The Police Response to Active Shooter Incidents

There have been many active shooter incidents in the United States since Columbine, and police agencies continue to modify their policies and training to reflect the lessons that are learned from each new tragedy. This report summarizes the state of the field as of 2014. The Police Executive Research Forum conducted research on these issues and held a one-day Summit in Washington, D.C., in which an overflow crowd of more than 225 police chiefs and other officials discussed the changes that have occurred, and where they are going from here

Burn mass casualty incidents in Europe: A European response plan within the European Union Civil Protection Mechanism

Background: Burn care is centralized in highly specialized burn centers in Europe. These centers are of limited capacity and may be overwhelmed by a sudden surge in case of a burn mass casualty incident. Prior incidents in Europe and abroad have sustained high standards of care through well-orchestrated responses to share the burden of care in several burn centers. A burn mass casualty incident in Romania in 2015 sparked an initiative to strengthen the existing EU mechanisms. This paper aims to provide insight into developing a response plan for burn mass casualties within the EU Civil Protection Mechanism. Methods: The European Burns Association drafted medical guidelines for burn mass casualty incidents based on a literature review and an in-depth analysis of the Romanian incident. An online questionnaire surveyed European burn centers and EU States for burn mass casualty preparedness. Results: The Romanian burn mass casualty in 2015 highlighted the lack of a burn-specific mechanism, leading to the late onset of international transfers. In Europe, 71% of respondents had existing mass casualty response plans, though only 35% reported having a burn-specific plan. A burns response plan for burn mass casualties was developed and adopted as a Commission staff working document in preparation for further implementation. The plan builds on the existing Union Civil Protection Mechanism framework and the standards of the WHO Emergency Medical Teams initiative to provide 1) burn assessment teams for specialized in-hospital triage of patients, 2) specialized burn care across European burn centers, and 3) medevac capacities from participating states. Conclusion: The European burn mass casualty response plan could enable the delivery of high-level burn care in the face of an overwhelming incident in an affected European country. Further steps for integration and implementation of the plan within the Union Civil Protection Mechanism framework are needed.publishedVersio

Implementation of an E-Learning Module To Increase RN Knowledge and Skills of Emergency Preparedness

Background By failing to prepare, you are preparing to fail. —Benjamin Franklin, writer, philosopher, politician. Having education initiatives for mass casualty incidents and disaster preparedness that are concise and organized is of high importance. This issue is pertinent to the midwestern medical center where this project took place because in the event of a true mass casualty or disaster scenario, many lives could be saved if registered nurses (RNs) in the emergency department (ED) were better prepared. For a hospital to provide adequate and effective care during a crisis, healthcare workers must be effectively trained to do so. However, many studies have found that hospitals across the nation are lacking in this education for hospital staff (Goniewicz et al., 2021a). While guidelines are currently in place within the midwestern medical center for drills, there is no current e- Learning module available to staff which address mass casualty incidents, Sort, Access, Lifesaving Intervention, and Treat or Transport (SALT) triage, and disaster preparedness with information specific to the midwestern medical center’s county. It was the Doctor of Nursing Practice (DNP) student’s goal to create an online educational module for Registered Nurses in the emergency department of the midwestern medical center where this project took place to bridge this gap. Purpose The United States National Preparedness Goal is to achieve a secure and resilient nation with the capabilities required across the whole community to prevent, protect against, mitigate, respond to, and recover from the threats and hazards that pose the greatest risk (Federal Emergency Management Agency [FEMA], 2020a). This project aimed to achieve this at the midwestern medical center where this project took place. The purpose of this project was to bridge knowledge gaps and improve perceived knowledge and perceived skills regarding mass casualty incidents and disaster preparedness in Berrien County through the creation and implementation of an e- Learning module. The hypothesis of this project was that this intervention would improve ED RN knowledge and perceived knowledge and perceived skills regarding mass casualty incidents and disaster preparedness Methods After obtaining IRB approvals from Andrews University and the medical institution of interest, 53 registered nurse participants from three emergency departments at a midwestern medical center were surveyed. Consent was obtained prior to completion of the demographic questionnaire, pre- and post-survey, pre- and post-test, and the e- Learning module. Participants were given a 25 question pre-survey to assess their current perceived knowledge and perceived skills regarding disaster preparedness. They also completed 25 multiple choice questions (MCQ\u27s) to assess their base knowledge of mass casualty incidents, SALT triage, and information on mass casualty and disaster preparedness specific to the county of interest. Immediately after the pre-survey and pretest, participants were presented with the e-Learning module to complete at their own pace. Approximately seven days later, participants were asked to re-take the same test and survey to assess for changes in perceived knowledge, perceived skills, and true knowledge of mass casualty incidents and disaster preparedness

