Attacks

[Guest guest]

No one is ever completely prepared for a major incident like you are talking

about. No one ever thought that the WTC would be gone, or that we would have

to respond to an anthrax incident. No pre-plans were made for these

incidents. The response to these 2 incidents will be broken apart, questioned

and evaluated for years. The best thing we can do is to learn from them.

Preparing for an NBC incident is hard and tedious. It takes a lot of

research, patience and understanding. Not only will our EMS crews be hit

hard, the hospitals, fire departments, police departments and other

supporting agencies will be taxed to the max also. The events of 9-11 have

changed the way that the Feed's look at these incidents. No longer are they

pushing for a centralized location of resources, they would like support the

first responder at the local level. They have found that training the

responders in the areas of B-NICE (biological, nuclear,

incendiary,chemical,and explosive) that we would be more prepared to respond

for the initial size-up, triage, treatment, and containment of the incident.

This includes developing local resources available for the initial response.

The local emergency plan should reflect this policy as well as when to

activate the county or state emergency response plan. The state will evaluate

and if needed activate the federal emergency response plan. But it all starts

at the local level. We need to educate ourselves, develop our own SOP's,

obtain the protective clothing and respiratory protection, push for

vaccination and continue to train with other local agencies. If we don't play

well with others, we won't accomplish our goal which is to go home that

night. The numbers figured by all the computer models reflect that we will

lose around 25-30% of our responders to a B-NICE incident. The service at the

initial site of a nuclear or chemical incident could lose more. We have to

prepare ourselves by improving what we have. Revise your disaster plans, look

at your mutual aid partnerships, increase your PPE stock, revise and develop

a terrorism response document and educate your staff to the awareness level

for terrorism response. It is hard and tedious work to be prepared for these

events, but getting a better understanding of the entire situation can

increase your effectiveness in these responses.

[Guest guest]

Talk about getting me on my soapbox! Basically, I believe that somehow or

another, our local EMS agencies will muddle through, but it will be messy

and will probably involve some morbidity and mortality. Basically, THEY'RE

NOT PREPARED, both EMS and hospitals.

Greg Higgins LP/FF

[Guest guest]

About 3 years ago the service I was with had a call that should have fit the

NBC profile.

Breathing difficulty at a restaurant. Upon arrival, several folk outside

with mucous secretions, difficulty breathing and pain to the skin of the

face.

Medics (one of whom was a CONTOMS trained tac medic active with a tactical

medic group at the time) proceed to enter the building to find other folks

and figure out what's going on.

What should have been, in an NBC context, two dead medics ended up with

attaboys.

EMS agencies are NOT ready for NBC attacks, for the most part (though some

agencies are VERY prepared, it runs the spectrum), as the street medics

aren't treating EVERY call with suspicion. How many could recognize a

rather unsophisticated secondary or booby-trap device in a drug lab? Now

make that a device created and planted by a " professional " terrorist?

How many agencies just roll right up to MVA's, especially involving ones

with 18-wheelers or other delivery trucks, because there's no spill reported

or they " don't see anything leaking " ?

How many non-fire medics are trained and carry basic SCBA/positive pressure

face masks and understand when they are and are not effective?

How many non-fire EMS services, especially in rural/volunteer areas, train

with their local fire and police responders for an incident?

How many regions hold region-wide training for joint incidents that cross

municipal, service, county and even state/national boundaries?

How many services have adequate radio and communications systems to actually

implement a joint IC that's usable by all interactants?

How many people in EMS understand that you don't EVER transport contaminated

patients - they get decontaminated on scene FIRST, no matter WHAT is going

on with them medically, even if this means that some people die from

otherwise treatable medical conditions because they're being deconn'ed at

the time? How many cowboys will end up needing decontamination themselves

because " they needed to help " ?!?

Our trauma center just ran a drill for decon of multiple patients a while

back. I was not part of the drill, I was actually working that day, but had

a little interaction with the outside world... <grin>. I was amazed to see

folks not involved in decon standing in the mist generated by the decon

showers and the wind... nobody realizing that there was a wind-created

extension of the warm zone... and that they were being secondarily

contaminated.

