EMS Counter-terror operations awareness

[SRS131EMTFF 471]

Do not let the title confuse you, I am inquiring about how to make EMS aware of the operations involved in counter-terrorism response.

Let me start by saying that we (my squad) are a small suburban EMS squad with ~40 members and 1 full time employee in Northern Vermont. We do not see much in the way of requiring counter-terrorism knowledge so our trainings tend to focus more on things regarding the 5 nursing homes in our district and the large bodies of water (read we do a lot of geriatric EMS and still-water and ice rescue training). Thus we have not had a specific training on HazMat, Counter-terror or MCIs in the three years I have been a member.

The events of yesterday are going to change that.

I was asked by my training officer to prepare a squad wide 2 hour training on HazMat, MCI and counter-terror. I am no expert on these topics by any means. However, after having been a member of the EMS community in Westchester from 2005 to 2010 and obtaining my federal HAZWOPER certification, I have more experience in these matters than anyone else in my squad (scary, I know). With that in mind I am trying to design a series of training activities that will be practical to field in EMS in Northern VT 99.99% of the time but can also be used during the remaining 0.01% when we might not be so lucky.

What I had in mind was taking some of the lessons and successes from Boston and using them as a sort of EMS field operations guide.

The first lesson from Boston that has implications on terror response but certainly has every day applications is the successful use of tourniquets. Dr. Mooney, the trauma director at Boston Children’s Hospital has been quoted in numerous publications as saying as the reason why there were not more fatalities was the immediate use of tourniquets either improvised or manufactured. I would like to incorporate the application of commercial tourniquets and cravats to the upper and lower extremities as well as the application of improvised tourniquets and what can be used as an improvised tourniquet.

I would also like to incorporate the initial/primary (30 second) MCI trauma assessment such that the people in my squad have practical hands on experience going to multiple wounded parties and performing rapid assessments and making decisions.

Finally I would like to incorporate the use of the ERG into the training to cover some HazMat. Obviously the ERG is for transportation however knowing how to use the ERG and apply its contents would be the first step in building us up for decon and hazmat operations trainings.

I honestly envision each of these as stand alone stations united by the common theme of building up to Counter-terrorism operations awareness using the bombings in Boston as a case study/practical lesson. Additionally, I chose these skills because they had immediate applications outside of just counter-terrorism. If anyone has any ideas on how to improve or unify these separate ideas I am all ears, I want to develop this training such that it can be used as the base of other more detailed and specific counter-terrorism and HazMat trainings.

[JM15 386]

I would also like to incorporate the initial/primary (30 second) MCI trauma assessment such that the people in my squad have practical hands on experience going to multiple wounded parties and performing rapid assessments and making decisions.

You seem to be making this very complicated (KISS). I would start by addressing a key deficiency that jumped out at me. One of the basic building blocks is the MCI response it is a very important skill that every EMT should have and can be honed pretty simply through training and exercises. While the chances of having a large scale terrorism related event in your small part of Vermont isn't likely to happen. Think about other MCI scenarios you might be called to that are more realistic, especially MVA's and large responses to your nursing homes for whatever reason. ERG training should already have been apart of your training as it is federally mandated that all responders be at least the Hazmat Operations level. When it comes to counter-terror that isn't my specialty but one thing that you might want to consider is an informational session for your members to help them identify suspicious packages, actions, people etc. and how they can report them. Having 40 "trained" eyes driving around your town on a daily basis noticing and reporting suspicious events could in general improve security.

[38ff 250]

Check into the Federal training that is at no cost thru DHS

[helicopper 1,050]

Thus we have not had a specific training on HazMat, Counter-terror or MCIs in the three years I have been a member.

I was asked by my training officer to prepare a squad wide 2 hour training on HazMat, MCI and counter-terror.

I would also like to incorporate the initial/primary (30 second) MCI trauma assessment such that the people in my squad have practical hands on experience going to multiple wounded parties and performing rapid assessments and making decisions.

Finally I would like to incorporate the use of the ERG into the training to cover some HazMat. .

I want to develop this training such that it can be used as the base of other more detailed and specific counter-terrorism and HazMat trainings.

A hearty two cents for you...

From what you described above, it seems as though you've got three key areas you want to focus on and you want to highlight the relationships they share. Good plan! Trying to accomplish that in a single two hour session is near impossible as you can't possibly cover everything you want to cover in sufficient detail to be meaningful in that timeframe.

My suggestion is to do three two hour blocks, one on each building on the skills, in successive sessions. You can space them as far apart as necessary to suit the needs of the agency but it is still going to be awareness level and only an introduction for your peeps.

• Haz-Mat Awareness
  • Use of ERG
• MCI Operations
  • Triage
• Counter-Terrorism Awareness

While the Boston bombing certainly captured headlines around the world, for your audience I think the West, TX explosion last night is more relevant as you've got far more farms and silos and fertilizer stored in northern Vermont than you have metro area marathons. Then you can use Boston to highlight the similarities between the response to a conventional incident (West explosion) and a terrorist incident (Marathon bombing). It will probably be easier to sell a local incident (silo explosion, tanker accident or feed store/hardware store fire) to your responders than a terrorist bombing.

Look at OSHA 1910.120 for specific requirements on Haz-Mat awareness level training and tailor your presentation to meet those objectives. There are tons of references on that out there to guide you in developing something so you don't have to start from scratch. In fact, check with the State EMS Office to see if they have a program already prepared that can be used to meet that training requirement.

I know how difficult it can be to get people into training or to get the buy-in for a lot of training on something that may never happen but training is the key to the success in Boston and many other incidents so I will always advocate more training. Good luck to you!