Fire/EMS Department Operational Considerations and Guide for Active Shooter and Mass Casualty Incidents
Fire/EMS Department Operational Considerations and Guide for Active Shooter and Mass Casualty Incidents (PDF)
Source: U.S. Fire Administration
This guide is a fire and emergency medical services (EMS) resource that can be used to support planning and preparation for active shooter and mass casualty incidents. These complex and demanding incidents may be well beyond the traditional training and experience of the majority of firefighters and emergency medical technicians. The U.S. Fire Administration offers this guide as one source of many available for the public safety community, but it takes into consideration the diverse local service levels available across America. In developing the guide, we consulted with individuals and groups engaged in fire and pre-hospital emergency medical services, law enforcement, and hospital medical and trauma care. We also consulted with public safety organizations and numerous federal agencies.
Drowsy Driving and Risk Behaviors — 10 States and Puerto Rico, 2011–2012
Source: Morbidity and Mortality Weekly Report (CDC)
Findings in published reports have suggested that drowsy driving is a factor each year in as many as 7,500 fatal motor vehicle crashes (approximately 25%) in the United States (1,2). CDC previously reported that, in 2009–2010, 4.2% of adult respondents in 19 states and the District of Columbia reported having fallen asleep while driving at least once during the previous 30 days (3). Adults who reported usually sleeping ≤6 hours per day, snoring, or unintentionally falling asleep during the day were more likely to report falling asleep while driving compared with adults who did not report these sleep patterns (3). However, limited information has been published on the association between drowsy driving and other risk behaviors that might contribute to crash injuries or fatalities. Therefore, CDC analyzed responses to survey questions regarding drowsy driving among 92,102 respondents in 10 states and Puerto Rico to the 2011–2012 Behavioral Risk Factor Surveillance System (BRFSS) surveys. The results showed that 4.0% reported falling asleep while driving during the previous 30 days. In addition to known risk factors, drowsy driving was more prevalent among binge drinkers than non-binge drinkers or abstainers and also more prevalent among drivers who sometimes, seldom, or never wear seatbelts while driving or riding in a car, compared with those who always or almost always wear seatbelts. Drowsy driving did not vary significantly by self-reported smoking status. Interventions designed to reduce binge drinking and alcohol-impaired driving, to increase enforcement of seatbelt use, and to encourage adequate sleep and seeking treatment for sleep disorders might contribute to reductions in drowsy driving crashes and related injuries.
Statewide Ban on Ambulance Diversions Reduces Ambulance Turnaround Time and Emergency Department Length of Stay for Patients Admitted to the Hospital
Statewide Ban on Ambulance Diversions Reduces Ambulance Turnaround Time and Emergency Department Length of Stay for Patients Admitted to the Hospital
Source: Agency for Healthcare Research and Quality
In 2009, the Massachusetts Department of Public Health became the first State to ban ambulance diversions—a practice in which a crowded emergency department temporarily stops accepting patients who are transported by ambulance, instead sending them to other nearby emergency departments. To make implementation of the ban as smooth as possible, the Department of Public Health gave hospitals 6 months advance notice, provided general guidance on how hospitals could improve overall patient flow (thereby reducing crowding), and offered administrators frequent opportunities to ask questions and seek guidance on implementation. Despite fears that the ban would lead to increased emergency department crowding and ambulance delays, the steps hospitals took to improve patient flow in the wake of the ban prevented such problems. At nine Boston-area hospitals, emergency department length of stay for patients subsequently admitted to the hospital fell, as did ambulance turnaround time (i.e., how long the ambulance spends at the hospital before returning to service). Emergency department leaders strongly support the ban, believing it has improved patient care, strengthened relationships among health care staff, and increased patient satisfaction.
Moderate: The evidence consists of pre- and post-implementation comparisons of length of stay for patients in the emergency department and ambulance turnaround times, along with post-implementation feedback from emergency department leaders about their impressions of the impact of the ban.
Massachusetts Department of Public Health
Use By Other Organizations
In King County, WA, 18 emergency departments voluntarily agreed to halt diversions in 2011.
Date First Implemented
Indicators of School Crime and Safety: 2013
Source: National Center for Education Statistics
A joint effort by the Bureau of Justice Statistics and National Center for Education Statistics, this annual report examines crime occurring in schools and colleges. This report presents data on crime at school from the perspectives of students, teachers, principals, and the general population from an array of sources–the National Crime Victimization Survey, the School Crime Supplement to the National Crime Victimization Survey, the Youth Risk Behavior Survey, the School Survey on Crime and Safety, the School and Staffing Survey and the Campus Safety and Security Survey.
