The Banks is a proposed 18-acre neighborhood district on Cincinnati's riverfront between Paul Brown Stadium and Great American Ball Park. The Banks is Cincinnati’s attempt to create a vibrant destination on North side of the Ohio River. Over the years, Covington and Newport have successfully attracted the types of businesses on the South side that Cincinnati has longed for. The Banks has been planned for nearly 10 years yet the vision continues to change. The latest version envisions up to 1,800 apartments and condominiums, up to 400,000 square feet of retail space, up to 1 million square feet of office space and up to 400,000 square feet of hotel space.
Local citizens have weighed on a various concepts for the Banks. Most want some type of entertainment and leisure activity to be the primary focus. Of these, some type of sports-centric theme is the order of the day. Others see the Banks more as a created neighborhood with a style attractive to affluent residents looking for an urban lifestyle. Regardless of the vision, the Banks seems to finally be on track with ground breaking occurring sometime in early 2008 and occupancy beginning in 2009.
I had resisted about writing about the Banks even though hardly a day goes by without some news item in the local paper or news broadcasts. The concept has finally settled enough where I felt there was something of interest from a safety and security standpoint. While that is my area of interest, I’m somewhat skeptical that planners for the Banks will take some of these into consideration as they develop their final concept. I say that from a purely economic approach. The planners’ first priority is a development plan guaranteed to provide a return on investment. The look and layout of the Banks has to appeal both to developers as well as prospective residents and business owners. Safety and security concerns, while certainly not to be ignored, will be addressed only to the extent necessary to insure compliance without aversely impacting any return on investment. Any safety or security measure that means reduced revenue will most likely be discarded (unless laws or local codes compel otherwise).
The Banks will be situated between the two sports arenas downtown with the confluence of two major Interstates immediately to its north (Fort Washington Way) and the Ohio River immediately to the South. The geography means that at best, the Banks will only be accessible via three approaches (north, east, and west). Boaters may have access from the Ohio River but the majority of traffic will be land-based. Any east/west access is going to add additional traffic problems to the five bridges that cross the Ohio River near downtown. Access from the North will be very difficult with little room to design access due to the presence of Fort Washington Way.
Planners need to think through carefully about first responders access during a crisis response. The location does not lend itself to swift and efficient evacuation especially during peak use times. The Banks location means it will be exposed to any natural disaster or terrorist attack to adjacent sites (such as Paul Brown Stadium, Great American Ball Park, or the downtown area). Residents in the Banks could find themselves stranded as a tornado or fire creates gridlock in and around their locality. A crisis in any of the adjacent areas means casualties within the Banks will most likely have to air evacuated out. (A helipad for medical air rescue helicopters would be a nice and easy addition to the grounds.) If proper egress routes are not planned during the concept stage, gridlock will be too severe for emergency vehicles to navigate in a timely manner.
It may not even take a disaster to make this point. Paul Brown Stadium seats just over 65,000 fans. Great American Ball Park seats approximately 42,000 fans. Getting out of downtown Cincinnati after a game lets out is a very slow process. It only takes one accident on a bridge or exit ramp to really start jamming up the traffic flow. If access routes to the Banks overlook these chokepoints (without coming up with a viable alternate) this could mean residents will quickly grow disenchanted with the Banks.
One of the major appeals to living on the river will be the view. The Ohio River begins at the confluence of the Allegheny and Monongahela rivers at the Point in Pittsburgh, PA, and flows 981 miles to join the Mississippi at Cairo, Ill. The Ohio River accounts for over one-third of the maritime cargo moving inland in the United States each year, (approximately 275 million tons) and by comparison handles more cargo per year than the Panama Canal. With this much traffic, there is a potential for a disaster involving toxic chemicals or an explosion. In the past, the risk along the banks would be primarily industrial areas or office areas downtown. Now with a residential area that could be ground-zero, emergency response planners will have additional challenges to evacuating victims and casualties. Developers need to work with emergency planners now to minimize the risk to both residents of the Banks as well as the first responders that may have to come and rescue them.
Up until now I’ve focused on accidents and natural disasters, however there is an additional concern that the Banks poses for Cincinnati and Northern Kentucky. The very location and nature of the Banks makes it a target for a terrorist attack or the base for an attack. For the same reasons the Banks poses disaster response challenges, a terrorist attack (or threat of attack) could completely gridlock both sides of the river. In addition to the casualties, such an attack would disrupt major economic activities in the regions. Offices would have to evacuate and close. River traffic would have to be stopped. The Interstates may be closed or rerouted. The potential economic damage could be severe. Some kind of attack could be attempted from the Banks targeting either stadium or the downtown. Merely the threat of attack would cause the region to go into a defensive posture interrupting key governmental and economic activities. An actual attack could leave the region economically crippled for years.
