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Mission Failure: Emergency Medical Services Response to Chemical, Biological, Radiological, Nuclear, and Explosive Events

Published online by Cambridge University Press:  28 June 2012

Scot Phelps*
Affiliation:
Metropolitan College of New York, New York City, New York, USA
*
Scot Phelps Associate Professor of Public Administration/Emergency ManagementEmergency and Disaster Management ProgramGraduate School of Public Affairs and AdministrationMetropolitan College of New York75 Varick Street, New York City, NY 10013USA E-mail: [email protected]

Abstract

Introduction:

Only 4% of the United States Homeland Security funding for public safety terrorism preparedness is allotted to emergency medical services (EMS), despite the primary threat from a mass-terrorism chemical weapons attack (MTCWA) being personal injury. This study examines the preparedness of the EMS torespond to, treat, and transport victims of such attacks.

Hypothesis:

It was hypothesized that US EMS agencies lack the necessary equipment to mitigate large-scalemorbidity and mortality from a MTCWA.

Methods:

Seventy after-action reports from full-scale, chemical weapons exercises conducted in large cities across the US were examined by the Office of Domestic Preparedness, Chemical Weapons Improved Response Program to ascertain if EMS responders had personal protective equipment sufficient to operate at the scene of aMTCWA.

Results:

Of the 50 after action reports that mentioned EMS personal protective equipment, only six (12%) EMS agencies equipped their staff with personal protective equipment.

Conclusions:

Results indicate that EMS responders are not prepared to safely respond to MTCWAs, which mayresult in a significant loss of life of victims and responders.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2007

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References

1.US Department of Labor, Bureau of Labor Statistics: Occupational outlook handbook, emergency medical technicians and paramedics. Available at: http://www.bls.gov/oco/ocos101.htm. Accessed 07 July 2006. Data from other sources indicate that this may be a gross underestimate. Available at http://info.jems.com/jems/2004resources/guide1.html. Accessed 04 October 2006.Google Scholar
2.Emergency Medical Services Magazine: State and province survey. Available at http://www.emsresponder.com/survey. Accessed 25 July 2007.Google Scholar
3.Stilp, R, Bevelacqua, A: Emergency Medical Response to Hazardous Material Incidents. New York: Delmar Publishers, 1997, pp 18–19.Google Scholar
4.Responder Disciplines: Emergency Medical Services. Department of Homeland Security, Center for Domestic Preparedness. Available at http://cdp.dhs.gov/responders_ems.html. Accessed 06 July 2006.Google Scholar
5.US Department of Justice, Office of Domestic Preparedness: Emergency responder guidelines. Available at http://www.ojp.usdoj.gov/odp/docs/EmergencyRespGuidelinesRevB.pdf. Accessed 07 July 2006.Google Scholar
6.US Department of Labor, Occupational Safety and Health Administration (OSHA): OSHA General description and discussion of the levels of protection and protective gear.–1910.120 App B. Available at http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9767. Accessed 07 July 2006.Google Scholar
7. Army Soldier Biological Chemical Command's Guidelines for Mass Casualty Decontamination During a Terrorism Chemical Agent Incident. Available at http://transit-safety.volpe.dot.gov/security/SecurityInitiatives/Top20/1%20--%20Management%20and%20Accountability/3A%20--%20Integrated%20System/Additional/SBCCOM_Guidelines_for_Mass_Casualty_Decon.pdf. Accessed 07 July 2006.Google Scholar
8.New York State Department of Health: Chemical Terrorism Response Card. Available at http://www.health.state.ny.us/nysdoh/bt/chemical_terrorism/docs/chemical.pdf. Accessed 07 July 2007.Google Scholar
9.De Lorenzo, R: Cyanide: The deadly terror weapon that every emergency medical services provider must know about. Available at http://www.jems.com/terrorismwmdresponse/articles/13127/. Accessed 07 July 2006.Google Scholar
10.Agency for Healthcare Quality and Research: Emergency medical services, development of models for emergency preparedness: Personal protective equipment, decontamination, isolation/quarantine, andlaboratory capacity. Available at http://www.ahrq.gov/research/devmodels/devmodel2.htm. Accessed 06 July 2006.Google Scholar
11.Phelps, S: There is no cold zone: The hazardous materials zone model and mass terrorism chemical weapon events. Journal of Emergency Management 2006;5256.CrossRefGoogle Scholar
13.OSHA: OSHA best practices for hospital-based first receivers of victims from mass casualtyincidents involving the release of hazardous substances. Available at http://www.osha.gov/dts/osta/bestpractices/html/hospital_firstreceivers.html#appa2132.Accessed 07 July 2006.Google Scholar
14.US Department of Homeland Security: Lessons learned information shared Website. Available at https://www.llis.dhs.gov. Accessed 07 July 2006.Google Scholar
15.Office of Domestic Preparedness: Domestic Preparedness Exercise Series Report #10, page 14, Unnamed city. Reports are available from the secure lessons learned information shared web site. Available at https://www.llis.dhs.gov. Accessed 07 July 2006.Google Scholar
16.Neufield, J: Bush to city: Drop dead. The Nation. Available at http://www.thenation.com/doc/20040419/newfield. Accessed 07 July 2006.Google Scholar
17. FDNY 2004 Strategic Plan, Enhanced Health & Safety of FDNY Members, Available at http://www.nyc.gov/html/fdny/pdf/pr/2004/strategic_plan/goal_2.pdf. Accessed 07 July 2006.Google Scholar
18.Smithson, A: Ataxia: The chemical and biological terrorism threat and the US response. Available at: http://www.stimson.org/cbw/pubs.cfm?id=12. Accessed 07 July 2006.Google Scholar
19.Gilmore Commission: Advisory Panel to Assess Domestic Response Capabilities for Terrorism Involving Weapons of Mass Destruction. Available at http://www.rand.org/nsrd/terrpanel/. Accessed 07 July 2006.Google Scholar
20.New York University Center for Catastrophe Preparedness and Response: Emergency medical services: The forgotten first responders. Available at http://www.nyu.edu/ccpr/NYUEMSreport.pdf. Accessed 07 July 2006Google Scholar
21.Kocieniewski, D: Facing the city, potential targets rely on a patchwork of security. Available at http://www.nytimes.com/2005/05/09/nyregion/09homeland.html?ex=1273291200&en=b3a933ec6ddf6c89&ei=5089. Accessed 06 July 2006.Google Scholar
22.New Jersey Department of Health and Senior Services, Office of Emergency Medical Services:Guidelines for the use of nerve agent antidote kits MARK-1 Kits by emergency medical services providers. Available at http://www.state.nj.us/health/ems/documents/convention/h_mark1policy.pdf. Accessed 06 July 2006.Google Scholar
23.The Food Allergy and Anaphylaxis Network: Survey of emergency medical services (use of Epi-pen). Available at: http://www.foodallergy.org/ems.html. Accessed 06 July 2006.Google Scholar
24.Meridian Medical Technologies: Mark ITM, Nerve Agent Antidote Kit (NAAK). Available at: http://www.meridianmeds.com/homeland.html. Accessed 06 July 2006.Google Scholar
26.Pediatric Expert Advisory Panel Addressing Terrorism, Disaster, and Public Health Emergency: Atropineuse in children after nerve agent exposure. Available at http://www.ncdp.mailman.columbia.edu/files/AtropineAutoInjectorV1N1.pdf. Accessed 06 July 2006.Google Scholar