All items with an asterisk (*) are required for submission.
* Name:
* Position:
* Pick facility from list below
Other facility, if not listed above:
RESOURCES REQUIRED
Personnel must be:
Appropriately equipped and knowledgeable about chemical, biological, radiological, nuclear, and explosives (CBRNE) detection, personal protection, and decontamination.
Educated in the care of blast-related injuries for adult and pediatric patients.
Prepared to institute triage.
Prepared to institute and participate in unified incident command.
A communications system that is interoperable with public safety disciplines (fire, law enforcement, EMS, and emergency management) and with receiving hospitals and local public health officials.
Rapid access to sufficient ambulance resources to transport critically injured patients.
Rapid access to sufficient alternative resources (e.g., buses) to transport noncritical, injured persons.
Have the necessary material and the capability to detect CBRNE agents to assist with decontamination plans.
Decontamination equipment for ambulatory and non-ambulatory patients; equipment should be rapidly deployable to the explosion site, a secondary treatment site, or a hospital.
Determine/implement secondary triage and treatment sites within the community.
Which of the above resources, if any, necessitated additional expenditures over those currently planned for your department?
Based on your experience implementing the template, what resources should be added to the "Required Resources" section?
Which of the above resources, if any, caused you the biggest concerns or problems? (Please explain.)
What were the most significant barriers you encountered related to the "Required Resources"?
ACTION STEPS 1. Train responding EMS personnel about how to treat primary, secondary, tertiary, and quaternary blast-related injuries.
* Indicate your current progress in implementing this action step
Please provide any additional comments or explanation that will help to explain your progress.
* How long did it take to implement this step? (If you have not completed this step, estimate how long it will take you to complete implementation.)
Please provide an estimate of the effort — # of people and # of actual person hours — required to complete this action step
Please provide an estimate of the cost of implementing this action step.
What types of additional resources were required to complete this action step?
What would you change about this action step?
What were the most significant barriers you encountered in implementing this action step?
How many people were (or will be when the training is completed) involved in the training?
* How long do you estimate it took (or will take) to complete this training for your staff/personnel?
* Was/Is the required training readily available?
* How did you (will you) provide this training for all of your staff/personnel?
* If commercial or publicly provided course, please identify: ** If 'Other,' please specify:
How much do you estimate you have spent (or will spend) on this training?
What types of additional resources were required to complete this training?
2. Train EMS personnel about National Incident Management System (NIMS) compliance; Incident Command System (ICS Homeland Security Presidential Directive 5); and the importance of command, staging, triage, and treating initial casualties should be emphasized.
* Indicate your current progress in implementing this action step
Please provide any additional comments or explanation that will help to explain your progress.
* How long did it take to implement this step? (If you have not completed this step, estimate how long it will take you to complete implementation.)
Please provide an estimate of the effort — # of people and # of actual person hours — required to complete this action step
Please provide an estimate of the cost of implementing this action step.
What types of additional resources were required to complete this action step?
What would you change about this action step?
What were the most significant barriers you encountered in implementing this action step?
How many people were (or will be when the training is completed) involved in the training?
* How long do you estimate it took (or will take) to complete this training for your staff/personnel?
* Was/Is the required training readily available?
* How did you (will you) provide this training for all of your staff/personnel?
* If commercial or publicly provided course, please identify: ** If 'Other,' please specify:
How much do you estimate you have spent (or will spend) on this training?
What types of additional resources were required to complete this training?
3. Train EMS personnel about the use of personnel protective equipment (PPE) and the risks of transporting potentially contaminated patients. The relative importance of gross vs. technical decontamination should be reviewed.
* Indicate your current progress in implementing this action step
Please provide any additional comments or explanation that will help to explain your progress.
* How long did it take to implement this step? (If you have not completed this step, estimate how long it will take you to complete implementation.)
Please provide an estimate of the effort — # of people and # of actual person hours — required to complete this action step
Please provide an estimate of the cost of implementing this action step.
What types of additional resources were required to complete this action step?
What would you change about this action step?
What were the most significant barriers you encountered in implementing this action step?
How many people were (or will be when the training is completed) involved in the training?
* How long do you estimate it took (or will take) to complete this training for your staff/personnel?
* Was/Is the required training readily available?
* How did you (will you) provide this training for all of your staff/personnel?
* If commercial or publicly provided course, please identify: ** If 'Other,' please specify:
How much do you estimate you have spent (or will spend) on this training?
What types of additional resources were required to complete this training?
4. Train EMS officials in advanced ICS (ICS 700 or equivalent).
* Indicate your current progress in implementing this action step
* Indicate your current progress in implementing this action step
Please provide any additional comments or explanation that will help to explain your progress.
* How long did it take to implement this step? (If you have not completed this step, estimate how long it will take you to complete implementation.)
Please provide an estimate of the effort — # of people and # of actual person hours — required to complete this action step
Please provide an estimate of the cost of implementing this action step.
What types of additional resources were required to complete this action step?
What would you change about this action step?
What were the most significant barriers you encountered in implementing this action step?
How many people were (or will be when the training is completed) involved in the training?
