Emergency Response to Terrorism TC: Emergency Medical Services

1. Emergency Response to TerrorismTC: Emergency Medical Services Unit 1: Introduction

2. Terminal Objective • Given a terrorist event, the student will be able to recognize the event and determine possible response strategies.

3. Enabling Objectives • Distinguish between strategies & tactics. • Identify strategic goals regarding terrorism response. • Define terrorism & several categories of terrorist targets. • List several cues for recognizing a terrorist event. • Identify potential field medical resource needs.

4. The TC:EMS Course • Instructor introduction & welcome • Course goal • Increase survivability • Increase EMS operational effectiveness • Administrative issues • Student Manual overview • Course background

5. Course Overview • Unit 1 - Introduction • Unit 2 - Safety • Unit 3 - Security • Unit 4 - Patient Care • Unit 5 - Conclusion

6. Student Introductions • Who are you? • Where are you from? • Anything in particular you hope to obtain through your attendance

7. Strategies versus Tactics • Strategies • Broad objectives, e.g., extrication • Tactics • Actual procedures employed, e.g., • Gain access • Package patient • Disentangle • Develop means for removal • Move patient to triage

8. Activity 1.1 Strategic Considerations at a Terrorist Event: Masland Island Scenario

9. Terrorism Involves • Mass casualties • Hazardous materials • Technical rescue • Warfare • Criminal investigation

10. Terrorism Involves (cont.) • Numerous strategic goals systems exist to manage these events daily • Mass casualty • HazMat • Structural collapse

11. Sizeup Response and Arrival Security Protective Measures Establish Command Isolate Notification Evidence Preservation Product Identification Rescue Medical Care Control (spill, leak, fire) Recovery and termination Terrorism Strategic Goals

12. Emerging Response Doctrine • Emerging strategies and tactics • Sources • U.S. military • Lessons learned in U.S. and outside • Application of existing response technology • Dynamic and rapidly changing

13. Terrorism Defined • An act • Illegal (in U.S. or its subdivisions), or • Dangerous to human life, with • Intent to intimidate or coerce • Government, or • Civilian population, that • Furthers a political or social agenda

14. Key Concepts of Terrorism • Violence need only be threatened • Agent of change: fear • Victims not necessarily the target • Intended audience: observers • Desired outcome: change in political or social structure

15. Issues of Terrorism • Types of terrorists • Domestic versus international • Left versus right • Special interests • Terrorist ideology • Extremist viewpoint • Intolerance of difference • Vilification

16. “The end justifies the means”

17. Terrorist Targets • Selection based on ability to: • Instill fear • Achieve high profile exposure • Demonstrate the cause • Create public distrust or frustration with government

18. Target Candidates • Targets can be: • People (including responders) • Places • Infrastructure • May be based upon • Criticality • Vulnerability

19. Recognizing Terrorist Events • Recognition is the most important factor in an effective response • Late recognition places responders in jeopardy • Must use “clues” or “mental triggers”

20. Pre-Event Recognition • Awareness of: • Political & social situations • Potential targets • Intelligence-gathering activities (others watching us) • Integrated Threat Analysis Group (ITAG) development

21. Advisories • ITAG issues advisories based on current threat • Tactical awareness • Tactical warning • Tactical alert

22. Event Phase Recognition • Occupancy or location • Types of events • Conditions en route and on scene • Weather conditions • Channeling, choke points • Tactical disadvantages • Timing • On-site observations

23. Local Resources • Local community resources • EMS mutual aid agreements • EMS regional response plans & response teams • Fire service response (HazMat engine companies) • Other local agencies • Local Emergency Operations Plan

24. State Resources • State emergency operations plan activated by local declaration of emergency • Governor activates plan • Enables state resources to be used • May be developed under same organization as FRP • When state resources exceeded, the FRP is activated

25. Federal Resources • FRP implements Stafford Act • Can be fully or partially activated • 2 forms of Presidential activation • Disaster declaration • Declaration of major emergency

26. Resources Available from Feds • FRP makes an exception by allowing Fed involvement • Via FRP, Fed resources can be available to meet the need • Fed response is organized under ESFs • Each function has a lead federal agency

27. Unique Medical Resources • ESF mobilized by PHS/OEP under NDMS • DMATs (Disaster Medical Asst. Teams) • Burn DMATs • Crush DMATs • Other DMATs

28. Unique Medical Resources (cont.) • MMRS • Rescue & decon of mass casualties • NMRTs are based in Denver, Winston-Salem, Los Angeles • Rescue & decon of mass casualties created by terrorism

29. Summary • Definition of terrorism • Terrorist targets • Recognizing terrorism • Strategies versus tactics • Potential resource needs