This past week, we noted that coordinated and connected bombings happened in both New York and New Jersey. As reported by multiple media outlets there were at least four devices or explosions.
Many of the sites impacted are a short distance from each other and most are within one metropolitan area. It only took a few people to build and place these devices.
To date, this does not appear to be a large terror cell with massive resources, thus this type of attack could easily be replicated. Because of this simple fact, those of us located within metropolitan areas must begin to think about how we will manage or be a part of the management of the mass casualty response.
Multiple Jurisdictions, but Not Federal
Because of the local control principles of our country, management of emergency events and disasters is handled by the local jurisdiction, often the municipal government. This has advantages, but in the coordinated attack in an urban area, this local control design, and escalation of a disaster through the declaration process prevents the ability to quickly coordinate.
If we look at the New York and New Jersey incident, we would need a local and state declaration and an EMAC signed to allow responders and medical professionals to cross over state lines and coordinate the overall response. While I am sure that the New York metropolitan area has provisions for this, begin to think about how this would work in the Midwest or other smaller urban areas that expand beyond state lines.
Numerous ICS, EMA, and Medical Nodes that Must Become a Network
During a coordinated mass casualty, there will be numerous IC’s that may not initially know there are multiple incidents. Each of these IC’s will establish a command post, begin the patient triage, and start to transport the patients to the appropriate hospitals.
Based on ICS best practices, the EMS branch will be staffed with a Triage Group Supervisor, and Treatment Group Supervisor, and a Transportation Group Supervisor. Part of the Transportation Group Supervisor’s job responsibilities are to ensure that each hospital receive the appropriate patients in a timely manner and to not overwhelm or move the disaster to one hospital.
Failure of this key position will only cause a tertiary disaster at one hospital that will delay the needed treatment of the patients.
Stay tuned for parts 2 and 3, as I will discuss the collaboration of the EMA’s and the Hospital Disaster Network.