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Glow, Steven D., Vincent J. Colucci, Douglas R. Allington, Curtis W. Noonan, and Earl C. Hall. "Managing Multiple-Casualty Incidents: A Rural Medical Preparedness Training Assessment." Prehospital and Disaster Medicine 28, no. 4 (April 18, 2013): 334–41. http://dx.doi.org/10.1017/s1049023x13000423.
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AbstractObjectiveThe objectives of this study were to develop a novel training model for using mass-casualty incident (MCI) scenarios that trained hospital and prehospital staff together using Microsoft Visio, images from Google Earth and icons representing first responders, equipment resources, local hospital emergency department bed capacity, and trauma victims. The authors also tested participants’ knowledge in the areas of communications, incident command systems (ICS), and triage.MethodsParticipants attended Managing Multiple-Casualty Incidents (MCIs), a one-day training which offered pre- and post-tests, two one-hour functional exercises, and four distinct, one-hour didactic instructional periods. Two MCI functional exercises were conducted. The one-hour trainings focused on communications, National Incident Management Systems/Incident Command Systems (NIMS/ICS) and professional roles and responsibilities in NIMS and triage. The trainings were offered throughout communities in western Montana. First response resource inventories and general manpower statistics for fire, police, Emergency Medical Services (EMS), and emergency department hospital bed capacity were determined prior to MCI scenario construction. A test was given prior to and after the training activities.ResultsA total of 175 firefighters, EMS, law enforcement, hospital personnel or other first-responders completed the pre- and post-test. Firefighters produced higher baseline scores than all other disciplines during pre-test analysis. At the end of the training all disciplines demonstrated significantly higher scores on the post-test when compared with their respective baseline averages. Improvements in post-test scores were noted for participants from all disciplines and in all didactic areas: communications, NIMS/ICS, and triage.ConclusionsMass-casualty incidents offer significant challenges for prehospital and emergency room workers. Fire, Police and EMS personnel must secure the scene, establish communications, define individuals’ roles and responsibilities, allocate resources, triage patients, and assign transport priorities. After emergency department notification and in advance of arrival, emergency department personnel must assess available physical resources and availability and type of manpower, all while managing patients already under their care. Mass-casualty incident trainings should strengthen the key, individual elements essential to well-coordinated response such as communications, incident management system and triage. The practice scenarios should be matched to the specific resources of the community. The authors also believe that these trainings should be provided with all disciplines represented to eliminate training “silos,” to allow for discussion of overlapping jurisdictional or organizational responsibilities, and to facilitate team building.GlowSD, ColucciVJ, AllingtonDR, NoonanCW, HallEC. Managing multiple-casualty incidents: a rural medical preparedness training assessment. Prehosp Disaster Med. 2013;28(4):1-8.
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Bateman, V. Frank, and Donald P. Montoro. "THE EVOLUTION OF MARINE FIRE-FIGHTING CONTINGENCY PLANNING AND EXERCISING AT THE MARINE SAFETY OFFICE SAN FRANCISCO BAY." International Oil Spill Conference Proceedings 1997, no. 1 (April 1, 1997): 627–30. http://dx.doi.org/10.7901/2169-3358-1997-1-627.
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ABSTRACT Because no one entity has the resources to deal with a major vessel fire, contingency planning and exercising within the port community are critical. Achieving the highest level of response readiness is an evolutionary process made more difficult by today's fiscal constraints on both government and industry. This paper will discuss the steps taken over the last 15 years (workshops, table-top exercises, hands-on drills) to develop a comprehensive marine fire-fighting contingency plan that was tested during a recent area PREP exercise. The PREP drill scenario involved a collision between two vessels that resulted in a large spill and fire well away from shoreside access. Participants included over 200 personnel representing 50 federal, state, and local agencies. Shipboard flammable liquid fires are never easy to extinguish; however, the degree of difficulty escalates exponentially when an event does not occur pierside with adequate access for local fire departments. Mutual aid agreements and state-of-the-art response strategies and equipment are essential to resolving this unique situation. Proper use of the incident command system helps ensure smooth, efficient waterside command and control of the fire attack assets. Special logistics systems and staging techniques need to be developed to bring adequate water and foam delivery (8000+ gpm) resources to bear on an away-from-shore incident. These requirements were shown to be well within the response capabilities of the San Francisco Bay fire-fighting community when dedicated fireboats and vessels-of-opportunity were converted to foam master stream delivery platforms.
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Nagata, Takashi, Stephanie N. Rosborough, Michael J. VanRooyen, Shuichi Kozawa, Takashi Ukai, and Shinichi Nakayama. "Express Railway Disaster in Amagasaki: A Review of Urban Disaster Response Capacity in Japan." Prehospital and Disaster Medicine 21, no. 5 (October 2006): 345–52. http://dx.doi.org/10.1017/s1049023x0000399x.
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AbstractIntroduction:On the morning of 25 April 2005, a Japan Railway express train derailed in an urban area of Amagasaki, Japan. The crash was Japan's worst rail disaster in 40 years.This study chroniclesthe rescue efforts and highlights the capacity of Japan's urban disaster response.Methods:Public reports were gathered from the media, Internet, government, fire department, and railway company. Four key informants, who were close to the disaster response, were interviewed to corroborate publicdata and highlight challenges facing the response.Results:The crash left 107 passengers dead and 549 injured. First responders, most of whom were volunteers, were helpful in the rescue effort, and no lives were lost due to transport delays or faulty triage. Responders criticized an early decision to withdraw rescue efforts, a delay in heliport set-up, the inefficiency of the information and instruction center, and emphasized the need for training in confined space medicine. Communication and chain-of-command problems created confusion at the scene.Conclusions:The urban disaster response to the train crash in Amagasaki was rapid and effective.The KobeEarthquake and other incidents sparked changes that improved disaster preparedness in Amagasaki. However, communication and cooperation among responders were hampered, as in previous disasters, by the lack of a structured command system. Application of an incident command system may improve disaster coordination in Japan.
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Lenz, Matthias, and Tanja Richter. "Disaster Response to the Release of Biohazardous Agents: Instrument Development and Evaluation of a Firefighter's Exercise." Prehospital and Disaster Medicine 24, no. 3 (June 2009): 197–203. http://dx.doi.org/10.1017/s1049023x00006804.
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AbstractIntroduction:The release of biohazardous agents could affect many people. Preparedness is crucial for adequate responses to accidental or deliberate release of biohazardous agents. It is believed that exercises based on simulated incident scenes are effective methods for the training of firefighters and biohazard response teams. Structured evaluations are important methods used to identify areas of ineffectiveness and to assure the quality of responses to releases of biohazards.Methods:A local fire department conducted a full-scale biohazard exercise in an elementary school. The firefighters practiced prohibiting entry to the area, establishing security zones, evacuating victims, assessing hazards, preventing further dissemination, and sampling and keeping the suspicious material in safe custody.Trained observers systematically evaluated the exercise following a standardized evaluation protocol. A set of data collection templates were created based on standard operating procedures extracted from current guidelines.Results:There were 60 firefighters, eight members of the incident command, 16 simulated victims, and 18 trained observers that participated in the exercise. Out of 31 standard operating procedures, 20 were in accordance with the guidelines, 10 were performed incorrectly, and one was not applicable. Major problems related to the assessment and handling of the suspicious material, the use of protective equipment, and decontamination of victims. Reasons for incomplete and/or conflicting documentation included insufficient knowledge and training of observers, imprecise instructions about documentation, and the size of observation zones.Conclusions:Intensive education and training of response activities is necessary. Each fire department should perpetually reassess their technical equipment and specific skills and their communication and command structures. The applied documentation system performed well in disclosing discrepancies between observed response activities and current recommendations. Using external observers provided transparent and independent data. However, intensive observer training is necessary. Observer training should include detailed, written instructions and short guidelines that could be available during the exercise.
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Shane, Daniel M. "Westley Tire Fire, Stanislaus County, California." International Oil Spill Conference Proceedings 2001, no. 1 (March 1, 2001): 379–83. http://dx.doi.org/10.7901/2169-3358-2001-1-379.
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ABSTRACT This is a case study of U.S. Environmental Protection Agency (EPA) emergency response actions taken at one of the largest tire fires in California. The site was an illegal scrap tire dump known as the Filbin Tire Pile. There was an estimated 7 million tires in the pile. The site was located in a canyon in the rolling hills above the San Joaquin Valley near the Town of Westley, California. This tire fire was considered a major environmental disaster where large populations were affected and there was a potential for severe environmental damage. Responders with past experience recognized that the tire fire would be a unique multi-category event containing the elements of a major fire: hazardous materials release and oil spill discharge combined into one event. Shortly after the fire ignited the tires began to pyrolyze, producing a steady stream of oil that discharged to an unnamed drainage in the hills above the valley. The oil in the drainage flashed sending great plumes of thick black smoke into the valley. The oil and tire fires quickly overwhelmed the resources of the local fire departments. The EPA On-Scene Coordinator (OSC) immediately responded using federal authority to respond to and, if necessary, remove a discharge of oil or a hazardous substance under the Clean Water Act (33 U.S.C. 1321(c)) as amended by the Oil Pollution Control Act of 1990 (OPA 90). Some of the most difficult problems that were encountered included making decisions on fire suppression tactics; conducting safe operations in extremely hot and unstable fire conditions; maneuvering heavy equipment on steep slopes, and deep and spongy tire piles; controlling massive volumes of oil and water runoff; coordinating with local and state governmental agencies; forming a fully integrated and effective Incident Command System led by a Unified Command (ICS/UC); and recycling of pyrolytic oil under current California hazardous waste regulations.
