Latvia's Emergency Medical Service Introduces International System for Mass Casualty Incidents

Latvia's Emergency Medical Service (NMPD) is continuing to introduce MIMMS (Major Incident Medical Management and Support), an internationally recognised system for the medical management of mass casualty incidents. The aim is to better prepare the country for disasters and other emergencies with many victims, NMPD spokesperson Ilze Bukša told the news portal Delfi.

This week, Latvia is hosting the first national-level MIMMS training organised by NMPD for its medics. It is led by certified MIMMS instructors from Latvia and by Justin Burke-Jones, a British expert in medical management of major incidents.

Why it is needed

NMPD director Liene Cipule said Latvia has so far been spared major disasters, but terrorist attacks, destructive natural disasters and the war in Ukraine over the past decade have significantly changed the security situation in Europe. In her words, every country must be ready for events in which a large number of people need medical help within a short time.

Introducing MIMMS principles is expected to bring more coordinated action among NMPD, the State Fire and Rescue Service, the police, the National Guard and the armed forces, as well as more effective cooperation with services from other countries. The system relies on common standards that rescuers can understand regardless of which country they represent.

What medics are taught

Participants learn command in incidents with many casualties, communication in crises, assessment of scene safety, prioritising victims (triage) and evacuation planning. In practical simulations, medics practise making quick decisions when the number of victims far exceeds everyday resources. The training is run together with the UK's Advanced Life Support Group (ALSG), which developed the course standard.

Next steps

The plan is to extend the training to firefighters, police, the armed forces, the National Guard, hospital emergency departments and crisis management groups. Funding is still being sought, and an informative report on developing military and crisis medicine is under review at the Ministry of Health. The introduction of MIMMS is also foreseen in NMPD's 2026–2030 operational strategy.