Wearable proximity sensors for monitoring a mass casualty incident exercise: a feasibility study

Over the past several decades, naturally occurring and man-made mass casualty incidents (MCI) have increased in frequency and number, worldwide. To test the impact of such event on medical resources, simulations can provide a safe, controlled setting while replicating the chaotic environment typical of an actual disaster. A standardised method to collect and analyse data from mass casualty exercises is needed, in order to assess preparedness and performance of the healthcare staff involved. We report on the use of wearable proximity sensors to measure proximity events during a MCI simulation. We investigated the interactions between medical staff and patients, to evaluate the time dedicated by the medical staff with respect to the severity of the injury of the victims depending on the roles. We estimated the presence of the patients in the different spaces of the field hospital, in order to study the patients' flow. Data were obtained and collected through the deployment of wearable proximity sensors during a mass casualty incident functional exercise. The scenario included two areas: the accident site and the Advanced Medical Post (AMP), and the exercise lasted 3 hours. A total of 238 participants simulating medical staff and victims were involved. Each participant wore a proximity sensor and 30 fixed devices were placed in the field hospital. The contact networks show a heterogeneous distribution of the cumulative time spent in proximity by participants. We obtained contact matrices based on cumulative time spent in proximity between victims and the rescuers. Our results showed that the time spent in proximity by the healthcare teams with the victims is related to the severity of the patient's injury. The analysis of patients' flow showed that the presence of patients in the rooms of the hospital is consistent with triage code and diagnosis, and no obvious bottlenecks were found

Burn mass casualty incidents in Europe: A European response plan within the European Union Civil Protection Mechanism

Burns; Disaster planning; European UnionQuemaduras; Planificación de desastres; Unión EuropeaCremades; Planificació de desastres; Unió EuropeaBackground Burn care is centralized in highly specialized burn centers in Europe. These centers are of limited capacity and may be overwhelmed by a sudden surge in case of a burn mass casualty incident. Prior incidents in Europe and abroad have sustained high standards of care through well-orchestrated responses to share the burden of care in several burn centers. A burn mass casualty incident in Romania in 2015 sparked an initiative to strengthen the existing EU mechanisms. This paper aims to provide insight into developing a response plan for burn mass casualties within the EU Civil Protection Mechanism. Methods The European Burns Association drafted medical guidelines for burn mass casualty incidents based on a literature review and an in-depth analysis of the Romanian incident. An online questionnaire surveyed European burn centers and EU States for burn mass casualty preparedness. Results The Romanian burn mass casualty in 2015 highlighted the lack of a burn-specific mechanism, leading to the late onset of international transfers. In Europe, 71% of respondents had existing mass casualty response plans, though only 35% reported having a burn-specific plan. A burns response plan for burn mass casualties was developed and adopted as a Commission staff working document in preparation for further implementation. The plan builds on the existing Union Civil Protection Mechanism framework and the standards of the WHO Emergency Medical Teams initiative to provide 1) burn assessment teams for specialized in-hospital triage of patients, 2) specialized burn care across European burn centers, and 3) medevac capacities from participating states. Conclusion The European burn mass casualty response plan could enable the delivery of high-level burn care in the face of an overwhelming incident in an affected European country. Further steps for integration and implementation of the plan within the Union Civil Protection Mechanism framework are needed.This work was supported by funding from the European Commission, Directorate-General for European Civil Protection and Humanitarian Aid Operations (ECHO), Directorate B - Disaster Preparedness and Prevention, Unit B1 - Civil Protection Horizontal Issues by tender contract ECHO-B1-NP-2019-05 regarding a European response to mass burn casualty disasters

