Major incident tactical (silver) command: DipIMC practice questions

Answer: D

Gold, silver and bronze denote the role held during the incident, not the holder's rank

The NARU National Ambulance Service Command and Control Guidance (2012) describes a three-tier system of strategic (gold), tactical (silver) and operational (bronze) commanders in which individuals are empowered through their role within the structure, regardless of their rank in the organisation's day-to-day structure. The tiers divide the work: the gold commander sets the strategic aims (the Gold Strategy), providing a framework for the silver commander, who is responsible for developing the Tactical Plan for the use of resources; bronze commanders deliver that plan at the scene. The Oxford Manual of Major Incident Management describes the strategic level as notional rather than geographical, usually located in a regional or national command centre, and states that there is normally only one strategic (gold) level for any given incident. The military distractor is a real trap: the UK armed forces refer to bronze level as 'tactical' and silver as 'operational', with gold still strategic. Learn the tiers rather than the job titles: the national ambulance command guidance was revised in 2024 (version 5.0, which could not be obtained), and nothing here turns on a particular post name.

Answer: A

IIMARCH

The JESIP Joint Doctrine (section 7.8, Briefing) says that in the initial phases of an incident the Joint Decision Model may be used to structure a briefing, but that as incidents develop past the initial phases, or if they are protracted and require a handover of responsibility, a more detailed briefing tool should be used, and that the mnemonic IIMARCH is a commonly used briefing tool: Information, Intent, Method, Administration, Risk assessment, Communications and Humanitarian issues. JESIP publishes an IIMARCH template. The distractors are all real mnemonics used for other purposes: M/ETHANE is the common method for passing incident information between services and their control rooms; ATMIST (age, time of injury, mechanism, injuries, signs, treatment) is the clinical handover of a trauma patient; SBAR (situation, background, assessment, recommendation) is a general clinical communication tool; and CSCATTT is the Major Incident Medical Management and Support (MIMMS) framework of priorities (command, safety, communication, assessment, triage, treatment, transport) for managing the medical response.