Optimizing first response in national crises focus of IAFC-DHS conference
All first responders must continually exchange information in best practices in the evolving discipline of homeland security responses if there is to be an improvement in the quality of services they render to the public they serve. This was among the major conclusions arrived at by participants in the Third Annual Conference on Strengthening the Public Safety Response to Terrorism and Other Hazards, held in June, according to Roger L. Kemp, Ph.D., career city manager, who attended the conference on behalf of the International City/County Management Association, Washington, DC. The event was sponsored by the International Association of Fire Chiefs (IAFC) and the U.S. Department of Homeland Security’s (DHS) Science and Technology Directorate. Attendees, by invitation only, included city and county managers, fire chiefs, health and human services directors, police chiefs and sheriffs, public works directors, and other emergency responders.
The agenda included presentations from representatives of all levels of government; academic institutions; and agencies responsible for developing, implementing, and overseeing polices for ensuring homeland security. Among the latter were the Department of Defense, the DHS, and the Federal Emergency Management Agency. Among the topics addressed were the nature of the threat of terrorism, the national perspective (including that of the President and Congress), the National Response Plan (NRP), the National Incident Management System (NIMS), the Incident Command System (ICS), and other issues critical to emergency first responders. Among them were state-of-the-art emergency management practices, on-site management and chain-of-command during emergency incidents, ensuring the availability of mutual aid, and improving communications among and between agencies involved in an emergency response.
Attendees, functioning in focus groups, made suggestions relevant to the topics, which were shared with all present. Federal observers within each focus group took notes on ways to improve intergovernmental relations and first responder management issues.
A major positive outcome of the group discussions was a multiperspective sharing of information that would provide a basis from which to formulate plans to update and continuously evaluate policies for enhancing crucial aspects of homeland security such as a complete communications interoperability system for all levels of government during an emergency.
Among other critical areas addressed were the following:
- Unified command. The public officials within the jurisdiction of the emergency must be in charge, regardless of whether high government agencies and mutual-aid organizations are participating. All involved should agree beforehand on who will be in charge and the appropriate chain of command to follow during an emergency.
- Mutual-aid agreements. The terms of these agreements should be stipulated in legal documents that have been approved by the governing bodies of all participating parties (cities, towns, counties, states, for example).
- Human/social services for victims. Expert first responders in the fields of human/social services and public health are needed to work with other first responders so victims can be given the immediate assistance they need. Such services are essential immediately after police and fire personnel respond and also make the area safer for other public service providers.
- Continuity of government operations. These plans should include providing immediate services to the families of first responders so the responders can stay on the job without worrying about their loved ones as well as backup government facilities and systems.
The role of the federal government, attendees agreed, is to establish security priorities, provide appropriate funding so the objectives can be achieved, and follow-up to ensure that these priorities are being implemented by first responders throughout the country, Kemp explained. Conferences like this one, he added, help first responders share information about how to achieve national priorities.
Thanks to Roger L. Kemp, Ph.D., for reporting on this conference.
IAFC announces finalists in 2006 Excellence in Safety Award competition
Following are the 2006 finalists in the International Association of Fire Chiefs (IAFC)/U.S. Safety Fire Technologies award competition. The Fire Service Award for Excellence recognizes innovation and achievement in managing resources to reduce the loss of life and property from fire and other hazards. The winner will be announced September 14, 2006 (after press time) at Fire-Rescue International in Dallas, Texas.
• Gresham (OR) Fire and Emergency Services: Its Compartment Fire Behavior Training (CFBT) program provided 50 hours of in-depth structural fire behavior training, including classroom instruction, case study, live-fire exercises, and simulations over a two-year period. It has been followed up with integration of live-fire training, structure-fire case studies, and tactical simulations on a quarterly basis.
• Fairfax County (VA) Fire and Rescue Department: It developed comprehensive manuals to deal with significant aspects of firefighting operations. The manuals have unified firefighting command operations and have been adopted throughout the Northern Virginia region.