New Report Outlines the Rise of Crude-by-Rail in North America
Source: Oil Change International
Today Oil Change International released the first major exposé of the burgeoning crude-by-rail industry in North America, detailing where crude trains are being loaded and unloaded, how many oil trains are crossing the North American continent, and what companies are involved.
Runaway Train: The Reckless Expansion of Crude By Rail in North America is the first in a series, exposing North America’s booming crude-by-rail industry. It is published in conjunction with the launch of a unique interactive online map of crude-by-rail terminals and potential routes in North America.
The report shows that there are currently over 230 crude-by-rail terminals in Canada and the United States either in operation, expanding, under construction or planned.
Today, one million barrels of crude oil per day is loaded and unloaded on the North American rail network, meaning roughly 135 trains of 100 cars each are moving dangerous crude oil each day through the continent. But if used at full capacity, existing loading and unloading terminals could handle 3.5 times more crude-by-rail traffic and by 2016 that capacity could grow to over 5 times current levels.
Dangerous by Design 2014 highlights preventable pedestrian fatalities
Source: Smart Growth America
Every day, in communities across the country, people are killed while walking to school, to work or to the store. From 2003 to 2012, more than 47,000 people were killed while walking – sixteen times the number of people who died in natural disasters, but without the corresponding level of urgency. But these deaths can be prevented and it is past time for our state and federal leaders to act.
Dangerous by Design 2014, a new report released today by the National Complete Streets Coalition, a program of Smart Growth America, takes a look at where these fatalities happen and who’s most at risk, presenting data from every county, metro area, and state. The report also ranks the major metropolitan areas according to the Pedestrian Danger Index (PDI), which assesses the safety of walking by normalizing fatality rates by how often people walk to work, and by the share of traffic fatalities suffered by people on foot.
As in past years, Sunbelt communities that grew in the post-war period top the list of most dangerous regions according to the PDI: Orlando, Tampa-St. Petersburg, Jacksonville, Miami, Memphis, Birmingham, Houston, Atlanta and Charlotte. These areas developed rapidly, with many low-density neighborhoods overly dependent on extra wide, fast arterial roads to connect homes, schools, jobs and shops. Such roads rarely feature the facilities needed for safe travel by foot.
The report also calls out the unacceptably high number of pedestrian deaths seen in nearly every major metro region. The fact is that even our most walk-friendly communities can—and must—do more.
At the Nexus of Cybersecurity and Public Policy: Some Basic Concepts and Issues
Source: National Research Council
We depend on information and information technology (IT) to make many of our day-to-day tasks easier and more convenient. Computers play key roles in transportation, health care, banking, and energy. Businesses use IT for payroll and accounting, inventory and sales, and research and development. Modern military forces use weapons that are increasingly coordinated through computer-based networks. Cybersecurity is vital to protecting all of these functions. Cyberspace is vulnerable to a broad spectrum of hackers, criminals, terrorists, and state actors. Working in cyberspace, these malevolent actors can steal money, intellectual property, or classified information; impersonate law-abiding parties for their own purposes; damage important data; or deny the availability of normally accessible services. Cybersecurity issues arise because of three factors taken together – the presence of malevolent actors in cyberspace, societal reliance on IT for many important functions, and the presence of vulnerabilities in IT systems. What steps can policy makers take to protect our government, businesses, and the public from those would take advantage of system vulnerabilities?
At the Nexus of Cybersecurity and Public Policy offers a wealth of information on practical measures, technical and nontechnical challenges, and potential policy responses. According to this report, cybersecurity is a never-ending battle; threats will evolve as adversaries adopt new tools and techniques to compromise security. Cybersecurity is therefore an ongoing process that needs to evolve as new threats are identified. At the Nexus of Cybersecurity and Public Policy is a call for action to make cybersecurity a public safety priority. For a number of years, the cybersecurity issue has received increasing public attention; however, most policy focus has been on the short-term costs of improving systems. In its explanation of the fundamentals of cybersecurity and the discussion of potential policy responses, this book will be a resource for policy makers, cybersecurity and IT professionals, and anyone who wants to understand threats to cyberspace.