<rant off>

Mike

Re: Attacks

> Talk about getting me on my soapbox! Basically, I believe that somehow or

> another, our local EMS agencies will muddle through, but it will be messy

> and will probably involve some morbidity and mortality. Basically, THEY'RE

> NOT PREPARED, both EMS and hospitals.

>

> Greg Higgins LP/FF

>

>

>

>

>

>

[Guest guest]

Good for you, this is the right way to go about being prepared. For anyone

that's interested, we are hosting a HAZMAT EXPo6 Conference here in Las Vegas

Dec 2-6, it's $95 for the whole thing and they have really cheap room rates;

they will be giving BIO/Chemical and radiological training. It will be at the

Orleans hotel and casino. Check it out.

Re: Attacks

No one is ever completely prepared for a major incident like you are talking

about. No one ever thought that the WTC would be gone, or that we would have

to respond to an anthrax incident. No pre-plans were made for these

incidents. The response to these 2 incidents will be broken apart, questioned

and evaluated for years. The best thing we can do is to learn from them.

Preparing for an NBC incident is hard and tedious. It takes a lot of

research, patience and understanding. Not only will our EMS crews be hit

hard, the hospitals, fire departments, police departments and other

supporting agencies will be taxed to the max also. The events of 9-11 have

changed the way that the Feed's look at these incidents. No longer are they

pushing for a centralized location of resources, they would like support the

first responder at the local level. They have found that training the

responders in the areas of B-NICE (biological, nuclear,

incendiary,chemical,and explosive) that we would be more prepared to respond

for the initial size-up, triage, treatment, and containment of the incident.

This includes developing local resources available for the initial response.

The local emergency plan should reflect this policy as well as when to

activate the county or state emergency response plan. The state will evaluate

and if needed activate the federal emergency response plan. But it all starts

at the local level. We need to educate ourselves, develop our own SOP's,

obtain the protective clothing and respiratory protection, push for

vaccination and continue to train with other local agencies. If we don't play

well with others, we won't accomplish our goal which is to go home that

night. The numbers figured by all the computer models reflect that we will

lose around 25-30% of our responders to a B-NICE incident. The service at the

initial site of a nuclear or chemical incident could lose more. We have to

prepare ourselves by improving what we have. Revise your disaster plans, look

at your mutual aid partnerships, increase your PPE stock, revise and develop

a terrorism response document and educate your staff to the awareness level

for terrorism response. It is hard and tedious work to be prepared for these

events, but getting a better understanding of the entire situation can

increase your effectiveness in these responses.

[Guest guest]

What are we preparing for? Do we even know. Large Attack Small Attack, Rural

Urban, Military Civilian---- We just barely stay prepared for day to day

operations. I think we are prepared as we will get. I would not go as far as

to use the word muddle. However, I think we and when I say we I mean EMS in

general will rise to the occasion and perform well. EMS has a history of

thinking quickly and taking action that is necessary.

Henry

Greg Higgins wrote:

> Talk about getting me on my soapbox! Basically, I believe that somehow or

> another, our local EMS agencies will muddle through, but it will be messy

> and will probably involve some morbidity and mortality. Basically, THEY'RE

> NOT PREPARED, both EMS and hospitals.

>

> Greg Higgins LP/FF

>

>

>

>

>

[Guest guest]

To me the issue is not how EMS responds or performs, but whether EMS personnel

are adequately prepared and equipped to detect and survive lethal environments.

I agree with Henry that we have a history of thinking quickly and taking action,

but we also have a history of getting a lot of our people killed in the name of

duty and social responsibility (i.e., NYC). I don't view an attack with

conventional weapons to be the problem. It's the non-conventional (chemical,

biological and radiological) attack scenarios that put EMS responders at

greatest risk.

Since we'll be the first to arrive on the scene, what means do we have to detect

the presence of nerve agents, deadly biologics or radiation? Beyond detection,

what equipment are we carrying that will optimize our survival in these

environments? Or, is it our mission to serve as the " Canaries in the mine " for

the state's epidemiologists and surveillance experts? Is the death or

contamination of initial responders an acceptable and unavoidable risk?

If not, then who is taking steps to insure that Texas' EMS personnel are trained

and equipped to survive these potentially lethal environments? I know for sure

that Darryl Quigley (TLC) has situated M95's, biohazard suits, etc. in each of

his units to protect his crews. He did it a year ago. Are other EMS agencies

doing the same? Or, are they playing the cost vs. threat vs. risk shell game?