• Firefighter Shane Ferguson, Winnipeg (Canada) Fire Paramedic Service: His Great Escape animated, interactive fire-safety game targets children ages 3 to 10 years old and teaches them how to make their way out of their home safely when the smoke alarm sounds.
• Colorado Springs (CO) Fire Department and Traffic Management Center: The project, used by Colorado Springs, to improve the delivery of public safety services, is a combination of GPS/AVL technology, traffic signal control and preemption, wireless communication, interactive GIS mapping, and single-touch access to emergency responder information about buildings and inspections.
• Tualatin Valley (OR) Fire & Rescue: Its Multi-Family Housing Fire Reduction Program offers education, materials, and motivation to landlords and property managers in the forms of quarterly landlord-training workshops and educational resources that include a comprehensive Web site, pictorial smoke-alarm posters, handouts for new tenants, and a monthly safety newsletter.
• Hebron (KY) Fire Protection District: Its Facility Liaison Program (FLP) was designed to foster relationships with target-hazard facilities within its rapidly growing district. It involves acquiring specific and detailed information from selected facilities, which is used to develop a multimedia presentation that is delivered to all district employees, and establishing a single point of contact for the facility to access the Fire District’s services.
• Westmont (IL) Fire Department: The Children’s Safety Day Camp, cosponsored by the Westmont Fire and Police Departments, provides an opportunity for eight-, nine-, and 10-year-olds to spend two days that cover safety topics like bike safety, fire safety, 9-1-1 procedures, water safety, personal safety, outdoor safety, and first aid in a fun and educational atmosphere.
Chief Ronny Coleman, IAFC President 1988-1989, and U.S. Safety Fire Technologies President H. Wayne Boyd created the Excellence in Safety award to recognize the fire service’s creative solutions to community problems.
Funding urged for vigilant monitoring of AED performance
Dr. N.A. Mark Estes, from Tufts University in Boston, is urging that manufacturers of automated external defibrillators (AEDs) and the federal government allocate the funds needed to successfully develop rigorous mechanisms for accurately monitoring AED performance.
Dr. Estes was responding in an editorial to a report by Dr. William H. Maisel and Dr. Jignesh S. Shal, of Harvard Medical School in Boston (JAMA 2006;296:655-660, 700-702). The investigators analyzed Food and Drug Administration (FDA) weekly reports from 1996 to 2005 and found that 52 advisories, affecting 385,922 AEDs, were issued during 2.78 million device-years of observation and that about 21 percent of AEDs released during the study period were recalled, generally because of an electrical or software issue.
The authors of the study noted that a reliable system should be developed to locate and repair potentially defective devices. However, they pointed out also that the AEDs have nevertheless saved many lives and improved the outcomes of out-of-hospital cardiac arrest. Yet, they stressed the need for data pertaining to their reliability. The researchers observed that the number of AED advisories rose each year during the study period and that fatal AED-related device malfunctions were recorded in 270 patients. http://www.medscape.com/viewarticle/542485_print, Aug 9, 2006
NFPA: U.S. fire deaths down in 2005
The National Fire Protection Association (NFPA) study “Fire Loss in the United States During 2005” estimates that one person died in a fire every 143 minutes in 2005 (3,675 people). The report notes that although the number of fires increased 3.3 percent from 2004, the overall number of fire deaths decreased by 5.8 percent in 2005.
Among other findings in the report are the following:
- Home fires accounted for 82 percent of the fatalities, 74 percent of civilian fire injuries, and 63 percent of directly reported property damage.
- Highway vehicles were responsible for an estimated 500 fire deaths (14 percent).
- Other buildings, vehicles, and locations accounted for 145 fire deaths (4 percent).
In 2005, public fire departments responded to an estimated 1.6 million fires, including 381,000 reported home structure fires, 130,000 other structure fires, 259,000 highway vehicle fires, 31,000 other vehicle fires, and 801,000 outdoor fires.
