Biomedical Engineering Reference
In-Depth Information
transporting units and hospital, Emergency Depart-
ment, Police and Fire Departments as well as
Federal assets (Such as a TopOff exercise).
Remember that drills and exercises are meant
to be a practice for the real event. The more real-
istic and stressful the environment for the drill the
better. When responders are faced with a real situa-
tion they will fall back on what they have practiced.
This is a level of skill called “accommodation” by
educators. This is when responders know what the
appropriate intervention is for the patient, and do
not have to think about performing the interven-
tion, they can just do it with minimal direction. It
is also referred to “tacit knowledge” or “muscle
memory.” This level of knowledge and skill comes
from hands on, emotional, and realistic practice.
These frequent drills are for experience and will
help the rescuers to approach a true WMD scenario
with confidence. If a responder has never practiced
a WMD scenario, then they will be approaching
the scene as a novice rather than as a practiced
veteran. If we want EMS staff to respond properly,
this is the level of knowledge we need to attain.
Besides being practice for street personnel, drills
also allow for supervisory and executive personnel
to practice their roles in a WMD event. Not having
leadership experience in an emergency situation
can have poor outcomes, even with experienced
street personnel.
Often we promote our experienced street
level providers to supervisory positions, without
adequate training. Leadership training is impor-
tant. Practice in the leadership role is important.
Remember, changing your normal role is difficult.
How many times has second and third arriving
units assummed the role of incident commander
because the first arriving unit did not? Many times
this has happened because the initial responder was
unfamiliar with the leadership role that he or she
was supposed to assume.
Leaders and managers are trained and just like
anyone else when confronted with extraordinary
circumstances they may not always rise to the chal-
lenge. Some people may say that it is impossible
to train someone to that level. But we regularly
train street level providers to go into burning
buildings, hazardous material incidents and other
Table 8.1
Potential targets of terrorist events
Urban
Rural
Water Supply
Water Supply (typically
to urban areas)
Electrical Generation
Electrical Generation
Stadiums
Stadiums
Entertainment venues
Entertainment venues
Airports (smaller municipal
airports)
Airports
(many
times
larger airports)
Monuments
Monuments
Government Offices
Government Offices
Schools
Schools
Hospitals
Hospitals
Mass Transit
Internet Hubs
Communications grids
actually located in rural communities. For example,
Shippingport, PA, population 237, is about 40
miles from Pittsburgh and is home to a nuclear
power plant. Our newer, larger airports that serve
urban areas are also commonly located outside of
city limits in a suburban or rural environment.
8.4 Personnel and Training
The Occupational Health and Safety Administra-
tion has rules and regulations regarding training
for personnel who respond to Hazardous Mate-
rials Incidents (Table 8.2) [1]. A weapons of mass
destruction (WMD) event can be thought of a
hazardous material incident. Using the same termi-
nology as haz-mat regulations, staff can be thought
of as having the following levels of training:
Awareness, Operations, Technician, Specialist and
Incident Commander.
The National Fire Protection Administration also
has guidelines that address the training of staff for
response to Hazardous Materials Incidents (NFPA
427). In addition to training staff to the appropriate
level, realistic drills are needed to reinforce the
training. These drills should be done frequently to
keep responders skills sharp.
Drills can be run in a variety of ways. They can
be as simple as playing the “Mass-Casualty Board
Game” to as complex as a full-fledged exercise
with a live burn, explosions, moulaged patients,
