Should the ICS be commanded by a public health official/EMS Chief/MD rather than the police and fire units
Discussion Requirements
A substantive comment should be approximately 300 words or more for each response (A total of 4 responses).
Read the initial comments posted by your classmates and reflect upon them.
Before writing your comments:
Review the Discussion grading rubric to see what is expected for an excellent discussion, in order to earn full credit.
Review some resources to help you synthesize, such as the following:
Sullivan, J. (2011). Strategies for Synthesis Writing. Retrieved from http://www.findingdulcinea.com/features/edu/Strategies-for-Synthesis-Writing.html
NOTE: You are required to cite sources and include a reference list for the second post if it is simply your opinion. However, if your opinion is based on facts (as it should be), it is good practice to strengthen your position by citing sources.
Be sure to meet all of the criteria in the rubric, as noted in the instructions above.
Third post for each module discussion:
Read the initial and secondary comments posted by your classmates and reflect upon them.
Directly respond to at least one classmate in a way that extends meaningful discussions, adds new information, and/or offers alternative perspectives.
MY POST
Classmates and Professor,
Question 1.
In such cases, should the ICS be commanded by a public health official/EMS Chief/MD rather than the police and fire units?
When emergency medical personnel are called up to transport patients who could easily spread infectious diseases, they should be extremely careful. They should be donned with personal protective equipment, and they should have their mouth and nose covered so that they may not be infected by the various diseases that the patients are suffering from(Nizolenko & Bachinsky, 2014). Emergency medical personnel should be allowed to lead or command a station where the bioterrorist attack has occurred, and people are badly injured. They should be allowed to lead the evacuation process while the police offer security to them and the patients. Bioterrorism uses biology to manufacture a disease that terrorists can use to attack people for their own political and financial gain. It is a disease manufactured in the laboratory and used to attack people, and it is used as an act of terrorism.
Some of the diseases that can be manufactured and released to people are Anthrax and Smallpox. These diseases take some days before the patients become ill, and therefore, the affected people may not need transport to the hospital(Aschenbrenner, 2018). Instead, they will most likely walk into the hospital when they find that they have symptoms of these diseases. When they get into the hospitals, they are treated by receiving vaccines or antibiotics, and the emergency medical personnel treats them.
Question 2
To what extent should non-medical personnel/managers make medical decisions during a bioterrorist incident?
Non-medical personnel can take the lead in an operation when the terrorist attack has no injuries, and the damage that a terrorist attack has done does not involve people. For example, if the target was on a building and there are no injuries reported, the police or other professionals who handle crime can be trusted to lead in investigating the incident; when the attack involves weaponry that the medical personnel cannot understand, then it the work of the police to call in ballistics who have knowledge and skills in the weapons so that they can determine how to handle the situation (Grundmann, 2014). On the bioterrorist, if the attack involves the use of chemicals that the medical personnel is unable to understand, the experts should be called in to determine the kind of chemicals that have been used.
Emergency medical personnel may not lead the investigations when the attack involves diplomacy of two or more countries. The experts in the ministry of foreign affairs should lead the process of building talks between countries affected to reach an amicable solution (Green et al., 2019). If a country attacks another country, then the discussions cease to be local and become international where serious talks should be held between those two countries. If the two cannot reach a consensus, then bodies such as United Nations may lead the talk to bring the two fighting countries into a consensus. In a nutshell, medical personnel should lead post in case of a bioterrorist attack, and there are other times that the police or the ministry concerned should lead the investigations.
Pedro
References
Aschenbrenner, D. (2018). Drug Approved to Treat Smallpox After a Bioterrorist Attack. AJN, American Journal Of Nursing, 118(11), 21. https://doi.org/10.1097/01.naj.0000547660.47166.0f
Grundmann, O. (2014). The current state of bioterrorist attack surveillance and preparedness in the US. Risk Management And Healthcare Policy, 177. https://doi.org/10.2147/rmhp.s56047
Green, M., LeDuc, J., Cohen, D., & Franz, D. (2019). Confronting the threat of bioterrorism: realities, challenges, and defensive strategies. The Lancet Infectious Diseases, 19(1), e2-e13. https://doi.org/10.1016/s1473-3099(18)30298-6
Nizolenko, L., & Bachinsky, A. (2014). Universal Local Epidemic Model and Its Usage in the Assessment of Novosibirsk Region Resource Preparedness to a Bioterrorist Attack. Problems Of Particularly Dangerous Infections, (4), 21-24. https://doi.org/10.21055/0370-1069-2014-4-21-24
RESPONSE 1:
PROFESSOR’S QUESTION:
Can you think of any potential issues created by the medical personnel not having a leadership role?
