Lecture 2

Question 1

national response framework (NRF)

Answer 1

-guide on response to major disasters
-framework
-scale it to small or large incidents
-scope is domestic incident response
-immediate actions to save lives, protect property and the environment, and meet basic human needs
-The execution of emergency plans and actions to support
short-term recovery
-ALWAYS IN AFFECT
-elements can be implemented as needed on a scalable, flexible basis to improve response
-living document
-needs support from government BUT also private business to have a successful outcome

Question 2

NRF applicability’s

Answer 2

-applies to everyone
-state, government, companies
-apples to all federal dept and agencies that may be requested to provide assistance in Catastrophic Incidents including:
-Major disasters, emergencies, and terrorist incidents/threat
-Other events requiring Department of Homeland Security
(DHS) assistance with national coordination

Question 3

response doctrine: overview

Answer 3

-response doctrine define basic roles, responsibilities and operational concepts for response across all levels of government, Non Governmental Organizations (NGOs) and the private sector

Question 4

5 key principles of NRF

Answer 4

• 1. engaged partnership
• 2. tiered response- handle at the lowest level and go from there -> can come all the way back around to low level (bell curve)
• 3. scalable, flexible, and adaptable operational capabilities
• 4. unity of effort through unified command (use common lang)
• 5. readiness to act- best care possible through preparedness
• handle at the lowest level and go from there
• needs to be scaled (may start small and get bigger)

Question 5

NRF is always in affect

Answer 5

-The Framework is always in effect, and elements can be implemented as needed on a scalable, flexible basis to improve response.

Question 6

federal response goals for NRF

Answer 6

• support the states to:
• ensure basic human needs are met
• Restore critical infrastructure
• Restore essential government services
• Roles:
• provide resources and capabilities to support the state response
• serve as first responders for incidents involving primary federal jurisdiction or authorities
• Work with private sector and nongovernmental organizations who support response efforts

Question 7

federal response key players

Answer 7

-president leads the federal government response
-secretary of Homeland Security is the principal federal
official for domestic incident management consistent with
HSPD-5
-The FEMA Administrator is responsible of the preparation
for, protection against, response to, and recovery from
all-hazards incidents
-When DHS coordination is NOT required, federal agencies
may provide assistance consistent with their authorities
-attorney general- serves as the chief law enforcement officer
-secretary of defense- approves requests for military support
-secretary of state- coordinates international response
-director of national intelligence- oversees national intelligence

Question 8

emergency management

Answer 8

-the people who create the framework for responding to incidents
-the managerial function charged with creating the framework within which
communities reduce vulnerability to hazards, emergencies and cope with disasters.
-comprehensive, risk-drive, integrated, coordinated, progressive, collaborative, flexible, professional
-creates safer communities that can cope with disaster
-integrated

Question 9

integrated management system

Answer 9

• adapted by emergency managers in 1980s
• well coordination and networked
• big picture approach
• all threats/hazards approach:
• direction
• control
• coordination
• whole community preparedness

Question 10

why emergency management?

Answer 10

• threats and hazards exist- never go away
• disaster events have a significant impact on humans and the environment
• success in dealing with disasters depends primarily on how well prepared, organized, and coordinated we are
• emergency management principles and practices actually work to achieve successful outcomes

Question 11

Principles of Emergency Management

Answer 11

• comprehensive
• risk-driven- emergency managers need to ensure unity of effort in order to assess situations and use a risk management approach to respond to things
• integrated- networking with private and public entities
• coordinated
• progressive- anticipate disasters
• collaborative
• flexible- the plan needs to change with the situation
• professional- use science and evidence based decisions

Question 12

why an integrated response?

Answer 12

-Existing networks, linkages, and partnerships.
-Communication across organizational and jurisdictional boundaries,
enabling all emergency functions to communicate with each other.
-Creative thinking about resource shortfalls.
-Coordinated testing, training, and exercising.
-Improved ability to see the “big picture” for simultaneous responses

Question 13

The stafford act

Answer 13

-Covers all hazards, including natural disasters and terrorist events.
-Provides primary authority for the Federal Government to respond to
disasters and emergencies.
-Gives FEMA responsibility for coordinating Government response efforts.
-The President’s authority is delegated to FEMA through separate
mechanisms.
-Describes the programs and processes by which the Federal Government provides disaster and emergency assistance to State and local governments, tribal nations, eligible private nonprofit organizations, and individuals affected by a declared major disaster or emergency
-presidential disaster declaration triggers financial help for the state or person -> any disaster or emergency

Question 14

1850

Answer 14

-president is able to issue a disaster order to declare an area where

Question 15

executive order 12127 (1979)

Answer 15

-the order that established FEMA

Question 16

under the stafford act the president can designate any disaster as….

