilities. DHBs and 
area
the appropriate hospitals therefore require timely 
notification and accurate details of the incident.
The Ambulance Incident Command Notebook should 
be used by all First Crews arriving on scene in major 
The CCCS will develop and maintain procedures that:
incidents, and then by Ambulance Operations Managers 
  Inform the DHBs of possible and declared major 
in the majority of Level 1 or 2 incidents where simple 
incidents. This will be achieved by paging / texting 
management structures are in place. The notebook 
information to DHB Operational Points of Contact5
provides:
  Facilitate teleconference/s between the Ambulance 
At the Front (multiple copies of): METHANE reports, 
1982
Service, receiving DHB/s and the CCCS to enable 
formats for command structures and communications 
efficient information transfer. The teleconference 
networks, maps, Ambulance Action Plans (AAP), patient 
numbers will be communicated to the DHBs on or 
tracking, decision / communications logs, debrief 
Act 
prior to a declaration of a major incident.
checklist and Commanders report.
 
The leader of the teleconference will be the 
At the Back: Aide de memoire for responding 
Ambulance Commander, Ambulance Operations 
ambulances and managers as to their initial roles, 
Manager and / or the Ambulance Service Duty 
including triage algorithms.
Executive (Ambulance Service Controller) depending 
See Appendix 6 for an example of notebook pages. 
on availability and scale of the incident. The format 
There is ongoing developments relating to electronic 
of the teleconference shall follow a METHANE report 
patient information management. As tools come on line, 
plus information such as arrival times at the receiving 
Ambulance Services will incorporate these appropriately 
health facilities. The teleconference will be a short 
into their Major Incident Management.
Information 
briefing (5-10 minutes maximum). In-depth planning or 
clinical discussions should be held separately.
Level 2–3 incidents
It is the responsibility of the DHBs to maintain their 
For more complex and prolonged incidents (Level 2 or 
operational points of contact and to ensure information 
3) or where there is a comprehensive management 
is cascaded to the appropriate operational staff and 
structure in place for ambulance and also the incident as 
executive management within their organisations.
a whole, then an Ambulance Incident Command Board 
Official 
shall be used. The command board has the following: 
For incidents with large numbers of casualties, 
communications notifying the hospital of every arriving 
  Event and Communications Log forms
ambulance and status of patients being transported, 
the 
  Incident and Ambulance Organisation Chart
may be suspended. This is owing to resource 
  Situation Report forms (based on METHANE)
constraints in the receiving hospitals.
  Patient / Casualty Tracking forms
3.4.4 Information Management tools
  Ambulance Action Plan form
  Ambulance Staff Tracking form
under 
At the scene, in the CCCS and in the ASEOC (Ambulance 
  Ambulance Resource Tracking form
Service Emergency Operations Centre), comprehensive 
information management is required to ensure that 
  Small whiteboard/s plus pens.
coordination between partners, communication 
See Appendix 6 for examples of forms.
regarding resource provision and the appropriate and 
safe transport of casualties is maintained.
Emergency Management Information Systems (EMIS)
Level 1–2 incidents
The Ministry of Health and the Ministry of Civil Defence 
and Emergency Management both have EMIS (for 
Released 
To assist with this, the First Crew on scene, the 
example, E.Sponder). Ambulance Services currently 
Ambulance Operations Manager and the Ambulance 
access and utilise the Health EMIS.
Commander are provided with tools to provide quick 
reference to procedures and specific responses 
For complex and prolonged responses, the use of an 
information, and access to appropriate forms.
EMIS may be required at the scene by the Incident 
Management Team. Should this occur, the Ambulance 
These tools will be held in Ambulance Major Incident 
Commander will need to request the appropriate 
Folders in all ambulances. These folders will contain:
resources from the ASEOC. For example, a laptop with 
  An Ambulance Incident Command Notebook
mobile communications etc.
5The DHB Operational Points of Contact may differ from the DHB Single Point of Contact as specified in the NHEP. They may include 
emergency department clinicians or managers, duty managers, emergency planners, telephonists and/or executive managers. It is a DHB 
decision as to who should receive communications from the CCCS.
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3.4.5 Integration with the Incident Management Team
Figure 6: Simple Command Structure
It is a requirement of CIMS that the information 
systems of all responding agencies be integrated to 
provide a single set of information. This will enable 
Incident Controller 
the Incident Controller to maintain a comprehensive 
or Lead Agency 
overview of the situation and therefore enable the 
Officer In Charge
development of appropriate incident action plans. To 
facilitate this, the Ambulance Commander will: 
  Provide the Incident Controller with regular and 
Ambulance 
comprehensive Ambulance Sitreps
Operations 
Manager
  Action specific orders from the Incident Controller 
relating to the overall management of the incident 
CCCS
1982
while ensuring that appropriate patient care and 
ambulance staff safety is maintained
  Provide the Incident Controller with the Ambulance 
Treatment  Act 
Triage Officer/s
Action Plan (AAP) and modify the AAP if necessary 
Officer/s
for the improvement management of the incident 
while ensuring that appropriate patient care and 
ambulance staff safety is maintained
  Control: provides coordination across agencies
  Inform the Incident Controller of changes to 
  Command / Control: directs the operational 
Ambulance resourcing
response within an Ambulance Service at the 
scene
  Request, through the Incident Controller, any non-
ambulance resources required by Ambulance 
 Communications
Services.
Information 
The physical placement of the Ambulance Commander 
CIMS components of control, logistics and planning 
with the Incident Management Team will facilitate the 
/ intelligence are undertaken by the Ambulance 
communication and coordination within the incident.
Operations Manager (AOM) and Operations are 
undertaken by the Triage and Treatment Officers.
3.5 Command Structure and Scene 
Ambulance roles such as transport, communications 
Official 
Management 
etc, will be undertaken as part of other roles. The 
Safety Officer role is the responsibility of the AOM. 
This section provides ambulance managers with 
the 
a guideline as to the roles required and scale of 
structure that may need to be set up to manage two 
3.5.2 Comprehensive Command Structure
examples of incidents. These examples note the 
A Command Structure for long duration Controlled 
modular and expandable nature of CIMS.
and / or Complex Incidents (Level 2 or 3), or simple / 
restricted incidents equivalent to Level 1 or 2 (short 
under 
3.5.1 Simple Command Structure
duration but with large numbers of casualties) will 
require the Ambulance Commander or Operations 
A simple command structure for normal operations 
Manager to decide how the Ambulance and CIMS 
and Level 1 incidents or Open, Simple, Restricted or 
roles will be implemented and therefore the staffing 
Controlled incident of short duration (< 4hrs) and a 
required. This will need constant reassessment as part 
small number of patients (< 6 patients). See Figure 6.
of the ambulance incident action planning processes. 
See Figure 7 for the structure.
It is recognised that the ability of an Ambulance 
Released 
Service to fill all roles or functions in a full CIMS 
structure may be limited. Therefore roles may need 
to be prioritised and / or combined to match the 
personnel available.
PART 2 SEPT 2016
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There are a number of priority roles that need to be in 
5.  Longer-term logistics and planning and intelligence.
place immediately by ambulance officers, then roles may 
The following roles are discretionary and will be 
be able to be combined with priority roles, and others 
requested and deployed by the Ambulance Commander 
that may wait until more resources arrive. As a guide, the 
depending on the complexity (type, duration and scale) 
priority of responsibilities and roles should be:
of the incident: Communications Officer, Aviation 
1.  Incident management and coordination with partner 
Coordination, and Administration Officer.
agencies, including safety and communications 
The Ambulance Commander will have to decide quickly 
2. Triage
to request support from the ASEOC via the CCCS to 
3. Treatment
enable appropriate resources to be deployed from the 
4.  Immediate transport (loading / parking) and 
most appropriate Ambulance Service.
logistical management 
Figure 7: Complex Command Structure
1982
Act 
Ambulance 
Incident 
Service 
CCCS
Controller 
Controller
CIMS Incident Management Team
Ambulance Service EOC (ASEOC)
Ambulance 
Information 
Admin Officer
Commander
Planning & 
Safety Officer
Intelligence Officer
Official 
Communications 
Logistics Officer
Ambulance 
Officer
Operations 
the Manager
Aviation 
Sector Officer 
Sector Officer 
under 
Coordinator
Sector 1
Sector 2
Transport 
Triage 
Officer
Officer/s
Treatment 
Officer/s
Released  Sector 1
Sector 2 (all roles not shown)
  Control: provides coordination across agencies
  Command / Control: directs the operational response within an Ambulance Service at the scene
 Communications
Priority roles in dark colours, other roles to be combined with priority roles or resourced depending on the incident 
and resource availability. This is a Commander decision.
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1982
Act 
3.6 Summary of scene roles and 
Triage Areas and is responsible to the AOM or Sector 
Officer.
responsibilities
Ambulance Treatment Officer: Responsible for 
Key scene roles are summarised below. Task cards for 
coordinating patient treatment, liaising closely with the 
all roles are in Appendix 7.
Transport Officer and the Triage Officer. To delegate 
Ambulance Commander (AC): The officer responsible 
tasks to all medical and other personnel at the Casualty 
Information 
for scene management, all medical resources for 
Clearing Post. To report to the AOM or Sector Officer.
complex and prolonged incidents. The AC will be 
Ambulance Transport Officer: The officer responsible 
part of the Incident Management Team (IMT) when 
for all transport, loading and parking management in 
an IMT has been established for controlled or 
consultation with the AOM. Responsibilities include: 
complex incidents (Level 2 or 3 Incidents). The AC is 
allocating vehicles for transport, according to patient 
responsible for the safety of all health and ambulance 
priority, ensuring that suitable access and egress is 
Official 
personnel on scene for this scale of incident. This 
available into the ambulance loading point at or near 
is an incident management role and therefore shall 
the Casualty Clearing Point (CCP), for the efficient use 
not have patient care responsibilities. The AC is 
of vehicles, establishing an appropriate ambulance 
the 
responsible to the Ambulance Service Controller.
parking area. Reports to the AOM or Sector Officer.
Ambulance Operations Manager (AOM): The officer 
Ambulance Administration Officer: This officer will 
delegated with the responsibility to manage operational 
be assigned to the Ambulance Commander at the 
activities of the incident at the point of patient contact 
scene. The responsibilities will be to maintain the 
and the site role most commonly established for open 
AC’s decision and communications log, communicate 
under 
simple, restricted or minor controlled incidents (Level 1 
on behalf of the AC, if appropriate, and act as the 
or 2 incidents). This is an incident management role and 
communications officer (if no specific person is 
therefore shall not have patient care responsibilities. 
appointed). There may be an Administration Officer 
The AOM is to take on the role of Ambulance Safety 
attached to the AOM if resources allow.
Officer if one is not appointed.
Ambulance Communications Officer – on-site: 
Ambulance Sector Officer/s: A major incident may be 
The officer who establishes, and is responsible for, 
sufficiently large to divide into sectors. A Sector Officer 
effective communications on-site. May be deployed 
is responsible for managing a sector of an incident. 
from the CCCS or from the local Ambulance Service.
Released 
They are responsible to the Ambulance Operations 
Ambulance Logistics Officer:
Manager.
 This role is responsible 
for the systems and management relating to control, 
Ambulance Safety Officer: The officer responsible for 
monitoring and re-supply of all personnel, materials 
ensuring the overall safety of ambulance and other support 
and equipment at major incidents. 
personnel at the incident scene. Reports directly to the AC 
when established or more commonly to the Ambulance 
Responsible to the AC and may only be required for 
Operations Manager. Will work very closely with the lead 
prolonged controlled or complex (Level 2 or 3) incidents. 
agency or Incident Safety Officer if established.
This role will also work closely to the Incident Logistics 
Ambulance Triage Officer: Responsible for the triage of 
Manager in such incidents. 
all patients in an incident or sector. In command of all 
PART 2 SEPT 2016
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The Ambulance Logistics support will be provided by 
The ICP is where the Incident Controller and 
the ASEOC in the majority of incidents.
members of the Incident Management Team direct 
Aviation Coordinator: This role will be provided by the Air 
responsibilities during an emergency situation.
Ambulance Service and is responsible for landing zones 
Every incident will have an ICP.  The ICP is critical 
and safety of operations. This role is responsible to the 
to command and control and is the point where the 
Operations Manager/Commander for the coordination of 
Incident Controller will manage the whole incident. 
all aviation resources at the incident scene.
For smaller incidents, the ICP may move with the 
Ambulance Planning and Intelligence Officer(s):
Incident Controller. For larger incidents, the ICP may be 
These roles are responsible for assembling, maintaining 
a vehicle (fire appliance, police car or command unit), 
and analysing all information available relating to the 
trailer, tent or building.
ambulance and wider incident response. This will include:
Ambulance Command Point (ACP)
  Resource summaries 
1982
The Ambulance Command Point is responsible for 
  Analysis that will identify and prioritise issues of 
managing all ambulance activities at the scene and 
concern 
ideally should be co-located with, or very near, the ICP.
Act 
  Development or revision Ambulance Action Plan 
‘Ambulance Command Point’ will initially be the first 
(AAP) objectives and actions for approval by the AC. 
ambulance vehicle on the scene, using a red flashing light. 
The only ambulance or health response vehicle to display a 
Depending on the scale of the incident and the 
flashing light will be the scene Ambulance Command Point 
ambulance staff available these roles may be two 
where it is safe to do so and where it does not conflict with 
persons or combined.
other agency protocols (e.g. airport emergency plan).
Responsible to the AC and may only be required at the 
scene for prolonged controlled or complex (Level 2 or 
Sectors
3) incidents. This Officer(s) will also work closely to the 
For complex and large scale incidents it may be 
Incident Planning and Intelligence Managers in such 
necessary to divide a scene into sectors. This aids 
Information 
incidents. 
the management and accountability of the incident 
In the majority of incidents, the Planning and Intelligence 
by breaking down the span of control and allowing 
roles will be provided by the ASEOC and will be 
individual operations.
responsible to the Ambulance Service Controller.
Sectors may be defined by the Incident Controller for 
Medical, Nursing and allied Health personnel: 
overall use, or by individual agency commanders for their 
Official 
Appendix 7 also contains task cards for both PRIME6 
agency’s needs. Several numbering variations exist for 
doctors and nurses as well as for those health 
sectorisation and common sense and logic should be 
personnel who may volunteer or be assigned by their 
applied, along with an understanding of the conventions 
the 
organisation to assist at the scene.
that apply to other agencies. See Appendix 8 for examples.
Ambulance Liaison: It will be important that 
A sector can also be established to fulfil a special 
communication is maintained directly with the receiving 
purpose or field of operation. For example, a large 
emergency departments, hospitals or DHBs, and / or 
Forward Triage Area may be considered a sector. Often 
the partner agencies, such as CDEM. The Ambulance 
the combined area of CCP and transport facilities is 
under 
Service Controller will appoint Liaison Officers to the 
defined as a sector with a Sector Officer managing the 
appropriate facilities for the particular incident. A 
Treatment Officer and Transport Officer and associated 
Liaison Manager may be required if there are a number 
incident facilities.
of liaison points in place. This role is based in the 
Ambulance command within a sector lies with the Sector 
ASEOC to support the Ambulance Service Controller 
Officer who reports to the Ambulance Operations Manager.
with the information flow to and from partner EOCs. 
See Part 3 and Appendix 15 for task cards etc for the 
Assembly Area
Liaison Managers or Officers.
The Assembly Area is where resources are organised 
Released 
3.7 Site Set up
and prepared for deployment. It may include the 
provision of crew welfare and maintenance facilities. 
There are consistent site or scene locations or 
An Assembly Area would normally be located away from 
facilities required by CIMS as well as those specialist 
an incident at an established facility, for example, an 
facilities required by Ambulance. Below is a summary 
ambulance station. Assembly Areas are for support 
of these facilities and their roles. See Figure 8.
rather than being operational.
Incident Control Point (ICP)
6PRIME = Primary Response In Medical Emergencies.
22
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1982
Act 
Staging Areas
Forward Triage
Staging Areas are locations where resources are 
Forward triage is carried out in the field to identify and 
gathered before being despatched to a Safe Forward 
triage patients in a priority order to their removal to a 
Point or directly to an incident area. As an incident grows, 
Casualty Clearing Point. In large scale incidents, where 
there may need to be more than one Staging Area.
there are a number of sectors, forward triage may be 
Staging Areas:
required in each.
  Provide a safe location for resources awaiting 
Triage wristbands / tags should be attached in the field, 
Information 
assignment
where possible, and re-assessed when patients enter 
the triage area.
  Keep track of resources 
Casualty Clearing Point (CCP)
  Provide a check-in area for all arriving personnel
This area is made up of two areas: 
  Allow the Incident Management Team to plan for 
resource use
  Triage Area: This is normally a point positioned at 
Official the entrance of the CCP. It is essential this area 
  Must be located in a safe area
does not become blocked – a continual flow of 
  Should have separate entrance and exit routes
patients is essential. Patients should be re-triaged 
the 
at this point (and tagged if not already attached) 
  Should be large enough to accommodate 
prior to their flow through to the appropriate 
anticipated levels of resources
priority sections in the treatment area. Uninjured 
  Reduce traffic congestion.
patients and the deceased must be removed to two 
separate areas and not enter the treatment area.
Ambulance Parking Area 
under 
  Treatment Area: This must be a safe area large 
The place designated at the scene of a major incident 
enough to accommodate the anticipated number 
(forward of the Assembly Point) where ambulances can 
of casualties. It should be between the Triage Point 
park, thus avoiding congestion at the entrance to the 
and the ambulance loading area and should be 
scene or at the Ambulance Loading Point. These areas 
separated into three sections:
are also suitable for staff briefings, refreshments and 
re-stocking of equipment. This area may be part of an 
 
