Biomedical Engineering Reference
In-Depth Information
acceptable PPE in this zone. The press, treatment
area, and responder rehabilitation area are located
in this zone as well [2]. The size of the zones
and the distances between them should be based
on conditions specific to each incident, the mate-
rial involved and the judgement of the incident
commander. The following criteria should be used
when considering establishing zone boundaries:
planning bodies include Local Emergency Plan-
ning Committees (LEPCs) and regional councils of
governments. Using these resources terrorist events
can be planned for and more importantly can be
reviewed post event.
This pre-event planning and post event
reviewing is a concept borrowed from the military.
Before a standard military operation, a mission
briefing is conducted reviewing the mission goals
and objectives. After the operation everyone
attends a debriefing which among other things
looks at lessons learned from the event.
Examples of emergency plans include local
EMS service plans, regional disaster plans and
state emergency response plans. An example
of a regional emergency response plan by the
Connecticut Capitol Region Council of Govern-
ments appears in the appendix.
Using realistic scenarios with “live” patient
actors, EMS, and hospital resources is the only
way to truly test any plan prior to it being
needed. It is important to be certain that high-
level operational management takes part in these
drills, as these people are likely to be the ones
looked upon to control the situation. Conversely
it is equally important for street level providers,
including supervisors, crew chiefs, and the greenest
of new recruits to know the roles they may play and
how to organize the scene. Almost all the time the
street level provider will be on scene well before
senior officers are. So the initial organization of
the scene is many times left to those with the least
experience or training with large scene manage-
ment. This initial organization is one of the most
important times during the incident, indeed, it sets
the stage for all later operations.
When practicing the plan, there are two options
for the practice session. One is to have a table
top exercise. Traditionally table top exercises are
attended by senior EMS officers and city/town
officials. They have the opportunity to prac-
tice making difficult decisions. A well-thought
out, well-planned table top exercise can be an
eye opening experience, especially to those who
have never attended one. But one of the major
drawbacks to this type of exercise is the lack of
participation (at least commonly) by street level
Table 8.3
RI DEM ERP 3-1 p1-. 2 Checklist of
response issues [2]
Physical and topographical features of the site
Weather conditions and wind direction
Field measurements of air contaminants
Air dispersion models of the chemicals involved
Physical, toxicological, chemical and other characteristics
of the agents involved.
Cleanup activities
Potential for fire and/or explosions
Access to roads, power sources and water
The value of quick reference material, such as
the NAERG [3], local Standard Operating Proce-
dures (SOPs), pre-plans and treatment protocols
cannot be downplayed. These are all tools that
every EMS provider should be intimately familiar
with. When possible, copies of this material should
be in every EMS vehicle for reference. Options
include using three ring binders or storing the infor-
mation electronically in Pesonal Digital Assistants
(PDAs), or other “electronic clipboards.”
8.7 Planning
Preparation also includes planning. Planning
includes sitting down with all responders and agen-
cies that are likely to be involved in a terrorist
event. The idea is to establish written response
guidelines and create intra-agency agreements and
a network whereby individual department heads
know each other, as well as what each agency's
role is and what their needs and expectations would
be during a terror event.
This planning process can lessen tensions and
stress when faced with a real scenario. Local
