Training and Tools for Emergency Responders

ATSDR has training programs and tools to help communities develop sound, evidence-based assumptions in preparing for hazardous materials (HazMat) emergencies and disasters. Information about some of these programs and tools follows.

Evidence-Based Disaster Lecture Series (Lessons Learned)

Introductory training in disaster planning helps communities define and sharpen their planning assumptions. This lecture series focuses on lessons learned from real-world experiences during actual disasters. These lessons are emphasized so that planners learn to anticipate how their community is likely to react under real disaster conditions, and plan accordingly.

Managing Hazardous Materials Incidents

See Managing Hazardous Materials Incidents section.

Toxicological Profiles

See Toxicological Profiles section.

ToxFAQs

ATSDR’s ToxFAQs are two-page summaries of the most commonly asked questions about a specific chemical. Information for the ToxFAQs is excerpted from the ATSDR Toxicological Profiles and Public Health Statements. Each ToxFAQ is a quick and easy-to-understand guide. Written in lay terms, the ToxFAQs can be used for risk communication with the general public. These summaries provide answers to the most frequently asked questions about exposure to hazardous substances found around hazardous waste sites and the effects of exposure on human health.

Mapping and Spatial Analysis Technologies for Public Health Preparedness

Geographic information systems (GIS) are computer-based tools that provide maps of traditional data sources. Public health and safety personnel can consider jurisdiction boundaries of ambulance and health services and identify the resources in relation to these services. Query tools can help identify resources that meet a particular need. Health professionals can also consider facilities that produce and use chemicals, to determine if adequate numbers of hospital personnel and emergencyresponders would be available. This information is critical to planning for possible chemical emergencies.

Mapping technology can also help estimate the dispersion of chemicals in the event of a release or other emergency. Computational models link to real-time weather data to predict the likely path of chemical plumes. This information can help local officials make evacuation decisions and determine how to control access to dangerous areas. The location and number of potentially affected persons and sensitive subpopulations (like children and the elderly) can be quickly identified. Communities benefit from these powerful tools by learning up-to-date information on public health resources, emergency equipment, and emergency contact numbers. For more information about GIS mapping and community preparedness, contact Cherryll Ranger at 404-498-0388 or 1-888-42-ATSDR (1-888-422-8737).

Case Studies in Environmental Medicine

Technical Assistance for Plans, Drills, and Exercises

Community planners can get ATSDR’s technical assistance in designing, implementing, and evaluating realistic scenarios for testing some or all components of their disaster plans. ATSDR reviews response and contingency plans with community staff for hospital emergency departments, emergency medical technicians, public health officials, and hazardous materials teams. ATSDR has assisted local scenario design teams in developing victim cue cards describing realistic symptoms, behaviors, and clinical signs. ATSDR also can provide on-site evaluators to assist communities in achieving their objectives.

Training To Manage Stress During Technological Disasters

Stress management training helps prepare communities to deal with psychosocial stress induced by HazMat events or terrorist attacks. HazMat events present considerable challenges, even for experienced personnel, because threats come from hazards that are often invisible and unfamiliar. This training is based on evidence-based research findings from technological (nonnatural) disasters as well as from ATSDR’s first-hand experience with communities affected by HazMat sites and chemical releases. Stress management training provides skills and strategies to promote resiliency and cope with the emotional issues and aftermath related to chemical threats.

Training can be tailored specifically for first responders, medical personnel, and communities.

Analysis of Surveillance Data From HazMat Incidents (HSEES)

See the Tracking Emergency Events article.

Risk Communication Training

This resource provides a framework for developing an effective risk communication plan in a public health crisis. The training addresses the role of risk communication in response operations, public perception of risks, and development of specific messages to accomplish identified goals.

“I learned how to communicate scientific information and uncertainty and I learned to always include the community from the beginning. This training made me aware of what I say. I found out that I can be sending the wrong message and that how I conduct myself in dealing with a community could change the real meaning of my message.”
—Training Attendee

Background

ATSDR trained and coached about 30 victims for this scenario, which was staged at Thames River State Pier in New London. The victims (Coast Guard Academy cadets) were made up to look like they had been injured. Victims’ injuries included a lost limb, facial cuts, and bleeding.

• “An unexpected Nor’easter taught some good disaster preparedness lessons.” —ATSDR Staff Member Evaluating the Exercise

  evaluated first-responder stress and its consequences on job performance,

• evaluated hospital decontamination effectiveness,

• evaluated emergency medical technician (EMT) activities, and

• provided ATSDR satellite stations to educate other jurisdictions and the public about ATSDR products and services.