Triage 1  
 
Red
Incident Staging Area.
 
Triage 2  
Yellow
Released 
Safe Forward Point (SFP)
 
Triage 3  
Green
The SFP is a safe facility or location near the incident 
Specific priority areas should be designated by some colour 
from which forward operations can be supported.
identification e.g. coloured flags, tarpaulins or signage.
Landing Zone (LZ) or Helipad (HP)
There may be more than one CCP.
Specific area that has been identified for safe arrival, 
Ambulance Loading Point (ALP)
landing and departure of helicopters.  Consideration needs 
to be given to night operation requirements (i.e. lighting).
This is an area (preferably of hard standing) in close 
proximity to the CCP, where ambulances can manoeuvre 
and load patients.
PART 2 SEPT 2016
23

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Figure 8: Major Incident Footprint
Scene Access and Egress 
It is expected that the majority of casualties will be transported by road.
A considerable number of emergency and support vehicles will be travelling to and from the scene.
It is recommended that the Ambulance Commander/Ambulance Operations Manager, in liaison with the Police and 
Fire Commanders, establish clearly marked entry points and exit points to avoid congestion and improve vehicle flow.
All keys should remain in the ambulances unless specified otherwise.
1982
Act 
W
Cordon
ind dir
ec
Road
tion
Closures
Cordon
Possible need  
D
for E
iversions
vacuation
er
Uninjur
ut
Incident Site
ed
Information 
Evacuation
O
Assembly
Point
escue
nner I
Forward
Reception
Triage + R
Area
Pocil
Casualty
Official 
e
Clearing
/ F 
Point
tion
ir
S
e
afe F
 /
or
 R
w
P
ar
A
e
oin
d
mbulanc
Evacua
s
t
Loading PT
cu
the 
e
e
Helipad
Ambulances
Staging Area
Welfare, Friends 
Inciden
C
and Relatives
Con
t 
tr
under 
ol
asualt
Point
y E
Welfare
v
Assistance
Ambulanc
acua
Command e
P
tions
oint
Ambulanc
Parking A e
rea
Exit
Scene
Only
Released 
Access
Control
Ambulance Route
to Hospital/s
Assembly
Area
24
NEW ZEALAND AMBULANCE MAJOR INCIDENT AND EMERGENCY PLAN (AMPLANZ)

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3.8 Coordination with Health, 
It will also be necessary to coordinate with non-health 
organisations and perhaps access their resources and 
Emergency Services and other Agencies 
expertise. It is necessary for senior ambulance officers 
In mass casualty incidents it is unlikely that any single 
to be fully briefed on:
agency will have the required resources to meet the 
  The role, capacity and capability of the emergency 
needs of a response. The CIMS approach provides for 
services and non-government organisations (NGOs) 
coordination across all responding agencies.
e.g. Salvation Army and NZ Red Cross, private 
sector organisations and Civil Defence Emergency 
3.8.1 Health 
Management Organisations
A mass casualty incident may impact severely on 
  The communication channels with these 
the local, regional and national health system. The 
organisations to be able to access appropriate 
coordination of patient transport, according to priority, 
resources.
1982
to the most appropriate health facility is therefore 
An Ambulance Service is responsible to ensure that 
critical. All senior ambulance officers who may fulfil the 
Ambulance Commanders and Operations Managers 
Ambulance Commander or Operations Manager roles 
have access to contact points for appropriate agencies 
at scene are to be fully briefed on: 
Act 
that have access to specialist support services7. 
  Capacity and capability of the local and regional 
receiving health facilities
3.9 Media
  Emergency plans of the local DHBs as they impact 
Media representatives will arrive at the scene following 
on Ambulance Service
a major incident. Media will also go to hospitals and 
any other site where there is a possibility of acquiring 
  The communication channels with receiving health 
information on the incident.
facilities or DHBs to coordinate patient transport
An Ambulance Service will receive inquiries from 
  The communication channels with Regional Health 
the news media seeking information on the incident 
Information 
Coordination and / or National Health Coordination 
including the numbers of injured and deceased etc.
structures.
Ambulance officers will be aware of and follow their 
An Ambulance Service is responsible to ensure that 
organisation’s media policies. For all incidents, an 
Ambulance Commanders and Operations Managers 
Ambulance Service Public Information Manager (PIM) 
have access to appropriate contact points for the local 
will be available to coordinate inquiries from the media 
and regional health facilities and services. 
with appropriate other agencies. This person will be 
Official 
For all Level 2 and 3 incidents, the DHBs will be 
based initially at the Ambulance Service EOC.
informed via the notifications system as part of the 
For large scale incidents, where there is a clear CIMS 
activation of the ambulance response. DHBs can 
the  incident management team in place, all media inquiries and 
choose to be informed for Level 1 incidents. See Part 2 
the release of information to the media will be managed by 
Sections 3.1 and 3.4.
the Incident Public Information Manager responsible to the 
Incident Controller. Public Information Management will also 
3.8.2 Emergency Services and other Agencies
be part of the CIMS Incident Action Plan.
under 
All senior ambulance officers, who may be appointed 
For smaller incidents, the lead agency (for example, 
to the Ambulance Commander or Operations Manager 
Police or Fire) may request all news releases be 
roles at the scene, will need to have access to 
directed to their Public Information Managers or a 
information on tactical ambulance responses for 
Senior Officer.
specific hazards in their operational area. These will 
be in the form of ambulance tactical plans and will 
In all cases Ambulance Services will coordinate media 
be developed in coordination with other responding 
inquiries and release of information with the Incident 
agencies and the ‘owners’ of the plans (for example, 
Controller’s Public Information Manager.
an airport company, stadium event management etc). 
Released 
These plans will be developed by the Ambulance 
Service and be accessible from the CCCS CAD system, 
with appropriate accessible backup copies.
7Note: This does not necessarily mean an Ambulance Service maintaining lengthy lists of agencies etc. For example, many CDEM 
organisations have agreements with the NGOs and contacts with private sector service providers. 
PART 2 SEPT 2016
25