Logistical Resource Capability During a Mass Casualty Event in Washington State

The need for increasing efficiencies for medical resource delivery during a mass casualty incident/event is a paramount logistical planning factor that could mean life or death to the citizens affected by a disaster. As such, Washington State has prioritized emergency management and preparedness. Using the just-in-time system by way of Baghbanian\u27 s complex adaptive decision-making theory as the foundation, gave purpose to this qualitative study. This was accomplished by analysis of emergency management professional responses, and to what degree, improvements can be made to the medical resource delivery system during a mass casualty incident/event. Data were collected through semi structured interviews with a random sample of 12 experienced emergency professionals from the State of Washington. This study was guided by primary research questions that focused on emergency managers and their understanding and adaptability toward preparedness. Interview data were deductively coded and analyzed through a thematic analysis procedure. The key theme of this study is that participants perceived slight differences in logistical and operational approaches that vector into transportation and operational understanding as the main factors influencing medical resource delivery. The positive social change association of this study is that it provides emergency managers, first responders, and medical staff with recommendations for analysis and planning development for medical resource delivery, thereby mitigating the life and death implications for citizens in future disasters

Roundtable on Hospital Communications in a Mass Casualty Radiological Event : participants\u2019 comments, ideas, and recommendations : a summary report

On January 14-16, 2003, the Centers for Disease Control and Prevention (CDC) held a communications roundtable in Atlanta, Georgia, to explore hospitals\u2019 challenges in communicating with internal and external audiences in communitywide emergencies involving radioactive materials. The roundtable, Hospital Communications in a Mass Casualty Radiological Incident, is part of CDC\u2019s effort to help prepare the nation\u2019s public health community for threats of terrorism.CDC\u2019s Radiation Studies Branch (Division of Environmental Hazards and Health Effects, National Center for Environmental Health) organized the roundtable discussion. Participants included professionals from hospitals (administrators, clinicians, community planners, communications personnel, and mental health personnel); state and local emergency management agencies; professional associations; and federal, state, and local public health agencies, as well as experts in risk communications.rt-hospital-communications.pd

Self-care decontamination within a chemical exposure mass-casualty incident

Growing awareness and concern for the increasing frequency of incidents involving hazardous materials (HazMat) across a broad spectrum of contaminants from chemical, biological, radiological, and nuclear (CBRN) sources indicates a clear need to refine the capability to respond successfully to mass-casualty contamination incidents. Best results for decontamination from a chemical agent will be achieved if done within minutes following exposure, and delays in decontamination will increase the length of time a casualty is in contact with the contaminate. The findings presented in this report indicate that casualties involved in a HazMat/CBRN mass-casualty incident (MCI) in a typical community would not receive sufficient on-scene care because of operational delays that are integral to a standard HazMat/CBRN first response. This delay in response will mean that casualty care will shift away from the incident scene into already over-tasked health care facilities as casualties seek aid on their own. The self-care decontamination protocols recommended here present a viable option to ensure decontamination is completed in the field, at the incident scene, and that casualties are cared for more quickly and less traumatically than they would be otherwise. Introducing self-care decontamination procedures as a standard first response within the response community will improve the level of care significantly and provide essential, self-care decontamination to casualties. The process involves three distinct stages which should not be delayed; these are summarized by the acronym MADE: Move/Assist, Disrobe/Decontaminate, Evaluate/Evacuate.Peer reviewedbuddy system; chemical exposure; decontamination; decontamination response algorithm; hazardous materials; HazMat/CBRN; mass-casualty incident; self-care decontamination protoco