- An estimated half of all fires responded to were outdoors, principally involving brush or rubbish.
- There were an estimated 17,925 civilian injuries.
- Fires resulted in an estimated $10.6 billion in property damage.
Additional information is at www.nfpa.org/.
NFA online training courses have moved
The National Fire Academy (NFA) online training courses (“Q” courses) have moved to a new home on the Web. The NFA online training courses and the 75-5a application form for the “Q” courses can be accessed through the U.S. Fire Administration Web site at www.usfa.dhs.gov/training.
Dr. Denis Onieal, NFA superintendent, has reminded class participants that the deadline for filing the application to receive recognition for course completion was October 1. He explained that once the new system is in effect, students who have not submitted the 75-5a application form will have to retake the course to receive credit and an NFA certificate.
Questions can be directed to joyce.glass@dhs.gov or cathy.broughton@dhs.gov/.
NVFC supports legislation to clarify LOSAP tax status
Congressmen Peter King (NY) introduced legislation (H.R. 6027) in August that would clarify how length-of-service award programs (LOSAPs) for volunteer firefighters would be treated in the federal tax code. Nearly 20 percent of America’s volunteer firefighters participate in some type of LOSAP, according to the National Volunteer Fire Council (NVFC).
In 2002, the NVFC formed a LOSAP Committee to examine current law and propose ways to determine how LOSAPs should be taxed. The NVFC worked closely with Congressman King and other fire service groups to develop H.R. 6027.
“LOSAPs have no clear place in the current federal tax structure. This creates problems for states and communities that want to provide LOSAPs for their volunteers but face unnecessary complications in setting up programs,” NVFC Chairman Philip C. Stittleburg explains.
A problem Stittleburg cited was that many LOSAP accounts are unfunded even though they “show on paper how much money has accrued for a beneficiary.” He says the reason for this is that if payment were guaranteed to an individual, the payment would be considered taxable in the year it was made. This results in many LOSAP bookkeeping accounts that go unfunded until a beneficiary begins drawing from the account, Stittleburg adds. He notes that even funded plans are not portable and are vulnerable to creditors should the plan sponsor declare bankruptcy.
The objective is to have a LOSAP taxed when a beneficiary begins to draw from it, not each year a payment is made into the account.
“H.R. 6027 clarifies how LOSAPs should be taxed, providing volunteer emergency service organizations and state and local governments with a clear legal framework to administer their LOSAP internally,” Stittleburg notes. It also would increase the limit that can be contributed into an individual’s LOSAP account each year from $3,000 to $5,000 (the $3,000 limit was established in 1996) and creates a mechanism for adjusting the $5,000 limit based on inflation.
Stittleburg urges all NVFC members and supporters of the volunteer fire and emergency services to contact their representative and ask them to co-sponsor H.R. 6027.
OSHA offers publication on building and fire protection systems
The Occupational Safety and Health Administration (OSHA) is offering “Fire Service Features of Buildings and Fire Protection Systems,” aimed at increasing safety for building occupants and emergency responders.
According to OSHA, fire service operations take place in stressful and time-sensitive environments. Decisions are often made in unfamiliar settings and without vital information, such as what is burning, where the fire is spreading, and the location of occupants. Poorly located fire hydrants, inaccessible fire department connections, confusing zone information, unmarked valves, and improperly designed standpipes are examples of features that can slow fire service operations. Delays, however brief, can dramatically affect an operation’s outcome.
The booklet can be downloaded from the OSHA Web site on the publications page or can be obtained by calling (202) 693-1888.
CPSC proposes new warning label for portable generators
Some 64 people died last year from carbon monoxide (CO) poisoning associated with portable generators, the majority after hurricanes and major storms, according to the U.S. Consumer Product Safety Commission (CPSC). In the six-year period 2000 through 2005, the CPSC has been aware of at least 222 deaths related to CO poisoning associated with portable generators.