Air Attack Against Wildfires: Understanding U.S. Forest Service Requirements for Large Aircraft
Source: RAND Corporation
An aging fleet of contracted fixed-wing airtankers and two fatal crashes in 2002 led the U.S. Forest Service to investigate how to recapitalize its fleet of airtankers. The Forest Service asked RAND for assistance in determining the composition of a fleet of airtankers, scoopers, and helicopters that would minimize the total social costs of wildfires, including the cost of large fires and aircraft costs. The research team developed two separate but complementary models to estimate the optimal social cost-minimizing portfolio of initial attack aircraft — that is, aircraft that support on-the-ground firefighters in containing a potentially costly fire while it is still small. The National Model allocates aircraft at the national level, incorporating data on ten years of historical wildfires, and the Local Resources Model provides a more nuanced view of the effect of locally available firefighting resources, relying on resource allocation data from the Forest Service’s Fire Program Analysis system. Both models favor a fleet mix dominated by water-carrying scoopers, with a niche role for retardant-carrying airtankers. Although scoopers require proximity to an accessible body of water, they have two advantages: shorter cycle times to drop water and lower cost. Two uncertainties could affect the overall optimal fleet size, however: future improvements in the dispatch of aircraft to fires and the value attributed to fighting already-large fires with aircraft.
Reducing Alcohol-Impaired Driving: Publicized Sobriety Checkpoint Programs
Source: Community Preventive Services Task Force (CDC)
Publicized sobriety checkpoint programs are a form of high visibility enforcement where law enforcement officers stop drivers systematically to assess their degree of alcohol impairment. Media efforts to publicize the enforcement activity are an integral part of these programs. The program goal is to reduce alcohol-impaired driving by increasing the public’s perceived risk of arrest while also arresting alcohol-impaired drivers identified at checkpoints.
There are two types of sobriety checkpoints:
- Selective Breath Testing (SBT) – police must have reason to suspect that a stopped driver is intoxicated before a breath test can be requested. SBT is used in the United States.
- Random Breath Testing (RBT) – all stopped drivers are given breath tests for blood alcohol concentration (BAC) levels. RBT is used in Australia and several European countries.
Chemical Facility Security: Issues and Options for the 113th Congress (PDF)
Source: Congressional Research Service (via Federation of American Scientists)
The Department of Homeland Security (DHS) has statutory authority to regulate chemical facilities for security purposes. The 113th Congress extended this authority through October 4, 2014. Congressional policymakers have debated the scope and details of reauthorization and continue to consider establishing an authority with longer duration. Some Members of Congress support an extension, either short- or long-term, of the existing authority. Other Members call for revision and more extensive codification of chemical facility security regulatory provisions. Questions regarding the current law’s effectiveness in reducing chemical facility risk and the sufficiency of federal chemical facility security efforts exacerbate the tension between continuing current policies and changing the statutory authority.
Situations involving active shooters in schools have increased in recent years. We define an “active shooter incident” as an occurrence where one or more individuals participate in an ongoing, random, or systematic shooting spree with the objective of multiple or mass murders. Attempts to build a profile of active school shooters have been unsuccessful to date, although there is some evidence to suggest that mental instability, social isolation, a self-perception of catastrophic loss, and access to weapons play a role in the identification of the shooter in a school shooting incident. This article details theories and after-the-fact findings of investigations on previous school shooters, and we offer an application of Levin and Madfis’s Five Stage Sequential Model to Adam Lanza, the perpetrator of the massacre at Sandy Hook Elementary School in December, 2012. Prevention strategies, suggestions for positive school climates, school security for the physical plants, and threat assessments are discussed, and implications for future research are offered.
Assistance to Firefighters Program: Distribution of Fire Grant Funding (PDF)
Source: Congressional Research Service (via National Agricultural Law Center)
The Assistance to Firefighters Grant (AFG) Program, also known as fire grants or the FIRE Act grant program, was established by Title XVII of the FY2001 National Defense Authorization Act (P.L. 106-398). Currently administered by the Federal Emergency Management Agency (FEMA), Department of Homeland Security (DHS), the program provides federal grants directly to local fire departments and unaffiliated Emergency Medical Services (EMS) organizations to help address a variety of equipment, training, and other firefighter-related and EMS needs. A related program is the Staffing for Adequate Fire and Emergency Response Firefighters (SAFER) program, which provides grants for hiring, recruiting, and retaining firefighters.
The fire grant program is now in its 14th year. The Fire Act statute was reauthorized in 2012 (Title XVIII of P.L. 112-239) and provides new guidelines on how fire grant money should be distributed. There is no set geographical formula for the distribution of fire grants—fire departments throughout the nation apply, and award decisions are made by a peer panel based on the merits of the application and the needs of the community. However, the law does require that fire grants be distributed to a diverse mix of fire departments, with respect to type of department (paid, volunteer, or combination), geographic location, and type of community served (e.g., urban, suburban, or rural).
