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orThe FBI designated 28 shootings in 2019 as active shooter incidents. The 28 incidents resulted in 247 casualties, 97 people killed, and 150 people wounded, excluding the shooters. No community appears immune from these potential incidents; therefore, it is important for every community to develop an Active Shooter Program.
The purpose of this guide is to provide emergency services personnel with the basic building blocks for developing an Active Shooter Program with communities. This guide highlights resources and planning considerations, which will enhance emergency services organizations’ ability to develop or improve community planning and preparedness for active shooter incidents.
For more information, email the Emergency Services Sector-Specific Agency at essteam@cisa.dhs.gov.
NHTSA Office of EMS and U.S. Fire Administration share resources to help local EMS and fire departments safely respond to civil unrest incidents in their communities
Fire and emergency medical services (EMS) personnel have been called upon to respond to incidents related to protests and civil unrest occurring in locations across the United States. While the last several weeks have seen an increase in these types of events, civil unrest can occur during any period of heightened community tension or mass gatherings, from sporting events to political conventions.
These incidents present unique challenges and sometimes place first responders at higher than anticipated levels of risk. The U.S. Fire Administration (USFA) and the National Highway Transportation Administration (NHTSA) Office of Emergency Medical Services (OEMS) worked together to compile best practices to assist you as you respond to civil unrest incidents in your community.
You can view these best practices online or download them as a pdf document from the EMS.gov Preparedness page under “Additional Resources”.
May 29, 2020
Dr. Jon Krohmer, NHTSA, HRTF EMS/Pre-hospital Team Lead
Kate Elkins, NHTSA, HRTF EMS/Pre-hospital Deputy Team Lead
911, the universal number to call for emergency help nationwide, is a proven, life-saving service to the public. NHTSA’s Office of EMS oversees the National 911 Program, which envisions an emergency response system that best serves the public, providing immediate help in all emergency situations. This presentation covered the current Emergency Medical Services (EMS) Environment, Impacts and Next Steps for EMS in regards to COVID-19, and EMS and Fire Impacts on Community Lifelines.
May 21, 2020
Presentation by N. Clay Mann PhD, MS, MBA
NEMSIS Technical Assistance Center
This document is provided by NHTSA in an effort to help State EMS Officials track particular EMS activations occurring during the COVID‐19 pandemic. This document will be updated periodically to provide current information regarding temporal variations in the type and characteristics of EMS activations occurring in the U.S. during the COVID‐19 outbreak.
Please contact the NEMSIS Technical Assistance Center for updates to this document.
Contact N. Clay Mann at clay.mann@hsc.utah.edu.
FEMA released “COVID-19 Pandemic Operational Guidance for the 2020 Hurricane Season” to help emergency managers and public health officials best prepare for disasters, while continuing to respond to and recover from COVID-19.
The guide provides actions emergency managers and public officials can take to prepare for response and recovery operations during ongoing COVID-19 response efforts. Specifically, the guidance:
Private sector and non-governmental organizations can use the guidance to gain an understanding of the government’s posture, planning and readiness efforts.
To expand awareness and understanding of the guidance, FEMA’s National Preparedness Directorate is conducting four webinars. The webinars will allow emergency managers an opportunity to discuss how the guidance can assist jurisdictions review and modify their plans given the constraints and limitations of the ongoing pandemic. To register, please click on the link for the preferred webinar from the list below:
Download the COVID-19 Pandemic Operational Guidance for the 2020 Hurricane Season on the FEMA website.
2020 Hurricane Season During COVID-19
Are you prepared for the 2020 hurricane season while the world is also responding to COVID-19? CDC’s National Center for Environmental Health is joining the CDC EPIC Team Wednesday, May 27, at 1 p.m. EST. CDC experts will discuss possible health risks that could come from hurricanes combined with COVID-19; planning for the 2020 hurricane season while adhering to guidance on social distancing; and how community leaders, nonprofit organizations, and public health professionals can effectively communicate messages. Closed captioning will be available. Click here to learn more about this webinar, including continuing education options.
More information on this webinar, previous EPIC webinars, and continuing education can be found on the EPIC Webinar website.
