InfoGram 17-12: April 25, 2012

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.

Receive InfoGrams and Bulletins by Email

Critical Drug Shortage Affects EMS and Public Health

(Source: JEMS Magazines)

A nation-wide drug shortage is affecting the ability of the Emergency Medical Services (EMS) to provide care during critical medical incidents.  The shortage that began in 2010 has been getting progressively worse, and EMS departments have to either find work-around options, substitutions, or go without.  Examples cited in an EMS World article include some pain medications, anesthetics, pediatric Epipens, and anti-seizure drugs.  A news video from Phoenix, AZ, shows the effects of the shortage on a municipal department and hospital.

To compound the issue, sometimes the workaround solution is to stock different concentrations of a commonly used drug.  This can lead to accidentally overdosing a patient in the repetitive setting of emergency medicine when a medic is used to having a specific concentration of a drug on hand.

The Food and Drug Administration and the American Society of Health-System Pharmacists maintain pages about drug shortages including detailed lists of drug shortages, email or RSS feed notification updates, and frequently asked questions.  An article in Jems Magazine offers these suggestions:

• Monitor usage of medications and adjust "par levels" across your agency's drug boxes.
• Use the medications that are set to expire soonest.
• See if it is possible to extend the expiration date of medications, which may require consultation between the medical director and state agencies or drug manufacturers.
• Your agency's medical director can explore the possibility of using a compounding pharmacy accredited by the Pharmacy Compounding Accreditation Board (PCAB).  

Wildland Fire Incident Staff Rides

(Source: Wildland Fire Leadership Development Program)

The wildland fire community has been using Staff Rides as a way to return to major fire sites, understand the decisions made on the fireground, and learn from them.  Staff Rides began as a way for military leadership to revisit the sites of important battles to understand not only the tactics involved but the psychology behind decisions made.

The Wildland Fire Leadership Development Program's Staff Ride Library states that it shouldn't be "a tactical-fault finding exercise.  Participants should be challenged to push past the basic question of 'What happened?' and examine the deeper questions of leadership and decision-making."  Staff Rides start with the circumstances leading up to the incident, which may include prior fires in the area and how they were handled, expected weather patterns, and land management history.  This gives the participants the chance to see the incident from a situational awareness perspective instead of a historical perspective.  The Staff Ride Library has 14 Staff Rides available with maps, interviews, and audiovisual materials describing each event.

Fire Management Today magazine's Fall 2002 issue (PDF, 3.1 Mb) was themed around a Staff Ride of the 1990 Dude Fire, in which six firefighters were killed. In 2006 the magazine had another article entitled "Staff Ride to the Battle of Little Bighorn and Mann Gulch Fire" (PDF, 913 Kb). The Wildland Fire Lessons Learned Center has DVDs available of the Tarkio Fire Shelter Deployment Staff Ride and the Dude Fire Staff Ride for order.

Type 3 All Hazards Incident Management Teams (AHIMT)

(Source: Emergency Management Magazine and USFA)

An article published in Emergency Management Magazine last month is bringing more attention to Type 3 All-Hazards Incident Management Teams (Type 3 IMT) and the benefits they offer in the immediate aftermath of a disaster.  Type 3 IMTs are multi-discipline, multi-jurisdictional teams formed and managed at the local, state, or tribal level, and are deployed to incidents such as natural disasters, joint law enforcement operations, or planned exercises or events. 

According to the article, the push for an All-Hazards alternative to the existing wildfire-focused teams came after Hurricanes Katrina and Rita.  The U.S. Fire Administration (USFA) had begun studying the development of Type 3 IMTs in 2003 and decided to stay within the Incident Command System (ICS) requirements for modeling and training.  Type 3 IMTs now exist in all 10 FEMA regions.   A timeline on the USFA website shows the timeframes for response and operations of the different types of IMTs.  

USFA offers guidance on IMT development, including the "authorized" Type 3 IMT courses coordinated through the USFA.  ICS and ICS position-specific courses are also offered by the Emergency Management Institute and the National Fire Academy in Emmitsburg, MD, the United States Coast Guard, National Wildfire Coordinating Group (NWCG), and the U.S. Office of Health and Human Services.

New Mass Gathering Resources for Emergency Responders

(Source: Homeland Security Digital Library)

The Homeland Security Digital Library made "Mass Gatherings" a new Featured Topic section of their website.  Some of the more recently published items from the topic area:

The Northwest Center for Public Health Practice (NWCPHP) 90-minute online training module "Mass Gatherings: Are You Prepared?" discusses the topics of risk evaluation, surveillance, health response, coordination, and communication.  It includes a training scenario, and the entire training can be completed at once or in short sessions if necessary.  The NWCPHP has other training modules, webinars, and table-top exercises available.

"Operation Partnership: Trends and Practices in Law Enforcement and Private Security Collaborations" helps private security and law enforcement agencies recognize the opportunities of combining resources while overcoming common problems such as jurisdiction and trust.  An already-existing and working partnership like this can be invaluable during a planned mass gathering event.

Less than 100 days to the 2012 Summer Olympics in London, England, and the world is watching to see how the city is planning for and will deal with the thousands of participants, tourists, and foreign dignitaries to the international games.  In addition to the usual planning that come with mass gatherings, there is a concern of terrorist activity and the MI5 director-general is reported as recently saying that the terror threat is "substantial."  The Greater London Authority published "Business as Usual? London's emergency and health services' preparations for the 2012 Olympic and Paralympic Games" (PDF, 501 Kb), which discusses how to keep public health and emergency services running smoothly without any noticeable gaps.