New: Residential Building Electrical Fires (2009-2011) (PDF)
Source: U.S. Fire Administration
Findings from this report:
- An estimated 25,900 residential building electrical fires were reported to fire departments within the United States each year. These fires caused an estimated 280 deaths, 1,125 injuries and $1.1 billion in property loss.
- Residential building electrical fires resulted in greater dollar loss per fire than residential building nonelectrical fires.
- In 79 percent of residential building electrical fires, the fire spread beyond the object where the fire started.
- The leading items most often first ignited in residential building electrical fires were electrical wire/cable insulation (30 percent) and structural member or framing (19 percent).
Secretary of Energy Advisory Board — Task Force Report on FracFocus 2.0 (March 28, 2014) (PDF)
Source: U.S. Department of Energy (Energy Advisory Board)
This report presents the findings and recommendations for the Secretary of Energy Advisory Board (SEAB) Task Force on FracFocus. This Task Force report builds upon and extends the 2011 SEAB Subcommittee report on the environmental impacts of unconventional gas production.
The Task Force believes that the FracFocus experience to date demonstrates the ease of disclosure of chemicals added to fracturing fluid for companies, the value of this disclosure for the public, and the importance of public confidence in the quality and accessibility of the FracFocus chemical registry data. It has accomplished a good deal and shows the capacity to make improvements at modest additional cost. FracFocus has greatly improved public disclosure quickly and with a significant degree of uniformity.
The Task Force recommends a number of actions that will further improve the effectiveness of the FracFocus disclosure of chemical additives and improve transparency for regulators, operating companies, and the public. Recommendations are made for improving the accuracy and completeness of registry submissions. In addition, the Task Force believes that an independent audit to assess the accuracy and compliance of the process will be useful for all stakeholders.
Reducing Firearm-Related Injuries and Deaths in the United States: Executive Summary of a Policy Position Paper From the American College of Physicians
Firearm violence is not only a criminal justice issue but also a public health threat. A comprehensive, multifaceted approach is necessary to reduce the burden of firearm-related injuries and deaths on individuals, families, communities, and society in general. Strategies to reduce firearm violence will need to address culture, substance use and mental health, firearm safety, and reasonable regulation, consistent with the Second Amendment, to keep firearms out of the hands of persons who intend to use them to harm themselves and others, as well as measures to reduce mass casualties associated with certain types of firearms.
As an organization representing physicians who have first-hand experience with the devastating impact firearm-related injuries and deaths have on the health of their patients, the ACP has a responsibility to participate in efforts to mitigate these needless tragedies. Because patients trust their physicians to advise them on issues that affect their health, physicians can help to educate the public on the risks of firearms and the need for firearm safety through their encounters with their patients. This Executive Summary provides a synopsis of the full position paper, which is available in Appendix 1.
Facts for Features: 2014 Hurricane Season Begins
Source: U.S. Census Bureau
The North Atlantic hurricane season begins June 1 and lasts through Nov. 30. The U.S. Census Bureau produces timely local statistics that are critical to emergency planning, preparedness and recovery efforts. The growth in population of coastal areas illustrates the importance of emergency planning and preparedness for areas that are more susceptible to inclement weather conditions. The Census Bureau’s rich, local economic and demographic statistics from the American Community Survey gives communities a detailed look at neighborhood-level statistics for real-time emergency planning for the nation’s growing coastal population.
Emergency planners and community leaders can better assess the needs of coastal populations using Census Bureau statistics. This edition of Facts for Features highlights the number of people living in areas that could be most affected by these dramatic acts of nature.
State Fire Death Rates and Relative Risk
Source: U.S. Fire Administration
The fire problem varies from region to region in the United States. This often is a result of climate, poverty, education, demographics, and other causal factors. Perhaps the most useful way to assess fire fatalities across groups is to determine the relative risk of dying in a fire. Relative risk compares the per capita rate for a particular group (e.g., Pennsylvania) to the overall per capita rate (i.e., the general population). The result is a measure of how likely a group is to be affected. For the general population, the relative risk is set at 1.
In addition to the District of Columbia, the states with the highest relative risk in 2010 included West Virginia, Alabama and Mississippi. The populace of West Virginia was 3.3 times more likely to die in a fire than the general population; however, people living in Oregon, Massachusetts and Arizona were 50 percent less likely to die in a fire than the population as a whole. Twenty-three states and the District of Columbia had a relative risk higher than that of the general population. Three states, Iowa, Washington and New Mexico, had a relative risk comparable to that of the general population.
Relative risk was not computed for HI, ME, ND, VT and WY due to small numbers of fire deaths which are subject to variability.