MULTI-JURISDICTIONAL EXERCISE

PARTICIPANT MANUAL

MONTGOMERY COUNTY FIRE TRAINING ACADEMY, ROCKVILLE, MD

JUNE 2, 2007

PARTICIPANT EXERCISE MANUAL INDEX

Montgomery County FTA Campus Map 3

Safety Message 5

Exercise Planners 5

Exercise Goals 6

Exercise Script 6

Exercise Stations 7

Fire Suppression 7

Disaster Medical 11

Light Search and Rescue 17

SAFETY

Safety is one of the most important considerations in conducting an exercise. The Safety Officer is responsible for monitoring and assessing hazardous and unsafe situations, and developing measures for assuring personnel safety. The Safety Officer will correct unsafe acts or conditions through the regular line of authority, although the Safety Officer may exercise emergency authority to stop or prevent unsafe acts when immediate action is required. The Safety Officer maintains awareness of active and developing situations, ensures the preparation and implementation of the Site Safety Plan and all safety messages with the Incident Action Plan. There will be only one Safety Officer. The procedure to shut down the exercise in the event of a real emergency ?????? All accidents/injuries must be reported to the Safety Officer as soon as they occur.

EXERCISE PLANNERS

Captain Ty Dement, Montgomery County Fire and Rescue Service

Tyrone.Dement@montgomerycountymd.gov – (240) 777-2202

Captain Allen Keyser, Montgomery County Fire and Rescue Service

Max.keyser@montgomerycountymd.gov - (240) 777-2253

Calvin Hawkins, Prince George’s County Office of Emergency management

cshawkins@co.pg.md.us – (301) 583-1976

Major Eugene Jones, Prince George’s County, Fire/EMS Department

ejones@co.pg.md.us – (301) 883-5200

Martin Flemion, Emergency Services Director, City of Laurel

mflemion@laurel.md.us – (301) 725-5300

Mike Attick, Prince George’s County Council of CERT

mjattick@verizon.net

Captain Keith Mapp, City of Laurel Police Department

kmapp@laurel.md.us – (301) 498-0092

Mike Lhotsky, Director, City of laurel Parks and Recreation

mlhotsky@laurel.md.us – (301) 725-5300

Paul McCullagh, Project Manager, City of Laurel Public Works

pmccullagh@laurel.md.us (301) 725-0088

Kevin Frost, Director, City of laurel Information Technology

kfrost@laurel.md.us (301) 725-5300

Tyler Huntington, Code Enf. Spec., City of laurel Cmty. Plan. & Bus. Services

thuntington@laurel.md.us – (301) 725-5300

Karl Brendle, Director, City of laurel Cmty. Planning & Business Services

kbrendle@laurel.md.us (301) 725-5300

Carreen Koubek, Station Manager, City of Laurel, information Technology

ckoubek@laurel.md.us (301) 725-5300

MASS CASUALTY EXERCISE: NATURAL DISASTER

(SUDDEN ONSET): TORNADO

NOTE: The goals and objectives of this exercise are to examine the coordination required in responding to a natural disaster occurring on the border between two or more jurisdictions: (County, Municipal). The exercise is tailored to support this objective.

14:30 hrs It is late afternoon on a Saturday in August in south west Montgomery County. Since noon, there has been a growing overcast moving in from the west accompanied by a drop in temperature of about 10deg F. The barometer has also been dropping steadily, and the wind has increased to a consistent 18 knots from the north-northwest. A summer storm seems clearly imminent, and weekend vacationers at Central Park have begun moving to shelter.

14:40 hrs, the National Weather Service issues a severe weather warning for all of Central Maryland. There is a possibility of a tornado, and citizens are warned to be vigilant. Weather alerts are repeated on area television and radio stations.

15:05 hrs. a funnel cloud is sighted south of Rockville, moving generally southward with the gathering storm. It is not reported to have touched ground.

15:10 a news bulletin from the local radio station MXYZ reports that a tornado has touched down north of Central Park which is moving in a southerly direction towards Central Park. The tornado begins cutting a swath across a rural residential area Within two minutes, the tornado has traveled six miles along a path between _______ and _______. It dissipates after crossing Route _______, just north of the _______ border. In the tornado's wake lies a quarter-mile wide path of devastation.

In all, fourteen homes are demolished along the path between _______ and _______, including three farmhouses and numerous barns and outbuildings. On the edge of the suburban areas northwest of _______, twenty additional homes are destroyed along with several businesses, fast-food restaurants and a strip mall. Twenty or more cars and trucks lie strewn like toys along Highway _______, and the heavy Saturday evening traffic has come to a chaotic stop.

