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Appendix F Scenarios and Discussion Materials for Use on Site Visits
Pages 252-310

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From page 252...
... Coordinator of volunteer organizations Emergency medical service Hazardous materials team State emergency management office Area military and local federal facilities National Guard U.S. Department of Energy Federal Bureau of Investigation Public Health Service Centers for Disease Control and Prevention Environmental Protection Agency 252
From page 253...
... 253 Instructor's Background Information on the Incident, Scene I This scenario involving terrorism with a biological weapon of mass destruction (WMD) portrays an incident that local response groups and agencies can use to evaluate their coordination and response capabilities.
From page 254...
... Responders are challenged to · assess the incident, · initiate appropriate public health operations, and · arrange for fast medical treatment of victims. At this time, the local and state health departments and the Centers for Disease Control and Prevention (CDC)
From page 255...
... , local hospitals report that approximately 30 airport workers are dead or critically ill; these deaths are reported to the [name of state health department]
From page 256...
... A major national cable news network requests an interview with a representative from the city. A Joint Information Center is established in the ROC to ensure that the CDC and state and local health departments as well as the FBI and state and local law enforcement agencies deliver accurate and consistent messages.
From page 257...
... In many jurisdictions, the 911 dispatcher serves as the hub of the notification system and notifies certain agencies or certain individuals, or both. In the case of anthrax and other biological agents with delayed effects, the activation and notification process would be more deliberate than normal.
From page 258...
... The screening process should be defined in local EOPs and often relies on the local office of emergency management or the EOC (if it is staffed 24 hours a day) to serve as the decision maker.
From page 259...
... What types of information should the emergency medical services units relay to the hospitals in the area to prepare them to receive patients potentially contaminated with an unknown hazardous material? Should any areas be quarantined?
From page 260...
... What access and egress control procedures should be implemented? The EOP should provide details on contamination control procedures and crime scene protection as part of its WMD annex, if it exists.
From page 261...
... The FBI initiates the structure for crisis management and takes the lead in the criminal investigation. When FEMA arrives, the structure changes to reflect the need for FEMA to lead the federal consequence management effort under the Terrorism Annex of the Federal Response Plan.
From page 262...
... need to be procured and used, although a filtering mask may be sufficient (most fire departments carry SCBAs at all times, but it would be unlikely that they would have enough equipment to supply SCBAs to all those responding to this incident)
From page 263...
... A very important nonfederal agency is the American Red Cross, which offers invaluable assistance in dealing with family notification and reunification issues, as well as assisting stranded travelers. The American Red Cross may have difficulties with volunteers (and contracted responders)
From page 264...
... Local response agencies are overwhelmed with the numbers of potentially exposed persons demanding treatment, potentially infected rescue personnel, and an increase in media interest in the incident. The governor declares a state of emergency, and immediately requests a presidential disaster declaration.
From page 265...
... Information on the symptoms, decontamination procedures, and treatment for anthrax is disseminated to hospitals and to local, state, and federal response agencies as they arrive on the scene. Because of the vast number of infected people, the CDC and the state health department estimate that contamination of the airport began 5 to 7 days earlier.
From page 266...
... At the federal level, the FBI has authority over the incident site and is responsible for crisis management. FEMA has federal authority for consequence management, but it must conform to the directions of the FBI to protect as much of the crime scene as possible while providing the needed rescue and relief to protect the population.
From page 267...
... The community should consider establishing a database to track the health of those members of the community, including responders, who may have been exposed to anthrax. The LOP should define the linkage between the community health program and the emergency operations management structure, and a representative of the community health agency or emergency medical services should be on the management team.
From page 268...
... External communications issues should focus on the procedures for providing essential information to state and federal responders and managers who are en route to the incident site. Solutions that rely on public hard telephone lines or cellular telephone systems should be discouraged in light of the numerous demands that will be made on those systems, unless the plan review revealed that a priority override system for emergency communications is in place with local telephone service providers.
From page 269...