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Packard, Richard, Mike Popovich, and John Stengel. "Massachusetts First Responder Exercises: Preparing Local Communities for Oil Spill Response." International Oil Spill Conference Proceedings 2014, no. 1 (May 1, 2014): 300125. http://dx.doi.org/10.7901/2169-3358-2014-1-300125.1.
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As a result of the Buzzards Bay oil spill in 2003, and subsequent passage of the Oil Spill Act of 2004, the Commonwealth of Massachusetts, through its Department of Environmental Protection's (MassDEP) Oil Spill Program, has developed a comprehensive, 3-tiered program to protect coastal resources. The program includes three elements: 1) the development of 160 Geographic Response Plans (GRP) to protect environmentally sensitive areas, 2) the acquisition and distribution of 83 oil spill response equipment trailers to coastal communities and, 3) the development of a training and exercise program to better prepare local first responders, including fire departments, police departments, harbormasters and other town officials, to respond to oil spills that threaten environmentally sensitive areas in their communities. This training and exercise program has increased first responders competency and skills as they relate to oil spill response resulting in a higher degree of readiness and preparedness amongst first responders throughout coastal Massachusetts. The program follows standard Homeland Security Exercise and Evaluation protocols with clearly defined goals and objectives. Each exercise includes personnel from multiple municipalities working together to achieve the common goal of protecting coastal resources. The objectives of each exercise include, 1) foster inter-agency planning and coordination by providing the opportunity for local responders to work with each other and with Federal and State responders. 2) deploy a GRP protective booming tactic during a simulated incident, 3) promote resource coordination among local responders by coordinating use of assets from participating towns and agencies, 4) improve local oil spill preparedness by deploying equipment from pre-positioned trailers, providing participants hands-on experience in the field, and 5) evaluate the effectiveness of the booming tactic and identify any modifications necessary. Participants utilize the Incident Command System (ICS), operating within a Unified Command structure, testing their ability to effectively communicate goals, objectives and tactics.
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Leonard, Joseph J., Michael Drieu, and Robert W. Royall. "IMPROVING MARINE FIREFIGHTING AND SALVAGE RESPONSE USING A NON-REGULATORY APPROACH THROUGH KEY STAKEHOLDER INVOLVEMENT." International Oil Spill Conference Proceedings 2005, no. 1 (May 1, 2005): 295–99. http://dx.doi.org/10.7901/2169-3358-2005-1-295.
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ABSTRACT While catastrophic marine fires are a rare event, minor shipboard fires do have a significant potential for damage and a potential impact on the marine transportation system. As such, it is critical that responders at the federal, state, local, industrial, and contractor levels be trained and prepared to conduct timely operations to mitigate any incidents that occur. Due to the nature of services performed in the firefighting community today (fire suppression, rescue, hazardous materials response, and emergency medical services, to name but a few), time and effort is not always dedicated towards responding to events onboard vessels. As over 70% of fire departments in the United States are volunteer departments, this has the potential to become even more of an issue. In addition, shipboard fires typically require some level of participation from a marine salvor. Depending on the damage to the vessel, this may involve significant salvage activities. The number of salvors scattered throughout the United States is somewhat limited, and their home base locations dictate their response times to specific geographic areas. Critical issues that need to be addressed by senior response managers who may find themselves involved in responding to vessel fires include: 1. Establishment of an effective Unified Command to address all stakeholder issues, 2. Enhancing knowledge of regional capabilities and resources to respond to shipboard fires and resultant salvage activities, 3. Ensuring appropriate training of response personnel that meets recognized standards (such as NFPA 1405), and 4. Developing, exercising, and validating plans to respond to shipboard fires and salvage activities. Efforts throughout the Eighth Coast Guard District over the past several years have begun to address many of these issues, with enhanced incident management training, challenging exercises to validate plans, and extensive workshops to improve responder knowledge being a few of the positive steps. Only by addressing these four critical areas can response managers be assured of an effective and efficient response that would minimize the impact to the marine transportation system.
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Muskat, Judd, Mark Lampinen, and Randy Imai. "THE USE OF GIS TECHNOLOGY AT THE CALIFORNIA SONS 2004 EXTRAVAGANZA." International Oil Spill Conference Proceedings 2005, no. 1 (May 1, 2005): 367–70. http://dx.doi.org/10.7901/2169-3358-2005-1-367.
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ABSTRACT Geographic Information System (GIS) support has become a basic tool for oil spill response because of the inherent data management, analysis, and display capabilities. Presented here are example GIS maps from the 2004 California Spill of National Significance (SONS) exercise. The SONS scenario had two major spill incidents occurring off the coast of southern California requiring a massive response from State, Federal and Local agencies. The exercise locations included Port-level incident command posts (ICP) in San Diego, Los Angeles and Ensenada, Mexico. A regional ICP for the US Coast Guard (USCG) National Incident Command (NIC) was established in Los Alamitos, CA, and USCG National Response Team activities occurred in Washington, DC. The California Department of Fish and Games (CDFG) Office of Spill Prevention and Response (OSPR) had GIS equipment and personnel deployed at the three southern California ICP locations. GIS data was electronically transferred between the three ICPs through email attachments to GIS personnel directly, or via internet file transfer protocol (ftp) to a secure internet site. GIS data layers were transmitted in ESRI shapefile format while map files were transmitted in Adobe PDF file format. In addition to the GIS activities at the three ICPs, an internet mapping site (using ArcIms software) was available on-line for the duration of the SONS drill housed on a secure server located in Sacramento, CA. GIS data layer sharing at the individual ICP's was achieved using USB data “sticks”. Oil slick trajectory models run by the National Oceanic and Atmospheric Agency (NOAA) Hazmat team were imported into the GIS via the GNOME extension to ArcView. Airborne observation teams were employed to document marine or coastal species that were either in immediate danger or already impacted in real time. The airborne pelagic transects were captured via GPS and waypoints were marked for key observations. These data were transmitted to the ICP via email upon landing. During an oil spill emergency large amounts of data are generated and utilized, much with a geospatial component. The inherent ability to import and display convergent data layers provides the incident Unified Command with a powerful decision making tool.
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Hsiau, Yawen, Yu-Han Liu, and Chi-Chun Lin. "Emergency Response Training Program for Theme Parks: Experiences of Taiwan." Prehospital and Disaster Medicine 34, s1 (May 2019): s126—s127. http://dx.doi.org/10.1017/s1049023x19002735.
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Introduction:“Tailor-made” training programs have been started in two theme parks in North and East Taiwan after the dust explosion of Ba-xien theme park in 2015. The training programs emphasized several areas. They work to strengthen the incident command system (ICS) and the skills of first responders, especially evacuation, placement, triage, and first aid, as well as to assist the park’s cooperation with local disaster response units, such as the fire department and Health Bureau.Methods:The first step was to find out the practical problems of the two theme parks, and then make a one-year, tailor-made training program according to the needs of parks and different levels of staff: senior supervisors, middle-level district supervisors, and frontline colleagues. After the phased training, the training results are inspected in the non-scripted exercise mode.Results:It was found that the staff are relatively familiar with the evacuation process and placement of tourists. The initial emergency responses such as triage, first aid skills, and patient transport gradually improve after several drills. The ICS operation and communication also became more effective and efficient. The regional emergency response units could understand these theme parks capability and how to cooperate with them.Discussion:The experience of emergency response training and exercise in these two theme parks has shown that such a model is feasible and should be valued.
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Jamieson, Gil. "NIMS AND THE INCIDENT COMMAND SYSTEM." International Oil Spill Conference Proceedings 2005, no. 1 (May 1, 2005): 291–94. http://dx.doi.org/10.7901/2169-3358-2005-1-291.
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The way this nation prepares for and responds to domestic incidents is about to change. It won't be an abrupt change; best practices that have been developed over the years are part of this new comprehensive national approach to incident management known as the National Incident Management System (NIMS). But it will change—and for the better. Developed by the Department of Homeland Security and issued in March 2004, the NIMS will enable responders at all jurisdictional levels and across all disciplines to work together more effectively and efficiently. Beginning in FY 2006, federal funding for state, local and tribal preparedness grants will be tied to compliance with the NIMS. One of the most important ‘best practices’ that has been incorporated into the NIMS is the Incident Command System (ICS), a standard, on-scene, all-hazards incident management system already in use by firefighters, hazardous materials teams, rescuers and emergency medical teams. The ICS has been established by the NIMS as the standardized incident organizational structure for the management of all incidents. Although many agencies now use various forms of ICS, there is considerable uncertainty about NIMS ICS and the impact it will have on systems and processes currently in place. These are important questions because one of the FY 2005 requirements for implementing NIMS is “institutionalizing the use of ICS, across the entire response system.” This paper is intended to provide an historical perspective on the development of ICS, explain how NIMS ICS works, describe how it is different from previous systems, and discuss the future of NIMS ICS training.
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Smith, Duane Michael. "ICS: Can it Be a National Incident Management System?1." International Oil Spill Conference Proceedings 2003, no. 1 (April 1, 2003): 1179–83. http://dx.doi.org/10.7901/2169-3358-2003-1-1179.