The Banks could be the catalyst to providing Cincinnati the economic recovery that has eluded the area for years. Properly planned and executed, the Banks could provide the incentive for tired downtown workers to spend more of their leisure time in Cincinnati rather than fleeing to the suburbs at quitting time. However, the additional risk to the safety and security of Cincinnati posed by the Banks is something that needs to be addressed while concepts are still in draft form.
“If you would not be forgotten, as soon as you are dead and rotten, either write things worth reading, or do things worth the writing.”--Benjamin Franklin
Showing posts with label emergency response. Show all posts
Showing posts with label emergency response. Show all posts
Wednesday, November 7, 2007
Wednesday, October 31, 2007
Disaster Preparedness for Healthcare Workers
According to the Department of Labor, about 545,000 establishments make-up the healthcare industry (source, Bureau of Labor Statistics website). These establishments vary greatly in terms of size, staffing patterns and organizational structures. They exist in every population center, from major metropolitan areas to the smallest rural communities. The common denominator for all of these establishment is they employ a wide variety of workers with unique skill-sets which are invaluable during a response to a homeland security crisis.
Most healthcare workers in this day and age have to have at least an associate’s degree in order to be certified and hired. The training they receive is rigorous and subject to various state and national certifications. As healthcare worker’s technical proficiency increases in complexity, the one critical element that may be missing is an understanding of emergency response procedures during a large scale event (such as a terrorist attack).
Healthcare workers, as opposed to first-responders, often do not receive training in the Incident Command System (ICS) or the National Incident Management System (NIMS). Many would be at a loss if suddenly assigned to a medical strike team or may even wonder why their skills would be needed. The healthcare workers of today have dynamic technical skills that are applied at the individual level. What is needed to enhance their abilities is a basic understanding of how those skills are applied on a large-scale to a whole community facing a crisis.
Healthcare workers tend to focus on their primary skills without realizing the value of their ancillary skills. For example, during an emergency response the processing of hundreds or even thousands of casualties still requires the basics; taking patient histories, identifying allergies, identifying medication, or simply providing comfort and support to the injured. These are common skills shared across a wide spectrum of disciplines.
The healthcare worker who has had some initial training in ICS or NIMS is able to immediately function in a multi-agency response involving not only other healthcare providers but other responders as well. Healthcare workers unfamiliar with these incident response systems are not as immediately effective and may cause unnecessary delays. The training need not be overly arduous, the majority of those working towards a degree in healthcare already have full course loads. The intent here is encourage all healthcare workers to obtain at least a basic familiarization with ICS or NIMS, not to become subject matter experts.
A simple familiarization course of 1-3 credit hours for students enrolled in healthcare curriculums would be a good start. The course should cover the basics of the National Response Plan (NRP) and the 15 Emergency Support Functions (ESF) with emphasis on ESF #8 (Public Health and Medical Services). Healthcare workers need an early exposure to the concept of multi-agency response to a crisis situation. The individual needs to understand that they may have to respond as part of a larger effort versus their more individual centric responses. Their hospital or clinic may be only one of many dealing with mass casualties.
In order to better prepare these professionals, it is necessary to help them understand how they may have to help augment other healthcare professionals with whom they have not worked before. The healthcare worker responding during a major emergency may have to perform their duties at a different location than they are used to. The responding healthcare worker may have to pack up a kit and re-locate to another city or state and be able to still perform their jobs immediately upon arrival. This is a skill not taught in most healthcare curriculums. It may be an unnecessary skill for most making it too costly to add to all curriculums. However, the basic concept should be introduced to the student healthcare worker with follow-on training once they begin working in the field.
A healthcare worker leaving his or her home base should plan on being gone from anywhere from a week to 30 days. For major crisis response, these are not unusual timeframes. The responding healthcare worker needs to have already in advanced planned out their kit. While the basic equipment may seem obvious for their respective field, many other questions still need answering. Will there be additional equipment at their destination or will they have to pack everything before leaving? Will there be sufficient power or do they need to bring portable equipment and batteries? Will they need to pack their own food and water? If they do leave their home, what family care plans have they arranged? The time to start answering these questions is BEFORE the healthcare worker finds himself or herself heading out the door.