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3.10 Resources and Equipment 
and emergency services partners. All areas of 
operations require specific and specialised education 
All potential Ambulance Commanders and Operations 
and awareness. Many of these areas are used as part 
Managers shall be made aware of the resources and 
of local normal business but may also be required as 
equipment that may be available in their service area. 
part of a major incident response. These include: 
These may include: 
  Land Search and Rescue 
  Ambulance major Incident cache of medical 
materials and equipment
  Marine Search and Rescue 
  DHB medical materials etc that may be accessible 
  Mines Rescue 
to a pre-hospital response
  High Angle Rescue
  Specialist materials, equipment, services and 
  Helicopter response.
personnel from a partner emergency service or 
1982
support agency that may be accessible to a pre-
There are a number of national Special Operations 
hospital response. For example, urban search and 
Teams that may be deployed regionally or nationally. 
rescue (USAR) equipment, CDEM logistics.
Below are summaries of their current roles.
Act 
There will be a defined procedure for an Ambulance 
Special Emergency Response Teams (SERT)
Commander or Operations Manager to request 
These teams are required to respond rapidly at the 
resources as part of METHANE reports and Ambulance 
request of partner emergency services, Ambulance 
Action Plans sent to the CCCS and the ASEOC.
Service management and CCCS. SERT are deployed 
Ambulance officers shall be regularly trained in the 
nationally. SERT Officers are under the command of 
deployment and use of ambulance major incident 
the lead agency at the Scene, but remain under the 
caches. These will also be used in major public events 
control of the Ambulance Service. SERT operate with 
to improve familiarity with the materials and equipment.
the following groups or areas:
In all emergency, PTS and event ambulances, there 
Police Armed Offenders Squad (AOS)/Special Tactic 
Information 
is an Ambulance Major Incident Folder. This folder 
Group (STG): The SERT team is trained to operate 
contains role task cards, triage tags, aid memoires etc. 
with these two groups.  The distinction has been that 
See Part 2 Section 3.4.4. These folders will form part 
Armed Offenders Squad (AOS) carries out all armed 
of the ambulance manifest and be audited as such.
incidents and the STG deal with hostage situations 
and counter-terrorist activity.  SERT trains with both 
To assist managers in the Ambulance Commander or 
of these groups and is regarded as part of the Police 
Ambulance Operations Manager roles a number of Official 
operation.  The role is to provide clinical care in 
tools have been developed. These include: 
the hot/warm zone (see Appendix 1 for definition), 
Ambulance Incident Command Notebook: See Part 2 
SERT officers wear the same protective equipment 
the 
Section 3.4.4 and Appendix 6. 
as the police and use police radios during AOS/STG 
operations. 
Ambulance Incident Command Boards: See Part 2 
Section 3.4.4 and Appendix 6.
Land Search and Rescue (SAR): SERT often support 
Police by providing medical care to all searching 
3.10.1 Major Incident Vests
personnel and the lost or injured party when found. 
under 
These can be very labour intensive with a number of 
There are standard vests to identify ambulance 
hazards.  Care of the searching staff is the major role, 
incident management and roles at the scene of a 
including assessing and treating reactively and also 
major incident. 
monitoring staff during prolonged searches. 
These need to be consistent across all Ambulance 
Marine Operations: SERT works closely with Police 
Services to ensure all ambulance roles are clearly 
on security and mass casualty incidents at sea. 
identified.
Specific training includes water rescue and patient 
See Appendix 9 for the details.
retrieval. SERT are also involved with the inter-service 
Released 
preparation and operation to intercept illegal ‘boat 
3.11 Specialist Operations
people’ with the role being to assess the health of 
passengers, organise evacuation, in the event of 
To be able to access patients quickly, Ambulance 
serious illness or injury and help in a decision-making 
Services have developed skills and strong 
role to quarantine the vessel if necessary. As with AOS 
relationships with other emergency services and 
operations, SERT officers also provide care to Police if 
agencies to undertake specialist operations. There is 
required.
a mix of local and national approaches to meeting the 
needs of patients, the local operational environment 
26
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Urban Search and Rescue USAR
3.11.2 Pre-hospital Responses by DHBs and other 
There are currently four USAR teams and these are 
organisations
deployed nationally. The ambulance sector provides 
There are Ambulance response procedures for PRIME8 
the USAR Team Medics. This role is firstly to ensure 
Doctors and Nurses as part of a pre-hospital response. 
health and welfare of the USAR staff. The treatment 
and extrication of trapped patients would be completed 
There are currently few formal pre-hospital medical 
with consultation and active participation of the USAR 
responses developed as part of DHB or hospital 
Medic. USAR Medics may also be members of SERT. 
emergency plans. DHB and hospital emergency plans 
USAR Team Medics, when deployed, are under the 
need to consider the deployment of these resources 
command of the USAR Officer incharge.
in support of the pre-hospital response and formalise 
the notification, activation, roles and responsibilities, 
Chemical Biological Radiological (CBR)
training and equipping of these resources.
CBR trained officers work as part of AOS operations (as 
There is also a NZ Red Cross volunteer pre-hospital 
1982
part of SERT) and / or Fire Service hazardous materials 
response capability that may be deployed if requested.
(HazMat) operations (as part of the Ambulance CBR 
The Ambulance Commander may request specialist 
Team). Both are deployed nationally. All officers are 
medical and nursing resources to assist with the 
Act 
trained to Level 3 Chemical Protection, which involves 
general pre-hospital response and to undertake 
the wearing of a chemical resistant splash suits and 
specialist procedures. There are clear doctor and 
self-contained breathing apparatus progressing to 
nurse task cards as well as other task role cards in 
use of chemical suits.  CBR Officers are trained in 
Appendix 7.
decontamination procedures for both walking and 
stretcher patients and the problems associated with 
Note: In a pre-hospital response, all specialist medical, 
both. Level 2 protection is used at ‘clandestine labs’ 
nursing and first aid resources working at the scene 
(Clan labs) in association with ballistic equipment as 
will be under command of the Ambulance Commander 
part of an AOS operation.
or Operations Manager.
Information 
CBR trained officers working in a HazMat operation 
are under the command and control of the Ambulance 
3.11.3 Activation of Responses by DHBs and other 
Commander or Ambulance Operations Manager on 
organisations 
scene. In an AOS operation, the CBR trained officers are 
Requests for health or medical support (from a 
under the command of the lead agency at the scene.
DHB, for example) shall be done by the Ambulance 
Ambulance Rescue 
Commander directly to the agency concerned and in 
Official 
coordination with the Incident Controller.
There is currently one rescue squad, trained in 4WD, 
High Angle rescue, basic rescue techniques and 
Requests for non-health support (from the Salvation 
the 
swift water rescue. Team members are activated by 
Army, for example) or from a voluntary agency (from 
CCCS and respond urgently to all cases. Specialist 
the NZ Red Cross, for example) shall be done by the 
equipment includes 4WDs, ropes, abseiling hardware, 
Ambulance Commander to the Incident Controller.
PFDs (Personal Flotation Devices), throw bags, 
stretchers with mule wheel, winches, and an A-Frame 
4.0 Recovery
for high angle rescue.
under 
The process of recovery for an Ambulance Service 
is defined as the re-establishment of normal service 
3.11.1 Activation of Ambulance Specialist Operations
delivery after a major incident. This process should 
A specialist response shall be activated in the 
start as soon as possible in the response phase 
following ways:
and be aligned with Ambulance Service business 
continuity plans. Ambulance Services will be required to 
  By the Ambulance Commander or Ambulance 
contribute to the overall recovery of the health services 
Operations Manager at scene in consultation with 
and community. It may also be that, dependent on 
the lead agency or Incident Controller. This will be 
the incident, there may be a new ‘normality’ for the 
Released 
done through the CCCS using normal processes 
community. Ambulance Services will have to realign 
and possibly in consultation with local Ambulance 
themselves appropriately as part of the recovery 
Service management. OR
process.
  By Police or Fire directly via the CCCS for SERT, 
All logs and notes made during the incident will need 
USAR or CBR resources. The CCCS will inform 
to be correlated in case of possible public inquiries as 
Ambulance Service management.
to the effectiveness of the overall management of the 
response.
8PRIME = Primary Response In Medical Emergencies.
PART 2 SEPT 2016
27

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It is envisaged that even in a moderately sized major 
  Crews lacking expertise or skills
incident there will be an effect on staff, supplies, 
  Equipment failures 
equipment, finance and vehicles. Areas requiring 
consideration for recovery will include, but should not be 
  Significant impact on non-operational 
limited to:
departments of the Ambulance Service
  Staff welfare/debriefs
  External criticism or triggers impacting 
perceptions of the ambulance response
 Rosters
  Or other issues that may trigger a response 
 Leave
from the Ambulance Service’s Reportable 
  Operational review and learning
Events Management System.
  Development of new models of operation where 
and when required
4.1.2 Debrief and Reporting tools
1982
  Consumables (medical/fuel)
An Ambulance Commander and staff who worked at 
the scene or in the CCCS as part of the response, will 
 Equipment
be required to take part in one or more of the following 
Act 
  Vehicles (servicing repairs etc)
processes:
  Finance and cost recovery.
Hot or Scene debrief
Ambulance Service management is responsible for 
This is the lowest level of debrief but may be the most 
ensuring that the majority of the above areas are 
important. All responding ambulance officers and 
managed. This may require the appointment of a 
communications staff should take part in this debrief. 
Recovery Manager. See Part 3.
This is a relatively informal process and should follow 
the debrief template as noted in the Ambulance 
4.1 Ambulance Debrief Processes  
Incident Command Notebook. This should occur as 
Information 
and Tools9
soon as possible following the incident. See Appendix 
6.
4.1.1 Debrief aims and requirements
Ambulance Commander’s After Action Report
The aim of the debrief process is two-fold:
For a significant incident, the AC will be required to 
complete an After Action Report. The aim here is to 
  To identify and acknowledge where the response 
communicate the findings from the incident scene, 
Official 
went well and ensure that these experiences are 
including learning and acknowledging excellence. 
shared
This report will contribute to the wider Ambulance 
  To identify where improvements in the response 
Service debrief and reporting process. This should be 
the 
is required and develop a plan of action to ensure 
completed within one month of the incident. An After 
that learning occurs.
Action Report Template is in Appendix 10.
An incident debrief and / or reporting is required:
Ambulance Service Debrief
  Following all Level 2 and 3 incidents 
This process will be managed by the Ambulance 
under 
  A level 1 incident (or where a major incident should 
Service Controller and may be delegated to an 
have been declared) where there has been one or 
Ambulance Service Recovery Manager (if appointed). 
more of the following: 
This process will be more formal and will draw in all 
relevant staff; operations, communications (CCCS), 
  Injury to or safety issues for Ambulance Officers
and non-operations. This debrief should occur within 
  Poor clinical outcomes of patients possibly 
two months of the incident. The guidelines and 
attributable to the Ambulance scene 
documentation for this level of debrief are in Part 3.
management
Released 
  Communications failures or issues
  Failure of SOPs or Tactical Plans that have 
impacted on response
  Ineffective coordination between responding 
agencies
9This section draws on the NZFS Incident Management – Command and Control Technical Manual Aug 2009. Section 6 pages 1–19. The 
NZFS Special Operations support is gratefully acknowledged.
28
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AMPLANZ Part 3:
Ambulance Service Approach
For Ambulance Service Managers working in all areas of the emergency management cycle
September 2016
1982
Act 
Content
Part 1: Introduction to AMPLANZ and Emergency Management for the 
Ambulance Sector
Information 
Part 2: Consistent Operations at the Scene
Part 3: Ambulance Service Approach
1.0 Introduction 
 
30
3.5 Ambulance Service Emergency Response Management Structure 34
2.0 Readiness and Reduction   
30
3.5.1 Simple Ambulance Service Emergency Response Management 
Structure  
34
2.1 Risk Management and Planning 
 
30
3.5.2 Comprehensive Ambulance Service Emergency Response 
2.1.1 Business Continuity Planning 
 
30
Management Structure 
 
34
Official 
2.1.2 Ambulance Tactical Planning  
 
30
3.5.3 CCCS Incident Management Structure 
 
36
2.1.3 Inter-agency Planning  
3.6 Ambulance Operations and CCCS roles and responsibilities   
38
Inter-Ambulance Service Cooperation 
 
31
2.2 Exercising 
 
31
3.7 Ambulance Non-operational staff: roles and responsibilities   
40
the 
2.3 Training and education 
 
32
3.8 Coordination with health, emergency services and other agencies 
 40
2.4 Review and Audit 
 
32
3.8.1 Health coordination 
 
41
3.0 Response 
 
32
3.8.2 Emergency Services and Other Agencies 
 
41
3.1 Activations, Level of Response, and Notifications   
32
3.9  Media  
41
under 
3.2 Activation based on national and regional warnings 
 
