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Emergency Response to Terrorism: Tactical Considerations: Emergency Medical Services

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Emergency Response to Terrorism: Tactical Considerations: Emergency Medical Services FEMA/USFA/NFA-ERT:TC-EMS-SM STUDENT MANUAL March 2000 Emergency Response to Terrorism: Tactical Considerations: Emergency Medical Services FEDERAL EMERGENCY MANAGEMENT AGENCY UNITED STATES FIRE ADMINISTRATION NATIONAL FIRE ACADEMY EMERGENCY RESPONSE TO TERRORISM: TACTICAL CONSIDERATIONS: EMERGENCY MEDICAL SERVICES ii EMERGENCY RESPONSE TO TERRORISM: TACTICAL CONSIDERATIONS: EMERGENCY MEDICAL SERVICES Federal Emergency Management Agency United States Fire Administration National Fire Academy FOREWORD The Federal Emergency Management Agency (FEMA) was established in 1979. FEMA's mission is to focus Federal effort on preparedness for, mitigation of, response to, and recovery from emergencies encompassing the full range of natural and manmade disasters. FEMA's National Emergency Training Center (NETC) in Emmitsburg, Maryland, includes the United States Fire Administration (USFA), its National Fire Academy (NFA), and the Emergency Management Institute (EMI). To achieve the USFA's legislated mandate (under Public Law 93-498, October 29, 1974), "to advance the professional development of fire service personnel and of other persons engaged in fire prevention and control activities," the U.S. Fire Administration has developed an effective program linkage with established fire training systems which exist at the State and local levels. It is the responsibility of the USFA to support and strengthen these delivery systems. The field courses of the USFA's National Fire Academy have been sponsored by the respective State fire training systems in every State. In recent years the growing threat of terrorism has given greater visibility to the need for up-to-date training on tactical considerations when dealing with a possible terrorist situation. The major focus for the American fire service is to learn how to prepare for, identify, and respond to terrorist incidents, such as the Tokyo Sarin attack and the bombings at the World Trade Center and Oklahoma City. To this end, several training initiatives are underway at the National Fire Academy. This course shall focus on the emergency response to terrorism tactical considerations and options, especially dealing with issues of the emergency medical service responders. The USFA's National Fire Academy is proud to join with State and local fire agencies in providing educational opportunities to the members of the Nation's emergency services. iii EMERGENCY RESPONSE TO TERRORISM: TACTICAL CONSIDERATIONS: EMERGENCY MEDICAL SERVICES iv EMERGENCY RESPONSE TO TERRORISM: TACTICAL CONSIDERATIONS: EMERGENCY MEDICAL SERVICES TABLE OF CONTENTS Copyright Warning ii Foreword iii Table of Contents v Overview vii Course Goal vii Scope of the Course viii Target Audience viii Course Methodology ix Presentations ix Course Schedule xi Unit 1 Introduction SM 1-1 Unit 2 Safety SM 2-1 Unit 3 Security SM 3-1 Unit 4 Patient Care SM 4-1 Unit 5 Conclusion SM 5-1 APPENDICES Appendix A Bibliography A-1 Appendix B Glossary B-1 Appendix C Supplemental Information on Self-Protection C-1 Appendix D Blue Water County Model D-1 Appendix E State of the Art Terrorism E-1 Appendix F Improvised Explosive Devices F-1 Appendix G Turnout Gear Study G-1 Appendix H EMS Course Slides H-1 v EMERGENCY RESPONSE TO TERRORISM: TACTICAL CONSIDERATIONS: EMERGENCY MEDICAL SERVICES vi EMERGENCY RESPONSE TO TERRORISM: TACTICAL CONSIDERATIONS: EMERGENCY MEDICAL SERVICES OVERVIEW COURSE GOAL The goals of the course are to: 1. Increase an emergency responder's chance of surviving a terrorist incident that: a. Is in violation of the criminal laws of the United States to intimidate or coerce a government or the civilian population in furtherance of political or social objectives. b. Consumes a significant portion, if not the majority, of the readily available law enforcement, fire, and EMS resources. c. Entails multi-agency, multi-disciplinary, multi-jurisdictional response to confront the problem. d. Places an EMS first responder in a position of making important decisions in sizing up hazards and risks. 2. Increase an EMS first responder's ability to anticipate potential terrorist incident targets. 3. Increase a department's ability to respond effectively to a terrorist incident through coordinated planning, training, and exercising. 