... The CDC is actively involved in supporting the community's consequence management effort, and adequate amounts of antibiotics are rushed to local treatment centers. The response required all of the city's emergency response forces and most of those available from the county and other nearby cities.
From page 270...
... Aircraft operators also ask if and when the airport will be safe to resume normal business. The CDC and the state health department continue to generate detailed information on appropriate methods for the cleanup of contamination with anthrax spores.
From page 271...
... The EOP should outline the procedures for integration of state and federal resources. State andfederal assistance is supplementary to the local response; and as the Disaster Field Office is established, the Federal Coordinating Officer and State Coordinating Officer will coordinate the activities of the state and local governments, the American Red Cross, the Salvation Army, and other relief and disaster assistance organizations.
From page 272...
... anthracis, the local emergency management team should consider the need for "safe certification," that is, having a third-party laboratory verify that the area is free from contamination.
From page 273...
... Coordinator of volunteer organizations Emergency medical service Hazardous materials team State emergency management office Area military and local federal facilities National Guard U.S. Department of Energy Federal Bureau of Investigation Public Health Service Centers for Disease Control and Prevention Environmental Protection Agency U.S.
From page 274...
... At some point, it should be obvious that the casualties require decontamination before they can be treated by unprotected medical personnel or before casualties can be allowed to depart the area. Furthermore, casual exposure to the nerve agent increases the number of casualties.
From page 275...
... Reports of casualties at the mall follow. Fire and police squads and medical emergency units arrive on site and initiate emergency response operations.
From page 276...
... Traffic bottlenecks form on all major city transportation arteries, including [name of one or two major transportation arteries normally used during emergency responses] , further complicating response activities.
From page 277...
... Are you satisfied that the current notification process is timely and adequate? Each jurisdiction and agency should have notification procedures outlined in their emergency operations plans (EOPs)
From page 278...
... Additionalinformation can be obtained bythefollowing: -M-1 Chemical Agent Detector Paper and the M256 Chemical Agent Detector Kit can both identify the presence of nerve agents. Both are commonly used by military units; however, mostfire departments and hazmat units are not equipped with this technology and must be cautious when using it.
From page 279...
... What types of information should the emergency medical service units relay to the hospitals in the area to prepare them to receive potentially contaminated patients? Should any areas be quarantined?
From page 280...
... 5. How will the incident site be secured to ensure that the crime scene is protected and no contaminated personnel or equipment leave the area?
From page 281...
... At the same time, the scope of the situation makes it clear that there is also a federal role for consequence management. The Federal Emergency Management Agency (FEMA)
From page 282...
... A very important nonfederal agency is the American Red Cross, which offers invaluable assistance in dealing with family notification and reunification issues, as well as shelter operation. The resources most likely required from the state National Guard are transportation, communications, and security, as well as expertise and resources related to chemical warfare.
From page 283...
... EOC to determine the best sites for establishment of the Disaster Field Office. An advanced emergency response team is on its way from FEMA headquarters in Washington, D.C.
From page 284...
... Explore the federal definitions of crisis management and consequence management. At the federal level, the FBI has authority over the incident site and is responsible for crisis management.
From page 285...
... Adequate amounts of nerve agent antidotes and sufficient numbers of medical personnel resources are the most obvious shortfalls. State and federal plans provide for mobilization of these types of resources in disaster situations.
From page 286...
... Community health planning should account for locating within the incident area personnel who may be asymptomatic at this point. The EOP should define the linkage between the community health program and the emergency operations management structure, and a representative of the community health agency or emergency medical service should be on the management team.
From page 287...
... External communications issues should focus on the procedures for providing essential information to state and federal responders and managers who are en route to the incident site. Solutions that rely on public hard telephone lines or cellular telephone systems should be discouraged in light of the numerous demands that will be made on those systems, unless the plan review revealed that a priority override system for emergency communications is in place with local telephone service providers.
From page 288...
... , the president issues a major disaster declaration granting FEMA authority to provide emergency response support to [city of the incident] and to conduct consequence management activities.
From page 289...
