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In Boston they were prepared. Are you?
THE BOMBS WENT off, one after the other. There was the potential more would explode, or some other threat would come to pass. The EMS providers were prepared for athletes, and an occasional bystander injury. But special events with big crowds mean rescuers must be prepared for any type of emergency.
In Boston on April 15, the scene evolved within seconds from marathon medicine to bomb and blast injuries, and EMS responders performed in the midst of hundreds of cameras. They did so with the highest level of professionalism.
Big Events, Bigger Risks
All-hazards preparedness begins with assessment of the community and preparation of emergency response personnel. It means EMS organizations and their individual EMTs must be prepared for responding to masscasualty events of any cause, and have triage, treatment and transportation plans in place for all contingencies. An all-hazards plan means everyone understands the basic steps of scene safety, triage, primary interventions and transportation.
Start with identification of high-risk major events and likely scenarios. As in Boston, many communities have large events for which EMS providers must be accountable. Common ones are fairs, festivals, and athletic, faithbased and entertainment events. Each of these events requires a large-event plan. Contained within that must be contingencies for weather, acts of violence and unplanned structural problems (e.g., bleacher collapse at an athletic event, accidental carbon monoxide release). All event plans should address an element of unknown risks, and specify how further levels of resources can be tapped. EMS providers are typically assigned duties for planned medical events. Those personnel must serve as the center point of an MCI response should the unexpected occur.
Preparation of Personnel
Emergency providers must have three elements of preparedness firmly in place.
* Caregivers must be a flexible resource. With all-hazards training, EMTs and others can be used to provide care for a wide variety of medical problems, even those that change quickly. Day-to-day management of emergency medical problems provides the basis for this flexibility.
* Emergency providers must be provided with appropriate personal protective equipment and trained in its use. The elements of PPE (masks, gloves, gowns, eye protection) may change over time and even during an incident, but all personnel must...