General Considerations SES SatEC STF 472 © ETSI 2013. All rights reserved

Organisation Wish List Public STF 472 website? Who wants to prepare a draft? Common introduction slides (e.g., for interviews)? Regular internal status meetings (telephone, web-conference) Common translation table (see draft on DocBox, EMTEL wording missing) - optional Notification of administrative tasks by STF leader (e.g., monthly accounting etc.) STF 472 Internal Kick-off 2014-01-22

General Considerations “Multi Language Risk Management Glossary” is one of the deliverables of the FP6 WIN project There are several UN field guides and handbooks (e.g., UNDAC Handbook) FP7 EULER seems to be a good overview of end user requirements Personal considerations (for information only): scalability is mandatory consider not only communication channels, but also (distributed) data storage and data formats no dependence on centralized services no services requiring a steady Internet connection (e.g., DNS) STF 472 Internal Kick-off 2014-01-22

Part 2: Mass casualty incident in public transportation SES SatEC STF 472 © ETSI 2013. All rights reserved

STF 472 Internal Kick-off 2014-01-22 Deliverable DTS/SES-00341-2: ” Satellite Earth Station (SES); Reference scenario for the deployment of emergency communications; Part 2: Mass casualty incident in public transportation” Scope: The purpose of this WI is to develop an evaluation framework for the dimensioning of a satellite-based emergency telecommunication network used by first responders (in charge of search & rescue operations and emergency sheltering) in the context of a mass casualty incident taking place in a public land transport in the countryside. For the second scenario, the focus is put on an environment where responders are concentrated over a small area. Missions are likely to be restricted to a few specialities (search and rescue, first aid). Satellite communications will provide a permanent communication hub to mitigate the lack of existing infrastructures. STF 472 Internal Kick-off 2014-01-22

Introduction to Mass Casualty Incidents (MCI) Mass casualty incident (MCI): Number of injured/sick exceeds available medical resources  ration resources so adequate treatment of as many as possible patients is possible In other words: Teams classify victims (e.g., deceased, immediate, delayed, minor) and attach paper labels. Subsequent rescue teams treat victims according to this classification. In parallel: registration of patients (names, tracking, etc.) Immediate (life threatening injury) Delayed (serious, non life threatening) Minor (walking wounded) No chance of survival (fatal life threatening injury) Morgue (pulseless, non-breathing) I II III IV STF 472 Internal Kick-off 2014-01-22

STF 472 Internal Kick-off 2014-01-22 Example Triage Tag (1) Source: Wikipedia STF 472 Internal Kick-off 2014-01-22

STF 472 Internal Kick-off 2014-01-22 Example Triage Tag (2) Source: German Red Cross front side back side STF 472 Internal Kick-off 2014-01-22

Typical MCI Structure Authorities Field Emergency Control Emergency Control Centre (112) Incident Location/ Disaster Area MCI Patient Repository Interim Care Centre Transport Hospitals Speciality Clinics / Maximum Care Centers Immediate Patients Care Triage Minor Information flow voice or paper Optional STF 472 Internal Kick-off 2014-01-22

Regional/National/Civil Protection Authorities Example authorities Civil protection authorities Crisis management groups Government, police, armed forces Example tasks Call center for relatives Organization infrastructure (shelter, water, food, transport) Coordination of supra-regional help STF 472 Internal Kick-off 2014-01-22

Field Emergency Control Example tasks Coordination of different rescue disciplines Mapping of patients to ambulance cars / hospitals Contact to emergency control centre Reordering of additional rescue forces/specialists STF 472 Internal Kick-off 2014-01-22

Emergency Control Centre (112) Example tasks Call center for emergency calls Alerting Dispatching of ambulance cars / fire brigades Hospital resource allocation (?) STF 472 Internal Kick-off 2014-01-22

STF 472 Internal Kick-off 2014-01-22 Patient Repository Interface between “hazard zone” and “safe operation area” First triage (if not done directly in the incident area) Depending on the incident one to many patient repositories Typically “self-organising” selection of patient repository location Very theoretical approach, works only in rare cases STF 472 Internal Kick-off 2014-01-22

STF 472 Internal Kick-off 2014-01-22 Interim Care Centre Optional, depending on available transport capacities Functionality ranging from weather protection to field hospital with pre-clinical treatment Triage at the entrance Typically different “pipelines” for different triage categories Can be based on tents or available buildings STF 472 Internal Kick-off 2014-01-22

