Overview of Emergency First Response and the Start System

The Department of Health and Human Services (DHHS) recognizes active shooters as a threat to healthcare facilities and encourages them to incorporate planning and preparedness into their emergency operation plans. A guide was developed, and backed by the DHS, FBI, US Department of Justice, and Federal Emergency Management Agency, focused on prevention, protection, mitigation, response, and recovery, as well as stressing the importance of plans

Problems resulting from disasters linger for quite some time after the acute phase in a disaster and victims may have issues arise that they were not aware of initially. Community health nurses are often a primary point of contact for many of these situations and must be prepared for various problems. Sometimes, they are called on to simply reassure the victim that they are not alone in the situation and that help will continue to come. When a nurse allows a victim to discuss their concerns, the nurse can quickly expedite referrals to the appropriate area if it is out of their scope of practice. Occasionally, just having the validation and reassurance from a professional instills hope that things will get better soon. In the situation where the

The Blocker Burn Unit is a six bed Burn Intensive Care Unit located at the University of Texas Medical Branch (UTMB) in Galveston. It has a long and storied history of providing innovative burn care to its patients. The Burn unit was initially founded after a massive explosion in Texas City Harbor that injured hundreds of people in 1944. Since inception, the unit has dealt with disaster both fabricated and natural. In 2008, the BBU was one of only a handful of services to remain open and operational after Hurricane Ike landed and dealt massive injury to UTMB. The BBU not only sustained operations but also briefly expanded to provide pediatric burn care when Shriners Burns Hospital was subsequently unable to reopen post hurricane. This paper will detail the realities confronted by the BBU both currently, and in the future, with an exploration as to those implications on fiscal outlook and provision of care.

Memorial Hospital did not have suffice evacuation guidelines for a disaster, let alone one of this magnitude. The hospital staff developed their own triage system to evacuate patients, and as a result the LifeCare and other critically ill patients were neglected. Memorial Hospital had a vast variety of departments at the hospital including: neonatal intensive care, dialysis, oncology,

“GET DOWN!.... SHHH!!!!.... GET DOWN! GET INTO A ROOM AND LOCK IT!!!!” This is the first thing our opposite crew heard as they walked into the ER with a patient last month. Should this crew have recognized the signs of an active shooter? Is walking into a hospital with an active shooter even a real concern? From 2000-2012, there were 154 hospital related shootings in the United States with 235 injuries or deaths. That’s more than 1 shooting a month. As QIC I will implement parts of the “Active Shooter Preparedness” from United States Homeland Security. Knowing exactly what Emergency Action Plans our hospitals have in place will help us know how to recognize and react to possible active shooter situations. Scene safety is constant with EMS.

Local protective measure planning equips first responders with the knowledge needed to organize efficient response results in the event of an emergency. Structured open dialogue between local emergency jurisdictions enables responders to delegate the appropriate individuals and equipment resources to the impacted local areas requiring the most aid following a terror event. By establishing a streamlined communication framework, local emergency responders can collaborate their efforts and resources to promote collective well-being. When a local emergency plan specifies what responders and resources belong where and at what time, response overlap and shortages can be avoided. Unionized response action established prior to a terrorist incident, serves to mitigate the risks, hazards and threat of injury or harm the people and property of the US face when a terrorism event occurs. Furthermore, a structured local emergency operations plan for a hazardous materials incident involving a terrorist is imperative to public health and safety, as the blueprint outlines protective measures the public can follow to minimize their exposure to dangerous substances. The people of a community affected by a terror event can be warned and notified of the event’s associated dangerous materials, which threaten their well-being, through a variety of methods such as warning sirens or horns, emergency alert systems, automated

The various local, state, and federal emergency management systems of the United States suffered a crude awakening in the decade of the 2000s. Systems expected to hold up were put to the test and failed to prepare for disaster, mitigate the damage, and, in some instances, actually hampered responses in life-or-death situations. Worse, all failings were highlighted in an age of global communication and mass media, on display first whether a man-made incident like September 11th attacks or natural disaster like Hurricane Katrina. The decade found the complacent government failing to maintain modern emergency management practices, stimulating began a series of doctrinal upgrades and training improvements. Yet, no matter the bureaucracy, writings, or money thrown at a problem, the first responder to the incident has and will continue to influence the outcome. While the individual responder stands as the most important part of