4. Increase an EMS first responder's skills level to work in a team setting to address terrorist incidents. The numerous activities included in the course account for less than one half of the class time. vii EMERGENCY RESPONSE TO TERRORISM: TACTICAL CONSIDERATIONS: EMERGENCY MEDICAL SERVICES SCOPE OF THE You will be trained in security considerations, COURSE identifying signs of terrorism, anticipating unusual response circumstances, assessing information and taking corrective actions, and determining strategies for survival. You will also learn to apply your knowledge about response to B-NICE events, providing patient care, identifying and preserving evidence, managing site safety, documenting the event and debriefing personnel. It is recommended that you take the ERT:TC Company Officer course as well. TARGET AUDIENCE This course was designed for the first on-the-scene responding EMS personnel with the responsibility to render patient care to victims of terrorist incidents. Secondarily, this two-day course was designed to cover the needs of response personnel, who would be career and volunteer fire fighters, EMS industrial contractors, allied health personnel or members of the military or other government agencies. It assumes exposure to FEMA's Basic Concepts course (ERT:BC) or self-study course (ERT:SS). viii EMERGENCY RESPONSE TO TERRORISM: TACTICAL CONSIDERATIONS: EMERGENCY MEDICAL SERVICES COURSE METHODOLOGY PRESENTATIONS Presentations are interactive lectures that, in some cases, include skill-based activities. Word slides have been used only for main points, and, where possible, are accompanied with illustrative photos and graphics. Students should read the Student Manual materials and limited Supplemental Readings the night before the lecture. ix EMERGENCY RESPONSE TO TERRORISM: TACTICAL CONSIDERATIONS: EMERGENCY MEDICAL SERVICES x EMERGENCY RESPONSE TO TERRORISM: TACTICAL CONSIDERATIONS: EMERGENCY MEDICAL SERVICES COURSE SCHEDULE UNIT TITLE Unit 1 Introduction Unit 2 Safety Unit 3 Security Unit 4 Patient Care Unit 5 Conclusion xi Emergency Response to Terrorism: Tactical Considerations: Emergency Medical Services Student Manual Unit 1: Introduction Terminal Objective • Given a terrorist event, the student will be able to recognize the event and determine possible response stages. Enabling Objectives The student will be able to: • Distinguish between strategies and tactics. • Identify strategic goals regarding terrorism response. • Define terrorism and several categories of terrorist targets. • List several cues for recognizing a terrorist event. • Identify potential field medical resource needs. EMERGENCY RESPONSE TO TERRORISM: TACTICAL CONSIDERATIONS: EMERGENCY MEDICAL SERVICES SM 1-2 UNIT 1: INTRODUCTION WELCOME TO EMS TACTICAL CONSIDERATIONS Welcome to the National Fire Academy's Emergency Response to Terrorism: Tactical Considerations for Emergency Medical Services. This program is one of three tactical-level training programs developed by the Academy for the training of the nation's first responders to potential terrorist events. This program, in combination with the components "Tactical Considerations: Company Officer" and "Tactical Considerations: Hazardous Materials," presents the response considerations for three of the major public safety disciplines involved in responding to terrorism. This program is intended to be taken separately from the other two components and will present the information necessary for you to effectively carry out your functions. However, both the Company Officer and Hazardous Materials programs have specific information that may be valuable to you during a response. Program Goals and Objectives The primary goal of this program is to provide the EMS responder with the tactical and field medical considerations necessary for a safe and effective response to terrorist events. To achieve that goal it will be necessary for you to: • recognize potential targets and events, as well as the associated impact of the event and resource needs/requirements; • develop a safety plan for EMS operations; • understand the very important implications of incident security upon your personal safety and survival; • understand the components of a patient care plan; and • understand the importance of planning for the event. Course Background The first needs assessment for this course was conducted at a meeting hosted by the National Fire Academy in October 1996. Attendees represented a broad spectrum of the community including Federal agencies, State and local firefighting and/or emergency response organizations, US military organizations and professional trade groups. The group sought and received input from experienced emergency professionals in Israel, Northern Ireland and Tokyo. SM 1-3 EMERGENCY RESPONSE TO TERRORISM: TACTICAL CONSIDERATIONS: EMERGENCY MEDICAL SERVICES A development team composed of a variety of fire and emergency professionals from across the country met in 1998 to create this particular course using guidance from the original needs assessment. They convened a law enforcement round table with Federal, State and local law enforcement officers to complement their knowledge of fire and HazMat response. Members of the team also spoke with representatives from a number of agencies
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