Why haven’t we seen more emphasis on emergency response training for healthcare workers? Large scale responses to emergencies involving large numbers of healthcare workers operating outside of their normal establishment aren’t the norm. In large metropolitan areas, healthcare workers tend to remain centered around their normal work locations. Responses to events with mass casualties can often be handled within existing healthcare systems negating the need to re-locate healthcare workers. Smaller communities normally don’t experience emergencies of large enough scale to require importing large numbers of healthcare workers from outside their region. Patients requiring specialized care can be flown to the nearest trauma center.
A pandemic illness, such as avian flu, could introduce the very set of circumstances that would cause the need for healthcare workers from one area being deployed to another area. Models of the effect of a pandemic illness on the workforce show something on the order of 40 percent of the workforce being out due to illness. Imagine the crisis that could happen should pandemic illness take out a large number of healthcare workers in a major city that simultaneously experiences a natural disaster (flood, hurricane, or earthquake). The need for large numbers of healthcare workers would be incredible. These workers won’t have much time to get ready to deploy and will need to focus on getting their gear together, not taking initial courses on incident management.
Healthcare workers that have been trained in the basics of incident management will more quickly grasp their role in a multi-agency response. Those who may have to work from a different location will be able to more quickly identify they equipment and supplies to take with them. The workers who have such preparation and training are able to quickly leave and report to their new work location. Fresh workers who are able to quickly start working in a multi-agency response environment are incredibly valuable. They can assist in treating casualties as well as providing much needed relief for healthcare workers already working crisis response.
Two years after Hurricane Katrina stuck land, we are still evaluating the response efforts and trying to determine how to improve responses to future events. Successful coordination of a wide range of resources is the key to achieve an effective response. Healthcare workers who have basic familiarization with incident management are just one more step to achieving that goal.
Most healthcare workers in this day and age have to have at least an associate’s degree in order to be certified and hired. The training they receive is rigorous and subject to various state and national certifications. As healthcare worker’s technical proficiency increases in complexity, the one critical element that may be missing is an understanding of emergency response procedures during a large scale event (such as a terrorist attack).
Healthcare workers, as opposed to first-responders, often do not receive training in the Incident Command System (ICS) or the National Incident Management System (NIMS). Many would be at a loss if suddenly assigned to a medical strike team or may even wonder why their skills would be needed. The healthcare workers of today have dynamic technical skills that are applied at the individual level. What is needed to enhance their abilities is a basic understanding of how those skills are applied on a large-scale to a whole community facing a crisis.
Healthcare workers tend to focus on their primary skills without realizing the value of their ancillary skills. For example, during an emergency response the processing of hundreds or even thousands of casualties still requires the basics; taking patient histories, identifying allergies, identifying medication, or simply providing comfort and support to the injured. These are common skills shared across a wide spectrum of disciplines.
The healthcare worker who has had some initial training in ICS or NIMS is able to immediately function in a multi-agency response involving not only other healthcare providers but other responders as well. Healthcare workers unfamiliar with these incident response systems are not as immediately effective and may cause unnecessary delays. The training need not be overly arduous, the majority of those working towards a degree in healthcare already have full course loads. The intent here is encourage all healthcare workers to obtain at least a basic familiarization with ICS or NIMS, not to become subject matter experts.
A simple familiarization course of 1-3 credit hours for students enrolled in healthcare curriculums would be a good start. The course should cover the basics of the National Response Plan (NRP) and the 15 Emergency Support Functions (ESF) with emphasis on ESF #8 (Public Health and Medical Services). Healthcare workers need an early exposure to the concept of multi-agency response to a crisis situation. The individual needs to understand that they may have to respond as part of a larger effort versus their more individual centric responses. Their hospital or clinic may be only one of many dealing with mass casualties.
In order to better prepare these professionals, it is necessary to help them understand how they may have to help augment other healthcare professionals with whom they have not worked before. The healthcare worker responding during a major emergency may have to perform their duties at a different location than they are used to. The responding healthcare worker may have to pack up a kit and re-locate to another city or state and be able to still perform their jobs immediately upon arrival. This is a skill not taught in most healthcare curriculums. It may be an unnecessary skill for most making it too costly to add to all curriculums. However, the basic concept should be introduced to the student healthcare worker with follow-on training once they begin working in the field.