32
3.10 Ambulance Service Resources and Emergency Operations Centre   42
3.3 Communications  
32
3.10.1 Ambulance Service Resources
3.3.1 From an Ambulance Commander: 
 
32
3.10.2 Air Desk 
 
42
3.3.2 From a health or CDEM EOC 
 
32
3.10.3 Ambulance Service Emergency Operations Centre 
 
42
3.3.3 Ambulance Operations Management briefing 
 
33
4.0 Recovery 
 
42
3.3.4 Major Incident Notifications within Ambulance Services and to 
4.1 Ongoing Impact of the Incident 
 
42
partner agencies 
 
33
3.3.5 Call back 
 
33
4.2 Operations and CCCS: Roles and Responsibilities in Recovery 
 43
3.4 Information management   
33
Released 
3.4.1 Tools 
 
33
4.3 Non Operational Staff: Roles and Responsibilities in Recovery  43
3.4.2 Emergency Management Information Systems (EMIS) 
 
33
4.4 Ambulance Debrief and Reporting Processes 
43
3.4.3 Integration with the Incident Management Team   
33
4.4.1 Debrief aims and requirements 
 
43
4.4.2 Hot or scene debrief 
 
43
4.4.3 Ambulance Service Debrief 
 
43
4.4.4 Ambulance Service Major Incident Report 
 
43
Part 4: National Crisis Coordination Centre
Appendices

---

1.0 Introduction
and agencies such as New Zealand Fire Service 
(NZFS) are required to develop tactical or operational 
AMPLANZ is divided into four parts plus an overview 
response plans by law. The key preparedness activity 
document. This is Part 3 and focuses on the activities 
by Ambulance Services will be to ensure appropriate 
to be undertaken by Ambulance Service Management 
tactical response plans are developed, exercised and 
in all areas of the emergency management cycle.
communicated in coordination with other response 
This document should be read in conjunction with 
agencies and the owners of the facilities. 
Part 1: Introduction to AMPLANZ and Emergency 
Management for the Ambulance Sector and Part 2: 
2.1.1 Business Continuity Planning
Consistent Operations at the Scene.
Ambulance Services are required to have 
2.0 Readiness and Reduction
comprehensive business continuity policies 
management (BCM) and processes in place that 
include the development and management, as well 
1982
2.1 Risk Management and Planning
as testing, of plans. AS/NZS 5050:2010 and ISO/TS 
22317:2015 are appropriate references for BCM Plans 
All Ambulance Services are required to identify, analyse, 
shall be developed for all stations, service departments 
Act 
treat and monitor all risks facing their organisations. 
(operations and support or core department) ensuring 
An Ambulance Service’s risk management policies and 
they are integrated across the service. Where risks are 
frameworks should be based on AS/NZS ISO 31000 
identified, the Ambulance Service will develop a strategy 
Risk Management Principles and Guidelines1.
to treat these risks.
The major incidents covered by the AMPLANZ are 
Business Continuity Plans (BCPs) shall be fully 
normally considered as having risk of:
accessible to and understood by the appropriate staff 
  low likelihood of occurrence 
across the Ambulance Service.
  high impact on normal business.
Appendix 11 provides examples of templates for 
Information 
AMPLANZ certainly does not cover all aspects of risk 
station and department level BCPs.
management in an Ambulance Service. It focuses 
on the requirement to ensure that ‘normal’ services 
2.1.2 Ambulance Tactical Planning 
can be maintained and Ambulance Services are 
Noting the risk context of AMPLANZ, there is a need 
able to respond safely and appropriately to known 
to prioritise the mitigation of hazards according to the 
hazards in the community. Therefore the focus here 
possible risk to the community, Ambulance Services 
is on business continuity, tactical plans and their  Official 
and the health sector.  To assist with prioritisation, the 
prioritisation, and coordination of plans.
Ambulance Service will need to consider the following: 
For example: There are complex hazards that may 
  Complexity, and therefore coordination 
the 
require a health and therefore ambulance response. A 
requirements, of the incident. Issues that may 
number of these hazards, such as earthquakes, tsunami 
further complicate the response include: 
or floods, require significant national multi-agency 
coordination and response and need Civil Defence and 
  Communications issues 
Emergency Management lead planning. The nature and 
  Requirements for specialist trained ambulance 
under 
scale of the ambulance response would depend on the 
staff or services (e.g. SERT, CBR, mines rescue)
impact of the ‘event’ on the community. The Ambulance 
Services tactical response would be based on ensuring 
  Risk to responding staff if not informed or 
the ambulance management and communications are 
trained in preparation for the incident
in place to support the community response as the 
  The need for a multi Ambulance Service or 
incident unfolds. The welfare of staff and patients are 
emergency service response
central. The key preparedness activity by Ambulance 
Services would be based on appropriate and tested 
  Possible duration of the incident 
business continuity plans.
  Number of patients and their acuity
Released 
There are known hazards in the local area which may 
  Impact on local health services
require a specific ambulance response. These may 
include, for example, bus accidents, viral outbreaks, 
  Local Ambulance Service capacity and capability.
incidents at large factory or business premises, airports, 
It is necessary for an Ambulance Service to develop, 
tunnels, health and age-care facilities, petro-chemical 
maintain and test ambulance tactical response plans 
plants, and stadia etc. All plant, facility or infrastructure 
for known hazards. Tactical plans shall complement 
owners are required to manage their risks appropriately, 
1This Standard supersedes NZS 4360:2004 Risk Management. NZS 4360 noted in NZS 8156 Section 3.5 page 19.
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the Activation and Escalation Processes outlined in 
As part of this, Ambulance Services will need to 
Part 2 Section 3.1 and cover:
ensure the:
  Location details for the site or hazard area
  Notifications systems in place are clearly specified 
  Maps or plans
including Ambulance to DHB but also DHB to 
Ambulance
  Initial response actions by CCCS and Ambulance 
Managers
  Role of medical staff in the pre-hospital setting is 
clearly specified
  Critical Information for the safety of crews and others
  Integration of all DHB provider arms with the 
  Key Personnel details for the site authority or 
Ambulance response, including specifically Public 
hazard area
Health and Primary Care.
  Details of hazards
There is a requirement also for an alignment of the 
1982
  Review dates and responsibilities.
Ambulance Service plans with the National plans such 
as the National Mass Casualty Transport Plan.
  Evidence of agreement with the site authority.
Emergency Service, CDEM and private sector emergency 
Tactical plans will be easily accessible to the CCCS 
Act 
dispatchers and responding ambulance management 
planning 
and crews at the time of the response. This shall include 
CDEM Groups have completed risk analysis of their 
appropriate electronic access as well as hard copies.
regions and are developing contingency plans for 
Appendix 12 provides a template for local tactical plans.
the management of those risks and coordination in 
a response. These include, for example, initial and 
ongoing response, welfare and lifelines.
2.1.3 Inter-agency Planning  
Inter-Ambulance Service Cooperation
Police and Fire also have responsibilities to lead the 
response planning for significant hazards where they 
There are a number of hazards and therefore risks 
are the lead agencies.
Information 
shared between Ambulance Services that require a 
There are also private sector agencies that are 
combined response from all.
required to plan for major incidents in their operational 
For example: the northern Rimutaka Tunnel Train 
areas.
Incident (Wairarapa) may require a tactical response 
Ambulance Services are required to coordinate 
combining the resources of the Wellington Free 
their tactical plans with the lead agencies as part 
Ambulance, St John, a number of air ambulance  Official 
of the overall health response. This shall include 
providers and possibly NZDF. There may be a 
clear agreements for cost recovery with the incident 
requirement to activate national coordination 
controller.
mechanisms within the ambulance sector. A number of 
the 
DHBs are also likely to be involved.
2.2 Exercising
Therefore Ambulance Services are required to identify 
hazards, plan responses (management, clinical, 
A complete Ambulance Service Response, including 
communications, coordination), and test plans for 
the set up and activation of an ASEOC, shall be 
such hazards. The aim will be to build an appropriate 
exercised in at least one major CDEM (Tier 3–42) 
under 
response, build inter-service operational relationships 
exercise as well as at least one major emergency 
and develop coordination mechanisms.
services or health exercise each year.
Communication and activations systems shall be 
Health Emergency Planning
tested as appropriate for all exercises where there 
Ambulance Services are required to integrate their 
is a likelihood of a significant ambulance and health 
emergency management planning with that of the 
response. 
DHBs Likewise, the DHB Operational Planning 
All exercises shall be evaluated and results reported 
Frameworks (OPF) notes that a DHB will ensure that 
Released 
internally within the Ambulance Service. Lessons will 
all ambulance providers have plans and resources in 
be identified and shared. Processes will be developed 
place to ensure that their emergency responses are 
to incorporate changes into the appropriate level 
integrated, coordinated and exercised with the DHB’s 
of planning within the sector. This shall include the 
Health Emergency Plan (HEP).
annual AMPLANZ review by Ambulance New Zealand.
2Ministry of Civil Defence Emergency Management (MCDEM) Tier 3 exercises test territorial local authority (TLA) and CDEM group (CDEMG) 
operations. MCDEM Tier 4 exercises test National Crisis Management Centre (NCMC), CDEMG and TLA operations. Both of these will require 
a service and national response from Ambulance.
PART 3 SEPT 2016
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2.3 Training and education
3.0 Response
To enable a complete and effective Ambulance Service 
emergency response, appropriate members of the 
3.1 Activations, Level of Response, and 
ambulance management team shall be trained in their 
Notifications
initial response roles, the functioning and role of the 
ASEOC (Ambulance Service Emergency Operations 
The activation, levels of response and notifications for 
Centre). Such training shall include, but is not limited to:
an Ambulance Service are detailed in AMPLANZ Part 2 
Section 3.1.
  CIMS 2 (minimum)
  Emergency Coordination Centre or Operations 
3.2 Activation based on national and 
Centre management
regional warnings
  Leadership and On-call management roles for 
1982
middle and senior management required as part of 
The Ministry of Health and the Ministry of Civil Defence 
or in support of an ambulance response 
and Emergency Management will send out notifications 
to all emergency management stakeholders in the 
  Specific training as developed / run by key 
health sector and the wider CDEM sector.
Act 
partners, such as the Regional CDEM Groups, 
DHBs, MoH or MCDEM on specific roles E.g. 
The CCCS are the single points of contact for the 
Controllers’ course, Liaison Managers’ inductions
Ambulance Services.
  Emergency Management Information System (EMIS) 
The types of national notifications are noted in Appendix 
log in and basic use
13. The CCCS will receive these notifications and is 
responsible for cascading them to the Ambulance Sector. 
  Specific in-house training on the set up and 
procedures of the local ASEOC.
The CCCS will inform all Ambulance Services and the 
appropriate level of response, service management 
Potential staff of an ASEOC shall include key managers 
and/or national coordination will be determined.
and also support staff to undertake data entry and 
Information 
administration support functions.
There are also Regional CDEM group or local authority 
notifications. The CCCS will receive these notifications 
Training needs analysis is required to further enhance 
and cascade appropriately to the Ambulance Services. 
the appropriateness of emergency management 
Local Ambulance Service Management may also receive 
training and education within an Ambulance Service.
notification directly from local authorities and will ensure 
Training and education in emergency management 
that the CCCS is informed.
Official 
for Ambulance Services shall align appropriately 
Note: If there is an ambulance major incident response 
with competency frameworks and guidelines of other 
required, this will be activated and escalated using the 
emergency service partners, as well as with Civil 
the  process noted in Part 2 Section 3.1 and usually before 
Defence and Emergency Management Agencies.
MoH or MCDEM alerts have been received.
2.4 Review and Audit
3.3 Communications
The Ambulance Service Major Incident and Emergency 
under 
plans, and the related operational procedures, shall 
3.3.1 From an Ambulance Commander
be audited and reviewed as part of the Ambulance 
The Ambulance Service Management will receive 
Service’s quality management systems to ensure the 
METHANE reports from the scene as soon as possible 
notification, activation and management of a full and 
via the CCCS. For complex and / or long duration 
coordinated ambulance service response.
incidents, the Ambulance Commander will also develop 
AMPLANZ will be reviewed annually to take into account 
Ambulance Action Plans to be part of the overall 
local and internationally significant development and 
Incident Action Plan approved by the Incident Controller. 
lessons identified or learnt. There will be a formal  
See Part 2 Section 3.4.1.
Released 
review of AMPLANZ no later than every three years.  
The Ambulance New Zealand Standards and 
3.3.2 From a health or CDEM EOC
Accreditation Committee has national responsibility for 
review of AMPLANZ on behalf of the Ambulance New 
In a health or CDEM emergency (e.g. pandemic 
Zealand trustees.
or natural disaster etc), the Ambulance Service 
Management will receive sitreps, resource and 
information requests, and action plans. The Ambulance 
Service will be required to maintain communications 
remotely, or via a Liaison Manager, with the lead 
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agency and to contribute to briefings, provision of 
3.4.2 Emergency Management Information Systems 
intelligence and action plans as appropriate.
(EMIS)
3.3.3 Ambulance Operations Management briefing
The Ministry of Health and the Ministry of Civil Defence 
Emergency Management both have EMIS. At the 
All Ambulance Services shall maintain a procedure 
Ambulance Service level, the current EMIS is able to be 
to ensure that all local senior operations managers 
accessed and utilised.
and appropriate non-operations managers receive a 
Ambulance Services shall develop and use the EMIS, in 
briefing on the incident, be allocated roles/tasks, as 
coordination with the MoH, DHBs and other response 
appropriate, and develop the initial ambulance response.
and emergency management agencies. The Ambulance 
This briefing should be separate to and before the CCCS 
Service will use the EMIS to ensure appropriate 
briefing teleconference noted in Part 3 Section 3.3.4. 
intelligence, planning and operational information, 
This briefing is likely to be completed by teleconference.
relating to the incident, is integrated and transparent 
1982
across local and national responding agencies.
3.3.4 Major Incident Notifications within Ambulance 
The CCCS shall ensure that the key information 
Services and to partner agencies
captured in the CAD is linked to the EMIS. Information 
Act 
available in the EMIS should also be easily accessible 
See Appendix 14 for a guideline on the Ambulance 
to key staff to inform decision-making with in the CCCS 
Service staff and health partner agencies who should 
and ASEOC.
receive notifications of Level 1, 2 or 3 major incidents.
Ambulance Services shall also work towards ensuring 
The CCCS will maintain a Standard Operating 
that EMIS access is integrated into scene management. 
Procedure to notify (via page/text) and then brief (via 
short teleconference):
  DHB operational points of contact 
3.4.3 Integration with the Incident Management Team
  Ambulance Service management who were not 
Information 
required to be part of the briefing noted in Section 
It is a requirement of CIMS that the information 
3.3.3 above.
systems of all responding agencies be integrated 
to provide a single set of information. This will 
  Other appropriate response agencies (e.g. CDEM)
enable the Local or Regional Controller to maintain a 
It is the responsibility of the Ambulance Services 
comprehensive overview of the situation and therefore 
and the CCCS to maintain contact lists and test 
enable the development of appropriate incident action 
Official 
this notification system according to the Standard 
plans. To facilitate this, the Ambulance Service will: 
Operating Procedures.
  Provide the Controller with regular and 
comprehensive Ambulance sitreps
the 
3.3.5 Call back
  Action specific orders from the Controller relating 
All Ambulance Services shall maintain a procedure to 
to the overall management of the incident while 
ensure that all required operations and non-operations 
ensuring that appropriate patient care and 
staff are able to be called back to assist in the 
ambulance staff safety is maintained
operational response as appropriate.
under 
  Provide the Controller with the Ambulance Action 
Plan (AAP) and modify the AAP if necessary for 
3.4 Information management
the improved management of the overall incident 
while ensuring that appropriate patient care and 
3.4.1 Tools
ambulance staff safety is maintained
To assist with the management of information 
  Inform the Controller of changes to Ambulance 
during an incident, an Ambulance Service shall have 
resourcing
appropriate tools to be used by duty management 
  Request, through the Controller, any non-ambulance 
Released 
initially and then staff required to support a complex or 
resources required by Ambulance
prolonged response. These tools may include:
  For complex and multi-Ambulance Service 
  Communication and Decision Logs
responses, where there is national coordination 
  Sitrep / METHANE reports
(see part 4), ensure the Ambulance sitreps, AAPs, 
and ambulance resource status/requirements are 
  Ambulance Action Plan (AAP)
communicated to the Controller, the health EOC 
  Resource tracking reports
within the responding DHBs and National Health 
Coordination Centre (NHCC).
 Mapping.
 ePRF
PART 3 SEPT 2016
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3.5 Ambulance Service Emergency Response Management Structure
This section provides Ambulance Service Managers with a guideline on the roles required and scale of the 
management structure that may need to be set up to manage two types of incident. These examples note the 
modular and expandable nature of CIMS.
3.5.1 Simple Ambulance Service Emergency Response Management Structure
Simple command structure for Level 1 incidents or Open, Simple, Restricted or Controlled incident of short 
duration (< 4hrs) and a small number of patients (< 10 patients). See Figure 1.
Figure 1: Simple Ambulance Service Emergency Response Management Structure
1982
Ambulance  
Service 
Act 
Executive Team
Duty Operations 
Executive Officer 
Ambulance Public 
(Ambulance Service 
Information 
Controller – ASC)
Manager (PIM)
Information 
Incident 
CCCS
Controller
Ambulance 
Official 
Commander 
or Operations 
Manager
the 
Scene management (all roles not shown)
 
