Response Preparation

The breadth and variety of potential targets or vulnerable sites demonstrates the benefit of a multi-agency working group involving various industrial and community response stakeholders for the development and preplanning of a response plan. All emergency response agencies should be included including local law enforcement, fire and EMS as well as emergency management and public health officials. Local, state and federal affiliated agencies need to be included and work in synchrony.

Federal agencies such as the Department of Homeland Security (DHS) (lead agency), Federal Bureau of Investigation (FBI), Alcohol, Tobacco and Firearms (ATF) Federal Emergency Management Agency (FEMA) and state bureau of investigation may all be involved in the investigation and response of a terrorist incident.

The local hospitals, public health department and medical examiner’s office are important for inclusion in all phases of the healthcare response. Political leaders are also an important group to include in the planning phases and actual events as they may function to calm and inform the public in the time of an event. Many watching nationally televised news coverage on September 11. 2001 noted how Mayor Giuliani provided a calm yet informed leadership presence to the citizens of New York City during the hours and days of the terrorist bombings of the World Trade Center.

A nonpartisan facilitator may be necessary in these meetings to encourage multi-agency dialogue and cooperative planning and sharing of information and resources as policy allows. Critical in these meetings is to establish an integrated plan based on common response philosophy and a clear definition of the roles and responsibilities of each participating agency.

The Hospital Incident Command System (HICS) formerly the Hospital Emergency Incident Command System (HEICS), has been adopted and adapted from the fire services Incident Command System (ICS) structure to facilitate specific roles and responsibilities of involved emergency personnel. The ICS paradigm was applied in the hospital environment for ease of disaster planning and interoperability. Applying the precepts of these meetings to both table top (functional) as well as hands on (operational drills) will uncover gaps for improvement and improve the response to an event as well as improve the day to day operations of the local emergency response community.


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