RESPONSE 2:
Class and Professor,
The topic for this discussion is interesting and I am curious to read about everyone’s thought. Within the student manual for the US Fire Administration National Fire Academy it particularly states that ICS’ will be commanded by Fire or Law Enforcement personnel. “Fire departments are given the responsibility to manage fires, mass casualty (when EMS is a component of the agency), hazardous materials, and other non-law-enforcement emergency incidents” (Fire.NV, 1999). While, Law enforcement agencies generally are responsible for managing all operations related to criminal incidents such as terrorist events, bombings, snipers and hostage situations” (Fire.NV, 1999). While these two agencies act as the Incident Commander for their respective criterias. The coordinating structure of the ICS is usually composed of agencies with specific functional areas such as public works and emergency medicals services who serve on the Incident Command Post (ICP) at the Emergency Operations Center (EOC). This is where I believe public health officials/EMS Chiefs and MDs can provide best assistance.
In case where bioterrorism is involved, it would warrant Federal support and response. Unified coordination between local, state, tribal and federal incident management activities would be organized with principles of ICS structure. The Unified Coordination Group (UCG) composed of senior leaders has significant jurisdictional responsibility and authority to support on-scene response efforts. “Unified coordination must include robust operations, planning, public information, and logistics capabilities that integrate local, state, and federal—as well as tribal, territorial, and insular area governments—personnel, when appropriate, so that all levels of government work together to achieve unity of effort” (FEMA, 2019). With the support of Emergency Support Functions (ESF) effective organization and management of resources can be delivered.
Roderick
Work Cited:
FEMA. (1999). INCIDENT COMMAND SYSTEM FOR EMERGENCY MEDICAL SERVICES. Retrieved 10 May 2021, from https://fire.nv.gov/uploadedFiles/firenvgov/conten…
FEMA. (2019). National Response Framework. Retrieved10 May 2021, from https://www.fema.gov/sites/default/files/2020-04/N…
RESPONSE 3:
Hello class and professor!
When it takes a certain number of days for people to show symptoms of infection, this is one very traumatic effect of the use of biological weapons due to the incubation period they possess. Different agents used in these weapons will also produce different results because the incubation timeframe will vary from agent to agent. During the incubation, spreading will occur before the initial release has been recognized by anyone (Beeching, Dance, Miller, & spencer, 2002). An example of this would be in a non-immune community due to a non-vaccinated population for smallpox. The incubation period is around 12 days, but can vary anywhere from 7 to 17 days depending on the virus strain and/or individual.
Personally, I think ICS should be commanded by a public health official and a police/fire chief. I think it is a good idea to have the police/fire chief working alongside of the public health official to assist each other with any challenges that arise. Police and Fire Incident Commander’s knowledge of ICS, as in their knowledge of key points of contact, will be very valuable when coordinating relief efforts (FEMA, 1999). According to the Bureau of Justice Assistance (2010), law enforcement agencies should have an understanding of the local public health emergency plans to contain an influenza pandemic. This understanding is probably a good idea for other pandemics as well.
I don\’t think non-medical personnel should make medical decisions during the bioterrorism incident. To reinforce this, Malone (2001) states, “Overall, the Federal Bureau of Investigation (FBI) is in charge of the domestic terrorism response at the crime scene and has access to many other governmental resources.” Additionally, the state governor will be able to coordinate efforts of the public health department and National Guard for additional resources and containment procedures.
Tack
References:
Beeching, N., Dance, D., Miller, A., & spencer, R. (2002, Feb 09). Biological warfare and bioterrorism. Retrieved May 06, 2021, from National Center for Biotechnology Information: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1122269/#:~:text=The%20usual%20incubation%20period%20is,periods%20in%20non%2Dhuman%20primates.&text=Abrupt%20onset%20of%20fever%20and%20headache%20may%20initially%20be%20mistaken%20for%20influenza.