I can't think of a single " NBC Response Plan " that can be transformed into

protective equipment in the event of our people's exposure to small pox, VX or

radiation.

Bob Kellow

Henry Barber wrote:

> What are we preparing for? Do we even know. Large Attack Small Attack, Rural

> Urban, Military Civilian---- We just barely stay prepared for day to day

> operations. I think we are prepared as we will get. I would not go as far as

> to use the word muddle. However, I think we and when I say we I mean EMS in

> general will rise to the occasion and perform well. EMS has a history of

> thinking quickly and taking action that is necessary.

>

> Henry

>

> Greg Higgins wrote:

>

> > Talk about getting me on my soapbox! Basically, I believe that somehow or

> > another, our local EMS agencies will muddle through, but it will be messy

> > and will probably involve some morbidity and mortality. Basically, THEY'RE

> > NOT PREPARED, both EMS and hospitals.

> >

> > Greg Higgins LP/FF

> >

> >

> >

> >

> >

[Guest guest]

It's interesting that there are no responses to my original post. Are we all

expendable? Why doesn't the state weigh in? Hello?

Bob Kellow wrote:

> To me the issue is not how EMS responds or performs, but whether EMS personnel

> are adequately prepared and equipped to detect and survive lethal

environments.

>

> I agree with Henry that we have a history of thinking quickly and taking

action,

> but we also have a history of getting a lot of our people killed in the name

of

> duty and social responsibility (i.e., NYC). I don't view an attack with

> conventional weapons to be the problem. It's the non-conventional (chemical,

> biological and radiological) attack scenarios that put EMS responders at

> greatest risk.

>

> Since we'll be the first to arrive on the scene, what means do we have to

detect

> the presence of nerve agents, deadly biologics or radiation? Beyond detection,

> what equipment are we carrying that will optimize our survival in these

> environments? Or, is it our mission to serve as the " Canaries in the mine " for

> the state's epidemiologists and surveillance experts? Is the death or

> contamination of initial responders an acceptable and unavoidable risk?

>

> If not, then who is taking steps to insure that Texas' EMS personnel are

trained

> and equipped to survive these potentially lethal environments? I know for sure

> that Darryl Quigley (TLC) has situated M95's, biohazard suits, etc. in each of

> his units to protect his crews. He did it a year ago. Are other EMS agencies

> doing the same? Or, are they playing the cost vs. threat vs. risk shell game?

>

> I can't think of a single " NBC Response Plan " that can be transformed into

> protective equipment in the event of our people's exposure to small pox, VX or

> radiation.

>

> Bob Kellow

>

> Henry Barber wrote:

>

> > What are we preparing for? Do we even know. Large Attack Small Attack, Rural

> > Urban, Military Civilian---- We just barely stay prepared for day to day

> > operations. I think we are prepared as we will get. I would not go as far as

> > to use the word muddle. However, I think we and when I say we I mean EMS in

> > general will rise to the occasion and perform well. EMS has a history of

> > thinking quickly and taking action that is necessary.

> >

> > Henry

> >

> > Greg Higgins wrote:

> >

> > > Talk about getting me on my soapbox! Basically, I believe that somehow or

> > > another, our local EMS agencies will muddle through, but it will be messy

> > > and will probably involve some morbidity and mortality. Basically, THEY'RE

> > > NOT PREPARED, both EMS and hospitals.

> > >

> > > Greg Higgins LP/FF

> > >

> > >

> > >

> > >

> > >

[Guest guest]

In Galveston, we have purchased enough Tyvec suits and respirators with

various cartridges that are kept in the supervisors vehicle to out fit an

entire shift. We are putting together a ToxMedic program with some personnel

specializing in WMD response and will coordinate with the hospital for a mass

casualty incident. Also we are putting together a Database for

chemical/biological response. Further training and will include all the

Office of Domestic preparedness training programs (free of charge, offered by

the Federal Government) and more equipment will be purchased through the

equipment grant that will be available after the area Threat Assessment is

completed. These are just some of the steps we are taking down here to

prepare and be aware of the potential response.