Seventeen people have been killed in the small towns and business establishments along the storm's path, and another thirty-six have been seriously injured. Damage is extensive and over twenty families are left homeless. The potential clearly exists for the area to be declared a disaster area.

1.Given the proximity of this disaster to the city of _______, what agreements or protocols exist between your area's hospitals and those of _______ to assist in managing emergency situations such as this? Are there any additional or extraordinary conditions that must be met for bi-lateral medical support between the two (countries, states, counties, municipalities)?

2.How quickly can your medical facility muster support and be ready to receive patients evacuated from this area? How is the storm condition likely to affect helicopter operations? What affect will this have on the type of medical emergencies you might expect to see?

If the tornado had touched down in the center of with significant casualties and loss of life, what sort of support would your region's hospitals be prepared to provide?

3. What is the role of the American Red Cross or other voluntary aid organizations?

FIRE SUPPRESSION

The role of CERTs in fire safety:

• Put out small fires.

Extinguishing small fires before they become major fires.

• Prevent additional fires.

Preventing additional fires by removing fuel sources.

• Shutoff utilities.

Shutting off utilities, when necessary and safe to do so. Once turned off NEVER turn back on.

• Assist with evacuations where necessary.

When a fire is beyond the ability of CERTs to extinguish, CERT members need to protect life safety by evacuating the area, when necessary, and establishing a perimeter.

Rescuer safety is always the number one priority. Therefore, CERT members always:

• Work with a buddy.

• Wear ALL safety equipment (gloves, helmet, goggles, mask, and boots).

• The CERT goal is to do the greatest good for the greatest number.

The Fire Triangle

Fire requires three elements to exist:

• Heat: Heat is required to elevate the temperature of a material to its ignition point.

• Fuel: The fuel for a fire may be a solid, liquid, or gas. The type and quantity of the fuel will determine which method should be used to extinguish the fire.

• Oxygen: Most fires will burn vigorously in any atmosphere of at least 20 percent oxygen. Without oxygen, most fuels could be heated until entirely vaporized, yet would not burn.

Fire Chemistry

Classes of fire:

• A: Ordinary combustibles

• B: Flammable and combustible liquids

• C: Energized electrical equipment

• D: Combustible metals

Electric and Gas Utility Shutoffs

Circuit Box With Shutoff

Circuit box showing shutoff steps. Step 1: Shut off individual breakers. Step 2: Shut off main breaker.

The gas meter shut-off diagram indicates the shut-off valve location on the pipe that comes out of the ground. To turn off the valve, use a wrench to turn the valve clockwise one-quarter turn.

CERT Size Up

Answer these questions:

• Can my buddy and I fight the fire safely?

• Do we have the right equipment?

• Are there other hazards?

• Is the building structurally damaged?

• Can we escape?

The nine steps in size up are:

1. Gather facts. What has happened? How many people are involved (if you know)? What is the current situation?

2. Assess and communicate the damage. Take a lap around the building. Try to determine what has happened, what is happening now, and how bad things can really get.

3. Consider probabilities. What is likely to happen? What could happen through cascading events?

4. Assess your own situation. Are you in immediate danger? Have you been trained to handle the situation? Do you have the equipment that you need?

5. Establish priorities. Are lives at risk? Can you help? Remember, life safety is the first priority!

6. Make decisions. Base your decisions on the answers to Steps 1 through 3 and in accordance with the priorities that you established.

7. Develop plans of action. Develop a plan that will help you accomplish your priorities. Simple plans may be verbal, but more complex plans should always be written.

8. Take action. Execute your plan, documenting deviations and status changes so that you can report the situation accurately to first responders.

9. Evaluate progress. At intervals, evaluate your progress in accomplishing the objectives in the plan of action to determine what is working and what changes you may have to make to stabilize the situation.

Fire Type		Extinguishing
		Agent	Method
Ordinary Solid Materials		Water	Removes heat
		Foam	Removes air and heat
		Dry chemical	Breaks chain reaction
Flammable Liquids		Foam CO2	Removes air
		Dry chemical	Breaks chain reaction
Electrical Equipment		CO2	Removes air
		Dry chemical	Breaks chain reaction
Combustible Metals		Special agents	Usually remove air

Fire Types, Extinguishing Agents, and Methods

Components of a portable fire extinguisher: Hose, carrying handle and trigger, pressure gauge, cylinder

The acronym for operating a fire extinguisher is P.A.S.S.:

• Pull pin

• Aim hose

• Squeeze trigger

• Sweep at base of flames

To ensure that the extinguisher is working properly, test it before approaching any fire.