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ABSTRACT There are likely few that would argue with the proposal that a national incident management system would be of benefit. Numerous articles have been put forward over time, both for and against the adoption of an incident command system (ICS) as the model for a national incident management system. Those in favor of its adoption point out to its many successes, from major wildfires to the 2002 Olympics. Many seem to view ICS as simply another way of expressing the term command and control. In reality, ICS is not another way to say command and control; rather it is a specific of command and control system. The question then is whether ICS, and in particular the National Inter-agency Incident Management System – Incident Command System (NIIMS-ICS) is the model upon which this national system should be based. Most of the studies and papers regarding the use and adoption of ICS have focused on its use within the fire service community. This may be somewhat intuitive, given the origins of the system; however, if we are to truly gauge the applicability of this system to all risks, we must begin to exam it in those other events. It was a series of disasters that led to the development of the initial ICS system. It has been a subsequent series of disasters or national emergencies that have led to the continued evolution of ICS toward a national model. The question now before us is whether we need another disaster to take that final step to a truly national incident management system or are we willing to go there now. In this time of heightened national security we owe it to ourselves to have the best incident management system in the world.
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Zane, Richard D., and Ann L. Prestipino. "Implementing the Hospital Emergency Incident Command System: An Integrated Delivery System's Experience." Prehospital and Disaster Medicine 19, no. 04 (December 2004): 311–17. http://dx.doi.org/10.1017/s1049023x00001941.
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AbstractIntroduction:Hospital disaster manuals and response plans often lack formal command structure; instead, they rely on the presence of key individuals who are familiar with hospital operations, or who are in leadership positions during routine, day-to-day operations. Although this structure occasionally may prove to be successful, it is unreliable, as this leadership may be unavailable at the time of the crisis, and may not be sustainable during a prolonged event. The Hospital Emergency Incident Command System (HEICS) provides a command structure that does not rely on specific individuals, is flexible and expandable, and is ubiquitous in the fire service, emergency medical services, military, and police agencies, thus allowing for ease of communication during event management.Methods:A descriptive report of the implementation of the HEICS throughout a large healthcare network is reviewed. Results and Conclusions: Implementation of the HEICS provides a consistent command structure for hospitals that enables consistency and commonality with other hospitals and disaster response entities.
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Li, Hua, and Yong Bo Shui. "Research on Organization of On-Site Emergency Command System Based on FINC." Applied Mechanics and Materials 373-375 (August 2013): 2251–55. http://dx.doi.org/10.4028/www.scientific.net/amm.373-375.2251.
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Countries around the world have established the incident emergency command system in response to frequent emergencies. However, it can't use the traditional reductionism method to study the system efficacy. Emergency command system is a paramilitary organization, FINC network analysis method can be used to consider the accident scene of the cataclysm site and rescue situation. Using three levels of the scene of the fire emergency command and organization of the network topology structure model for the analysis of delay, central degree and the information quality, and other important system performance indicators, thus to establish a reasonable and efficient in the field of emergency command group provides reliable theoretical support.
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Vidrine, Grant, Larry Dietrick, Carl Lautenberger, and Charlene Hutton. "Integrated Incident Management System." International Oil Spill Conference Proceedings 1999, no. 1 (March 1, 1999): 867–68. http://dx.doi.org/10.7901/2169-3358-1999-1-867.
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ABSTRACT The North Slope of Alaska Oil Operators—ARCO, (Alaska), Inc.; BP Exploration (Alaska), Inc.; and Alyeska Pipeline Service Company—and their governing agencies—Alaska Department of Environmental Conservation (ADEC), Environmental Protection Agency (EPA), and the U.S. Coast Guard (USCG)—currently use some form of the Incident Command System (ICS) to manage oil spill incidents and exercises. Although the ICS principles are similar, the structure, terminology and forms are diverse. The North Slope operators and regulatory agencies in Alaska are “thinking out-of-the-box” these days with the development of a new, all hazards, systems to maximize the use of resources on the North Slope. The new integrated Incident Management System (IMS) was designed to offer benefits such as standardized processes, forms and nomenclature, integrated organizational structures, common management/training, enhanced interactions, shared learning's, central coordination, standard Emergency Operation Center layouts, and access to equipment and personnel.
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Branum, BA, BS, MS (Student), Andrew, J. Eric Dietz, PhD, PE, and David R. Black, PhD, MPH. "An evaluation of local incident command system personnel in a pandemic influenza." Journal of Emergency Management 8, no. 5 (September 1, 2010): 39. http://dx.doi.org/10.5055/jem.2010.0031.
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In 2008, 68 counties in the State of Indiana participated in functional exercises funded by the Indiana State Department of Health to evaluate local pandemic preparation and response. As a part of the exercise tasks, counties were asked to develop an Incident Command (IC) structure for the county as well as qualified personnel who would fill each position. By examining the individual structures, it was discovered that at the local level, no clear type of personnel was being used. This study will display the results of the findings by uniquely categorizing the local level IC personnel structure used in these exercises into three study-defined types: normal command, specialized command, and unified command. By looking at the various effectiveness aspects of each type of personnel structure, this study will provide consideration, with possible strengths and weaknesses, for effective IC use based upon selection of IC personnel. The results will allow localities to better modify their command to adjust to a pandemic emergency.
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Deal, Kelly E., Carolyn K. Synovitz, Jeffrey M. Goodloe, Brandi King, and Charles E. Stewart. "Tulsa Oklahoma Oktoberfest Tent Collapse Report." Emergency Medicine International 2012 (2012): 1–9. http://dx.doi.org/10.1155/2012/729795.
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Background. On October 17, 2007, a severe weather event collapsed two large tents and several smaller tents causing 23 injuries requiring evacuation to emergency departments in Tulsa, OK.Methods. This paper is a retrospective analysis of the regional health system’s response to this event. Data from the Tulsa Fire Department, The Emergency Medical Services Authority (EMSA), receiving hospitals and coordinating services were reviewed and analyzed. EMS patient care reports were reviewed and analyzed using triage designators assigned in the field, injury severity scores, and critical mortality.Results. EMT's and paramedics from Tulsa Fire Department and EMSA provided care at the scene under unified incident command. Of the 23 patients transported by EMS, four were hospitalized, one with critical spinal injury and one with critical head injury. One patient is still in ongoing rehabilitation.Discussion. Analysis of the 2007 Tulsa Oktoberfest mass casualty incident revealed rapid police/fire/EMS response despite challenges of operations at dark under severe weather conditions and the need to treat a significant number of injured victims. There were no fatalities. Of the patients transported by EMS, a minority sustained critical injuries, with most sustaining injuries amenable to discharge after emergency department care.
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Holtzclaw, Timothy, Shaina Derstine Newman, Matthew Dwyer, Joelle Simpson, and Tress Goodwin. "Coronavirus Disease 2019 in the Emergency Department: Establishing an Interprofessional Incident Command System." Journal of Emergency Nursing 48, no. 4 (July 2022): 477–83. http://dx.doi.org/10.1016/j.jen.2022.01.004.
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Casey III, USA, MSSI, MHS, Major John J. "The Hospital Emergency Incident Command System—is the Army Medical Department on board?" Journal of Emergency Management 4, no. 3 (May 1, 2006): 61. http://dx.doi.org/10.5055/jem.2006.0034.
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Catastrophic scenarios that once seemed merely theoretical have become a stark reality. Horrific natural disasters, the emergence of state-sponsored terrorism, pro liferation of chemical and biological agents, availability of materials and scientific weapons expertise, and recent increases in less discriminate attacks all point toward a growing threat of mass casualty (MASCAL) events. Hospitals across America are upgrading their ability to respond to disasters and emergencies of all kinds as the nation wages its war on terror. To respond to these challenges, many civilian hospitals are relying on the Hospital Emergency Incident Command System (HEICS), an emergency management model that employs a logical management structure, detailed responsibilities, clear reporting channels, and a common nomenclature to help unify responders. Modeled after the FIRESCOPE (FIrefighting RESources of California Organized for Potential Emergencies) management system, HEICS is fast becoming a key resource in healthcare emergency management. Over the past couple of years, military hospitals have begun embracing the HEICS model as well. This article discusses the prevalence of HEICS and provides an analysis of its effectiveness within the Army Medical Department (AMEDD).
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Robakowska, Marlena, Anna Tyrańska-Fobke, Daniel Ślęzak, Michał Rogowski, Andrzej Basiński, and Sylwia Jałtuszewska. "COMMAND SUPPORT SYSTEM EMS (SWD PRM)." Emergency Medical Service 8, no. 3 (2021): 126–29. http://dx.doi.org/10.36740/emems202103102.
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Poland is the only country in the world, which has a uniform nationwide command support system for medical rescue, integrated with the command support systems of the National Fire Service and the Police. SWD PRM is un-derstood as an ICT system that enables receiving alarm notifications from emergency notification centers and noti-fications about incidents, dispatching of emergency medical services, recording medical incidents, presentation of geographical location of the incident site, positioning of emergency medical services and support of tasks execution by emergency medical services and provincial coordinator of medical rescue. The purpose of this paper is to present assumptions of the SWD PRM system and history of its implementation as well as available technical and system capabilities. Its greatest advantage is the fact that it is a uniform nationwide teleinformatic system collecting data about medical events. Its functioning in terms of information and data collection allows for improvement of plan-ning and organization of the PRM system, which enables effective management of available forces and resources, which translates into shortening the waiting time for assistance for a person in a state of emergency by reducing the time of arrival of the Medical Rescue Unit at the scene of the event.
