This past weekend my department responded to a single vehicle rollover on a rural (no curbs, soft shoulder) road.  The older model SUV landed on its roof in a ditch with severe damage. First arriving unit reported 6 patients with limited patient contact and the need for extrication. In the end, the call required (or used) 8 ambulances, 3 engines, several auxiliary vehicles (command vehicles, etc), 5 helicopters (we have three hospitals in the area, but our nearest trauma 1 center is 15min by air, or 45-60min by ground; due in part to mountains), and several law enforcement vehicles.  All 6 patients presented with critical criteria, and extrication required 62 minutes from first unit on scene to last patient in ambulance (to be fair I haven't reviewed the documentation, this is simply what I was told).

It was certainly a hectic scene, but all in all I think it was well run.  We had a total of seven agencies involved.  This was the result of the number of patients.  Based on the time of day, and other calls, we used four local ambulances, two [local university rescue squad] ambulances (they have their own squad that covers the campus), an ambulance from an adjacent department, and one private transport company ambulance. Adding in the three helicopter companies, and you can see how the agency count was driven up.  In the end, the point I wanted to make is that I found implementing ICS damned difficult for such a big-little incident.  By that I mean, we really only had a single vehicle accident. I'm curious if any of you have experienced this, or quite frankly, have even thought about trying to implement ICS (NIMS if you like) on an incident spanning about 20 ft by 30 ft?  I'm just curious as to your thoughts, and I'm interested in similar experiences.

-Andrew