Prehospital care is provided by emergency medical services (EMS) responders, who are the initial health care providers at the scene of disaster. EMS personnel often are the first to recognize the nature of a disaster and can immediately evaluate the situation and determine the need for resources, including medical resources. These licensed/certified personnel (emergency medical dispatchers, emergency medical responders, emergency medical technicians, and paramedics) may be the first to apply crisis standards of care (CSC), and are integral partners in local and state¹ efforts related to the development and implementation of coordinated and integrated CSC plans