Consequently, the CPSC has issued a notice of proposed rulemaking (NPR) that would require manufacturers to place a new warning label on portable generators that state “a generator’s exhaust contains poisonous carbon monoxide and a generator should NEVER be used inside the home or in partially enclosed areas such as garages.”
Later this year, the CPSC staff will provide the Commission with information on other potential regulatory and nonregulatory options for reducing deaths and injuries caused by carbon monoxide poisoning from generators. The public has 75 days to comment on the NPR. Comments can be submitted to the CPSC’s Office of the Secretary at tstevenson@cpsc.gov/. The full release is at http://www.cpsc.gov/cpscpub/prerel/prhtml06/06239.html/.
NGA center recommends homeland security technology strategies
Technology-based information and communications tools are vital resources in disaster management, according to a new issue brief from the National Governors Association Center for Best Practices (NGA Center). The brief, State Strategies for Using IT for an All-Hazards Approach to Homeland Security, provides to governors recommendations for using information technology (IT) to strengthen homeland security strategies in their states.
The need for a coordinated approach to homeland security has never been greater. Increasing threats from terrorism, recent hurricanes, and pandemic flu have made it necessary for states to spend millions of dollars each year on disaster prevention, response, and communications to avoid major human and economic losses, the document notes.
According to the brief, IT has become a critical component of state homeland security infrastructure in recent decades. To help governors evaluate their homeland security IT deployment strategies, the NGA Center convened a group of IT industry experts to determine the top actions governors should take. The group recommended that governors consider four key strategies to prepare for and respond to disasters more effectively: improve communication to provide reliable and timely information to government agencies and the general public; monitor infrastructure, incidents, and response to ensure that incident information is adequate for decision making; use modeling and mapping tools for preparedness; and create identification and credentialing systems that will facilitate the credentialing of medical first responders and tracking of evacuees displaced by a disaster.
ACEP: One-third of emergency physicians may leave areas impacted by hurricanes
A new survey conducted by the American College of Emergency Physicians (ACEP) has found that the emergency care system in areas most affected by Hurricanes Katrina and Rita still had not recovered as of August and that progress has been slow. More than three-quarters of respondents (82 percent) said the system was not ready for another hurricane or mass-casualty event. Nearly 75 percent said long waiting times are harming their patients.
The emergency physicians who participated in the survey worked in the areas devastated by last year’s storms; many remained to care for their patients until they were evacuated.
The vast majority of emergency physicians (93 percent) said the number of beds is at least 25 percent below what is needed to care for patients; 30 percent put the gap at 50 percent. More than half (52 percent) said the need for medical specialists available for emergency care is greater than it was prior to the storms in “several” or “most” practice areas. Nearly all (96 percent) said their emergency departments were experiencing staffing shortages in areas such as nursing.
“We all knew when the storms hit that it would take a while for New Orleans to recover,” said Dr. James Moises of Tulane Medical Center and president of the Louisiana chapter of ACEP, “but despite some miraculous work at some individual hospitals and clinics, emergency medicine doesn’t look like it’s among the highest priorities in the rebuilding process. It’s frustrating for patients and doctors to see so little progress in one year.”
When asked what changes to the system might have saved more lives during the hurricanes, 54 percent said the most important change would be an increased ability to transport patients quickly out of the area to medical facilities. Twenty-five percent said that a quicker response from government and relief organizations would have been most important, and 15 percent said that increased surge capacity in nearby hospitals not devastated by the hurricane would be most important. More than one-third (36 percent) of emergency physicians said that if the post-hurricane recovery is not sufficiently improved in one more year, they would consider leaving to practice in another state.
ACEP has made the following recommendations:
- Authorities should take immediate and long-term steps to increase the number of staffed emergency department beds and acute care beds.