STF 472 Internal Kick-off 2014-01-22 Main Problems MCI incident has a dimension in space and time: “linear” patient flow is improper simplification (e.g., motorway mass crash, huge buildings etc.) Incident management structures are deployed over time (alerting of additional forces) Triage ethically difficult task for medical personnel  triage algorithms based on few vital parameters Paper & pencil are state of the art Delayed situation assessment (several teams, merging of paper lists, data transfer using voice etc.) Strategic planning might be based on outdated/incomplete/wrong assumptions No common situation awareness (operational picture) STF 472 Internal Kick-off 2014-01-22

Information Flows (with example data) Heaviness of disaster Number of victims Triage class TBI, burn? Sex, child? Date/time IDs Required equipment Triage class TBI, burn? Sex, child? Arrival time IDs Number of victims Triage class TBI, burn? Sex, child? Date/time IDs Required equipment Hospital Treatment capacity Status Name, age Field Emergency Control Incident Area Emergency Control Centre Heaviness of disaster Required equipment Number of victims Deployed forces Local transport capacity Local equipment Back-up Transport capacity Treatment capacity Back-up Authority Back-up Required information Logistic support TBI = traumatic brain injury STF 472 Internal Kick-off 2014-01-22

Patient Data (Patient Perspective) Patient Repository Interim Care Centre Transport Hospital/ Accommo-dation ID, triage category Patient Data short diagnosis initial therapy transport destination identity data for tracing services emergency medical service documentation STF 472 Internal Kick-off 2014-01-22

Definition of Reference Scenario „mass casualty incident taking place in a public land transport in the countryside“ e.g., railway accident, bus accident, massive freeway pileup, aircraft emergency landing Reference scenario has to be sufficiently realistic and complex (e.g., weather conditions, access, available rescue forces…) STF 472 Internal Kick-off 2014-01-22

Interview Guideline / Questions Personal experience with MCIs Definition of an MCI or official guideline available? Discussion on “typical MCI structure”: Do the building blocks reflect the actual situation? Are there other entities involved? Are there other roles involved? Which tools are currently used for MCI management? Which communication systems are used? Weaknesses of the current approach? STF 472 Internal Kick-off 2014-01-22

Interview Guideline / Questions Discussion on “information flows”: Any role/entity missing? Anything wrong? Any communication channel missing? What sort of data has to be exchanged between the different entities? STF 472 Internal Kick-off 2014-01-22

Interview Guideline / Questions Discussion on “patient data”: Anything missing? Anything wrong? Other questions: How do you know that hospitals nearby are not already in saturation? Known weaknesses of current approach? Integration with existing electronic fleet management or billing tools? Final discussion: Personal wish list? Need for standardization? STF 472 Internal Kick-off 2014-01-22

Identification of Users Fire brigade schools Disaster management schools Airports, public transportation operators Sports stadiums, concert hall (typically in densely populated areas, not in rural ones) Civil protection organizations and authorities Rescue organizations STF 472 Internal Kick-off 2014-01-22

Draft TS Table of Contents tbd STF 472 Internal Kick-off 2014-01-22

Part 1: Earthquake SES SatEC STF 472 © ETSI 2013. All rights reserved

STF 472 Internal Kick-off 2014-01-22 Deliverable DTS/SES-00341-1: ”Satellite Earth Station (SES); Reference scenario for the deployment of emergency communications; Part 1: Earthquake” Scope: The purpose of this WI is to develop an evaluation framework for the dimensioning of a satellite-based emergency telecommunication network used by first responders (in charge of search & rescue operations and emergency sheltering) in the context of a major earthquake in an urban environment. For the first scenario, the focus is centred on an environment where responders are likely to be distributed over a large area. Missions are likely to be diverse (fire-fighting, search and rescue, first aid, emergency sheltering). With that respect, satellite communications will be likely to replace temporarily disabled infrastructures. STF 472 Internal Kick-off 2014-01-22

General Disaster Classification EM-DAT – The International Disaster Database (www.emdat.be) Technological (man-made) Natural (5 sub-groups) Geophysical Meteorological Hydrological Climatological Biological (12 disaster types and more than 30 sub-types) See overview in Excel-sheet STF 472 Internal Kick-off 2014-01-22

Disaster Response Classification (Predictability, preparedness) Spatial dimension Incident duration Demand medical rescue Demand technical rescue Demand food/water/shelter Affected infrastructure Others?  Earthquake seems to be comparable to a flash flood? STF 472 Internal Kick-off 2014-01-22

Role Model Adaptation from TR102641 Infrastructure Emergency Control Centre Discipline A, B… Crisis Mgt. Group, Authorities Population Off-site Social Media PMR Data Telephone Coordinating Field Emergency Control Field Emergency Control Discipline A, B… On-site Rescue Teams Discipline A, B… Affected Operation Area Adaptation from TR102641 STF 472 Internal Kick-off 2014-01-22