December 14, 2006 InfoGram

This InfoGram will be distributed weekly to provide members of the Emergency Services Sector with information concerning the protection of their critical infrastructures. For further information, contact the Emergency Management and Response - Information Sharing and Analysis Center (EMR-ISAC) at (301) 447-1325 or by email at emr-isac@fema.dhs.gov.

C2 for CIP

Critical Infrastructure Protection (CIP) is a proactive approach to protecting invaluable infrastructures against catastrophes before they occur. As it pertains to the departments and agencies of America's Emergency Services Sector (ESS), CIP activities are primarily intended to ensure continuity of emergency services. "Failure to accomplish mission-essential tasks is not an option," is the prevailing philosophy among most ESS organizations. Therefore, countless emergency responder units are preparing to perform operations regardless of the circumstances, including the amount of time involved for response and recovery.

The Emergency Management and Response-Information Sharing and Analysis Center (EMR-ISAC) proposes that pre-event continuity preparations should include collaboration and communication (C2) more abundantly than the classic command and control (C2). When executing preparedness actions prior to any calamity, specialists believe it is necessary to dovetail operations with mutual aid partners and other neighboring jurisdictions. Doing so will help coordinate effective ESS responses to man-made and natural disasters protracted over extended periods.

Assertively working to facilitate collaboration and communication (C2) with surrounding departments and agencies can enhance CIP as well as the "unity of results that comes from a unity of effort" for sustained deployments. The EMR-ISAC additionally advises that human interaction is the preferred way to conduct C2 for the purposes of building permanent relationships and acquiring support partnerships for all hazards. No one can determine the "when," but with superb C2 the ESS can potentially be ready for the "what."

Air Medical Response Planning

Emergency Services Sector (ESS) leaders routinely review their own resources and assets (personnel, physical, and communication/cyber systems) as well as those of cross-sector agencies as they inventory which and how many resources can be brought to bear at emergency incidents. However, ESS leaders understand that not everything in the "inventory" is theirs to protect.

Nevertheless, assets in the emergency response arsenal, whether owned and protected by the ESS or not, still must be considered, and included, in overall preparedness. For instance, the Emergency Management and Response-Information Sharing and Analysis Center (EMR-ISAC) has written about the resources of public works agencies, e.g., how their heavy equipment can not only help responders maintain their response-ability with cleared roadways, but protect and rescue them in collapse situations.

Perhaps not included in all responders' inventories is a plan for using air medical response services. According to Michael Judy, a mass casualty coordinator for an emergency transport service, the air medical industry has much to offer to responders. He suggests that ESS agencies begin planning by identifying every air medical response program, including military resources, within a 150-nautical-mile-radius of their jurisdiction to ascertain the following about each program: number of helicopters, specific response radius, helicopter types and weights, patient transport capabilities, landing zone requirements, available first responder training, and 24-hour emergency contact numbers.

Part of an air medical response plan includes identifying one or more potential landing sites that are at least 100' X 100' and clear of all obstacles and hazards, such as poles, wires, vehicles, and people. "Think large, free and flat," Judy advises. (See In the Air by Michael Judy, November 27, 2006)

Many flight programs are willing to provide operations and safety training to responders, upon request, and can work with them in the use of patient tracking and accountability systems. In addition to rapid transport capabilities, air medical programs can deliver essential medical supplies directly to an incident scene. Some programs also offer Critical Incident Dispatchers capable of arriving with the medical crew to assist Incident Commanders in controlling multiple incoming aircraft. If severe weather prohibits air operations, many helicopter medical teams use ambulances to create ground-based critical care assets.

The EMR-ISAC suggests that drafting an air medical response plan is a valuable preparedness activity. It enhances an organization's critical infrastructure protection activities by encouraging sector resource sharing, bolstering ESS assets, and potentially protecting responders.

More Radiological Personnel Safety Information

Last week, the Emergency Management and Response-Information Sharing and Analysis Center (EMR-ISAC) reviewed a new radiological emergency response resource guide for the protection of Emergency Services Sector (ESS) personnel, the foremost critical infrastructure. The Yale New Haven Center for Emergency Preparedness and Disaster Response, part of Yale New Haven Health (YNHH), also introduced a resource: a short course that presents self-protection information for responders.

Introduction to Radiological Response (EM 110) is a 30-minute, narrated CD-ROM course developed by YNHH as part of its mission of advancing health care planning, preparedness, response, and recovery from emergency events and disasters. The YNHH endeavors to partner with ESS agencies, medical, academic, governmental, and private-sector organizations to develop and provide resources and services all of which are applicable to ESS critical infrastructure protection efforts.

The radiological response course covers principles of radiation, definitions of terms, risks, recommendations for safeguarding personnel during radiological or nuclear incidents, and an outline of strategies for addressing the psychological impact of such incidents. Course developer Joseph Albanese, Ph.D., whose training and education include medical biochemistry and infectious diseases, explained that many people harbor a morbid fear of radiation. While radiation should be treated with respect, he said, his aim in the course is to "exercise awareness of the potential impact of radiological events, while dispelling fears of radiation," in part because exaggerated fear could complicate emergency response to mass casualty events. A more advanced radiological preparedness course is under development and expected to be released in the spring of 2007.

YNHH offers a range of online courses (updated to meet National Incident Management System requirements) intended to protect community emergency personnel. Additional information and on-line courses can be seen at the YNHH Website. A CD-ROM of Introduction to Radiological Response can be obtained by writing to center@ynhh.org.

New Study Analyzes LODDs

The Emergency Management and Response-Information Sharing and Analysis Center (EMR-ISAC) writes regularly about the many threats to the safety and survivability of the Emergency Services Sector's (ESS) most critical asset, i.e., personnel. Based on the results of a newly released study, poor levels of health, fitness, and wellness are ultimately the leading contributors to line-of-duty deaths (LODDs).

Researchers studied LODD data from the years 2000 to 2005, recorded factors that contributed to the deaths, and analyzed contributing factors for frequency of occurrence and clustering with other factors. Based on a frequency analysis of data from 644 cases (supplied by the U.S. Fire Administration, International Association of Fire Fighters, National Institute for Occupational Safety and Health, and the National Fire Protection Association) the dominant contributing factors to LODDs are health/fitness/wellness (53.88 per cent), personal protective equipment (19.41 per cent), and human error (19.1 per cent).

The report includes recommended practices related to each contributing factor. It is available for download at ResponderSafetyOnline.com. For health/fitness/wellness, suggested practices include the following:

• Medical evaluations and clearances to use breathing apparatus, in-house exercise equipment and designated workout times, automated external defibrillators on apparatus (with training), member assistance programs, a communicable disease education program, and tests of carboxyhemoglobin levels on exposed responders.
• Autopsies on all LODD victims.
• Mandatory pre-employment and annual medical evaluations, and periodic physical exams to determine medical ability to carry out duties.
• Mandatory wellness/fitness programs (to be phased in) to help responders avoid cardiovascular disease and promote cardiovascular capacity.
• Stress tests as part of organizations' medical evaluation programs.
• Clearances for duty by physicians knowledgeable about job demands and, conversely, preclusions from duty for responders medically at risk.

The EMR-ISAC notes that the report finds LODDs to be "identifiable and preventable." Researchers believe that the analysis of LODD data "offers substantial guidance for shaping.policy decisions and operational priorities."