Fire Suppression Safety

DON’T:

• Try to suppress large fires.

• Get too close.

• Fight it alone.

• Enter smoke-filled areas.

Disaster Medical Operations

Treatment of Life-Threatening Conditions

The “killers”:

• Airway obstruction - clear the airway using the Head-Tilt/Chin-Lift method.

• Excessive bleeding - three types of bleeding and the type can usually be identified by how fast the blood flows:

Arterial bleeding. Arteries transport blood under high pressure. Bleeding from an artery is spurting bleeding.

Venous bleeding. Veins transport blood under low pressure. Bleeding from a vein is flowing bleeding.

Capillary bleeding. Capillaries also carry blood under low pressure. Bleeding from capillaries is oozing bleeding.

There are three main methods for controlling bleeding:

Direct pressure, Elevation and Pressure points. Direct pressure combined with elevation will address most bleeding.

Step 1: Place direct pressure over the wound by putting a clean dressing over the wound and pressing firmly.

Step 2: Maintain pressure on the dressing over the wound by wrapping firmly with a pressure bandage.

Shock

• Rapid and shallow breathing.

• Capillary refill of greater than 2 seconds.

• Failure to follow simple commands, such as “Squeeze my hand

The procedure for treating victims of shock:

• Step 1: If necessary, place a blanket or other material under the victim to provide protection from extreme ground temperatures (hot or cold). Position the victim on his or her back. Elevate the feet 6-10 inches above the level of the heart. Maintain an open airway.

• Step 2: Control obvious bleeding.

• Step 3: Maintain body temperature (e.g., cover the ground and the victim with a blanket if necessary).

• Step 4: Avoid rough or excessive handling unless the rescuer and victim are in immediate danger.

Triage

Experience has shown that triage is an effective strategy in situations where:

• There are many more victims than rescuers.

• There are limited resources.

• Time is critical.

During triage, victims’ conditions are evaluated and the victims are prioritized into three categories:

• Immediate (I): The victim has life-threatening (airway, bleeding, or shock) injuries that demand immediate attention to save his or her life; rapid, life-saving treatment is urgent.

• Delayed (D): Injuries do not jeopardize the victim’s life. The victim may require professional care, but treatment can be delayed.

• Dead (DEAD): No respiration after two attempts to open the airway. Because CPR is one-on-one care and is labor-intensive, CPR is not performed when there are many more victims than rescuers.

Triage in a Disaster Environment

General procedure for conducting triage:

• Step 1: Stop, Look, Listen, and Think. Before you start, stop and size up the situation by looking around and listening. THINK about your safety, capability, and limitations, and decide if you will approach the situation and how.

• Step 2: Conduct voice triage. Begin by calling out, “Emergency Response Team. If you can walk, come to the sound of my voice.” If there are survivors who are ambulatory, instruct them to remain at a designated location, and continue with the triage operation. (If rescuers need assistance and there are ambulatory survivors, then these survivors should be asked to provide assistance.) These persons may also provide useful information about the location of the victims.

• Step 3: Start where you stand, and follow a systematic route. Start with the closest victims and work outward in a systematic fashion.

• Step 4: Evaluate each victim and tag them “I” (immediate), “D” (delayed), or DEAD. Remember to evaluate the walking wounded.

• Step 5: Treat I victims immediately. Initiate airway management, bleeding control, and/or treatment for shock for Category I victims.

• Step 6: Document triage results for:

• Effective deployment of resources.

• Information on the victims’ locations.

• A quick record of the number of casualties by degree of severity.

The rescuer’s safety is paramount during triage. Wear proper protective equipment so as not to endanger your own health.

Triage Decision Flowchart

Maintain Hygiene

• Wash hands frequently using soap and water.

• Wear latex gloves; change or disinfect after each patient.

• Wear a mask and goggles.

• Keep dressings sterile.

• Avoid contact with body fluids

Medical operations personnel can maintain sanitary conditions by:

• Controlling the disposal of bacterial sources (e.g., latex gloves, dressings, etc.).

• Putting waste products in plastic bags, tying off the bags, and marking them as medical waste. Keep medical waste separate from other trash, and dispose of it as hazardous waste.

• Burying human waste.

Functions of Disaster Medical Operations

• Triage - The initial assessment and sorting of victims for treatment based on the severity of their injuries.