- There is a dire need to attract new primary care and specialist physicians to the region. The affected Gulf region has suffered the greatest relocation of physicians in U.S. history. It will be a difficult and long-term task to attract all the physicians that are needed. The first step should be to reestablish physician teaching facilities in the region. Government authorities should also consider creating economic incentives for physicians to locate in the region.
- Throughout the region affected by Katrina, there is an immediate need for more emergency and long-term care for psychiatric patients. Not only would this aid the patients, but it also would help to reduce crimes that might be committed by untreated patients and to reduce emergency department crowding.
- A disproportionate share hospital (DSH) of funding should be shared with the private sector caring for the uninsured.
- Electronic record keeping should be implemented for all medical records. During Hurricanes Katrina and Rita, patients were separated from their medical records. Electronic records would make it much easier for medical records to “follow” patients moved during emergencies. Also, many medical records kept only on paper were lost forever during the storms.
The full report is at http://www.acep.org/webportal/Newsroom/NewsMediaResources/StatisticsData/katrinareport.htm/.
Mobile hospital provides critical care to MS residents after Katrina
The Carolinas MED-1 mobile hospital, in its first deployment, treated 7,400 patients in Mississippi during a six-week period after Hurricane Katrina devastated the local hospital. The MED-1 prototype, according to “Use of an Innovative Design Mobile Hospital in the Medical Response to Hurricane Katrina,” published online in the Annals of Emergency Medicine, the peer-reviewed scientific journal for the American College of Emergency Physicians, could provide a model for rapid medical responses to future mass casualties.
Lead study author and MED-1 designer Dr. Thomas Blackwell of the Carolinas Medical Center in Charlotte, North Carolina, noted that Hurricane Katrina destroyed 80 percent of the dwellings and devastated the local hospital in Waveland and Bay St. Louis in Mississippi. Blackwell took MED-1 to a shopping center parking lot in Waveland on September 4. The crew started treating patients almost immediately. Blackwell evaluated the circumstances as “literally a do-or-die situation.”
For the first two weeks, five emergency physicians, three trauma surgeons, an orthopedist, two anesthesiologists, nurses, paramedics, pharmacists, and a radiation technician treated 250 to 300 patients a day. A slightly smaller staff treated patients for another month. The staff was responsible for acute, life-threatening conditions, surgical interventions, diagnostics, and extended observation care.
Designed as a fast and flexible resource to be adapted for use in a weapons of mass destruction event or pandemic, MED-1 performed so well after Katrina that Blackwell says it could be the model for a mobile medical response to any kind of disaster.
The unit incorporates an emergency department, a surgical suite, critical care beds, and a general treatment and admitting area. It consists of two 53-foot tractor-trailers, which expand to a workspace of 1,000 square feet and support an environmentally controlled awning structure that incorporates up to 130 beds. It carries its own generators, oxygen, X-ray and ultrasound capability, and diagnostic lab.
Dr. Frederick C. Blum, president of the American College of Emergency Physicians, likens emergency physicians like Dr. Blackwell and his team to heroes. “MED-1 is like the emergency physicians who designed and staffed it: flexible, durable, and ready to serve the patients who need them most,” he said.
Medtronic recalls intrathecal catheters and distal revision kits
The U.S. Food and Drug Administration (FDA) and Medtronic, Inc. sent a warning letter to healthcare professionals advising of a worldwide voluntary recall of nonimplanted intrathecal catheters (Model 8731) and associated distal revision kits (Model 8598). There is a risk that the platinum-iridium tip may be dislodged by the guidewire during implantation. This could result in infection or other potentially serious adverse consequences, noted an alert sent in July from MedWatch, the FDA’s safety information and adverse event reporting program.
In this country, the recall affects 45 lots of nonimplanted catheters and revision kits with a use-by date (UBD) of August 28, 2006, and one lot of nonimplanted revision kits with a UBD of October 28, 2006. Outside the United States, all devices with a UBD of August 28, 2006, or earlier are included in the recall. The letter said newer catheters and kits have been manufactured with a stronger bond to the tip and are not included in the recall.