Answer 16

-an emergency
-or major disaster
-In certain circumstances, the President may declare an “emergency”
unilaterally, but may only declare a “major disaster” at the request of a
Governor or tribal Chief Executive who certifies the State or tribal
government and affected local governments are overwhelmed

Question 17

emergency

Answer 17

“Any occasion or instance for which federal assistance is
needed to supplement state and local efforts and
capabilities to save lives and to protect property and public
health and safety, or to lessen or avert the threat of a
catastrophe in any part of the U.S.”

Question 18

major disaster

Answer 18

-“Any natural catastrophe … regardless of cause, any fire, flood, or
explosion … of sufficient severity to warrant major disaster
assistance …”
-Severe impact on lives and property
-Effective response beyond local and state capabilities

Question 19

major disaster declaration process

Answer 19

• 1. joint preliminary damage assessment (PDA)- how bad is the damage
• 2. formal governors request for assistance
• 3. FEMA recommendation
• 4. presidential declaration

Question 20

post-katrina emergency management reform act

Answer 20

• Established a Disability Coordinator -> ensure individuals with disabilities are addressed in emergency preparedness and disaster relief. (disabled were done wrong during katrina)
• Establishes the National Emergency Family Registry and Locator System to reunify separated family members.
• Coordinates and supports precautionary evacuations and recovery efforts. (evacuation was poor)
• Provides transportation assistance for relocating and returning individuals displaced from their residences in a major disaster.
• Provides case management assistance to identify and address unmet needs of survivors of major disasters.

Question 21

sandy recovery improvement act

Answer 21

• The Sandy Recovery Improvement Act of 2013 (SRIA) made changes to the way disaster assistance is delivered under a variety of programs.
• Public assistance.
• Hazard mitigation.
• Disaster cost reduction.
• Individual assistance.
• Unified federal review for disaster recovery projects.
• Payment of government employees for essential assistance.
• tribal emergency & major disaster request -> -tribal government can declare emergencies and request help from federal govt without going through the state

Question 22

FEMA mission and goals

Answer 22

• Federal Emergency Management Agency
• established by 1979.
• became part of the Department of Homeland Security (DHS) in 2003.
• mission is to support the Whole Community to ensure that as a Nation we work together to build, sustain, and improve our capability to prepare for, prevent, protect against, respond to, recover from, and mitigate all hazards.
• leads and supports the Nation in a risk-based, comprehensive emergency management system of preparedness that includes prevention, protection, response, recovery, and mitigation

Question 23

FEMA: coordination and support

Answer 23

FEMA’s Role:

• Coordinate the Federal resources in case of Federal emergency or disaster
• Provide disaster assistance to individuals and communities
• FEMA is not responsible (they assist) -> the state is responsible

Question 24

partners in emergency management

Answer 24

• local government
• tribal government
• nonprofit sector
• state government
• private sector
• community members
• territorial government
• the federal government cant do everything

Question 25

whole community approach to emergency management

Answer 25

-Whole community is a means by which residents, emergency management practitioners, organization and community leaders, and government officials can collectively understand and assess the needs of their respective communities and determine the best ways to organize and strengthen their assets, capacities and interests.” -A Whole Community Approach to Emergency Management: Principles, Themes, and Pathways for Action -even civilians

Question 26

national response coordination center (NRCC)

Answer 26

- Monitors potential or developing incidents - Supports the efforts of regional and field components - Initiates mission assignments or reimbursable agreements to activate other federal departments and agencies - Activates and deploys national-level specialized teams

Question 27

joint field offices (JFO)

Answer 27

The Joint Field Office (JFO): - Is the primary federal incident management field structure - Provides a central location for the coordination of response and recovery efforts - established locally - facilitates the way FEMA responds to a location -> facilitates federal response to local area

Question 28

phases of emergency management

Answer 28

- 1. mitigation- effort to reduce loss of life and property by lessening the impact of disasters and emergencies - 2. response - 3. recovery - 4. preparedness