  Control: provides coordination across agencies
  Command / Control: directs the operational response within an Ambulance Service at the scene
under 
 Communications
This follows ‘business as usual’ management. In this case the majority of incidents will require minimal 
communications with, or coordination by, the Ambulance Service Controller (ASC). The ASC will be undertaken by 
the Duty Operations Executive Officer3 on the declaration of a major incident of the Ambulance Service. Where 
there is an impact on normal operations, direction will be provided by the ASC.
The CIMS roles of Control, Logistics and Planning / Intelligence are undertaken by the ASC according to the 
requirements of the Ambulance Commander or Operations Manager at the scene. The ASC will decide if he/she 
requires extra support to undertake these roles.
Released 
The CCCS will follow business as usual management procedures across its national virtual structure to ensure 
management of the incident and normal service delivery.
Media inquiries will be managed by the Ambulance Public Information Manager (PIM) in coordination with incident 
lead agency media officer (e.g. Police or Fire). Release of Ambulance Information will also be approved by the ASC. 
Ambulance Service Executive Team shall receive timely updates of the incident from the ASC and may be 
requested to undertake specific tasks depending on the impact of the incident on the whole organisation.
3Business As Usual titles vary across the services at this level and include: Duty Operations Executive On-Call, Duty National Executive, 
District Duty Manager, On Call Manager or Executive etc. 
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1982
Act 
3.5.2 Comprehensive Ambulance Service Emergency 
Service Controller, unless formally agreed otherwise.
Response Management Structure
The response shall be managed from an Ambulance 
A clear Ambulance Service command and control 
Service Emergency Operations Centre (ASEOC), a 
structure will be required for long duration Controlled 
CCCS Major Incident Room or virtually, depending on 
Information 
and / or Complex Incidents (Level 2 or 3) or for 
the scale, duration and complexity of the incident(s).
a single or multiple simple / restricted incidents 
CIMS roles or functions will be implemented within 
equivalent to Level 1 or 2 (short duration but with 
the ASEOC and therefore increased staffing will be 
large numbers of casualties). There will be similar 
required. This will need constant reassessment as 
management requirements for conplex business 
part of the ambulance action planning processes. See 
continuity incidents.
Figures 2 & 3  and Part 3 Section 3.6 for summaries 
Official 
The Ambulance Service Controller (ASC) role is to lead 
of the ASEOC roles and responsibilities.
the Ambulance response management structure that 
It is recognised that the ability of a local part of an 
provides strategic direction, support and coordination 
Ambulance Service to fill all roles within the full CIMS 
the 
for Ambulance Commanders in complex or multiple 
structure in an ASEOC with individual managers 
incidents / emergencies. The ASC is responsible to 
is limited, particularly for long duration, complex 
the Ambulance Service Executive Team.
incidents. That said, all CIMS roles will need to be 
The Ambulance Service Executive Team delegates 
undertaken. To do this, CIMS roles may have to be 
authority to the ASC to manage the operational 
shared between managers. How this issue is managed 
under 
response of the Ambulance Service in a major 
by the Ambulance Service is the responsibility of the 
incident. The Executive Team will maintain strategic 
ASC. It may be necessary to request support from 
oversight of the response and will provide guidance as 
neighbouring Ambulance Services or other services to 
required. The ASC will ensure that the Executive Team 
ensure the appropriate roles are undertaken effectively 
is informed of the incident developments.
for the duration of an incident. A request may be made 
via national coordination mechanisms.  
For a large, complex incident, where local ambulance 
resources are insufficient, there may be a requirement 
for a national coordination mechanism (see part 4) 
Released 
that enables access to resources and expertise from 
across New Zealand. All Ambulance Services shall 
have in place a clearly defined mechanism to assist 
with the coordination of ambulance resources from 
outside the area affected by the incident. Should 
national coordination be required, operational control 
of the response remains with the local Ambulance 
PART 3 SEPT 2016
35