Additional information may be obtained from the company’s Neurological Tech Services at (1-800) 707-0933. http://www.medscape.com/viewarticle/541465_print.
FDA to Cardiac Science Corp.: “Ensure quality of external heart defibrillators”
The U.S. Federal Food and Drug Administration (FDA), in a letter in July to Cardiac Science Corp., cited an inspection of the company’s Deerfield, Wisconsin, plant, that “uncovered several violations of safety procedures, including failure to maintain procedures for taking corrective actions when flaws are found [in automated external defibrillators (AEDs)].” The agency rated some of the corrective measures taken by the company to address concerns discovered during the inspection as “inadequate.” The FDA said it would not approve any applications for related lifesaving medical devices until the deficiencies were addressed. The company’s AEDs are used in schools and other public environments.
The full release is at http://www.medscape.com/viewarticle/542192_print.
Line-of-Duty Deaths
July 26. Junior Firefighter Alethea Faye Nixon, 17, Asbury Volunteer Fire Department, Albertville, AL: injuries sustained when the tanker truck in which she was riding en route to a fire went off a bridge.
July 28. Firefighter Rose Woodbridge, 56, Hanover Township (OH) Fire Department: injuries sustained in an accident while en route to the fire station in her personal vehicle to respond to a vehicle accident.
July 29. Firefighter Jeffrey D. Irwin, 43, Eldorado (IL) Fire Department: heart attack; previously treated for heat exhaustion at a working residential fire.
July 30. Firefighter Paul R. Brady, 42, Malverne (NY) Fire Department: injuries sustained while training; he was caught between a fire apparatus and a ceiling beam of the firehouse.
August 2. Firefighter Larry Wayne Fanning, 57, Garner (NC) Fire Department: heart attack.
August 2. Assistant Chief Lee Walters, 54, Sheldon (SC) Fire District: collapsed while supervising operations at a working residential fire; cause of death pending.
August 4. Pilot Terry Wayne Jacobs, 48, U.S. Forest Service, Yreka, CA: helicopter crash after battling wildfires at the Titus Fire portion of the Happy Camp Complex.
August 4. Co-pilot Andrei Pantchenko, 38, U.S. Forest Service, Yreka, CA: helicopter crash after battling wildfires at the Titus Fire portion of the Happy Camp Complex.
August 8. Firefighter Ollie Phil Tate, 56, Thaxton (MS) Volunteer Fire Department: heart attack while responding to a confirmed structure fire; fell from the bed of the pickup truck in which he was riding.
August 8. Firefighter Richard Washington Jr., 49, Clark County Fire Department, Las Vegas, NV: apparent heart attack.
August 11. Firefighter Dana MacCrimmon, 45, City of Carbondale (IL) Fire Department: from a cause still to be released to the public.
August 12. Firefighter Denny Hayes, 59, McClure (PA) Volunteer Fire Company: cardiac arrest on the scene of a structure fire.
August 13. Lieutenant Paul R. Montavon Sr., 59, Whitewater Township Fire Department, Hooven, OH: respiratory and cardiac arrest.
August 13. Engineer Arnie Wolff, 55, Green Bay (WI) Fire Department: floor collapse while advancing a hoseline at a structure fire.
August 13. Pilot Quin R. Stone, 42; Firefighter Monica Lee Zajanc, 27; Firefighter/Assistant Helitack Manager Michael Gene Lewis, 37; Firefighter/Lookout Lillian M. Patten, 32, U.S. Forest Service, Payette National Forest, McCall, ID: helicopter crash while en route to a guard station.
August 17. Division Supervisor Spencer Stanley Koyle, 33, Bureau of Land Management, Fillmore (UT) Field Office: in “Devil’s Den” wildfire in Fishlake National Forest; details pending investigation.
Source: USFA Firefighters Memorial Database