A healthcare worker leaving his or her home base should plan on being gone from anywhere from a week to 30 days. For major crisis response, these are not unusual timeframes. The responding healthcare worker needs to have already in advanced planned out their kit. While the basic equipment may seem obvious for their respective field, many other questions still need answering. Will there be additional equipment at their destination or will they have to pack everything before leaving? Will there be sufficient power or do they need to bring portable equipment and batteries? Will they need to pack their own food and water? If they do leave their home, what family care plans have they arranged? The time to start answering these questions is BEFORE the healthcare worker finds himself or herself heading out the door.
Why haven’t we seen more emphasis on emergency response training for healthcare workers? Large scale responses to emergencies involving large numbers of healthcare workers operating outside of their normal establishment aren’t the norm. In large metropolitan areas, healthcare workers tend to remain centered around their normal work locations. Responses to events with mass casualties can often be handled within existing healthcare systems negating the need to re-locate healthcare workers. Smaller communities normally don’t experience emergencies of large enough scale to require importing large numbers of healthcare workers from outside their region. Patients requiring specialized care can be flown to the nearest trauma center.
A pandemic illness, such as avian flu, could introduce the very set of circumstances that would cause the need for healthcare workers from one area being deployed to another area. Models of the effect of a pandemic illness on the workforce show something on the order of 40 percent of the workforce being out due to illness. Imagine the crisis that could happen should pandemic illness take out a large number of healthcare workers in a major city that simultaneously experiences a natural disaster (flood, hurricane, or earthquake). The need for large numbers of healthcare workers would be incredible. These workers won’t have much time to get ready to deploy and will need to focus on getting their gear together, not taking initial courses on incident management.
Healthcare workers that have been trained in the basics of incident management will more quickly grasp their role in a multi-agency response. Those who may have to work from a different location will be able to more quickly identify they equipment and supplies to take with them. The workers who have such preparation and training are able to quickly leave and report to their new work location. Fresh workers who are able to quickly start working in a multi-agency response environment are incredibly valuable. They can assist in treating casualties as well as providing much needed relief for healthcare workers already working crisis response.
Two years after Hurricane Katrina stuck land, we are still evaluating the response efforts and trying to determine how to improve responses to future events. Successful coordination of a wide range of resources is the key to achieve an effective response. Healthcare workers who have basic familiarization with incident management are just one more step to achieving that goal.
Tuesday, October 30, 2007
We Don't Need a National Emergency Response Corps!
National Emergency Response and Disaster Assistance Corps
The title is from an article appearing in the September 2007 Homeland Defense Journal by Robert McCreight. Dr. McCreight asserts the need for the corps based on National Guard personnel and equipment deployed overseas and unavailable to respond to state emergencies.
Dr. McCreight feels National Guard overseas deployments adversely impact disaster response missions in their home states. This argument was first heard when Kansas Governor Kathleen Sibelius said that half of the trucks of the Kansas National Guard were in Iraq creating shortfalls in responding to the tornados that struck the state last May. No one challenged the governor as to where her other state agencies where during this emergency response.
The National Guard has a dual-mission charter. The first mission is the federal mission where the Army and Air National Guard function as Reserve components to the United States Army and the United States Air Force respectively. The National Guard receives federal funding for the training necessary to meet these mission requirements. Since9/11, this has been the mission getting the most attention as units are mobilized to support the Global War on Terrorism.
The second mission is the state mission. Each state (including Guam, Puerto Rico, the US Virgin Islands and the District of Columbia) has an Army and Air National Guard. The National Guard of each state falls under the jurisdiction of the governor. (Washington D.C. is the one exception to this rule). The National Guard is the organized militia of the state articulated in the U.S. Constitution. The National Guard is the governor’s resource to deal with emergencies or insurrections once other state resources have been exhausted.
The National Guard is the last in and the first out during a state emergency. Other state agencies are called up first and if there is a shortfall the National Guard responds. Part of the reason for utilizing other agencies first is that the National Guard receives reimbursement by their state for all personnel and equipment used during the emergency. Other agencies do not receive state reimbursement as a rule.
Dr. McCreight advocates ‘a special cadre of emergency and disaster response specialists deployable from each state, and specially trained and equipped, to surge and assist localities in handling the toughest and most demanding tasks during the first days and weeks following a disaster’. The National Guard already has skill sets and equipment to fulfill this requirement. The National Guard is able to maintain their skills as part of their war-time skills training using federal dollars. The proposal from Dr. McCreight could strain already austere state budgets beyond the breaking point.
The system he advocates pre-supposes a large number of professionals that are available to join this cadre. Most are already employed either in the private or public sector and it is unlikely that they employers will allow them to augment another group (effectively reducing their own agency’s ability to respond). Many are also already members of the National Guard.
