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More than 250 people have been killed in the United States during what has been classified as active shooter and mass casualty incidents (AS/MCIs) since the Columbine High School shootings in 1999. AS/MCIs involve one or more suspects who participate in an ongoing, random or systematic shooting spree, demonstrating the intent to harm others with the objective of mass murder.
This paper was developed as a fire and Emergency Medical Services (EMS) resource that can be used to support planning and preparation for active shooter and mass casualty incidents (AS/MCIs). These complex and demanding incidents may be well beyond the traditional training and experience of the majority of firefighters and emergency medical technicians. The U.S. Fire Administration (USFA) offers this report as one source of many available for the public safety community, but it takes into consideration the diverse local service levels available across America. In developing this paper, USFA consulted with individuals and groups engaged in fire and prehospital EMS, law enforcement, and hospital medical and trauma care. We also consulted with public safety organizations and numerous federal agencies.
Emergency Medical Services (EMS) agencies regardless of service delivery model have sought guidance on how to better integrate their emergency preparedness and response activities into similar processes occurring at the local, regional, State, tribal, and Federal levels. This primary purpose of this project is to begin the process of providing that guidance as it relates to mass care incident deployment.
This street-wise guide for responders and planners is one of the first texts to fully integrate the Incident Management System for EMS response to high impact incidents. Written for EMS systems, fire departments, military officers, and private industry as well as all levels of EMS providers, this book incorporates the National Incident Management System as the basis for a medical incident management system for disasters, terrorist events, and other mass casualty incidents.
While medical specialists in disaster mitigation, preparedness, and response are needed worldwide, the initial phase of disaster response is almost entirely dependent upon local resources—making it essential that all healthcare personnel have a working knowledge of the field and stand ready to integrate into the response system. Ciottone's Disaster Medicine, 3rd Edition, is the most comprehensive reference available to help accomplish these goals in every community. It thoroughly covers isolated domestic events as well as global disasters and humanitarian crises. Dr. Gregory Ciottone and more than 200 worldwide authorities share their knowledge and expertise on the preparation, assessment, and management of both natural and man-made disasters, including lessons learned by the responders to contemporary disasters such as the COVID-19 pandemic, Australian and western U.S. wildfires, European heatwaves, the Beirut explosion, recent hurricanes and typhoons, and the global refugee crisis. Part 1 offers an A-to-Z resource for every aspect of disaster medicine and management, while Part 2 features an exhaustive compilation of every conceivable disaster event, organized to facilitate quick reference in a real-time setting. Covers basic concepts such as identification of risks, organizational preparedness, equipment planning, disaster education and training, and more advanced concepts such as disaster risk reduction, health in complex emergencies, building local disaster resiliency, psychological impact of disasters on children, and more. Contains new decision trees throughout that help guide you through the decision-making process in difficult situations. Uses an easy-to-follow, templated approach to historical perspectives, overviews of current practice including pre-incident and post-incident actions, medical treatment of casualties, and potential pitfalls. Includes updated sections on man-made disasters, including mass casualties, active shooter situations, integrated response to terrorist attacks, and chemical/biological/radiological/nuclear/high-yield explosives disasters. Discusses the latest technologies, such as the use of mobile disaster applications, drone response systems, and virtual reality simulation training. Features thoroughly updated information on crisis leadership, practical applications of disaster epidemiology, disaster and climate change, and the integration of non-government agencies (NGOs) in disaster response—a critical topic for those responding to humanitarian needs overseas. Includes new chapters on Pandemic Preparedness and Response, Disaster Medicine in a Changing Climate, Disaster Response in Asia, Building Local Capacity and Disaster Resiliency, Civilian-Military Coordination in Disaster Response, Medical Simulation in Disaster Preparedness, Disaster Nursing, Crisis Meta-Leadership, Palliative Care in Disasters, Counter-Terrorism Medicine, SARS CoV (COVID-19 and SARS), and Disasters in Space Travel.
Healthcare Emergency Incident Management Operations Guide offers healthcare personnel a quick and intuitive guide to preparing for, responding to and recovering from events which have the potential to impact their operations. The recently updated Centers for Medicaid & Medicare Services (CMS) rules for emergency preparedness added 10-15 new healthcare organizations into the mix that require emergency preparedness efforts. The Hospital Incident Command System (HICS) is a good tool for event management but, like all tools, it requires practice. Many hospital personnel take online ICS courses and rarely practice enough to be proficient. This is a comprehensive guide to the HICS and can be referenced during initial and refresher training as well as during event management. Covers how to utilize the Hospital incident Command System (HICS) and Incident Action Planning (IAP) processes Includes Initial Incident Action Plan considerations for common disaster events Features exercises for initial and refresher training
This text is designed to present a comprehensive and state-of the-art approach to dismounted complex blast injuries. Sections address care of these patients from the point of injury through rehabilitation. The specific areas addressed include blast mechanics, stabilization and hemorrhage control at the point of injury, early resuscitation at local hospitals, a systematic approach to surgical care, and finally reconstruction and rehabilitation. Specific chapters focus on operative management of pelvic, abdominal, genitourinary, orthopedic, neurological and thoracic injuries. The authors of each chapter, are experts in treating DCBIs that have had direct hands-on experience through military deployments in Iraq and Afghanistan. Each chapter describes patient presentation and an algorithm outlining treatment with support from the literature. The text will conclude with three chapters. The first explores new advances in care that can be applied to these injuries. The second highlights the organization and team approach to care of these patients. Finally, the last chapter describes an actual case, cared for by the editors, that encompasses points from the chapters in the text. Extensive illustrations and flow diagrams are used throughout the text. This text is specifically designed to be a “how to” guide for inexperienced military and civilian providers. The chapters are organized in a step-wise fashion that mirrors the patient’s course from point of injury through their hospital course. Combining authors’ experience with illustrations and algorithm diagrams creates a text that is easy to use as a reference text or basis of training for future military and civilian surgeons.