(AC 1.2)

The ambulance team is usually the first to reach the scene and assess the scene to report back to the hospitals. The ambulance service consists of paramedics and an ambulance incident officer (AIO) who is the senior crew member in charge of the scene until a more senior officer is present. The paramedics report to the scene, assess the situation and report back to the control and deliver a co-ordinated response to the individuals involved and communicate with the senior officer. The responsibilities of the AIO include declaring a major incident and giving a situation report whilst liaising with hospitals, communicate with health service personnel, plan the entry and exit routes for the ambulances located on the scene, decide where to locate the ambulance parking point, the casualty clearing station and the control point, report back to the ambulance control and liaise with the senior crew members for additional support.

The Medical Incident Officer (MIO) is the most senior crew member on the scene who provides support and guidance to the emergency services. The MIO works closely with the AIO to ensure the immediate care staff are safe and take clinical decisions to appropriately distribute the casualties to hospitals. The MIO works alongside the AIO to allocate tasks and roles and keep the ambulance control informed of the situation on the scene. If there are deaths on the scene, the MIO needs to provide a doctor to confirm the deaths once the casualties have been removed and liaise with a coroner. The MIO will need to keep the receiving hospitals informed and provide accurate risk assessments to the appropriate advisors.

The Medical Emergency Response Incident Team (MERIT) commonly consists of a doctor or nurse or two of each. The key aim in providing a MERIT response is to get a specialist medical intervention to the casualties which can improve