Sam Dodson

[Guest guest]

I've had to think about this for a long time. I know how the Marines plan

to respond and act, but other than some vague rural chemical accident or

disease outbreak, I have not seen anything that would deal with this type of

a situation. I went through the WMD Instructors Course put on by the

Austin Fire Department last fall, and it all comes down to it's just another

day only a whole lot more.

Chemical attacks are really just very large HazMat incidents, but there is

the added psychological aspect of it was intentional. Many of us have the

opportunity to come in contact with anthrax and tularemia on a regular

basis, bio attacks are just scarrier.

Given the hype and the speed at which corporations are flocking to the

" homeland defense " feeding trough, it's hard to feel that anyone really sees

the front lines, only the bottom line.

Just my .02

Micheal

--

Micheal Mc Evoy, FF/NREMT-B, WFR

Bertram Community EMS

Bertram Volunteer Fire Department

Bertram, Texas

> It's interesting that there are no responses to my original post. Are

> we all expendable? Why doesn't the state weigh in? Hello?

>

> Bob Kellow wrote:

>

>> To me the issue is not how EMS responds or performs, but whether EMS

>> personnel are adequately prepared and equipped to detect and survive

>> lethal environments.

>>

>> I agree with Henry that we have a history of thinking quickly and

>> taking action, but we also have a history of getting a lot of our

>> people killed in the name of duty and social responsibility (i.e.,

>> NYC). I don't view an attack with conventional weapons to be the

>> problem. It's the non-conventional (chemical, biological and

>> radiological) attack scenarios that put EMS responders at greatest

>> risk.

>>

>> Since we'll be the first to arrive on the scene, what means do we have

>> to detect the presence of nerve agents, deadly biologics or radiation?

>> Beyond detection, what equipment are we carrying that will optimize

>> our survival in these environments? Or, is it our mission to serve as

>> the " Canaries in the mine " for the state's epidemiologists and

>> surveillance experts? Is the death or contamination of initial

>> responders an acceptable and unavoidable risk?

>>

>> If not, then who is taking steps to insure that Texas' EMS personnel

>> are trained and equipped to survive these potentially lethal

>> environments? I know for sure that Darryl Quigley (TLC) has situated

>> M95's, biohazard suits, etc. in each of his units to protect his

>> crews. He did it a year ago. Are other EMS agencies doing the same?

>> Or, are they playing the cost vs. threat vs. risk shell game?

>>

>> I can't think of a single " NBC Response Plan " that can be transformed

>> into protective equipment in the event of our people's exposure to

>> small pox, VX or radiation.

>>

>> Bob Kellow

>>

>> Henry Barber wrote:

>>

>> > What are we preparing for? Do we even know. Large Attack Small

>> > Attack, Rural Urban, Military Civilian---- We just barely stay

>> > prepared for day to day operations. I think we are prepared as we

>> > will get. I would not go as far as to use the word muddle. However,

>> > I think we and when I say we I mean EMS in general will rise to the

>> > occasion and perform well. EMS has a history of thinking quickly and

>> > taking action that is necessary.

>> >

>> > Henry

>> >

>> > Greg Higgins wrote:

>> >

>> > > Talk about getting me on my soapbox! Basically, I believe that

>> > > somehow or another, our local EMS agencies will muddle through,

>> > > but it will be messy and will probably involve some morbidity and

>> > > mortality. Basically, THEY'RE NOT PREPARED, both EMS and

>> > > hospitals.

>> > >

>> > > Greg Higgins LP/FF

>> > >

>> > >

>> > >

>> > >

>> > >

[Guest guest]

We put together two rubbermaid containers with equipment to handle

" suspicious packages " , fortunately they never materialized around here.

Steve

Azle FD/EMS

Re: Attacks

In Galveston, we have purchased enough Tyvec suits and respirators with

various cartridges that are kept in the supervisors vehicle to out fit an

entire shift. We are putting together a ToxMedic program with some personnel

specializing in WMD response and will coordinate with the hospital for a

mass

casualty incident. Also we are putting together a Database for

chemical/biological response. Further training and will include all the

Office of Domestic preparedness training programs (free of charge, offered

by

the Federal Government) and more equipment will be purchased through the

equipment grant that will be available after the area Threat Assessment is

completed. These are just some of the steps we are taking down here to

prepare and be aware of the potential response.

Sam Dodson