The attacks on the morning of September 11, 2001 left the American people in shock and awe. The attacks left nearly 3,000 people dead in New York, the Pentagon, and in Pennsylvania including 343 firefighters and paramedics, 23 New York City police officers, and 37 Port Authority police officers (history.com, 2010). Most people had not seen firsthand the kind of devastation that was brought upon this nation in their lifetimes. The police, firefighters, and port authority officers of New York responded quickly in an effort to save as many lives as possible. Many of them lost their lives during the collapse of the World Trade Center buildings. What is not as frequently cited is the number of health concerns that still plague the thousands of first responders that tried to help the victims of the vicious attacks. According to the Center for Disease Control’s World Trade Center Health Program (2012), there are currently 32 conditions and injuries and 60 types of cancers that are currently covered by the program. This is a continually growing list of health hazards that still affect those responding to the call to assist in recovery efforts over 15 years later. When the police and firefighters entered those buildings they did not know what would happen, but they accepted that risk. Some would lose their lives, but those that survived would have to deal with the health

The attacks were more localized than most catastrophic disasters, did not overwhelm emergency shelters or food distribution centers, and did not destroy the city infrastructure in either New York or Washington.. However, the 9/11 experience highlights one critical concept. One cannot ignore the importance of maintaining highly trained local emergency responders as well as properly staffed and equipped local emergency response agencies; local first responders are on scene first, handle the vast majority of rescue operations, and cannot be practically replaced by federal responders, especially when disasters strikes without

military’s vast experience in responding to and managing casualties from IED and/or active shooter incidents and from its significant investment in combat casualty care research into the civilian first responder environment” (DHS, First Responder Guide. 2015). In order to improve safety in response to terror events, especially those classified as international terrorism it will require that first responders to further prepare for a vast variety of potential threats. The focus of this increased preparation should not only regard the safe and effective responses of first responders to all potential hazards caused by a terrorist event; but should also include the improvement of first responder’s connections to their communities, the gathering of intelligence, information sharing, and realizing their role in domestic defense of the United States of America.

Past strategies of officer or rescue arrival, establishment of incident command(s), operational planning, and specialty unit deployment (such as SWAT or SRT) simply do not work for the active school shooter critical incident. Time is of the essence, and first responders have to act nearly instantaneously. Progressive agencies have noted the importance of creating policies and procedures that specify the action that first responders will take in the event of an active threat, and for the most part, they are training accordingly on methods which use small teams, or even pairs. In the instance of an active shooter, the school will be locked down upon public safety personnel’s arrival. For the first arriving units, police and rescue personnel have to mesh together and address the threat while keeping open communication with additional responding units. When possible, a fire-rescue medic may be placed with two or more law enforcement officers to assist in rescue and treatment efforts, in addition to serving as an additional observer (Morris, 2014). Rapid entry and quick advancement toward the active threat is absolutely paramount for victims’ survival, and in most circumstances, this will be the responsibility of the first few arriving personnel. These

Whenever a disaster strikes an unsuspecting community, from natural weather events like hurricanes and tornadoes to the manmade catastrophes caused by contamination, local community health nurses become a lifeline for stricken victims, providing medical care, basic sanitation, and nutritional sustenance. While treating the ailments of the sick and dressing the wounds of the injured are the chief priorities for any nursing professional, community health nurses typically administer care within a close-knit population group, and this familiarity often requires the offering of spiritual support as well. The immediate aftermath of any major disaster, whether natural or manmade, is a chaotic time when panic, fear, and uncertainty can easily run rampant, and community health nurses must prepare themselves to handle the nonmedical aspects of assisting patients through their recovery. Setting aside one's personal views on organized religion or faith, alleviating a patient's outward symptoms can only be effective to a certain point when they are grieving for the sudden loss of a loved one, or contemplating an uncertain future after their property and

I am progressing well in authoring an updated Mass Fatality Response Plan, Annex H of the Dane County Emergency Operations Plan (EOP). I am authoring this annex for my employer, the Dane County Medical Examiner’s Office. Although our office is the premier Medical Examiner’s Office in the state, providing resources to other counties, it seems to be lacking in its annex to the county’s EOP. From my understanding, each department writes its own plan before submitting to the emergency management department. In this paper, I will describe the current condition/structure of the annex, how I am improving and producing the annex, and its impact on Dane County’s EOP.

In some instances, COPs may find themselves in dangerous situations where there may be many casualties or situations that my demand that the medical staff needs to protect themselves as much as they need to protect their patients- the COPs. As much as evacuation is essential, there is need to provide adequate information through information sharing systems. This can be classified under their preventive role in a bid to approach the job in a proactive manner. Through this the COPs may have basic and fundamental knowledge of what to do in certain

“We, the Nations’ First Responders, professional and volunteer alike, are the nation’s first line of defense” (National First Responders Organization (NFRO), Mission Statement)