... The EOP should outline the procedures for integration of state and federal resources. State andfederal assistance is supplementary to the local response; and as the Disaster Field Office is established, the federal coordinating officer and the state coordinating officer (SCO)
From page 290...
... After the use of chemical agents, the local emergency management team should consider the need for "safe certification," that is, having a third-party laboratory verify that the area is free from contamination.
From page 291...
... Coordinator of volunteer organizations Emergency medical service Hazardous materials team State emergency management office Area military and local federal facilities National Guard U.S. Department of Energy Federal Bureau of Investigation Public Health Service Centers for Disease Control and Prevention Environmental Protection Agency U.S.
From page 292...
... The local news radio station reports the explosion and the possibility of a radioactive release, causing widespread panic. Spontaneous evacuation creates traffic chaos and overwhelms police.
From page 293...
... . The weather forecast predicts [insert the weather forecast for the scenario; make the temperature range, amount of cloud cover, wind speed, and wind direction within the normal ranges for the date of the exercise.
From page 294...
... By this time, emergency management team notifications are initiated and the [jurisdiction] 's Emergency Operations Center (EOC)
From page 295...
... How would the lower staffing normally associated with the lunch hour affect the notification process? Follow-up Questions: Does your jurisdiction have a policy that prevents full activation of the emergency management system when it is not needed?
From page 296...
... Some hazmat teams have received training on identifying radioactive materials and sources of radiation. In this scenario, it is unlikely that the local team would immediately recognize the presence of radioactive material until after the terrorists contacted the radio station.
From page 297...
... What types of information should the emergency medical services units relay to the hospitals in the area to prepare them to receive potentially contaminated patients? Should any areas be quarantined?
From page 298...
... (The Radiological Emergency Planning program is an excellent source of information for responding to an incident involving the dispersal of radioactive material.)
From page 299...
... At the same time, the scope of the situation makes it clear there is also a federal role for consequence management. The Federal Emergency Management Agency (FEMA)
From page 300...
... During this session participants should recognize that federal assistance, whether it is wanted or not, is on the way. The local response capabilities are overwhelmed.
From page 301...
... The president issues a disaster declaration. The Federal Response Plan and Federal Radiological Emergency Response Plan are activated.
From page 302...
... The governor orders the National Guard to mobilize to assist with the response effort. Community health coordinators report that most initial emergency responders suffer from acute radiation exposure.
From page 303...
... FEMA activates the Emergency Response Team and deploys the advanced elements of the Emergency Response Team and Federal Agency Support Team to the scene. Potential sites for the Disaster Field Office (DFO)
From page 304...
... Explore thefederal definitions of crisis and consequence management. At the federal level, the FBI has authority over the incident site and is responsible for crisis management.
From page 305...
... What type of epidemiological surveillance program does your community have in place? How well defined are the linkages between the community health program and plan and your consequence management infrastructure?
From page 306...
... External communications issues should focus on the procedures for providing essential information to state and federal responders and managers who are en route to the incident site. Solutions that rely on public hard telephone lines or cellular telephone systems should be discouraged in light of the numerous demands that will be made
From page 307...
... The Joint Information Center is inundated with calls from the media about the response effort and the lack of information being provided to them. Scene III: The Immediate Threat Wanes It is 7:45 p.m.
From page 308...
... , members of the National Guard arrive and take up positions in and around downtown to assist the police with their duties and the decontamination and containment efforts. The American Red Cross offers assistance in transporting food, water, medications, and other resources to shelter locations and wherever else they are needed.
From page 309...
... The EOP should outline the procedures for state and federal integration. State andfederal assistance is supplementary to the local response; and as the DFO is established the federal coordinating officer and state coordinating officer will coordinate the activities of the state and local governments, the American Red Cross, the Salvation Army, and other disaster relief organizations.
From page 310...
... The hazmat annex to the EOP should outline reentry procedures. After the release of radioactive materials, the local emergency management team should consider the need for safe certification, that is, having a third-party laboratory verify that the area is free from contamination.


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