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Young, Harry, Larry Dietrick, Arthur Pilot, Geoff Harben, and Mark Burger. "DEVELOPING THE STATE ON-SCENE COORDINATORS' COURSE FOR ALASKA." International Oil Spill Conference Proceedings 1995, no. 1 (February 1, 1995): 1019–21. http://dx.doi.org/10.7901/2169-3358-1995-1-1019.
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ABSTRACT Before the development of the state on-scene coordinators’ course, spill response training available to the Alaska Department of Environmental Conservation focused on technical aspects, safety, and the incident command system. To function in a unified command and carry out legislatively mandated tasks, a program was needed to instruct responders in the department's duties. As the course evolved, a synergistic relationship developed, which is redefining the response program.
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Nakata, Keiji. "Triage Problem Among the Ambulance Crew (Paramedic) in Japan." Prehospital and Disaster Medicine 34, s1 (May 2019): s173. http://dx.doi.org/10.1017/s1049023x19003972.
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Introduction:At various accidents or disaster sites, rescue, first aid, and transport to hospitals has been provided by ambulance crews (paramedics). In the case of mass casualties, they also need to operate triage for injured people.Aim:To consider and reveal challenges in triage by ambulance crews (paramedics) on-site.Methods:Interviews of seven ambulance crews (paramedics) and their instructors were conducted and their answers were analyzed.Results:(1.) Triage black tags: declaring “deceased: not able to survive” might give a heavy mental burden and psychological responsibility. Legal protection and an interstitial rule will be necessary in the future. (2.) Missed triage: the ambulance crew cannot perform a triage that may develop a legal problem. It is always important to prevent ambulance crews from being charged. (3.) Triage education and training: there are few triage trainings at fire departments although the number of emergency medical responses is increasing compared to fire response. It will be necessary to increase time of the triage education and training in near future. (4.) Command system (characteristic rank system in the fire department): There is a problem with the rank system in fire departments since confusion occurs when a commander of the First Aid Station is not a licensed paramedic. The ambulance crew (paramedic) usually consists of the three different ranked people. Individual operations are difficult during operation. Education for the paramedic executive is necessary for the fire organization.Discussion:For the triage by ambulance crew (paramedic), legal protection by medical control operation is required, and it may lead to a reduction of heavy mental burden. Triage training is needed to improve the training of triage. The ambulance crew (paramedic) operates under the fire department command system. However, at the time of disaster, the ambulance crew (paramedic) should also work under the medical command system.
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Clark, Marah S., and Adriane N. Rogers. "Florida Department of Agriculture and Consumer Services Mosquito Control Incident Response Team: An Exercise in Using the National Incident Management System's Incident Command System for Disaster Response." Journal of the American Mosquito Control Association 36, no. 2s (June 1, 2020): 35–40. http://dx.doi.org/10.2987/19-6886s.1.
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ABSTRACT The Florida Department of Agriculture and Consumer Services (FDACS) uses a Mosquito Control Incident Response Team (MCIRT) to respond to natural disasters and mosquito borne-disease threats. Since 2001, this team has responded to 9 different events and is responsible for organizing treatment to more than 15 million acres in Florida using wide-area adulticide applications. The MCIRT implements the Incident Command Structure (ICS) to coordinate response efforts because it enables FDACS to quickly deploy staff to the devastated areas, conduct necessary mosquito surveillance, communicate with multiple agencies, and direct mosquito control measures. It also allows for easier transfer of leadership, cross-training of employees, and postevent evaluation.
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Ehsan, Ibtisam, Asia Mumtaz, Muhammad Irfan Khalid, Jawaid Iqbal, Saddam Hussain, Syed Sajid Ullah, and Fazlullah Umar. "Internet of Things-Based Fire Alarm Navigation System: A Fire-Rescue Department Perspective." Mobile Information Systems 2022 (September 9, 2022): 1–15. http://dx.doi.org/10.1155/2022/3830372.
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In the past few years, fire alarm systems have become increasingly sophisticated and more capable and reliable. The two main objectives are the protection of life and property. As a result of state and local codes, fire protection has become more concerned with life safety over the past two decades. Several safety measures have been implemented to address the problems caused by the fires and reduce the number of fatalities and property damage. Our project is to develop and review a fire alarm navigation system and application that uses the internet of things. Fire alarm systems are designed to warn people about fires in advance so that they can evacuate the fire-affected area and take immediate action to control the fire. There will be a GPS module, a flame sensor, a smoke sensor, buzzers, LEDs, and a GSM module to ensure early notification to authorities and fire stations. The aim is to reduce the loss of lives and property. A questionnaire was designed to conduct a brief survey in a multinational sports production company in Sialkot, Pakistan, regarding the IoT fire alarm navigation system. Besides installing the system in the factory, we compare the results with fire incident response time with and without this system at rescue 1122 fire head station.
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duVair, Pierre H. "INCIDENT COMMAND SYSTEM AND NATURAL RESOURCE DAMAGE ASSESSMENT: MULTIPLE ROLES FACING NATURAL RESOURCE TRUSTEE AGENCIES1." International Oil Spill Conference Proceedings 1995, no. 1 (February 1, 1995): 345–50. http://dx.doi.org/10.7901/2169-3358-1995-1-345.
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ABSTRACT This paper discusses the continually evolving subjects of emergency response and natural resource damage assessment (NRDA) from the perspective of a state natural resource trustee agency. Following the Exxon Valdez and American Trader spills, California enacted a law that gave the Department of Fish and Game primary responsibility for management of oil spills in marine waters of the state. There are considerable advantages to placing the lead responsibility for spill response and damage assessment on a single trustee agency which must carry out prespill planning and training, and participate in drills. Trustee agencies potentially face numerous roles in significant spill events; methods have been developed to facilitate the conduct of these activities. In particular, the unified command structure, incident command system, and the trustee NRDA team concept are useful.
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Boland, William, and Pete Bontadelli. "TO BOLDLY GO WHERE NO STATE HAS GONE BEFORE1." International Oil Spill Conference Proceedings 1995, no. 1 (February 1, 1995): 761–65. http://dx.doi.org/10.7901/2169-3358-1995-1-761.
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ABSTRACT The Marine Safety Division of the 11th Coast Guard District and the California Office of Oil Spill Prevention and Response are pursuing new avenues to assure that federal, state, and local efforts in California achieve the goals of the Oil Pollution Act of 1990 and the Lempert-Keene-Seastrand Oil Spill Prevention and Response Act of 1990. Coordination of the seven California area committees, publishing detailed area contingency plans, and the implemention of a memorandum of agreement on oil spill prevention and response highlight recent cooperative successes. In 1994 a joint Coast Guard/state/industry incident command system task force drafted an ICS field operations guide and incident action plan forms that meet National Interagency Incident Management System and fire scope ICS requirements.
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Persell, D. J. "(A50) The Nurse as Incident Commander." Prehospital and Disaster Medicine 26, S1 (May 2011): s15. http://dx.doi.org/10.1017/s1049023x11000628.
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The year 2010 brought an unprecedented public health response to the novel H1N1 influenza pandemic. Included in that response were colleges and universities across the globe. At universities not associated with medical centers, medical directors of student health looked to nursing faculty or nurse practitioner directors of student health for leadership. From the day novel H1N1 was formally declared a public health emergency, Arkansas State University utilized a nurse faculty member with expertise in homeland security as its Incident Commander. A portion of the nurse's time was dedicated to managing the incident. The nurse was positioned to provide guidance and lead the response with an understanding of university structures as well as business and academic continuity. From the beginning, the nurse utilized the Incident Command System to manage the response. Portions of the University's Incident Command structure were activated and Incident Command meetings were held no less than every two weeks. A tabletop exercise was developed specifically for a university setting and to give University officials practice at pandemic management. The nurse's clinical focus and pre-established relationships with disaster response and public health officials allowed critical access to important resources that the University would have otherwise gone without. She guided the University through redefining their pandemic plan, including assisting residence life in establishing alternative housing for sick students. An on-line reporting system was developed that was utilized by faculty, students, staff, and other concerned constituents. A public awareness campaign on the campus was instituted and 1,000 posters were posted around campus encouraging sick students to stay home and/or seek medical care. The World Health Organization, (US) Centers for Disease Control and Prevention, and Department of Education guidelines were monitored and implemented. Two mass-immunization clinics were held on the campus with > 7,000 immunizations provided.
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Dal Ponte, Silvana T., Carlos F. D. Dornelles, Bonnie Arquilla, Christina Bloem, and Patricia Roblin. "Mass-casualty Response to the Kiss Nightclub in Santa Maria, Brazil." Prehospital and Disaster Medicine 30, no. 1 (December 29, 2014): 93–96. http://dx.doi.org/10.1017/s1049023x14001368.