The other problem is standardization of training. If the intent is to create a deployable team, then the team members need to be able to seamlessly adapt to their new location. The National Guard is already established and funded to perform exactly as Dr. McCreight’s cadre. Furthermore, it does this as part of a federal mission so there are national standards to which National Guard members are trained and certified.
The author based his model on Russia’s EMERCOM (Ministry of Civil Defense) which provides many of the same disaster response capabilities as the National Guard and state emergency management agencies do here in the United States. Russia and many other nations have basically two types of military forces, active and reserves. The active duty troops perform military missions and the reserves act as a manpower pool to backfill any shortfalls the active duty forces may encounter. The United States is one of the only countries with a National Guard with the dual missions of federal military reserve and state emergency response. It is a model that other countries (such as Hungary and Serbia) are trying to model.
The National Guard is being utilized more heavily than ever in its federal mission but rather than invent another version of them, states need to take a more active role in monitoring how may Guard members are activated and which equipment is being tasked. All states have a Joint Force Headquarters (JFHQ) with and Joint Operations Center (JOC). The JOC can track all of the information and then the JFHQ can asses the impact of the deployments on state active duty missions. The assessments can then be briefed by the Adjutant General (commander of the state National Guard) to the governor. All of this infrastructure is already in place and states need not re-invent a whole new program (at tremendous cost and time).
The drain of the National Guard to support overseas deployments does need to be addressed, however creating a new corps isn't the right answer.
The title is from an article appearing in the September 2007 Homeland Defense Journal by Robert McCreight. Dr. McCreight asserts the need for the corps based on National Guard personnel and equipment deployed overseas and unavailable to respond to state emergencies.
Dr. McCreight feels National Guard overseas deployments adversely impact disaster response missions in their home states. This argument was first heard when Kansas Governor Kathleen Sibelius said that half of the trucks of the Kansas National Guard were in Iraq creating shortfalls in responding to the tornados that struck the state last May. No one challenged the governor as to where her other state agencies where during this emergency response.
The National Guard has a dual-mission charter. The first mission is the federal mission where the Army and Air National Guard function as Reserve components to the United States Army and the United States Air Force respectively. The National Guard receives federal funding for the training necessary to meet these mission requirements. Since9/11, this has been the mission getting the most attention as units are mobilized to support the Global War on Terrorism.
The second mission is the state mission. Each state (including Guam, Puerto Rico, the US Virgin Islands and the District of Columbia) has an Army and Air National Guard. The National Guard of each state falls under the jurisdiction of the governor. (Washington D.C. is the one exception to this rule). The National Guard is the organized militia of the state articulated in the U.S. Constitution. The National Guard is the governor’s resource to deal with emergencies or insurrections once other state resources have been exhausted.
The National Guard is the last in and the first out during a state emergency. Other state agencies are called up first and if there is a shortfall the National Guard responds. Part of the reason for utilizing other agencies first is that the National Guard receives reimbursement by their state for all personnel and equipment used during the emergency. Other agencies do not receive state reimbursement as a rule.
Dr. McCreight advocates ‘a special cadre of emergency and disaster response specialists deployable from each state, and specially trained and equipped, to surge and assist localities in handling the toughest and most demanding tasks during the first days and weeks following a disaster’. The National Guard already has skill sets and equipment to fulfill this requirement. The National Guard is able to maintain their skills as part of their war-time skills training using federal dollars. The proposal from Dr. McCreight could strain already austere state budgets beyond the breaking point.
The system he advocates pre-supposes a large number of professionals that are available to join this cadre. Most are already employed either in the private or public sector and it is unlikely that they employers will allow them to augment another group (effectively reducing their own agency’s ability to respond). Many are also already members of the National Guard.
The other problem is standardization of training. If the intent is to create a deployable team, then the team members need to be able to seamlessly adapt to their new location. The National Guard is already established and funded to perform exactly as Dr. McCreight’s cadre. Furthermore, it does this as part of a federal mission so there are national standards to which National Guard members are trained and certified.
The author based his model on Russia’s EMERCOM (Ministry of Civil Defense) which provides many of the same disaster response capabilities as the National Guard and state emergency management agencies do here in the United States. Russia and many other nations have basically two types of military forces, active and reserves. The active duty troops perform military missions and the reserves act as a manpower pool to backfill any shortfalls the active duty forces may encounter. The United States is one of the only countries with a National Guard with the dual missions of federal military reserve and state emergency response. It is a model that other countries (such as Hungary and Serbia) are trying to model.