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Figure 2: Comprehensive Ambulance Service Emergency Response Management Structure
Ambulance 
Service 
Executive Team
Recovery 
Manager
Ambulance 
1982
Service 
Controller
Clinical/ 
Technical 
Advisors
Act 
EOC or  
Administration 
Response 
Officers
Manager
ASEOC Human 
ASEOC 
ASEOC 
ASEOC Public 
ASEOC Logistics 
ASEOC Planning 
ASEOC Liaison 
Resource 
Operations 
Intelligence 
Information 
Manager
Manager
Manager
Manager
Manager
Manager
Manager (PIM)
Information 
Supplies, ICT, 
Ambulance  
Equipment 
Liaison 
Contractors
Officers to:
– ED
CCCS 
– Health/
Official 
Field Operations 
Communication 
Hospital EOC
(Commander etc)
& Clinical Control 
– CDEM EOC / 
Services
ECC
– Police EOC
the 
– etc
Field / External incident
under 
  Control: provides coordination across agencies
  Command / Control: leads and supports the operational response within an Ambulance Service
 Communications
A similar structure may be used to manage complex internal or business continuity incidents that impact on patients 
and services. For example extensive communications failure.  The type of incident will dictate which managers 
Released 
undertake the key roles in the structure such as Ambulance Service Controller and ASEOC Operations Manager. See 
Figure 3 for an example structure. Note that the structure may be modified depending on the incident type.
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1982
Act 
Figure 3: Comprehensive Ambulance Service Emergency Response Management Structure for  
Internal or Business Continuity Incident
Ambulance 
Service 
Executive Team
Information 
Recovery 
Manager
Ambulance 
Service 
Controller
Clinical/ 
Official 
Technical 
Advisors
EOC or  
Administration 
Response 
Officers
Manager
the 
ASEOC Human 
ASEOC 
ASEOC 
ASEOC Public 
under 
ASEOC Logistics 
ASEOC Planning 
ASEOC Liaison 
Resource 
Operations 
Intelligence 
Information 
Manager
Manager
Manager
Manager
Manager
Manager
Manager (PIM)
Ambulance  
Supplies, ICT, 
Liaison 
Equipment
Officers to:
– ED
Released 
CCCS 
– Health/
Technical 
Field Operations / 
Communication 
Hospital EOC
Services (as 
Other Dept
& Clinical Control 
– CDEM EOC / 
required)
Services
ECC
– Police EOC
– etc
Internal or Business Continuity Incident  
impacting on Ambulance Services
PART 3 SEPT 2016
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3.6 Ambulance Operations and CCCS 
ASEOC Operations Manager 
roles and responsibilities
  Reports to the ASC
There are key responsibilities for all roles required in 
  Manages and supports the responding managers 
the ASEOC structure during an emergency response. 
(e.g. Ambulance Commander/s) 
The more complex the response and the longer the 
  Assesses and evaluates the incident operations, 
duration of the incident, the greater the demand on the 
including progress, resource requirements and priority
management structure.
  Provides information to the ASC and other sections 
Again it is noted that roles may be combined depending 
of the ASEOC
on staff availability and the workload to manage the 
response. In a short duration incident, the Ambulance 
  Contributes to the development of the Ambulance 
Service Controller may be able to undertake the majority 
Action Plan 
of the ASEOC roles, including operations, planning and 
  Implements the Ambulance Action Plan in 
1982
logistics while Public Information Management and 
coordination with the responding managers and 
Liaison may be delegated.
their teams.
Act 
See Appendix 15 for Task Cards for ASEOC roles.
ASEOC Intelligence Manager
Ambulance Service Controller (ASC)
  Reports to the ASC
  Responsible for the Ambulance Service emergency 
  Maintain a log to record activities 
operational response
  Liaises and / or integrates with the Intelligence 
  Sets the objectives for the Ambulance Service 
Sections of the Lead Agency, other responding 
Response
agencies, other internal ambulance sources and 
  Reports to the Ambulance Service Executive Team
nationally as required
  Coordinates with the National Crisis Coordination 
  Gathers, collates and analyses response 
Information 
Centre (if activated)
information
  Responsible for the activation for the ASEOC and 
  Develops and distributes intelligence products such 
the appropriate ongoing resourcing
as situation reports, situation maps etc. to ensure 
a common operating pictures
  Contributes to and approves Ambulance Action Plan 
(AAP) 
  Maintain information communication sources in the 
Official EOC – e.g. whiteboards, maps, etc. 
  Responsible for the management of the ‘Business 
as Usual Activities’ alongside the emergency 
  Contribute to response and contingency plans 
the 
response (but may be delegated to another 
through the provision of accurate current situational 
executive)
awareness and possible future scenarios
  Responsible for the quick operational recovery of 
  Contributes to the development of the Ambulance 
normal service delivery following the incident (may 
Action Plan
be delegated to a Recovery Manager).
ASEOC Planning Manager
under 
Ambulance Service Executive Team
  Reports to the ASC
  Delegates the operational Ambulance response to 
  Maintain a log to record activities 
the ASC
  Develop the Ambulance Action Plan based on 
  Maintain executive oversight of the response 
the Ambulance Controller’s objectives, current 
  Provide strategic guidance and support to the ASC
situational awareness and resource availability 
  Will decide to activate or request activation of the 
  Develop an action planning process (meetings, 
Released 
Ambulance National Crisis Coordination Centre 
teams, timelines etc.) appropriate for the incident
(NCCC). See Part 4
  Develop contingency plans based possible incident 
  Assist the ASC, where appropriate and when 
developments as required
requested, with Public and Internal information 
  Develop long term plans as appropriate including 
management and Business Continuity of the 
the planning for and transition to recovery
Service.
  Forecast the immediate, medium and long term 
resource requirements as appropriate for the 
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incident, and include these requirements in the 
ASEOC EOC or Response Manager 
Ambulance Plans for approval by the ASC
  Reports to the ASC
  Integrate the Ambulance Plans with those of the 
Lead Agency and Support Agencies as appropriate
  Ensures efficient flow of information in the ASEOC
  Supports the ASEOC functional Managers to 
ASEOC Logistics Manager
perform their role
  Reports to the ASC 
  Coordinates the internal function of the ASEOC
  Liaises with Logistics Sections in the lead agency, 
  Ensures the staffing needs of the ASEOC are met
other responding agencies, and nationally as 
required
  Monitors the health and welfare of ASEOC staff 
  Responds to the priority logistical needs identified 
  Ensures appropriate administrative support is in 
by Operations and noted in the AAP
place for the ASEOC
1982
  Work with and delegates to the appropriate 
ASEOC Clinical / Technical Advisors
departments of the Ambulance Service to meet 
  Reports to the ASC
the priority response needs of the incident; for 
Act 
example: Human Resources, IT, medical and 
  Provides advice to the ASC on clinical, technical or 
non- medical supply, catering, fleet, refuelling, 
management issues relating to the response and 
mechanical, and traffic support
subsequent recovery
  Develops a communications plan for the 
  May be required to coordinate with DHBs to 
management of the incident. This should be 
obtain hospital bed status information etc and 
done in liaison with the CCCS and the Ambulance 
communicate this information to the ASEOC 
Service IT department
Operations Manager and ASEOC Liaison Manager
  Contributes to the development of the Ambulance 
  Role may be filled by Service Clinical Advisors and 
Action Plan.
/ or Emergency Planning Advisors, depending on 
Information 
the requirement.
ASEOC Public Information Manager (PIM)
ASEOC Administration Officer/s
  Reports to the ASC 
Staff allocated to support the ASC or other managers 
  Liaises with Public Information sections in the lead 
as required. Tasks will include: 
agency, other responding agencies and nationally 
Official 
as required
  Maintaining a communications and decisions log 
for their manager 
  Maintains an Ambulance Service media contact 
point for the incident
  Maintaining currency of information in the ASEOC 
the 
on whiteboards or by other means
  Coordinates all media and information releases with 
the Lead Agency Public Information management
  Monitoring and disseminating information received 
via the MoH EMIS.
  Advises the ASC on Public Information Management 
strategies
Ambulance Service Recovery Manager
under 
  Develops and maintains up–to- date internal 
  Appointed early in the response (shared with P&I or 
information for Ambulance staff as required.
Logistics Manager during the response)
ASEOC Liaison Manager & Officers
  Engage with Roster Administrators, HR, peer 
support agencies, Fleet Managers/Service agents, 
  Report to the ASC
Suppliers and Finance Officers to plan for the quick 
  Responsible for maintaining information flow and 
return to normal service and readiness
contact with key partner agencies. For example: 
  Report to the ASC during the response and the 
Released 
CDEM EOC, DHB or receiving hospital/s
Ambulance Service Operations Manager during  
  Manage key Liaison Officers roles, such as 
the recovery.
Ambulance Liaison – ED, Ambulance Liaison – 
Health, Ambulance Liaison – Non-health (if required)
  May be based in the ASEOC or at the EOC of a 
partner agency.
PART 3 SEPT 2016
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1982
Act 
3.7 Ambulance Non-operational staff: 
It will be the ASEOC Liaison Manager who will have 
the responsibility for maintaining the relationship 
roles and responsibilities
with coordination mechanisms within partner 
All Ambulance Services have human resources working 
agencies during a response. This will include: sharing 
in support of front line ambulance staff and also 
information, requesting resources if required, inputting 
Information 
undertaking other business activities. The scale and 
into a multi-agency action plan. There may be a 
focus of these departments varies from service to 
number of Liaison Officers working with this Manager, 
service.
depending on the incident. See Appendix 16 for task 
cards.
The management of a complex or long duration 
incident will require tasks to be undertaken by non-
It is recognised that Ambulance Services have limited 
operations staff.
resources to provide liaison across a number of 
Official 
different agencies. Therefore the Ambulance Service 
To make the best use of the capability and capacity 
Controller will have to prioritise the placement of 
of these staff, managers will need clarity of the tasks 
direct ambulance liaison according to the incident’s 
the 
that may be required. Managers will also prepare their 
complexity, duration and impact on ambulance 
teams appropriately.
operations, health services and the wider community. 
All support services shall have business continuity 
In an MCI the key roles to be filled will be the Liaison 
plans in place and these shall include their response 
Officer – ED and the Liaison Officer – Health.
during a complex and long duration major incident that 
under 
impacts on the ambulance service and therefore will 
3.8.1 Health coordination
also impact on the work of the support service. The 
A mass casualty incident or health emergency may 
type of response may include (but not limited to):
impact severely on the local, regional and national 
  realignment of normal business
health system. The coordination of patient transport, 
  provision of staff to an ASEOC 
according to priority, to the most appropriate health 
facility is therefore critical. All senior ambulance 
  actioning on specific tasks as required by the    
officers who may fulfil the key roles in the ASEOC shall 
Ambulance Service Controller.  
be fully briefed on:
Released 
3.8 Coordination with health, emergency 
  Capacity and capability of the local and regional 
receiving health facilities
services and other agencies 
  Capacity and capability of the local and regional 
In a complex mass casualty incident or major 
Ambulance Services including air ambulance (rotary 
emergency, it is unlikely that any single agency will 
and fixed wing) with the support of the Air Desk 
have the required resources to meet the needs 
(see section 3.10.2)
of a response. The CIMS approach provides for 
  Emergency plans of the local DHBs as they impact 
coordination across all responding agencies.
the Ambulance Services
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  The communication channels with receiving health 
Ambulance managers need to maintain relationships 
facilities or DHBs to coordinate patient transport
with such organisations.
  The communication channels with Regional Health 
An Ambulance Service is responsible to ensure that its 
Coordination structures.
Ambulance Service Controller has access to contact 
An Ambulance Service is responsible to ensure that 
points for appropriate agencies.
ASEOC have access to appropriate contact points for 
the local and regional health facilities and services.
3.9 Media
For all Level 2 and 3 incidents, DHBs will be informed 
Media representatives will arrive at the scene following 
via the notifications system as part of the activation 
a major incident. Media will also go to hospitals and 
of the ambulance response. DHBs will receive Level 1 
any other site where there is a possibility of acquiring 
notifications. The MoH Regional Emergency Management 
information on the incident including the numbers of 
Advisors and 0800 GET MOH will be informed for Level 
injured and deceased etc.
1982
2 and 3 incidents. See Part 3 Section 3.3 and Appendix 
Ambulance officers will be aware of and follow their 
14. Procedures are in place to hold an initial briefing 
organisation’s media policies. For all incidents, an 
teleconference with partner agencies and neighbouring 
Ambulance Service Public Information Manager (PIM) 
Ambulance Services, based on the scale of the incident. 
Act 
will be available to coordinate inquiries from the media 
This will be facilitated by the CCCS Manager and managed 
with appropriate other agencies. This person will be 
by the Ambulance Commander, Ambulance Service 
based initially at the Ambulance Service EOC.
Controller or their delegate.
For large scale incidents, where there is a clear 
Ambulance Services will also coordinate their actions 
CIMS incident management team in place, all media 
in line with the National Mass Casualty Transport Plan.
inquiries, and the release of information to the media, 
will be managed by the Incident Public Information 
3.8.2 Emergency Services and Other Agencies
Manager responsible to the Incident Controller. Public 
Ambulance Managers working in an ASEOC will need 
Information Management will also be part of the CIMS 
Information 
to have access to information on tactical ambulance 
Incident Action Plan.
responses for specific hazards in their areas. These 
For smaller incidents, the lead agency (for example, 
will be in the form of ambulance tactical plans and 
Police or Fire) may request all news releases be directed 
developed in coordination with other responding 
to their Public Information Managers or Senior Officers.
agencies and the ‘owners’ of the plan (for example, 
an airport company, stadium event management etc). 
It is a priority for the Ambulance Service Controller to 
Official 
These plans will be developed by the Ambulance 
ensure consistent management of public and internal 
Service and be accessible from the CCCS CAD system, 
information is in place as quickly as possible.
with appropriate accessible backup copies.
the  3.10 Ambulance Service Resources and 
It will also be necessary to coordinate with non-health 
organisations and perhaps access their resources and 
Emergency Operations Centre 
expertise. In CIMS approach, the Ambulance Liaison 
or Logistics Manager will have the responsibility for 
3.10.1 Ambulance Service Resources
requesting such resources if required. That said, it is 
under 
necessary for senior ambulance officers to be fully 
Ambulance Service Managers who may be required 
briefed on:
to undertake the ASC role or other key roles in the 
ASEOC, such as Logistics or Operations Managers, 
•  The role, capacity and capability of the emergency 
shall make themselves aware of the resources and 
services, NZ Defence Force, NGOs such as 
equipment that may be used in their immediate service 
Salvation Army and NZ Red Cross, private sector 
areas during a major incident. These may include: 
organisations and Civil Defence Emergency 
Management Organisations
  Ambulance Major Incident cache of medical 
materials and equipment
•  The communication channels with the above 
Released 
organisations to enable access to appropriate 
  DHB medical materials that may be accessible to a 
resources.
pre-hospital response
Note: An Ambulance Service does not need to 
  Specialist materials, equipment, services and 
maintain extensive lists of agencies etc. Other 
personnel from a partner emergency service or 
agencies maintain contracts and contacts lists 
support agency that may be required by a pre-
for support services: for example, many CDEM 
hospital response. For example, USAR equipment, 
organisations have agreements with NGOs and 
CDEM logistics.
contacts with private sector service providers. 
PART 3 SEPT 2016
41