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AbstractOn January 27, 2013, a fire at the Kiss Nightclub in Santa Maria, Brazil led to a mass-casualty incident affecting hundreds of college students. A total of 234 people died on scene, 145 were hospitalized, and another 623 people received treatment throughout the first week following the incident.1 Eight of the hospitalized people later died.1 The Military Police were the first on scene, followed by the state fire department, and then the municipal Mobile Prehospital Assistance (SAMU) ambulances. The number of victims was not communicated clearly to the various units arriving on scene, leading to insufficient rescue personnel and equipment. Incident command was established on scene, but the rescuers and police were still unable to control the chaos of multiple bystanders attempting to assist in the rescue efforts. The Municipal Sports Center (CDM) was designated as the location for dead bodies, where victim identification and communication with families occurred, as well as forensic evaluation, which determined the primary cause of death to be asphyxia. A command center was established at the Hospital de Caridade Astrogildo de Azevedo (HCAA) in Santa Maria to direct where patients should be admitted, recruit staff, and procure additional supplies, as needed. The victims suffered primarily from smoke inhalation and many required endotracheal intubation and mechanical ventilation. There was a shortage of ventilators; therefore, some had to be borrowed from local hospitals, neighboring cities, and distant areas in the state. A total of 54 patients1 were transferred to hospitals in the capital city of Porto Alegre (Brazil). The main issues with the response to the fire were scene control and communication. Areas for improvement were identified, namely the establishment of a disaster-response plan, as well as regularly scheduled training in disaster preparedness/response. These activities are the first steps to improving mass-casualty responses.Dal PonteST, DornellesCFD, ArquillaB, BloemC, RoblinP. Mass-casualty response to the Kiss Nightclub in Santa Maria, Brazil. Prehosp Disaster Med. 2015;30(1):1-4.
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Packard, Richard F., Richard J. Wozmak, and Kevin D. Trainer. "THE APPLICATION OF THE MASSACHUSETTS LICENSED SITE PROFESSIONAL PROGRAM DURING A MARINE OIL SPILL RESPONSE." International Oil Spill Conference Proceedings 2008, no. 1 (May 1, 2008): 97–101. http://dx.doi.org/10.7901/2169-3358-2008-1-97.
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ABSTRACT The response to a marine oil spill incident in the United States involves mobilization of Federal, State, Local, and Responsible Party (RP)-contracted resources, using the National Incident Management System, Incident Command System (NIMS-ICS). The NIMS-ICS utilizing a Unified Command structure provides a mechanism for responding agencies to establish response priorities and implement cleanup strategies. A recent marine oil spill response in Massachusetts demonstrated that the incorporation of specific state environmental regulatory programs within the NIMS Unified Command system could be a challenging, but advantageous element in the successful cleanup of a marine oil spill. On April 27, 2003, a tank barge grounded in Buzzards Bay, spilling approximately 98,000 gallons of #6 fuel oil. Early in the response, the Massachusetts Department of Environmental Protection (MassDEP), also the State On-Scene Coordinator (SOSC), recognized the importance of utilizing the State'S Licensed Site Professional (LSP) program to assess cleanup effectiveness, characterize residual impacts, and identify clean up endpoints. Massachusetts established the LSP program in 1993 to place greater responsibility for cleaning up sites on the private sector, reduce the burden of approvals on the MassDEP, and to accelerate the cleanup of hazardous wastes sites. The 2003 Buzzards Bay spill was the first time that MassDEP integrated the LSP program into the early stages of a marine oil spill response and the NIMS Unified Command Structure. Including the LSP early in the process also facilitated the transition for conducting LSP-directed clean up after the NIMS Unified Command structure was deactivated. This paper describes the challenges and advantages associated with incorporating a privatized regulatory entity into this well-established and complex organizational matrix. The Massachusetts regulatory structure behind the LSP program is discussed, and recommendations are made for future application of the LSP program in marine oil spill response.
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Ersoy, Gürkan, Ridvan Atilla, Sülen Sarioglu, Dilek Güldal, Eyüp Sabri Ucan, Ulkümen Rodoplu, and Donald Walsh. "Assessment of the Staff of an Emergency Department Training in the Hospital Emergency Incident Command System." Prehospital and Disaster Medicine 16, S1 (June 2001): S61. http://dx.doi.org/10.1017/s1049023x00036281.
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Butler, Philip C., Robert C. Honey, and Sabrina R. Cohen-Hatton. "Development of a behavioural marker system for incident command in the UK fire and rescue service: THINCS." Cognition, Technology & Work 22, no. 1 (February 8, 2019): 1–12. http://dx.doi.org/10.1007/s10111-019-00539-6.
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Stambler, PhD, CEM, Kimberly S., and Joseph A. Barbera, MD. "The evolution of shortcomings in Incident Command System: Revisions have allowed critical management functions to atrophy." Journal of Emergency Management 13, no. 6 (February 25, 2016): 509. http://dx.doi.org/10.5055/jem.2015.0260.
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The original Incident Command System (ICS) was created through the federally funded Firefighting Resources of Southern California Organized for Potential Emergencies (FIRESCOPE) program. Initially developed as one element of multiagency coordination for managing severe wildfires, the FIRESCOPE ICS guidance was adopted and evolved through increasingly routine wildland firefighting. It then was modified for all hazards for the fire service. Only later, through the National Incident Management System (NIMS), was ICS officially adopted for all hazards and all responders. Over this multidecade evolution, the current NIMS ICS version became simplified in several key areas compared to the original, robust FIRESCOPE ICS. NIMS ICS is now promulgated as guidance for managing today's novel, complex, and lengthy disasters involving multidisciplinary response but experiences recurrent problems in key functions. This article examines the history of the subtle, yet critical differences in current ICS compared to the original system design, and focuses on information dissemination and intermediate, long-range and contingency planning. ICS transitions resulted in simplification and consolidation of positions and functions, without recognizing and maintaining critical position tasks necessary for managing complex, extended incidents.
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Ju, Young Kuk, and Jong Ho Lee. "A Study on the Problems and Improvement by Analyzing the Disastrous Large-scale Forest Fire Response System: Focusing on Simultaneous Forest Fires along the East Coast of Gangwon-do Province." Crisis and Emergency Management: Theory and Praxis 12, no. 5 (May 30, 2022): 21–28. http://dx.doi.org/10.14251/jscm.2022.5.21.
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On April 4, 2019, the forest fire that spread simultaneously to five cities and counties, including Inje, Goseong, Sokcho, and Gangneung and Donghae, on the east coast of Gangwon-do, was extinguished at an early stage. It is regarded as the result of the response with full force of Korea Forest Service, National Fire Agency, Militray, and other related organizations. However, it is also true that the limitations of current forest fire response system and the operation of forest fire response personnel, facilities and equipment were revealed in the process of responding Gangwon forest fire. To find solutions to these problems, from March 3 to April 2, 2021, a survey was conducted with firefighters, forest officials and residents in Gangwon-province with experience in forest fire on a total of 29 questions about Law and Policy, Forest Fire Response System and Operation of manpower and equipment. Based on the results of the survey and literature research, an improvement plan for the Forest Fire Disaster Response System was sought. Based on our survey results, we propose the following measures to improve South Korea's forest fire response system in the future. ; the incident command system should be unified, forest authorities' forest fire prevention and management system should be further strengthened, and forest fire response system must be improved to the level of other major countries through better legislations.
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McIlquham, Taylor, Anna Sick-Samuels, Carrie Billman, Jennifer Andonian, Melissa Dudley, Amyna Husain, Robert Maloney, et al. "Use of a Multidisciplinary Incident Command System in Response to Measles Outbreak in Maryland." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s502—s504. http://dx.doi.org/10.1017/ice.2020.1184.
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Background: Measles is a highly contagious virus that reemerged in 2019 with the highest number of reported cases in the United States since 1992. Beginning in March 2019, The Johns Hopkins Hospital (JHH) responded to an influx of patients with concern for measles as a result of outbreaks in Maryland and the surrounding states. We report the JHH Department of Infection Control and Hospital Epidemiology (HEIC) response to this measles outbreak using a multidisciplinary measles incident command system (ICS). Methods: The JHH HEIC and the Johns Hopkins Office of Emergency Management established the HEIC Clinical Incident Command Center and coordinated a multipronged response to the measles outbreak with partners from occupational health services, microbiology, the adult and pediatric emergency departments, marketing and communication and local and state public health departments. The multidisciplinary structure rapidly developed, approved, and disseminated tools to improve the ability of frontline providers to quickly identify, isolate, and determine testing needs for patients suspected to have measles infection and reduce the risk of secondary transmission. The tools included a triage algorithm, visitor signage, staff and patient vaccination guidance and clinics, and standard operating procedures for measles evaluation and testing. The triage algorithms were developed for phone or in-person and assessed measles exposure history, immune status, and symptoms, and provided guidance regarding isolation and the need for testing. The algorithms were distributed to frontline providers in clinics and emergency rooms across the Johns Hopkins Health System. The incident command team also distributed resources to community providers to reduce patient influx to JHH and staged an outdoor measles evaluation and testing site in the event of a case influx that would exceed emergency department resources. Results: From March 2019 through June 2019, 37 patients presented with symptoms or concern for measles. Using the ICS tools and algorithms, JHH rapidly identified, isolated, and tested 11 patients with high suspicion for measles, 4 of whom were confirmed positive. Of the other 26 patients not tested, none developed measles infection. Exposures were minimized, and there were no secondary measles transmissions among patients. Conclusions: Using the ICS and development of tools and resources to prevent measles transmission, including a patient triage algorithm, the JHH team successfully identified, isolated, and evaluated patients with high suspicion for measles while minimizing exposures and secondary transmission. These strategies may be useful to other institutions and locales in the event of an emerging or reemerging infectious disease outbreak.Funding: NoneDisclosures: Aaron Milstone reports consulting for Becton Dickinson.