When: May 27, 2020 at 1 p.m. ET
Please click the link below to join the webinar:
https://www.zoomgov.com/j/1614675517
Or iPhone one-tap:
US: +16692545252,1614675517# or +16468287666,1614675517#
Or Telephone:
Dial (for higher quality, dial a number based on your current location):
US: +1 669 254 5252 or +1 646 828 7666
Webinar ID: 161 467 5517
International numbers available: https://www.zoomgov.com/u/aedA7dyLM2
Document Developed by the Healthcare Resilience Task Force Emergency Medical Services (EMS) Prehospital Team. Download PDF
Current Situation
Personal Protective Equipment (PPE) supplies, including N-95 respirators and gowns, are in short supply due to the COVID-19 pandemic. These shortages are anticipated to resolve over time as additional sources are identified and manufacturing capacity is expanded. In the interim, Emergency Medical Services (EMS) agencies that are unable to meet their PPE requirements through regular distribution channels are advised to submit requests for PPE supplies through their local and/or state emergency management officials, which are then submitted to Federal Emergency Management
Agency (FEMA) for sourcing and allocation.
Background
Due to the COVID-19 pandemic, health care providers are exhausting PPE supplies faster than
they can be sourced. EMS agencies are part of the critical infrastructure sector and are strongly considered in the decision-making process to allocate supplies.
Actions Taken to Address Supply Issues
How to Request PPE Supplies
1. Requests for reordering of PPE should be made through the normal request process. Due to shortages, the entire order may not be able to be filled.
2. To request additional PPE supplies from state or federal resources for unmet needs, you must submit requests through your established local emergency management structure. Depending on the state, your request may be processed through the emergency management chain or through the public health chain to state-level emergency management. From the state level, it will be transmitted to FEMA.
3. When submitting a request, please include the following information:
a. Agency
b. Specific material and quantity request
c. Detailed risk/exposure justification for the request
d. Current on-hand requested supplies
e. Burn rate of current supplies – to provide an estimate of time remaining of current supply
f. Other information pertinent to the request
g. Alternatives that are available, if any, and risks associated with pending gaps (For
information regarding PPE alternatives and optimization strategies, click here.)
This information will help inform the allocation of state and federal PPE resources. Please understand that your request is important and is being considered seriously in the context of similar requests from your peers. The shortage of PPE will continue to be a challenge during the COVID-19 pandemic. Following the appropriate process for requesting supplies is critical to ensuring that you are able to receive needed PPE supplies. For more information regarding EMS response and infection control during the COVID-19 pandemic, please click here.
The explosion of the opioid epidemic that is responsible for thousands of overdoses and deaths is a consistent problem that EMS and law enforcement encounter on an almost daily basis. Usually, the victims of these powerful drugs, such as heroin and fentanyl, are opioid users, who EMS personnel and law enforcement are regularly called to assist. However, first responders are also being warned about the increased risks they face of being exposed to these deadly drugs, specifically fentanyl—a popular synthetic opioid that is 40 to 50 times more powerful than heroin. To respond to these dangers, the Drug Enforcement Administration (DEA) released a field guide called “Fentanyl: A Brief Guide for First Responders” for EMS and police who find themselves responding to opioid-related calls.
“We need everybody in the United States to understand how dangerous this is,” Acting DEA Administrator Chuck Rosenberg warned. “Exposure to an amount equivalent to a few grains of sand can kill you.”
The warnings have become more urgent in recent months due to numerous cases of accidental overdoses and exposures involving EMS and police.
In May, Chris Green, a police officer with the East Liverpool Police Department, was accidentally exposed to fentanyl during a routine traffic stop after he inadvertently ingested the drug through his skin. Green needed four shots of Narcan, an emergency overdose medication, to be revived after collapsing from the effects of the drug. In another case, two Paramedics and a sheriff’s deputy in Hardford County, Maryland, were treated after showing signs of opioid exposure while treating an overdose victim.
“It is important to get the word out to everyone because it may be the first responder who needs to have Narcan administered,” said Baltimore City Health Commissioner Leana Wen.
The risks of accidental exposure are so high, in fact, that some emergency personnel have even begun carrying Narcan kits for drug-sniffing K-9s, just in case the dogs ingest the deadly drugs.