The National Guard is being utilized more heavily than ever in its federal mission but rather than invent another version of them, states need to take a more active role in monitoring how may Guard members are activated and which equipment is being tasked. All states have a Joint Force Headquarters (JFHQ) with and Joint Operations Center (JOC). The JOC can track all of the information and then the JFHQ can asses the impact of the deployments on state active duty missions. The assessments can then be briefed by the Adjutant General (commander of the state National Guard) to the governor. All of this infrastructure is already in place and states need not re-invent a whole new program (at tremendous cost and time).
The drain of the National Guard to support overseas deployments does need to be addressed, however creating a new corps isn't the right answer.
Chemical Spill
10 sickened in chemical spill
BY JENNIFER BAKER AND WILLIAM A. WEATHERS JBAKER@ENQUIRER.COM AND BWEATHERS@ENQUIRER.COM
SPRINGDALE - A chlorine cloud at Maple Knoll Village, a retirement community in the 11000 block of Springfield Pike, sent 10 workers to area hospitals.
The employees were transported by ambulance to Bethesda North Hospital in Montgomery, Mercy Hospital in Fairfield and Jewish Hospital in Kenwood.
“Employees were mixing chemicals in the basement of the four-story building about 9:15 a.m. when an accident sent fumes through the building, said Becky Schulte, director of communications for Maple Knoll Village.”
It doesn’t take a terrorist attack to expose people to chemicals, sometimes all it takes is an accident. We need to keep this in mind at our workplace or school.
If you happen upon an individual that is down, our first inclination should be to run over and make sure they are okay. If they are not responsive, we want to check for vital signs. CPR may need to be administered.
However, if more than one individual is down, our response should be different. Heart attack, stroke and diabetes are not contagious so encountering a group of downed individuals indicates the presence of an agent or other danger in the area. This factor could be a chemical of some kind (either a gas or something that has been ingested such as a poison), perhaps a biological agent is present, or worse a sniper.
If you happen to see a group of individuals that have collapsed, immediately call 911 and report the situation. Do not enter further into the effected area as you risk becoming a casualty yourself. You need to report as much information to authorities possible. Take note of any signs of trauma (indicating an explosion or shooter), any chemicals spills, unusual odors or the presence of dead animals in the vicinity.
Mark the area to warn others behind you not to proceed.
While we are on this subject, be on the look out for suspicious packages. If you see powder or what looks like oil seeping through the wrapping, do not handle it! Get everyone out of the immediate area and call authorities. Mark the area to prevent others from entering the area until authorities area. Never smell, touch or taste any substances that may be on packages.
BY JENNIFER BAKER AND WILLIAM A. WEATHERS JBAKER@ENQUIRER.COM AND BWEATHERS@ENQUIRER.COM
SPRINGDALE - A chlorine cloud at Maple Knoll Village, a retirement community in the 11000 block of Springfield Pike, sent 10 workers to area hospitals.
The employees were transported by ambulance to Bethesda North Hospital in Montgomery, Mercy Hospital in Fairfield and Jewish Hospital in Kenwood.
“Employees were mixing chemicals in the basement of the four-story building about 9:15 a.m. when an accident sent fumes through the building, said Becky Schulte, director of communications for Maple Knoll Village.”
It doesn’t take a terrorist attack to expose people to chemicals, sometimes all it takes is an accident. We need to keep this in mind at our workplace or school.
If you happen upon an individual that is down, our first inclination should be to run over and make sure they are okay. If they are not responsive, we want to check for vital signs. CPR may need to be administered.
However, if more than one individual is down, our response should be different. Heart attack, stroke and diabetes are not contagious so encountering a group of downed individuals indicates the presence of an agent or other danger in the area. This factor could be a chemical of some kind (either a gas or something that has been ingested such as a poison), perhaps a biological agent is present, or worse a sniper.
If you happen to see a group of individuals that have collapsed, immediately call 911 and report the situation. Do not enter further into the effected area as you risk becoming a casualty yourself. You need to report as much information to authorities possible. Take note of any signs of trauma (indicating an explosion or shooter), any chemicals spills, unusual odors or the presence of dead animals in the vicinity.
Mark the area to warn others behind you not to proceed.
While we are on this subject, be on the look out for suspicious packages. If you see powder or what looks like oil seeping through the wrapping, do not handle it! Get everyone out of the immediate area and call authorities. Mark the area to prevent others from entering the area until authorities area. Never smell, touch or taste any substances that may be on packages.
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