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Henning, Tom, K. Tim Perkins, and Gary Stankovich. "COMPREHENSIVE RESOURCE MANAGEMENT." International Oil Spill Conference Proceedings 1997, no. 1 (April 1, 1997): 871–75. http://dx.doi.org/10.7901/2169-3358-1997-1-871.
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ABSTRACT Resources at the scene of an oil spill involve a significant number of response personnel, equipment, and support materials. The current practice of using single resource management during oil spill emergencies is ineffective and extremely time-consuming. This form of resource tracking results in the overtaxation of the resource status unit (RESTAT) and does not give the operations section the best opportunity to make tactical decisions based on the location of available resources. The recent use of comprehensive resource management as part of the incident command system (ICS) (Oil Pollution Act of 1990, 1990) with strike teams and task forces for the deployment of personnel and equipment during an industry-led National Preparedness for Response Exercise Program (PREP) (Incident Command Systems, Fire Publications, no date) exercise provided an opportunity to implement a more efficient and effective system for the deployment and tracking of resources. The deployment of strike teams and task forces greatly reduces the number of resources to be tracked and provides the operations section with a more realistic view of available and assigned resources. This results in better allocation of resources to more effectively manage the tactical priorities of an incident. In addition, the tasks of the cost control and food services units are made simpler by a more accurate picture of on-scene resources and personnel.
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McCrea, Deborah L., Robert C. Coghlan, Tiffany Champagne-Langabeer, and Stanley Cron. "Collaborative Interprofessional Health Science Student Led Realistic Mass Casualty Incident Simulation." Healthcare 11, no. 1 (December 23, 2022): 40. http://dx.doi.org/10.3390/healthcare11010040.
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In collaboration, a health science university and a fire department offered a mass casualty incident (MCI) simulation. The purpose of this study was to evaluate a cross-section of student health care providers to determine their working knowledge of an MCI. Students were given a pretest using the Emergency Preparedness Information Questionnaire (EPIQ) and the Simple Triage and Rapid Transport (START) Quiz. The EPIQ instrument related to knowledge of triage, first aid, bio-agent detection, critical reporting, incident command, isolation/quarantine/decontamination, psychological issues, epidemiology, and communications. The START Quiz gave 10 scenarios. Didactic online content was given followed by the simulation a few weeks later. A posttest with the same instruments was given after the simulation. Participants were majority female (81.7%), aged between 25–34 (41.7%), and 61.7% (n = 74) had undergraduate or post-graduate degrees. The overall pretest mean was 2.92 and posttest mean was 3.64. The START Quiz found participants struggled to correctly assign triage levels. Students also experienced challenges correctly assigning patients to specific triage categories. Findings will assist educators to understand knowledge gaps, so revisions can be made to enhance learning in disaster management. Concentration in proper field triage is also a needed focus.
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Kim-Farley, Robert J., John T. Celentano, Carol Gunter, Jessica W. Jones, Rogelio A. Stone, Raymond D. Aller, Laurene Mascola, Sharon F. Grigsby, and Jonathan E. Fielding. "Standardized Emergency Management System and Response to a Smallpox Emergency." Prehospital and Disaster Medicine 18, no. 4 (December 2003): 313–20. http://dx.doi.org/10.1017/s1049023x00000546.
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AbstractThe smallpox virus is a high-priority, Category-A agent that poses a global, terrorism security risk because it: (1) easily can be disseminated and transmitted from person to person; (2) results in high mortality rates and has the potential for a major public health impact; (3) might cause public panic and social disruption; and (4) requires special action for public health preparedness. In recognition of this risk, the Los Angeles County Department of Health Services (LAC-DHS) developed the Smallpox Preparedness, Response, and Recovery Plan for LAC to prepare for the possibility of an outbreak of smallpox.A unique feature of the LAC-DHS plan is its explicit use of the Standardized Emergency Management System (SEMS) framework for detailing the functions needed to respond to a smallpox emergency. The SEMS includes the Incident Command System (ICS) structure (management, operations, planning/intelligence, logistics, and finance/administration), the mutual-aid system, and the multi/interagency coordination required during a smallpox emergency. Management for incident command includes setting objectives and priorities, information (risk communications), safety, and liaison. Operations includes control and containment of a smallpox outbreak including ring vaccination, mass vaccination, adverse events monitoring and assessment, management of confirmed and suspected smallpox cases, contact tracing, active surveillance teams and enhanced hospital-based surveillance, and decontamination. Planning/intelligence functions include developing the incident action plan, epidemiological investigation and analysis of smallpox cases, and epidemiological assessment of the vaccination coverage status of populations at risk. Logistics functions include receiving, handling, inventorying, and distributing smallpox vaccine and vaccination clinic supplies; personnel; transportation; communications; and health care of personnel. Finally, finance/administration functions include monitoring costs related to the smallpox emergency, procurement, and administrative aspects that are not handled by other functional divisions of incident command systems.The plan was developed and is under frequent review by the LAC-DHS Smallpox Planning Working Group, and is reviewed periodically by the LAC Bioterrorism Advisory Committee, and draws upon the Smallpox Response Plan and Guidelines of the Centers for Disease Control and Prevention (CDC) and recommendations of the Advisory Committee on Immunization Practices (ACIP). The Smallpox Preparedness, Response, and Recovery Plan, with its SEMS framework and ICS structure, now is serving as a model for the development of LAC-DHS plans for responses to other terrorist or natural-outbreak responses.
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Kim-Farley, Robert J., John T. Celentano, Carol Gunter, Jessica W. Jones, Rogelio A. Stone, Raymond D. Aller, Laurene Mascola, Sharon F. Grigsby, and Jonathan E. Fielding. "Standardized Emergency Management System and Response to a Smallpox Emergency." Prehospital and Disaster Medicine 18, no. 4 (December 2003): 313–20. http://dx.doi.org/10.1017/s1049023x00001266.
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AbstractThe smallpox virus is a high-priority, Category-A agent that poses a global, terrorism security risk because it: (1) easily can be disseminated and transmitted from person to person; (2) results in high mortality rates and has the potential for a major public health impact; (3) might cause public panic and social disruption; and (4) requires special action for public health preparedness. In recognition of this risk, the Los Angeles County Department of Health Services (LAC-DHS) developed the Smallpox Preparedness, Response, and Recovery Plan for LAC to prepare for the possibility of an outbreak of smallpox.A unique feature of the LAC-DHS plan is its explicit use of the Standardized Emergency Management System (SEMS) framework for detailing the functions needed to respond to a smallpox emergency. The SEMS includes the Incident Command System (ICS) structure (management, operations, planning/intelligence, logistics, and finance/administration), the mutual-aid system, and the multi/interagency coordination required during a smallpox emergency. Management for incident command includes setting objectives and priorities, information (risk communications), safety, and liaison. Operations includes control and containment of a smallpox outbreak including ring vaccination, mass vaccination, adverse events monitoring and assessment, management of confirmed and suspected smallpox cases, contact tracing, active surveillance teams and enhanced hospital-based surveillance, and decontamination. Planning/intelligence functions include developing the incident action plan, epidemiological investigation and analysis of smallpox cases, and epidemiological assessment of the vaccination coverage status of populations at risk. Logistics functions include receiving, handling, inventorying, and distributing smallpox vaccine and vaccination clinic supplies; personnel; transportation; communications; and health care of personnel. Finally, finance/administration functions include monitoring costs related to the smallpox emergency, procurement, and administrative aspects that are not handled by other functional divisions of incident command systems.The plan was developed and is under frequent review by the LAC-DHS Smallpox Planning Working Group, and is reviewed periodically by the LAC Bioterrorism Advisory Committee, and draws upon the Smallpox Response Plan and Guidelines of the Centers for Disease Control and Prevention (CDC) and recommendations of the Advisory Committee on Immunization Practices (ACIP). The Smallpox Preparedness, Response, and Recovery Plan, with its SEMS framework and ICS structure, now is serving as a model for the development of LAC-DHS plans for responses to other terrorist or natural-outbreak responses.
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Rolan, Robert G., and Keith H. Cameron. "Adaptation of the Incident Command System to Oil Spill Response During the American Trader Spill." International Oil Spill Conference Proceedings 1991, no. 1 (March 1, 1991): 267–72. http://dx.doi.org/10.7901/2169-3358-1991-1-267.
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ABSTRACT While developing its new crisis management plan in 1989, BP America (BPA) modified the incident command system (ICS) for use as the organizational structure of its oil spill response team. This was done to be compatible with the post-Exxon Valdez organization of the Alyeska response team and for certain advantages it would provide for responses in other locations and in other types of crisis situations. The ICS was originally developed for fighting wildfires in California and has since been widely adopted by other fire and emergency services in the U. S. While retaining most of the ICS structure, ?PA developed modifications necessary to fit the unique requirements of oil spill response. The modified ICS was used during a full scale test of ?PA's draft crisis management plan in December 1989, and thus was familiar to ?PA's top executives and other participating response team members. When the American Trader spill occurred in February 1990, BPA's management used the modified ICS organization even though the crisis management plan had not been finalized or widely distributed within the company. Details of the organizational structure evolved as the spill response progressed, in part due to the changing requirements of the response over time and in part because of previously unrecognized issues. This paper describes that evolution and the resulting final structure. Essential differences between the original ICS and BPA's oil spill version of it are highlighted. Despite the unrecognized issues and the unfamiliarity of some team members with the ICS, the organization worked well and can be credited with a share of the success of the American Trader response.