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All Ambulance Services are required to maintain major 
situation, plans and resource requirements.
incident equipment and materials, with efficient means 
The Ambulance Service shall have a space 
of deployment, to ensure a major incident in their 
appropriately set up or able to be set up as an ASEOC 
service area could be appropriately resourced. These 
within 30 minutes of a major incident being declared. 
materials and equipment will be nationally consistent 
kits or caches to ensure interoperability between 
See Appendix 16 for the specification guideline on the 
Ambulance Services.
set up of the ASEOC.
The CCCS CAD will maintain current information on 
The CCCS is required to maintain an ‘Incident Room’ in 
the majority of ambulance resources available for 
each Centre to enable the communications management 
deployment. The status of ambulance resources shall 
of a major incident to be separated from normal service 
be in a form that is immediately accessible to national 
delivery, when appropriate. The CCCS Incident Rooms 
coordination mechanisms, if required. For example, 
will require similar specifications as the ASEOC.
this may be via the health EMIS. This will include the 
1982
location and detail of Major Incident Caches in urban 
4.0 Recovery
centres and Station Kits in strategic rural stations.
The ambulance or event services, including NZ Defence 
4.1 Ongoing Impact of the Incident
Act 
Force (NZDF) or NZ Red Cross, not normally deployed by 
the CCCS, will maintain their resource status, capacity 
The process of recovery for an Ambulance Service 
and capability in a form that is immediately accessible 
is defined as the re-establishment of normal service 
to the CCCS or to national coordination structures if 
delivery after a major incident. This process should 
required. For example, this may be via the health EMIS 
start as soon as possible in the response phase 
or Liaison Officers, in the case of the NZDF.
and be aligned with Ambulance Service business 
continuity plans. Ambulance Services will be required to 
contribute to the overall recovery of the health services 
3.10.2 Air Desk
and community. It may also be that, depending on 
The National Air Desk will aim to:
the incident, there may be a new ‘normality’ for the 
Information 
community. Ambulance Services may have to realign 
Resource appropriate rotary & fixed wing aircraft
themselves appropriately as part of the recovery process.
  Dispatch & coordinate both rotary & fixed wing aircraft
All logs and notes made during the incident at the 
   Recommend appropriate airport to use for staging  
Ambulance Service level will need to be correlated 
 
point between rotary & fixed wing aircraft
and stored in case of possible inquiries into the 
management of an incident.
Official 
   Coordinate with road dispatchers transfer of patients  
 
to hospitals from air
It is envisaged that even in a moderately sized major 
incident there will be an effect on the Ambulance 
   Ensure that air coverage is still maintained in the  
Service. Areas requiring consideration for recovery will 
the 
 
other regions and
include, but should not be limited to:
   If required provide an on the ground air coordinator
  Staff welfare/debriefs
3.10.3 Ambulance Service Emergency Operations 
  Rosters and leave
under 
Centre
  Operational review and learning
For smaller incidents, an ASEOC may be able to operate 
  Consumables (medical/fuel)
‘virtually’ from the CCCS Incident Room or from a 
  Equipment (repair, servicing, review and 
partner agency EOC. However, ASEOC will be physically 
replacement)
required for complex or long duration incidents.
  Vehicles (servicing, repairs etc)
The role of the ASEOC is to:
  Finance and cost recovery.
  Coordinate the ambulance response to a major 
Released 
incident with the Ambulance Commander(s) and the 
Recovery roles have been built into the role 
CCCS
descriptions for response managers at the service 
level as well as for key non-operational staff.
  Plan for future resource requirements of a major 
incident
For complex incidents that have impacted significantly 
on the ongoing functioning of the Ambulance Service, a 
  Manage the impact of the incident/s on normal 
Recovery Manager may be required to concentrate on 
service delivery
rebuilding or modification of the service in the post-
  Ensure that all key stakeholders, both internal 
incident environment. Note: the Recovery Manager is a 
and external, are informed of the current incident 
role not necessarily a position.
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4.2 Operations and CCCS: Roles and 
  External criticism or triggers impacting the 
perceptions of the ambulance response
Responsibilities in Recovery
  Or other issue that may trigger a response from 
All role descriptions in Appendix 15 have recovery 
the Ambulance Service’s Reportable Events 
actions included. A role description of the Recovery 
Management System.5
Manager is included.
4.4.2 Hot or scene debrief
4.3 Non Operational Staff: Roles and 
This is the lowest level of debrief but may be the most 
Responsibilities in Recovery
important. All responding ambulance officers and 
Each Ambulance Service shall ensure Business 
communications staff should take part in this debrief. 
Continuity Plans for non-operationals departments’ 
This is a relatively informal process and should follow 
BCPs or support services include both response 
the debrief template as noted in the Ambulance 
1982
actions as well as recovery actions. An example of 
Incident Command Notebook and in Appendix 17. 
a recovery action may be: The Ambulance Service 
This should occur as soon as possible following 
Financial Officer will be required to correlate and report 
the incident. It will be managed by the Ambulance 
Act 
on all direct incident costs to enable cost recovery. This 
Commander, the ASC or the Recovery Manager.
should be completed in a specific timeframe.
4.4.3 Ambulance Service Debrief
4.4 Ambulance Debrief and Reporting 
This process will be managed by the Ambulance 
Processes4
Service Controller and may be delegated to a Recovery 
Manager. This process will be more formal and will 
draw in all relevant staff; operations, communications 
4.4.1 Debrief aims and requirements
(CCCS), non-operations/support and Ambulance 
The aim of the debrief process is two-fold:
Service Executive as appropriate. This should be 
Information 
completed within two months of the incident. The 
  To identify and acknowledge where the response 
guidelines and documentation for this level of debrief 
went well and ensure that these experiences are 
are in Appendix 17.
shared
The outcome of this debrief will inform an inter-agency 
  To identify where improvements in the response 
debrief if required.
is required and develop a plan of action to ensure 
Official 
that learning occurs.
4.4.4 Ambulance Service Major Incident Report
An incident debrief and / or reporting is required:
The aim of this report is to communicate the findings 
  Following all Level 2 and 3 incidents  the 
relating to the ‘whole-of-service’ response. It will 
  A level 1 incident (or where a level 1 incident 
include learning and acknowledgement of excellence. 
should have been declared) where there has been 
This should be completed within six months of the 
one or more of the following: 
incident. The Ambulance Service Major Incident Report 
will include: 
  Injury to or safety issues for Ambulance Officers
under 
  Poor clinical outcomes of patients possibly 
  The Ambulance Commander’s After Action Report 
attributable to the Ambulance scene 
(See Part 2). 
management
  The Ambulance Service Debrief
  Communications failures or issues
  The Inter-agency Debrief
  Failure of SOPs or Tactical Plans that have 
impacted on response
  Specific information, experience, lessons 
identified and recommendations from operations, 
  Ineffective coordination between responding 
communications, non-operations/support 
Released 
agencies
departments (including financial costs to the 
  Crews lacking expertise or skills
service) or other source not covered in the above 
  Equipment failures 
debriefs.
  Significant impact on the non-operational 
An Ambulance Service Major Incident Report Template 
departments of the Ambulance Service
is in Appendix 17.
The reporting process will be coordinated by the 
Ambulance Service Recovery Manager (if appointed).
4This section draws on the NZFS Incident Management – Command and Control Technical Manual Aug 2009. Section 6 pages 1–19. The 
NZFS Special Operations support is gratefully acknowledged.
5See NZS8156 Section 3.7 page 20.
PART 3 SEPT 2016
43

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1982
Act 
Information 
Official 
the 
under 
Released 
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AMPLANZ Part 4:
National Crisis Coordination Centre
For Ambulance Service Managers to use as the framework for the development and use 
of the National Crisis Coordination Centre
1982
SEPTEMBER 2016
Act 
Content
Information 
Part 1: Introduction to AMPLANZ and Emergency Management for the 
Ambulance Sector
Part 2: Consistent Operations at the Scene
Part 3: Ambulance Service Approach
Official 
Part 4: National Crisis Coordination Centre
1.0 Introduction 
 
46
3.4 Information Management   
48
1.1 Requirement for National Coordination 
46
3.4.1 Tools 
 
48
3.4.2 Emergency Management Information Systems (EMIS) 
 
48
the 
2.0 Readiness and Reduction   
46
3.5 Structure and roles and responsibilities 
 
48
2.1 Response Planning 
 
46
3.6 Coordination with health, emergency services and other agencies 
2.2 Exercising  
 
46
 48
2.3 Training and education 
 
47
3.7  Media  
49
2.4 Review and Audit 
 
47
under 
3.8 Resources 
 
49
3.0 Response 
 
47
4.0 Recovery 
 
49
3.1 Notification 
 
47
4.1 Ongoing Impact of the Incident 
 
49
3.1.1. Escalation of a local incident 
 
47
3.1.2. National warnings 
 
47
4.2 Recovery Roles and Responsibilities    
49
3.2 Activation 
 
48
4.3 Debrief and Reporting Processes 
 
49
4.3.1 Debrief aims and requirements 
 
49
3.3 Communications  
48
4.3.2 Major Incident Reporting   
49
Appendices
Released 