Bureau of Justice Assistance. (2010, September). Law Enforcement Preparedness for Public Health Emergencies: An Executive Summary of the Resources Series. Retrieved May 06, 2021, from Bureau of Justice Assistance: https://www.policeforum.org/assets/docs/Free_Onlin…
FEMA. (1999, January). Incident Command System For Emergency Medical Services. Retrieved May 06, 2021, from FEMA: https://fire.nv.gov/uploadedFiles/firenvgov/conten…
Malone, J. (2001, July). Provider and health care system response to a bioterrorist attack. Retrieved May 06, 2021, from National Center for Biotechnology Information: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058…
RESPONSE 4:
Classmates,
I believe this question is best split in 2, whether this is an anticipated release, or an unanticipated release.
In the case of an unannounced or short term announcement release of Antrax, it should be on the local fire department to be the lead agency. Most fire departments have significant knowledge on response to HAZMAT scenarios and the working knowledge and is also the primary custody of the decontamination assets would be the best way to be sure that things work smoothly in the short term and saving lives. A public health official or Medical Doctor might not have the working knowledge for how to implement decontamination of actual casualties and the walking wounded of those infected and as of yet not showing symptoms.
If this was a release in an area that had their state’s Civil Support Team (like if the CST was onsite already due to a high population being at a football game like the Super Bowl) the Civil Support Team would be the preferred ICS element. They are trained in WMD response, and would be best to provide guidance and practical knowledge on decon and medical response to this type of incident(Shireley, 2009). There are 56 of these units across the US with at least 1 in every state (excepting North and South Dakota that share their CST.). They can typically respond to an incident in their state with 2-4 hours and provide ICS for WMD incidents and hand off control to the CRF-P or DCFR.
As for the second question: It is not a simple upcheck/downcheck for medical personnel making decisions during bioterrorist attack, or Fire/Law Enforcement. An appreciation for medical needs when agents and possible vectors is required, but practical knowledge of how to do decon and its 2nd and 3rd order effects needs to be a top tier requirement as well. A medical doctor might have an academic knowledge of how to do decon and minimize the risks and pitfalls of doing a certain technique versus another, and a firefighter might focus on the mechanical nature of decontamination and accidentally spread the biohazard farther by refusing to limit his decon operations since in a fire ‘more water is better’.
Perhaps the best solution is to make it a politician guided by public health official, with fire department and EMS being their high priority underlings. If you make the subject matter expert not be the one to make the decisions it means that the decision maker isn’t clouded by their expertise and is more objective. When all you have is a hammer, everything looks like a nail after all.
New Hampshire chose their Department of Health and Human Services for ICS and in charge for their 2009 anthrax potential outbreak (Lamothe, 2011). This isn’t an apples-to-apples comparison since the first case was discovered when the person was in the hospital and there was no terror incident that might cloud the issue with immediacy that this discussion’s scenario assumes. But they had the CSTs be the trusted agents and be the ones to sample the patients house and ministry, showing they are the first choice for WMD response.
Brett
References:
Shireley, L. (2009, January). National Guard Civil Support Teams: A 24/7 Response to Weapons of Mass Destruction. Researchgate. https://www.researchgate.net/publication/241837406_National_Guard_Civil_Support_Teams_A_247_Response_to_Weapons_of_Mass_Destruction.
Lamothe, W. D. (2011, June 1). Gastrointestinal Anthrax in New Hampshire: A 2009 Case Report. OUP Academic. https://academic.oup.com/labmed/article/42/6/363/2504992.
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Module 3 – Background
DISASTER PREPAREDNESS
Required Reading
How to prepare for a wildfire. (2014). FEMA. Retrieved from https://www.fema.gov/media-library-data/1409003859…
State of California Emergency Plan. (2017). Retrieved from http://www.caloes.ca.gov/PlanningPreparednessSite/…
2018 National Preparedness Report. (2018). Retrieved from https://www.fema.gov/media-library-data/1541781185…
Required Websites
California Office of Emergency Services: http://www.caloes.ca.gov/
California Wildfires (DR-4344). FEMA: https://www.fema.gov/disaster/4344
California Wildfires (DR-1731). FEMA: https://www.fema.gov/disaster/1731
Plan and Prepare for Disasters. DHS: https://www.dhs.gov/topic/plan-and-prepare-disaste…
Wildfire Mitigation. FEMA: https://www.fema.gov/hmgp-appeal-keywords/9155
Requirements: Information Provided above.
Answer preview to should the ICS be commanded by a public health official/EMS Chief/MD rather than the police and fire units
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