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Dhondt, E. L., T. Peeters, and L. Orlans. "(P2-17) “Burning Valentine,” a Simulated Evacuation Exercise of a Burn Unit (BU)." Prehospital and Disaster Medicine 26, S1 (May 2011): s141. http://dx.doi.org/10.1017/s1049023x11004614.
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BackgroundAccording to the Belgian Hospital Disaster Planning Act, all hospitals are required to have written disaster plans and to routinely conduct annual disaster drills. In 2010, the management of the Military Hospital decided to organize an evacuation exercise of the newly built 24-bed BU.AimTo evaluate this new BU's evacuation plan and drills and the overall hospital emergency incident response and command system.Methods and ResultsIt was decided to conduct a simulated evacuation exercise following an internal fire, before the BU effectively was put into use, thereby deploying fashioned simulated patients and visitors but bringing into action the regular attending medical, nursing and logistic staff. A multidisciplinary design and organizing team was launched, consisting of the hospitals disaster preparedness coordinator, the EMS-staff, external burn care, emergency incident management and operational engineering experts. The appointed objectives for evaluation were the knowledge of the regular evacuation drills, especially the clearance of an intensive care room; access to evacuation routes; visibility of safety guidelines; mission and tasks of the hospital's first response team and the medical incident manager; communication and information flow and the establishment of the hospital's coordination committee. In the mean time and following lessons learned, a number of mitigation measures have been instituted: adequate identification of evacuated rooms, new configuration of the fire detection alarm, optimized access to stairwells and elevators, adjustment of action cards and specific fire fighting training for hospital staff. Finally the decision was made not to purchase specific evacuation equipment for the movement of patients.ConclusionTaking advantage of the BU's provisional vacancy, a simulated hospital evacuation exercise increased the hospital emergency preparedness, awareness and response to disasters within the hospital, in particular in a critical care department, otherwise difficult to assess.
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Bullock, DHSc, CIH, CSP, FAIHA, William, E. Reed Smith, MD, FACEP, and Craig Heligman, MD, MPH. "Managing the “Worried Well” during a large-scale incident." Journal of Emergency Management 16, no. 1 (March 5, 2018): 61. http://dx.doi.org/10.5055/jem.2018.0354.
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A number of recent incidents in the United States resulted in a large number of citizens reporting to the Emergency Room seeking reassurance that they were okay. These citizens are being referred to in the medical community as the “Worried Well.” We conducted a review of a transportation incident involving a chemical release and fire, which resulted in over 100 people reporting to the local emergency room for evaluation. Few, if any of the patients seen in the hospital had a potential exposure to the chemical or combustion byproducts. It is probable that stress hormones released by the sympathetic nervous system caused the symptoms experienced by the majority of the patients. This review suggest the need for better coordination between incident command and the hospital, including more timely situation reports including parameters such as the wind direction and potential downwind pollutant levels, to assist the physicians and nurses more appropriately manage these “Worried Well.”
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Smith, Joe S., and Gretchen A. Kuldau. "Methods of Instruction of the Incident Command System and Related Topics at US Veterinary Schools." Disaster Medicine and Public Health Preparedness 8, no. 6 (November 21, 2014): 505–10. http://dx.doi.org/10.1017/dmp.2014.116.
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AbstractObjectiveThe Incident Command System (ICS) is an adaptable construct designed to streamline response efforts to a disaster or other incident. We aimed to examine the methods used to teach the ICS at US veterinary schools and to explore alternative and novel methods for instruction of this material.MethodsA total of 29 US accredited veterinary schools (as of February 2012) were surveyed, and 18 of the 29 schools responded.ResultsThe ICS and related topics were taught by both classroom methods and online instruction by most of the surveyed schools. Several of the schools used readily available Federal Emergency Management Agency and US Department of Agriculture resources to aid in instruction. Most schools used one course to teach the ICS, and some schools also used unique methods such as field exercises, drills, side-by-side training with disaster response teams, elective courses, extracurricular clubs, and externships to reinforce the ICS and related topics. Some of the surveyed institutions also utilized fourth-year clinical rotations and field deployments during actual disasters as a component of their ICS and emergency response curriculum.ConclusionThe ICS is being taught at some form at a significant number of US veterinary schools. Additional research is needed to evaluate the efficacy of the teaching methods of the ICS in US veterinary schools. (Disaster Med Public Health Preparedness. 2014;8:505-510)
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Quinn, Emma, Travers Johnstone, Zeina Najjar, Toni Cains, Geoff Tan, Essi Huhtinen, Sven Nilsson, Stuart Burgess, Matthew Dunn, and Leena Gupta. "Lessons Learned From Implementing an Incident Command System During a Local Multiagency Response to a Legionnaires’ Disease Cluster in Sydney, NSW." Disaster Medicine and Public Health Preparedness 12, no. 4 (September 5, 2017): 539–42. http://dx.doi.org/10.1017/dmp.2017.102.
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AbstractThe incident command system (ICS) provides a common structure to control and coordinate an emergency response, regardless of scale or predicted impact. The lessons learned from the application of an ICS for large infectious disease outbreaks are documented. However, there is scant evidence on the application of an ICS to manage a local multiagency response to a disease cluster with environmental health risks. The Sydney Local Health District Public Health Unit (PHU) in New South Wales, Australia, was notified of 5 cases of Legionnaires’ disease during 2 weeks in May 2016. This unusual incident triggered a multiagency investigation involving an ICS with staff from the PHU, 3 local councils, and the state health department to help prevent any further public health risk. The early and judicious use of ICS enabled a timely and effective response by supporting clear communication lines between the incident controller and field staff. The field team was key in preventing any ongoing public health risk through inspection, sampling, testing, and management of water systems identified to be at-risk for transmission of legionella. Good working relationships between partner agencies and trust in the technical proficiency of environmental health staff aided in the effective management of the response. (Disaster Med Public Health Preparedness. 2018;12:539–542)
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Park, C. B., S. D. Shin, G. J. Suh, J. O. Park, and C. H. Kim. "(P2-26) EMS-Assessed Mass Casualty Incident: A Pilot Surveillance." Prehospital and Disaster Medicine 26, S1 (May 2011): s144. http://dx.doi.org/10.1017/s1049023x11004705.
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Background Recently the number of disaster and mass casualty incident (MCI) is increasing in Korea, but there have been few administrative reports or technical reports for disaster and MCI. An ad hoc basis data collection method is usually incomplete and outdated. This study was conducted to investigate the new surveillance system composed of EMS based real time survey and medical records based in-depth survey.MethodsA retrospective review was conducted of the 119 fire department call center database and ambulance running sheets in one metropolitan city. The data on all transported patients with non-medical reasons (fire, rescue and others) between May 2006 and December 2008 was reviewed. We selected all data from the accidents which had more than 2 casualties to exam the feasibility and conducted in-depth surveillance based on medical records.ResultsThe total number of accidents was 2,027 with 2,625 patients. The number of accidents which had more than 2 patients was 307 (total 898 patients) and more than 6 patients was 19 (total 176 patients). Among the “MCI” events, 15 cases were traffic accidents (125 patients, 71.0%), 4 cases were fire (51 patients, 29%). Total 142 medical records (80.7%) were reviewed. Admission rate was 32.4% (46 patients) and overall mortality was 3.5% (5 patients).ConclusionThis nationwide public EMS system could contribute to the establishment of the systematic disaster database.
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Hadi, Tamer A., and Keren Fleshler. "Integrating Social Media Monitoring Into Public Health Emergency Response Operations." Disaster Medicine and Public Health Preparedness 10, no. 5 (May 27, 2016): 775–80. http://dx.doi.org/10.1017/dmp.2016.39.
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AbstractSocial media monitoring for public health emergency response and recovery is an essential response capability for any health department. The value of social media for emergency response lies not only in the capacity to rapidly communicate official and critical incident information, but as a rich source of incoming data that can be gathered to inform leadership decision-making. Social media monitoring is a function that can be formally integrated into the Incident Command System of any response agency. The approach to planning and required resources, such as staffing, logistics, and technology, is flexible and adaptable based on the needs of the agency and size and scope of the emergency. The New York City Department of Health and Mental Hygiene has successfully used its Social Media Monitoring Team during public health emergency responses and planned events including major Ebola and Legionnaires’ disease responses. The concepts and implementations described can be applied by any agency, large or small, interested in building a social media monitoring capacity. (Disaster Med Public Health Preparedness. 2016;page 1 of 6)
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Symons, Lisa C., and Robert Pavia. "NOAA NATIONAL MARINE SANCTUARIES AS RESOURCE TRUSTEES IN THE UNIFIED COMMAND: GOOD OR BAD?" International Oil Spill Conference Proceedings 2008, no. 1 (May 1, 2008): 761–64. http://dx.doi.org/10.7901/2169-3358-2008-1-761.