The DEA guide, along with a National Institute for Occupational Safety and Health manual on preventing fentanyl exposure, suggests certain precautions be taken to lower the risk of coming in direct contact with the substance. Personnel should be able to recognize the signs and symptoms of an overdose, be aware of the ways fentanyl can be ingested, and only allow trained professionals to handle substances that are suspect.
“Assume the worst,” Rosenberg said. “Don’t touch this stuff or the wrappings that it comes in without the proper personal protective equipment.”
The DEA video “Fentanyl: A Real Threat to Law Enforcement” offers advice on how police and EMS can protect themselves from the dangers of fentanyl.
The Department of Health and Human Services (HHS) announced $70 million in grants to help communities and health care professionals combat the ongoing opioid crisis that is ravaging communities across the U.S. The majority of the money will be used to help prevent opioid-induced deaths and to provide treatment for people with opioid use disorders, including $28 million allotted for medication-based treatment. More than 33,000 lives were claimed in 2015 due to opioid overdoses.
$41.7 million of the funding is set to expand resources and training for first responders on how to use emergency treatments, such as Narcan, to help reverse and treat overdoses. In many cases, first responders are often the difference between life and death for opioid users who experience an overdose, so it is imperative health care professionals have access to the needed resources and training to help save lives. The additional funding aims to help paramedics, EMTs and other emergency service personnel gain access to much-needed resources.
“The grants we announce today clearly demonstrate our efforts to meet the opioid crisis with every tool at our disposal,” said Substance Abuse and Mental Health Services Administration Acting Deputy Assistant Secretary Kana Enomoto. “The evidence-based training, medication, and behavioral therapies provided here will save lives and help people with addictions start a path toward reaching their potential.”
In addition to the most recent grants, $485 million in grants were awarded in April to treat and prevent opioid abuse.
To read more about the grants, please visit the HHS web site.
Ambulance services interact with people from all walks of life, and from all parts of the world. AAA checked in with expert Marcia Carteret, M.Ed., for some tips for communicating more effectively with people from other cultures. Marcia is an instructor of intercultural communications at University of Colorado School of Medicine in the Department of Pediatrics. She trains residents, faculty, and staff in healthcare communication with a focus on cross-cultural patient care and low health literacy. She has also trained in over 120 private pediatric and family practices across Colorado.
Marcia also developed a robust cross-cultural toolkit for AAA members. [Learn more about AAA membership]
In all healthcare settings, successful communication with patients and families depends on awareness of three key barriers to their understanding and compliance:
How do people understand one another when they do not share a common cultural experience? Nowhere is this a more pressing question than in healthcare settings, especially in emergencies. There is no easy list of things “to do” or “not to do” that can be applied to each culture. What can be useful are communication guidelines that work for people from all cultures. These guidelines are also important for people with low health literacy.
[quote_left]“The essence of cross-cultural communication has more to do with releasing responses than sending messages. And it is most important to release the right responses.” — Edward T. Hall[/quote_left]
Perhaps the most important is framing questions to elicit appropriate answers. As Edward T. Hall, anthropologist and cross-cultural researcher wrote,“The essence of cross-cultural communication has more to do with releasing responses than sending messages. And it is most important to release the right responses.” What could be more crucial when, for example, an EMT or paramedic is attempting to establish level of consciousness by directly eliciting information from a patient? Being able to get quality responses from patients from any culture is a communication skill that comes with experience. Learning and practicing a set of strategically designed questions is key to building confidence in this important skill.
Cultural norms vary around the world. Here are some key norms to keep in mind when assisting patients and their families.
As first-responders, EMS is often working in high stakes situations where communication is a challenge even without the added barriers associated with the “triple threat” to healthcare communication—language barriers, cultural understanding, and low health literacy. No matter which culture an EMT or Paramedic is interacting with, the key to good communication is asking good questions and phrasing all dialogue in simple short sentences. It should be clear that a question is being asked or a statement of information is being made by the EMS professional. Asking for clarification is essential. Head nods and affirmative answers should not be accepted immediately as evidence of sufficient understanding or agreement. EMTs will find that enhanced communication skills will not only improve cross-cultural interactions, these skills improve outcomes with all people – even “mainstream” Americans. Also, be aware that low health literacy is a problem for 90 million Americans. Never assume that same-culture communication in English requires less intentional speech on your part.