• Treatment- The area in which disaster medical services are provided to victims.

• Transport - The movement of victims from the triage area to the treatment area. If professional help will be delayed, for efficiency of operations, victims can be transported to the treatment area by CERT members.

• Morgue - The temporary holding area for victims who have died as a result of their injuries.

Patient Flowchart, which shows how the patients are rescued, triaged, and sent to the medical treatment areas according to the extent of their injuries (“I,” “D,” or “Dead”).

Establish Treatment Areas

The site selected should be:

• In a safe area.

• Close to (but upwind and uphill from) the hazard.

• Accessible by transportation vehicles.

• Expandable.

Remember – to conduct head-to-toe assessments on victims systematically, checking body parts from the top to the bottom for continuity of bones and soft tissue injuries in the following order:

1. Head

2. Neck

3. Shoulders

4. Chest

5. Arms

6. Abdomen

7. Pelvis

8. Legs

9. Back

Establish Transportation Area

The site selected should be:

• Secure

• As close to transportation facilities as possible.

Establish Morgue Area

The site selected should be:

• Secure

• Away from, and not visible from the treatment area.

• Away from media

Light Search and Rescue Operations

Understand your limitations!

Your safety is paramount, even above that of the victims!

Don’t become part of the problem!

Search and Rescue Operations

• Size up - involves assessing the situation and determining a safe action plan

• Search involves:

• Locating victims.

• Documenting location.

• Rescue involves procedures and methods to extricate victims

Decision To Attempt Rescue

• Risk involved to the rescuer

• Greatest good for greatest number of people

Goals of Search and Rescue

• Rescue greatest number in shortest amount of time

• Rescue lightly trapped victims first

CERT Search and Rescue Size up

1. Gather Facts

2. Assess Damage*

3. Consider Probabilities

4. Assess Your Situation

5. Establish Priorities

6. Make Decisions

7. Develop Plans of Action

8. Take Action

9. Evaluate Progress

• *If damage is moderate (visible signs of damage, decorative work damaged or fallen, many visible cracks in plaster, major damage to interior content, building is on its foundation) . . . The CERT mission is to locate, stabilize, and immediately evacuate victims to a safe area while minimizing the number of rescuers inside the structure.

• *If damage is heavy (partial or total collapse, tilting, obvious structural instability, building off its foundation, heavy smoke or fire, hazardous materials inside, gas leaks, rising or moving water) . . The CERT mission is to secure the building perimeter and warn others of the danger in entering the building.

REHABILITATION AREA

There will be a rehabilitation area setup for the staff and volunteers working on this exercise as well as refreshment stops at each of the exercise areas. At these locations you will find water, light snacks and juice. You will find the location of the rehabilitation area identified on the map of the training center complex on page??. At this location staff and volunteers can rest and take breaks if needed.

General safety tips when working on this exercise:

• In extreme sunlight conditions seek shade whenever possible.

• Cover your body as much as possible with clothing, including a hat and UV-blocking sunglasses. Make sure you don’t compromise your safety! Wear your CERT protective equipment at all times when in the exercise areas.

• Apply 1 oz. (two tablespoons) of SPF 15 or higher sunscreen to your body before starting your day outside. Reapply every two hours.

• Drink plenty of water. While the amount of water you should drink can depend on your body type, environment and health condition, the Institute of Medicine recommends that men drink approximately three liters (about 100 ounces) and women drink about 2.2 liters (about 75 ounces) per day. If you work outdoors in extreme heat and perspire a lot, you should consider taking in even more.

BEWARE OF HEAT EXHAUSTION

A common heat-related illness, symptoms of heat exhaustion can begin suddenly and are often attributed to excessive exercise, heavy perspiration and not drinking enough fluids while in the heat. Symptoms can include but, are certainly not limited to:

• Feeling faint

• Nausea

• Heavy sweating

• Ashen appearance

• Rapid, weak heartbeat

• Low blood pressure

• Cool, moist skin

• Low-grade fever

If you suspect one of your partners has developed heat exhaustion, you are advised to do the following:

• Advise your safety person immediately. He or she will in turn notify the Exercise Safety Officer for required action.

• Get the person out of the sun and into the shade, preferably an air-conditioned area.

• Lay the person down and elevate the legs and feet slightly

• Loosen or remove the person's clothing

• Have the person drink cool water (without ice) or a sports drink that contains electrolytes

• Cool the person down by spraying or sponging him or her with cool water and fanning him or her.

• Monitor the person closely, as heat exhaustion can quickly escalate to heatstroke.