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1.0 Introduction
Ambulance Service in the response and recovery 
phases of the emergency
This is Part 4 of AMPLANZ and provides a framework 
  Provide a sustainable support structure, with 
for the development and management of the National 
trained personnel and appropriate infrastructure, to 
Crisis Coordination Centre (NCCC) and its associated 
be able to operate 24/7 if required.
procedures, for use in a major emergency where 
national ambulance sector coordination may be required.
The operational control of the ambulance response 
shall always remain with the local Ambulance Service 
This document should be read in conjunction with  
unless the local service requests control be formally 
Part 3: Ambulance Service Approach
handed to another Ambulance Service.
1.1 Requirement for National 
2.0 Readiness and Reduction
Coordination
2.1 Response Planning
1982
It is a clear requirement of the National Health 
The majority of operational and tactical response 
Emergency Plan that the ambulance sector shall ““...
planning is undertaken by individual Ambulance 
coordinate... via the National Crisis Coordination Centre....”1
Services, the CCCS and their local emergency 
Act 
management agencies and neighbouring Ambulance 
There are two broad scenarios where a degree of 
Services. This is outlined in Part 3 Section 2.
national coordination may be required, these are:
The NCCC shall be written into specific ambulance 
1.  When there is an event affecting the nation (i.e. 
operational and tactical plans as appropriate.
pandemic, major environmental disaster) and the 
The ambulance sector contribution to national health 
National Health Coordination Centre (NHCC) or 
emergency planning may be undertaken in a number 
National Crisis Management Centre (NCMC) has 
of ways, including:
been placed on standby, opened or activated
  Meeting the obligations set out in legislation (e.g. 
2.  When one or more of Ambulance Services are 
CDEM Act) for Ambulance Services, DHB, MoH 
overwhelmed and require support from other 
Information 
or other national agencies. Individual Ambulance 
ambulance services, or perhaps national health 
Services may be contracted and funded to 
or national Civil Defence resources. Such an 
coordinate the emergency planning and capability 
emergency is likely, but not exclusively, to be a 
development of the ambulance sector. For example, 
protracted event and require an ongoing response 
(chemical, biological and radiological) CBR capability 
lasting a number of days and where recovery lasts 
development
a number of weeks before normal services can be 
Official 
  Aligning of Ambulance Service plans with national 
resumed.
plans, such as the National Mass Casualty 
The level of the national coordination will be 
Transport Plan
the 
dependent on the incident complexity, duration, scale 
  Cooperation between services for specific known 
and location.
pre-planned events or known threat (e.g. Rugby 
It is also noted, that an Ambulance Service will be 
World Cup 2011, VIP tours / meetings etc)
required to focus on the immediate Operational and 
  Using the NCCC in planning for exercises, pre-
Tactical response to a local or regional incident. The 
planned events or known threats, where it is 
under 
provision and coordination of external Ambulance 
necessary that national coordination will be required
resources is best managed through a separate 
  Individual Ambulance Services contributing to 
coordination mechanism. Therefore It has been 
specific issues relating to emergency response 
agreed that St John will maintain the National Crisis 
planning. For example; revision of the New Zealand 
Coordination Centre (NCCC) for its own national 
Influenza Pandemic Action Plan.
coordination and all ambulance service coordination. 
The choice of the approach used will depend on the 
This is broadly defined as a mechanism that, with 
planning issue, priority for individual services, capability 
supporting procedures, is able to:
in the sector and the resources available to assist the 
Released 
  Receive requests from the responding Service or 
sector.
part Service that has been overwhelmed 
  Coordinate the provision of requested ambulance 
2.2 Exercising 
resources from other Ambulance Services or 
The NCCC shall be involved in at least one major (Tier 
nationally
3–42) exercise each year. The communication and 
  Liaise and coordinate with key National Emergency 
activation procedures shall be tested as appropriate 
Management Agencies on behalf of the responding 
for all regional (Tier 3) exercises.
1NHEP 2015 page 12.
2MCDEM Tier 3 exercises test TLA and CDEMG operations. MCDEM Tier 4 exercises test NCMC, CDEMG and TLA operations. Both of these 
will require a National response from St John.
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1982
Act 
All activations of the NCCC for an exercise or a real 
Training and education in emergency management 
event shall be evaluated and lessons will be identified 
for Ambulance Services shall align appropriately 
and shared with the Ambulance Services. The key 
with competency frameworks and guidelines of other 
learnings shall then form part of the annual AMPLANZ 
emergency service partners, as well as with Civil 
Information 
review and the reviews of an Ambulance Service’s own 
Defence and Emergency Management Agencies.
Major Incident and Emergency Plan.
2.4 Review and Audit
2.3 Training and education
The Ambulance Service Major Incident and Emergency 
To enable the NCCC to undertake its role, all potential 
plans, and the related operational procedures, 
Official 
personnel who may be required to work at this level 
including national coordination mechanisms, to ensure 
shall be trained appropriately. It is noted that the 
the notification, activation and management of a full 
training requirements to assist in national coordination 
and coordinated Ambulance Service response, shall 
are similar to those required for an Ambulance Service 
be audited and reviewed as part of the Ambulance 
the 
Emergency Operations Centre (ASEOC). Such training 
Service’s quality management systems.
should include, but is not limited to:
AMPLANZ will be reviewed annually to take into account 
  CIMS 2 (minimum)
local and internationally significant development and 
lessons identified or learnt. There will be a formal 
  Emergency Coordination Centre or Operations 
review of AMPLANZ no later than every three years. The 
under 
Centre management
Ambulance New Zealand Standards and Accreditation 
  Leadership and On-call management roles for 
Committee has the national responsibility for the review 
middle and senior management required as part of 
of AMPLANZ on behalf of Ambulance New Zealand 
or in support of an ambulance response
trustees.
  Specific training as developed / run by key 
3.0 Response
partners, such as MoH or MCDEM. e.g. MCDEM 
Controllers course, NHCC and NCMC Liaison 
Released 
Officer Inductions
3.1 Notification
  EMIS login and basic use
3.1.1. Escalation of a local incident
  Specific in house training on the set up and 
The notification and escalation processes to be 
procedures of the facility from where the national 
used are outlined in Part 2 Section 3.0. This notes 
coordination mechanism may operate.
when an Ambulance Service’s national coordination 
Training needs analysis is required to further enhance 
mechanisms should be informed, placed on standby 
the appropriateness of emergency management 
or activated depending on the incident.
training and education within an Ambulance Service.
PART 4 SEPT 2016
3

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3.1.2. National warnings
appropriate intelligence, planning and operational 
information relating to the incident is integrated and 
MoH and the MCDEM will send out National 
transparent locally, regionally and nationally.
Warning notifications to all emergency management 
stakeholders in the health sector and the wider  
CDEM sector.
3.5 Structure and roles and 
The types of national notifications are noted in Appendix 
responsibilities
13. The CCCS will receive these notifications and is 
In developing a mechanism to access ambulance 
responsible for cascading these to Ambulance Services.
resources from other services or nationally, or from 
It is the responsibility of each Ambulance Service 
national partner agencies, St John will ensure that a 
to respond appropriately to these notifications and 
clear coordination structure is in place and the roles 
develop their responses, including the degree to which 
within that structure have defined responsibilities.
inter-service or national coordination is required.
The coordination structure shall be based on CIMS and 
1982
therefore shall include the following functions or roles: 
3.2 Activation
  National Ambulance Controller 
There will be a clear procedure as to how to activate 
Act 
 Operations 
the NCCC and this shall be communicated to the 
Ambulance sector and key partner agencies.
 Planning 
3.3 Communications
 Intelligence 
 Logistics 
The CCCS shall be the Ambulance sector ‘single point 
of contact’ for partner agencies (for example: the MOH 
  Public Information Management
and MCDEM) to notify Ambulance Services of potential 
 Liaison 
or actual events or to access Ambulance resources.
  Technical advice
Information 
An Ambulance Service shall ensure it has the ability 
access or provide resources, support or coordination 
  Human Resources
at any time as part of its national coordination 
Note the modular and expandable nature of CIMS. 
mechanism. An Ambulance Service’s key points of 
That is, all roles will need to be carried out to meet 
contact shall be communicated across the sector.
the requirements of the incident and the requests of 
the responding Ambulance Service.
Official 
3.4 Information Management
Each function shall have clear role descriptions in the 
form of task cards or similar.
3.4.1 Tools
the  The facility or location where the coordination functions 
The NCCC will have access to and use similar tools 
occur will normally be outside of the immediate 
in a service’s ASEOC. It will be required to produce 
geographic area where the incident has occurred.
information for national partner agencies and to 
Coordination functions may be managed ‘virtually’ or 
appropriately action requests from the NHCC or 
from an ASEOC depending on the scale, duration and 
NCMC. These tools shall include but are not limited 
under 
complexity of the emergency.
to:
The detailed structure of the NCCC will be noted in 
  Communication and Decision Logs
the St John Major Incident & Emergency Plan. It will 
 Sitreps 
be communicated nationally to all ambulance services 
  Ambulance Coordination Plan template
and partner agencies.
  Resource tracking reports
  Access to Mapping.
3.6 Coordination with health, 
Released 
emergency services and other agencies 
3.4.2 Emergency Management Information Systems 
The NCCC will liaise with national agencies. These 
(EMIS)
include: 
MoH and MCDEM both have EMIS. At the Ambulance 
  National Health Coordination Centre NHCC (MoH)
Service level, the EMIS is currently accessed and 
utilised appropriately.
  National Crisis Management Centre NCMC 
(MCDEM)
The EMIS shall be utilised to provide the NHCC and 
NCMC with the overall status of the ambulance sector. 
  National Welfare Coordination Group 
The NCCC will need to access the EMIS to ensure 
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  National Fire Service Headquarters
4.0 Recovery
  National Police Headquarters.
4.1 Ongoing Impact of the Incident
To facilitate this coordination, ambulance managers 
undertaking coordination roles shall maintain current 
The process of recovery for an Ambulance Service 
operational relationships with key staff in these 
is defined as the re-establishment of normal service 
national agencies. This will require appropriate 
delivery after a major incident. This process should 
security clearance for key ambulance managers.
start as soon as possible in the response phase 
and be aligned with Ambulance Service business 
As noted in Part 4 Section 3.5 above, the liaison 
continuity plans. Ambulance services will be required 
functions may be required to one or more of the above 
to contribute to the overall recovery of the health 
organisations. It is recognised that there are limited 
services and community. It may also be the case 
human resources to provide liaison across a number 
that, depending on the incident, there may be a new 
of different agencies and therefore a process of 
‘normality’ for the community. Ambulance Services 
1982
prioritisation will be required according to the incident’s 
may have to realign themselves appropriately as part 
complexity, duration and the impact on ambulance 
of the recovery process.
operations, health services and the wider community.
Act 
At the national level ambulance recovery coordination 
To perform the liaison function appropriately will 
following a complex and nationally significant 
require timely access to Ambulance Service Sitreps, 
emergency shall be based on the requirements of the 
intelligence as well as action plans. There will also 
local Ambulance Services and / or the needs of the 
need to have an understanding of the ambulance 
health sector locally, regionally and nationally.
sector’s current resource status and immediate and 
future resource requirements. This may be done most 
The Ambulance Services shall consider recovery 
effectively by an Emergency Management Information 
functions as part of the NCCC.
System (EMIS).
Part 3 has outlined the range of recovery issues for an 
The NCCC shall assist with the implementation of key 
Ambulance Service.
Information 
health sector emergency plans such as the National 
Mass Casualty Transport Plan.
4.2 Recovery Roles and Responsibilities 
3.7 Media
All key functions to be carried out as part of the NCCC 
(see Part 4 Section 3.5 above) shall have recovery 
Media representatives will arrive at the scene 
actions noted as part of role descriptions. A role 
following a major incident. Media will also go to 
description of the Recovery Coordinator shall be 
Official 
hospitals and any other sites where there is a 
considered.
possibility of information on the incident including the 
numbers of injured and deceased etc.
4.3 Debrief and Reporting Processes
the 
All staff shall be aware of and follow their 
organisation’s media policies.
4.3.1 Debrief aims and requirements
For all incidents, an Ambulance Service Public 
The aim of the debrief process is two-fold:
Information Manager will be available to manage  
  To identify and acknowledge where the response 
under 
local inquiries from the media with appropriate  
went well and ensure that these experiences are 
other agencies.
shared
At a national level, the NCCC will be required to 
  To identify where improvements in the response 
contribute with media releases by the NHCC and other 
is required and develop a plan of action to ensure 
similar national agencies. It is the NHCC that will 
that learning occurs.
coordinate all Public Information for the Health Sector 
as a whole.  
An Ambulance Service shall have debrief processes as 
specified in Part 3 Section 4.4. The NCCC shall have 
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3.8 Resources
similar processes in place. 
The NCCC shall specify what resources will be required 
4.3.2 Major Incident Reporting
to support a local operational Ambulance response 
An Ambulance Service shall have reporting processes 
for a sustained period. These will include, but are not 
as specified in Part 3 Section 4.4. The NCCC shall 
limited to, appropriate and trained Human Resources to 
have similar processes in place to capture lessons to 
fulfil key functions specified above, appropriate facilities 
assist future planning and service improvement.
(for example, an ASEOC) and tools.
All logs and notes made during the incident in the NCCC 
level will need to be correlated and stored in case of 
possible inquiries into incident management.
PART 4 SEPT 2016
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Appendices
Appendix 1:  Glossary of Terms and Abbreviations
Appendix 2: References
Appendix 3:  STEP 1-2-3 scene approach rule
Appendix 4:  Task Cards for First Responding Ambulance to a possible  
major incident
1982
Appendix 5:  Triage Tools and Tags (Review continuing)
Appendix 6:  Information Management Tools
Act 
Appendix 7:  Ambulance Scene Task Cards
Appendix 8:  Sector numbering – examples
Appendix 9:  Vest and role labels
Appendix 10:  Ambulance Commander After Action Report Template
Information 
Appendix 11:  Business Continuity Plan example template
Appendix 12:  Tactical Plan Template Official 
Appendix 13:  MCDEM and MoH alerts
Appendix 14:  Ambulance MI Notifications List (Guideline)
the 
Appendix 15:  Major Incident Task Cards for an Ambulance Service EOC (ASEOC)
Appendix 16:  Guideline for ASEOC set up
under 
Appendix 17:  ASEOC & NCCC Debrief and Reporting Tools
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NEW ZEALAND AMBULANCE MAJOR INCIDENT AND EMERGENCY PLAN (AMPLANZ)

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Act 
Information 
Official 
the 
under 
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Notes:
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Official 
the 
under 
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NEW ZEALAND AMBULANCE MAJOR INCIDENT AND EMERGENCY PLAN (AMPLANZ)

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Notes:
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Act 
Information 
Official 
the 
under 
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PART 4 FEB 2016
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1982
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Official 
the 
under 
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Document Outline

• AMPLANZ Part 1 NOV 2016 v2.pdf
• AMPLANZ Part 2 NOV 2016 v2.pdf
• AMPLANZ Part 3 NOV 2016 v2.pdf
• AMPLANZ Part 4 NOV 2016 v2[1].pdf

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