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ABSTRACT The National Oceanic and Atmospheric Administration (NOAA) is a federal trustee within the National Contingency Plan (NCP) in addition to providing scientific and technical support to the Incident Command System (ICS) during a response. NOAA is also the home of the National Marine Sanctuary Program (NMSP), a system of 14 marine protected areas that encompass 150,000 square miles of coastal and oceanic waters. NOAA is increasing its capacity for addressing a significant incident through participating in and leading spill response exercises. One of the most intense aspects of those experiences is often the discussion of the role of NOAA as a trustee and whether they should be part of the Unified Command (UC). While the NCP outlines the expectations of Regional Response Team (RRT) members from the Department of the Interior and the Department of Commerce (NOAA), it provides the Federal On Scene Coordinator (FOSC) considerable flexibility in determining whether to include trustees within the UC or working with the Liaison or through the Environmental Unit. A recent Technical Assistance Document from the National Response Team speaks directly to this issue and provides RRT'S more specific guidance. There are some RRT'S that feel strongly that the only trustee in the UC should be the states. NOAA and the DOI believe that they should be afforded the same considerations in the marine and coastal environment as trustees or landowners in the terrestrial environment. Both the Safe Sanctuaries 2005 in Florida and the Safe Seas 2006 in California provided a forum for dialogue on this issue. In both instances, the FOSC did engage the trustees in the UC. It is not always necessary or appropriate for NOAA to participate as a member of the UC. In some situations it could be more effective to participate in other capacities within the ICS and NOAA may not be the trustee with the most significant resources at risk. When participating in a UC, it is incumbent upon the NOAA representative to work with other members of the UC to manage the response under a single, collaborative approach.
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Imai, Randy. "Electronic Wildlife Recovery Tool." International Oil Spill Conference Proceedings 2017, no. 1 (May 1, 2017): 914–23. http://dx.doi.org/10.7901/2169-3358-2017.1.914.
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ABSTRACT Oil spills can have significant impact on wildlife. Documenting the spatial and temporal data associated with oil spills is an important component that aids in all phases of the response. After struggling long hours to incorporate hardcopy records into a Geographic Information System (GIS), the California Department of Fish and Wildlife, Office of Spill Prevention and Response (OSPR) recognized the importance of developing a wildlife recovery application specifically designed for the Wildlife Branch within the Incident Command System (ICS). The Wildlife Recovery Application (WRA) is an iOS based program designed to work optimally on an iPhone. The objective of the application was to keep it simple intuitive, reliable, and effective. The WRA can be used with minimal training and has the ability to operate in environments without cellular service. The interface permits the user to visually review the data and photographs, allowing the user to electronically transmit the information to the GIS Unit remotely once cell service or wireless internet has been established. Once the data is transmitted to the Incident Command Post (ICP), the information can be quickly integrated into a GIS. This eliminates the difficult task of manually inputting data from handwritten field notes that may have been compromised by the environmental elements or illegible due to variations in handwriting styles or penmanship. Lastly, the Care and Processing Group within the Wildlife Branch can integrate the data into an on-line medical database designed specifically for wildlife rehabilitators to collect, manage and analyze data for their individual wildlife patients.
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Moonasar, Devanand, Anban Pillay, Elizabeth Leonard, Raveen Naidoo, Shadrack Mngemane, Wayne Ramkrishna, Khadija Jamaloodien, et al. "COVID-19: lessons and experiences from South Africa’s first surge." BMJ Global Health 6, no. 2 (February 2021): e004393. http://dx.doi.org/10.1136/bmjgh-2020-004393.
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On 5 March 2020, South Africa recorded its first case of imported COVID-19. Since then, cases in South Africa have increased exponentially with significant community transmission. A multisectoral approach to containing and mitigating the spread of SARS-CoV-2 was instituted, led by the South African National Department of Health. A National COVID-19 Command Council was established to take government-wide decisions. An adapted World Health Organiszion (WHO) COVID-19 strategy for containing and mitigating the spread of the virus was implemented by the National Department of Health. The strategy included the creation of national and provincial incident management teams (IMTs), which comprised of a variety of work streams, namely, governance and leadership; medical supplies; port and environmental health; epidemiology and response; facility readiness and case management; emergency medical services; information systems; risk communication and community engagement; occupational health and safety and human resources. The following were the most salient lessons learnt between March and September 2020: strengthened command and control were achieved through both centralised and decentralised IMTs; swift evidenced-based decision-making from the highest political levels for instituting lockdowns to buy time to prepare the health system; the stringent lockdown enabled the health sector to increase its healthcare capacity. Despite these successes, the stringent lockdown measures resulted in economic hardship particularly for the most vulnerable sections of the population.
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Plourde, Kristy, Jean R. Cameron, and Vickie Huyck. "THE OIL SPILL FIELD OPERATIONS GUIDE (FOG)-NEW AND IMPROVED1." International Oil Spill Conference Proceedings 2001, no. 2 (March 1, 2001): 987–90. http://dx.doi.org/10.7901/2169-3358-2001-2-987.
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ABSTRACT The original oil spill Field Operations Guide (FOG) was a product of the Standard Oil Spill Response Management System (STORMS) Task Force comprised of representatives of the U. S. Coast Guard, California Department of Fish and Game Office of Spill Prevention and Response (OSPR), other states, the petroleum industry, oil spill response organizations, and local government. The STORMS Task Force produced this first version of the “oilized” Incident Command System (ICS) FOG and Incident Action Plan (IAP) forms in 1994 and made subsequent revisions in 1995 and 1996. With 2 more years of ICS experience and facilitated by the States/British Columbia Oil Spill Task Force, a new group of representatives from federal and state governments, the petroleum industry, and oil spill response professionals met to review and update the 1996 FOG and IAP forms in October 1998. The overall goal was to remain consistent with the National Interagency Incident Management System (NIIMS) yet reflect the experience gained using ICS at actual oil spills and drills. The group met quarterly over an 18-month period, working collaboratively to reach a consensus on numerous changes. Some of the changes included adding an Environmental Unit to the Planning Section, revising the planning cycle diagram for the oil spill IAP process, and revising the IAP forms as appropriate to reflect the way oil spills are managed. All significant revisions/improvements will be highlighted in this paper and poster.
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Cheng, Hsing Chia, Kuang Yu Niu, and Ming Han Ho. "The Experience of a Mass Casualty Incident Call in a Tertiary Hospital after the 2018 Hualien Earthquake." Prehospital and Disaster Medicine 34, s1 (May 2019): s131. http://dx.doi.org/10.1017/s1049023x19002851.
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Introduction:After a 6.0 magnitude earthquake struck Hualien on February 6, 2018, over one hundred and fifty patients crammed into the emergency department of a nearby tertiary hospital within two hours. The mass casualty incident (MCI) call was activated, and over 300 related personnel responded to the call and engaged with the MCI management.Aim:This research aimed to analyze the practice of an MCI call and to form the strategies to improve its efficiency and effectiveness.Methods:The research was conducted in a tertiary hospital in Hualien, Taiwan. Questionnaires regarding the practice of the MCI call were sent out to the healthcare providers in the emergency department who responded to that MCI operation.Results:Thirty-seven responders in the emergency department were involved in this study. 78% had participated in training courses for hospital incident command system (HICS) or MCI management before this event. On arrival at the emergency department, 69.4% of the responders were aware of the check-in station and received a clear task assignment and briefing. During the operation, 25.7% reported the lack of confidence carrying out the assigned tasks and 54.1% of the participants experienced great stress (stress score over 7 out of 10).Discussion:MCI is an uncommon event for hospital management. It is universally challenging owing to its unpredictable and time-sensitive nature. Furthermore, the administration could be further complicated by the associated disasters. Despite regular exercises and drills, there are still a significant number of participants experiencing stress and confusion during the operation. The chaotic situation may further compromise the performance of the participants. This study showed that optimizing task briefing and on-site directions may improve the performance of the MCI participants.
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Hutley, Tedd, Myola Martinez, and Mark Dix. "FOSS 248-P2 OIL SPILL – A CASE STUDY." International Oil Spill Conference Proceedings 2005, no. 1 (May 1, 2005): 485–89. http://dx.doi.org/10.7901/2169-3358-2005-1-485.
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ABSTRACT At 1205, on December 30, 2003, the Foss Maritime tank barge 248-P2 spilled nearly 6,000 gallons of bunker fuel oil during a loading operation at the Chevron-Point Wells facility in Shoreline, Washington. Approximately 4,637 gallons was discharged into Puget Sound. Upon notification, the U.S. Coast Guard (USCG) Marine Safety Office (MSO) Puget Sound, Washington Department of Ecology (DOE), and Foss Maritime launched an aggressive response, mobilizing numerous spill response personnel and nearly every major piece of spill response equipment in the Northwest. In less than 24 hours of the spill, nearly all the oil had moved ashore impacting only two miles of shoreline. The most heavily impacted area belonged to the Suquamish Indian Tribe, which included a highly sensitive and culturally significant saltwater marsh. A representative for the Suquamish Tribe quickly joined the Unified Command. Operational success can be linked to the frequent training and exercising of the responding agencies, preplanned geographic response plans, and use of incident command system. Despite the successes, weather and tides proved to be the leading contributor to the four-month shoreline clean up operation. Lessons learned identify response strong points in addition to areas needing improvement.