Transcript A-Report-from-Vigilant-Guard-and-the

A Report from Vigilant Guard and the
Role of NARR in Rad Exercises
Bill Stephens
NACCHO
Tarrant County
Public Health
Exercise Overview
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A 4-day, full-scale exercise for a 10KT IND
detonated in the center of Phoenix, AZ
following a tropical storm flood
 Over 8,000 participants, 200 local, state and
Federal agencies playing including 5
National Guard Civil Support Teams (CSTs)
 Local and state public health involved, but
primarily notional as observed at IC points
Public Health Exercise Objectives
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Objectives consolidated and focused on PHEP
Capabilities 5, 6, 7,9,10, 11,13
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Fatality Management
Information Sharing
Mass Care
Medical Materiel Management and Distribution
Medical Surge
Non-pharmaceutical intervention
Public Health Surveillance and Epi Investigation
Command and Control
Arizona Division of
Emergency & Military
Affairs and State EOC
Collated on Papago
Military Reservation
Key EM Operation Centers
91st Division of AZ National Guard Joint
Operations Center (JOC)
 State Division of Emergency Management
Center
 Maricopa Integrated Health System (County
hospital)
 Phoenix Fire Training Academy - simulated
rubble pile with radiological contamination and
manikin victims
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State DEM EOC
Well
located and equipped
EOC with redundant comms.
Large staffing with back-up and
liaisons with multiple agencies
throughout exercise.
Using WebEOC for 3 weeks.
Excellent plume modeling and
DOE presence and support.
Primary resource coordination
focused on severely injured in
the primary blast and fallout
zones.
Maricopa Integrated Health System
Medium
size hospital well
connected with HaVABed system,
EMSystems, redundant comm.
equipment, and numerous other
hospitals via voice and data
Have an excellent capability
with level 1 trauma and burn
center for both adult and pediatric
in the same facility.
Burn center is linked to
10+other hospitals via
telemedicine systems
Phoenix Fire Training – “Rubble Pile”
Extremely
well organized with
strong NIMS and ICS.
Advanced life support and
stabilization with advanced field
OR at base-camp prior to
transport
No presence or mention of
public health liaisons
PIO in communication with
JIC.
Victim sniffing dogs
Key Public Health Related Gaps Observed
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Exercise gap – no public health liaisons present
(exercise gap); notional only
Community reception center (CRC) function missing or
notional and CHC’s only playing in sheltering mode
(exercise gap)
Training on decon at base-camp and hospitals
outdated – scrubbing with soap and brushes!
Decon on injured patients done before treating trauma
- “it’s inevitable that in these [rad] MCI’s some patients will be lost [due to trauma
injuries] but it’s to protect other patients and personnel in ER from radiological
contamination.”
Opportunities for NARR Support
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Targeted training/exercise for EM and National Guard CSTs in roles
and responsibilities of public health – CRCs must be included
First receiver medical response – updated training for medical staff
on proper protocols for decon/trauma treatment (trauma first!)
Decontamination protocols for radiological contamination – REAC/TS
training?
Altered standards of care for radiological MCIs
Psychosocial/behavioral components not evident in protocols
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Proper briefing and exercise with media
First responders and receivers?
Table top exercise and seminar support early in cycle
 Selected tools cross-walked with identified gaps.