* How long do you estimate it took (or will take) to complete this training for your staff/personnel?
* Was/Is the required training readily available?
* How did you (will you) provide this training for all of your staff/personnel?
* If commercial or publicly provided course, please identify: ** If 'Other,' please specify:
How much do you estimate you have spent (or will spend) on this training?
What types of additional resources were required to complete this training?
5. Plan for mobilizing 50 ambulances within 10 minutes after the blast.
* Indicate your current progress in implementing this action step
Please provide any additional comments or explanation that will help to explain your progress.
* How long did it take to implement this step? (If you have not completed this step, estimate how long it will take you to complete implementation.)
Please provide an estimate of the effort — # of people and # of actual person hours — required to complete this action step
Please provide an estimate of the cost of implementing this action step.
What types of additional resources were required to complete this action step?
What would you change about this action step?
What were the most significant barriers you encountered in implementing this action step?
6. Plan describing each agency’s role in the command structure. This should include how critical functions of command, staging, triage, and treatment will be accomplished in the first 10 minutes of a response; how additional ICS elements will be filled over the first hour; and how the ICS structure will be formally filled by officials trained in advanced ICS (ICS-700 or equivalent) by the end of the first hour.
Please provide any additional comments or explanation that will help to explain your progress.
* How long did it take to implement this step? (If you have not completed this step, estimate how long it will take you to complete implementation.)
Please provide an estimate of the effort — # of people and # of actual person hours — required to complete this action step
Please provide an estimate of the cost of implementing this action step.
What types of additional resources were required to complete this action step?
What would you change about this action step?
What were the most significant barriers you encountered in implementing this action step?
7. Plan describing how alternative transport for 200 ambulatory patients will be initiated in the first 10 minutes after an explosion.
* Indicate your current progress in implementing this action step
Please provide any additional comments or explanation that will help to explain your progress.
* How long did it take to implement this step? (If you have not completed this step, estimate how long it will take you to complete implementation.)
Please provide an estimate of the effort — # of people and # of actual person hours — required to complete this action step
Please provide an estimate of the cost of implementing this action step.
What types of additional resources were required to complete this action step?
What would you change about this action step?
What were the most significant barriers you encountered in implementing this action step?
8. Plan describing the details of interdisciplinary communications.
* Indicate your current progress in implementing this action step
Please provide any additional comments or explanation that will help to explain your progress.
* How long did it take to implement this step? (If you have not completed this step, estimate how long it will take you to complete implementation.)
Please provide an estimate of the effort — # of people and # of actual person hours — required to complete this action step
Please provide an estimate of the cost of implementing this action step.
What types of additional resources were required to complete this action step?
What would you change about this action step?
What were the most significant barriers you encountered in implementing this action step?
9. Plan for decontaminating and protecting personnel that addresses the following:
Agency responsible for scene assessment and determining what (if any) decontamination measures are required.
Realistic assessment of the time required to deploy decontamination resources for ambulatory and non-ambulatory patients.
Deployment of decontamination resources to event site, secondary triage sites, or receiving hospitals.
Transport of patients after gross decontamination (technical decontamination of patients before transport; appropriate personal protective equipment, or PPE; and appropriately equipped destination choices).
* Indicate your current progress in implementing this action step
Please provide any additional comments or explanation that will help to explain your progress.
* How long did it take to implement this step? (If you have not completed this step, estimate how long it will take you to complete implementation.)
Please provide an estimate of the effort — # of people and # of actual person hours — required to complete this action step
Please provide an estimate of the cost of implementing this action step.
What types of additional resources were required to complete this action step?
What would you change about this action step?
What were the most significant barriers you encountered in implementing this action step?
10. Plan to establish secondary triage points for ambulatory patients (ideally, within the first hour after the explosion). This should address the following:
How sites can be activated and staffed with at least one transport ambulance, sufficient law enforcement personnel for security, and adequate support staff to record arrivals.
How gross and technical decontamination could be accomplished at affected site(s).
How medical care at secondary triage sites could be converted to treatment areas (e.g., provision of medical supplies, additional medical personnel, and other logistical concerns).
* Indicate your current progress in implementing this action step
Please provide any additional comments or explanation that will help to explain your progress.
* How long did it take to implement this step? (If you have not completed this step, estimate how long it will take you to complete implementation.)
Please provide an estimate of the effort — # of people and # of actual person hours — required to complete this action step
Please provide an estimate of the cost of implementing this action step.
What types of additional resources were required to complete this action step?
What would you change about this action step?
What were the most significant barriers you encountered in implementing this action step?
11. Plan to establish criteria for determination of death at the scene, particularly in a mass casualty situation, and appropriately manage the deceased.
* Indicate your current progress in implementing this action step
Please provide any additional comments or explanation that will help to explain your progress.
* How long did it take to implement this step? (If you have not completed this step, estimate how long it will take you to complete implementation.)
Please provide an estimate of the effort — # of people and # of actual person hours — required to complete this action step
Please provide an estimate of the cost of implementing this action step.
What types of additional resources were required to complete this action step?
What would you change about this action step?
What were the most significant barriers you encountered in implementing this action step?