Question 29

mitigation

Answer 29

-The effort to reduce loss of life and property by lessening the impact of disasters and emergencies -Structural and non-structural measures (observation a shelf may fall in a disaster and cause harm) -Comprehensive plan -> Period prior to an imminent or actual hazard (not after...after = a response) -1. organize the planning process and response -2. assess risks and capabilities -.3 develop of mitigation strategy -4. adopt and implement the plan

Question 30

prepardeness

Answer 30

- continuous cycle - planning, organizing, training, exercising, evaluate/improve - reevaluate plans to make sure they work

Question 31

response

Answer 31

- actual hardware - addressing the issue - coordination and management of resources - personnel - equipment - safety - the response phase is a is a reaction to the occurrence of a catastrophic disaster or emergency.

Question 32

recovery

Answer 32

-national disaster recovery framework (a book) -overall process by which communities can capitalize on opportunities to rebuild stronger, smarter, and safer -not everybody recovers -mitigation makes recovery more likely (being more prepared) -Recovery is focused on a timely restoration, strengthening and revitalization of: -Infrastructure -Housing -Sustainable economy -Health, social, cultural, historic and environmental fabric of communities affected by a catastrophic incident

Question 33

when does recovery start

Answer 33

- preparedness - disaster - short term- days - intermediate- weeks/months - long term- years

Question 34

mass causality incidents (MCI)

Answer 34

- Any incident causing injury and/or death of a number of patients beyond what medical care resources can routinely manage within a specific geographic area. - An MCI may be the result of any number of events including natural disaster, human error, accident, or terrorist activity. - more people injured than one EMS unit can support

Question 35

MCI plan

Answer 35

- The goal of the MCI plan is to ensure rapid medical assistance is received by victims and to provide this assistance through adequate and coordinated efforts that will minimize loss of life, disabling injuries, and human suffering - saving lives -> maximize - how do we determine who to save and who not to save -> who is the most likely to survive -> triage

Question 36

LCAN

Answer 36

- first thing you do when you get to a scene - information you need to relay - im at stony brook, there is a school bus crash, im going to start triage, i need ambulances - L – Location - C – Condition - A – Actions - N – Needs

Question 37

START triage systems

Answer 37

- normally the first person on scene is the incident commander (until someone else comes) - first thing to do as a medical professional -> triage - must know youre taking care of the right person in the right order - S.T.A.R.T. Triage stands for: - Simple Triage (30s) And Rapid Treatment - telling the people to move to a certain area -> separates all the wounded that are able to understand and walk - Assessment: - Respirations- rate of breath -> looking for if its greater than 30 times a minute - Pulse (Blood Flow Perfusion) -> blood getting to organs to stay alive (using pulse or capillary refill) - Mental Status (Neurological) - assess breathing -> if breathing (if not = black) -> assess perfusion (capillary refill or pulse) -> if fine (if not = red) -> mental status -> if bad -> yellow

Question 38

triage

Answer 38

- to sort out - saving the people who are most likely to survive - standardized process - too many casualties > not enough resources - we want to balance causalities to resources - 30 seconds to perform triage on a single person

Question 39

triage tags

Answer 39

- black tag- expectant, dead or expected to die, not breathing - red tag- immediate patients, life threatening injury, priority 1 - yellow tag- serious non-life threatening injury, priority 2, urgent - green tag- walking wounded, priority 3, delayed - white tag- involved, in the vicinity, not hurt

Question 40

triage examples

Answer 40

- follow command -> green - pulse but no breath -> black (even if not dead!) - open an airway if someone isnt breathing! -> still not breathing -> black tag - greater than 30/min respiration -> red tag - greater than 2s capillary refill -> red tag - *no radial pulse* -> red category -> can be cardiac arrest, they may have a carotid or femoral pulse just not radial (low perfusion) - broken leg -> yellow tag - mental confused but everything else is fine -> red - IF YOU FAIL ANY OF RPM YOU GET RED!!!!!!!!!!!

Question 41

patient has multiple penetrating injuries, blood in ears, response only to pain, airway clear, RR 20, strong radial pulse

Answer 41

- breathing -> less than 30 -> good - perfusion (pulse) -> good - mental status -> only responds to pain -> bad -> red