Nationwide Response Issues After an Improvised Nuclear Device Attack Medical and Public Health Considerations for Neighboring Jurisdictions: Workshop Summary (2014) / Chapter Skim
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5 Challenges to Command and Control
5 Challenges to Command and Control
Pages 35-46
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From page 35... ...
x The establishment of command and control starts with developing specific plans and policies ahead of time, ensuring clarity in roles and responsibilities, and planning for complex commands throughout the affected region. x Command and control systems are uniquely compromised in IND incidents relative to other disasters because of the massive disrup tion of communications, transportation, and financial systems, the scarcity of resources, the inability to deploy first responders into the severe damage zone, and ethical dilemmas for triaging patients.
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From page 36... ...
Changing Basic Framework The first question the two speakers addressed was, Would the current command and control framework change in the face of an IND incident? They said that the command and control framework using the Incident 1 Former fire department chief officer, Raton, New Mexico, and president of the New Mexico Fire Chiefs Association.
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From page 37... ...
The area command should include representatives from all affected agencies, such as law enforcement, public health, fire, emergency medical services, public works, and mass transit and transportation. As the response grows and becomes more complex, one of the area commands should evolve into a unified command.
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FIGURE 5-1 Organizational diagram for ICPs and EOCs at the local and state levels. NOTE: EOC = emergency operations center; ICP = incident command post.
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From page 39... ...
There will be a need to exploit surge health care capacity from nongovernmental organizations, disaster medical assistance teams, the military, and volunteers. Senior public health professionals should participate in the unified incident command structure and EOC.
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FEMA PERSPECTIVE Robert Farmer, again speaking for FEMA as the director of the operations division, opened his presentation by saying that after an IND attack or similarly catastrophic event, FEMA will immediately start sending resources to the affected area without waiting for a formal declaration of a state of emergency under the Stafford Act, the federal law designed to marshal an orderly flow of federal disaster assistance to state and local governments. A proactive stance by FEMA can save lives, he said.
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From page 41... ...
In the IND scenario, the city's main government buildings were destroyed, with significant loss of local leadership, and the state of Illinois immediately moved to assume command and control functions over the city and region. One significant downside of locating command and control so far from the site was the loss of situational awareness.
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From page 42... ...
began his presentation by emphasizing that command and control systems are uniquely compromised in IND incidents relative to other disasters. What makes them uniquely compromised is the massive disruption of communications, transportation, and financial systems; the scarcity of resources; the inability to deploy first responders into the severe damage zone; and ethical dilemmas for triaging patients.
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From page 43... ...
The EMG makes decisions about the range of resources that HHS can deploy, including disaster medical assistance teams and the U.S. Public Health Service's Commissioned Corps.
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Analysts marked the location of health care facilities that were known to be there before the earthquake and then tried to reconcile that knowledge with observations on the ground. Finally, command and control surrounding the movement of patients to care is one of the critical functions that HHS coordinates with FEMA and DOD.
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From page 45... ...
. As more and more jurisdictions become involved, a uniform command, with participation by public health, transportation, law enforcement, and other agencies, should assume control and should interact with state and federal authorities.
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