Managing Hazardous Materials Incidents

To ensure that emergency personnel deliver appropriate and timely care to exposed persons, as well as take measures to protect themselves, they must have an understanding of decontamination procedures and personal protective equipment that they often do not get during their routine professional training. The three-volume Managing Hazardous Materials Incidents series and the companion videotape program (see box) provide emergency medical services (EMS) personnel and hospital emergency departments (EDs) with the necessary guidance to plan for, and improve their ability to respond to, incidents that involve human exposure to hazardous materials.

EMS and ED personnel must increasingly depend on external sources, such as ATSDR’s manuals, to help bridge this information gap.

The documents were revised in 2001–2002 with an additional emphasis on the specialized toxicology of children. Volume III now comprises medical management guidance for 50 chemicals plus an unidentified chemical. The unidentified chemical protocol provides basic victim management recommendations.

These documents are available in printed form, on CD-ROM, and on the ATSDR Web page (see contact information in box).—SCOTT WRIGHT, MS, EMT-P

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Over the last few years, doctors have begun to accept the need for evidence-based medical practice. Now, ATSDR staff members are educating planners and responders about the advantages of evidence-based disaster and terrorism planning.

Disaster planning is only as good as the assumptions on which it is based. Yet many of our planning assumptions come from conventional wisdom that has been disproved by systematic field disaster research studies. Such plans might serve only to create a false sense of security.

It is commonly assumed, for example, that trained emergency workers will handle disaster response activities. In fact, neighbors, family members, co-workers, and others who happen to be in the area carry out most initial search and rescue, on-site care, and transportation to hospitals. Most of these untrained bystanders think that the best course of action is to transport victims as quickly as possible to the closest hospitals or to one that is most familiar or renowned for giving emergency care (for example, the trauma center). If enough ambulances are not promptly available, by-standers do not tend to sit idly by waiting for them to arrive. Instead, bystanders use whatever is available to get victims to the hospital. Thus, most injured persons arrive by private car, bus, taxi, or even on foot.

Evidence-based medical practice: providing medical treatment based on rigorous scientific research studies.

These bystander actions have several important consequences.

• On-site first aid, triage, or decontamination stations are usually bypassed. This is because transporters are unaware of their existence or location, or because these stations provide what bystanders consider an inferior level of care compared with that available at hospitals.

• Hospitals do not tend to receive advance notice before injured persons begin to arrive. Thus, hospitals will not have the lead time to set up special facilities and equipment for any contaminated victims.

• Most injured persons end up at the closest (or most familiar) hospitals; other hospitals wait for victims that never arrive.

These patterns have several implications for planning. For example, victims transported by ambulance should probably not be taken to the closest hospital. Hospitals should not expect that victims of chemical incidents will be decontaminated at the scene, or that they will be sent to a specially designated decontamination hospital. Hospitals need to be ready for contaminated victims that show up without advance warning.

These are only a few examples to show that although it is important to plan, it is even more important to plan for the right things. Many lessons can be learned from field disaster research studies. Familiarity with this body of knowledge can help to assure that plans will actually work when put into action.—ERIK AUF DER HEIDE, MD, MPH, FACEP

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Tracking Emergency Events

ATSDR maintains the Hazardous Substances Emergency Events Surveillance (HSEES) system, which has tracked chemical incidents and associated public health consequences since 1990. Data are collected from many sources in the participating states (e.g., police departments, environmental agencies, hospitals, fire departments, and responsible companies) and from federal sources (e.g., the National Response Center and the Department of Transportation). The states enter data directly into the ATSDR database through a CDC/ATSDR Web-based computer entry program. Data can then be instantly accessed by the states and by ATSDR for analysis of existing and emerging patterns.

Because of recent terrorist activities in the United States, HSEES staff are working to

• improve the timeliness of entry of events into the system and

• develop aberration detection programs to help identify unusual or suspicious events.

HSEES has a geographic information system (GIS) that allows for mapping of incidents along with other community information (e.g., population estimates, nearby hospitals, nursing homes, day care centers, recreational areas, fire departments, prisons). This capability provides important public health information to prepare a response if necessary. Because common industrial chemicals are easy sources of weapons for terrorists, HSEES data are useful in planning and prevention activities. Knowing what chemicals are released into a community and planning for these releases is important for both general community public health as well as for preventing and responding to terrorist activity.—MAUREEN ORR, MS

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This page last updated on October 24, 2003
Contact Name: Wilma López/ mailto:WLopez@cdc.gov