1. The Role of EMS in Catastrophic Incident Search and Rescue
Richard N. Bradley, MD, EMT-P, FACEP
Texas EMS Conference
Fort Worth, Texas
November 21, 2017

2. Potential Conflicts of Interest
Dr. Bradley is an employee of the University of Texas Health Science Center at Houston.
There are no other relevant conflicts of interest to disclose.

3. Objectives
Describe the basic intent of the Catastrophic Incident Search and Rescue Addendum to the National Search and Rescue Manual.
Recognize the EMS priorities for an Urban Search and Rescue Team.
Understand the role of EMS personnel in catastrophic incident search and rescue.

5. Catastrophic Incident
“A catastrophic incident is any natural or manmade incident, including terrorism, which results in extraordinary levels of mass causalities, damage, or disruption severely affecting the population, infrastructure, environment, economy, national morale, and/or government functions.”
National Response Framework, page 42

6. Hurricane Katrina
“Hurricane Katrina,” by Paul Morse. White House photo.

7. SR 530 Mudslide, Oso, Washington
“Aerial view of the Stillguamish River and SR 530 after the March 22, 2014 landslide,” by Washington State Department of Transportation is licensed under CC BY-NC-ND 2.0.

8. Hurricane Harvey
“Aransas County PSC,” by Richard N. Bradley. CC BY-NC-ND 4.0

9. Incident Complexity Incident Type Characteristics Type 5
1 or 2 single resources. Up to 6 personnel.
Type 4
C & G only if needed. Several resources. One operational period.
Type 3
Some or all C & G activated. Div/Group supervisors.
Possibly multiple operational periods. Written IAP.
Type 2
Beyond local capabilities; out of area resources.
Most or all of C & G positions. Written IAP.
Generally < 200 operations personnel per operational period and < 500 incident personnel.
Type 1
National resources. All C & G positions.
Operations personnel > 500 per operational period and total incident personnel > 1,000.
Branches established.
High impact on local jurisdiction

10. Local jurisdiction – Authority having jurisdiction
Texas mayors and county judges are the emergency management directors.
Agency representatives have the responsibility for:
Incident complexity analysis
Agency administration briefings
Written delegation of authority

11. Incident – AHJ Relationship
Emergency Operations Center
Incident Management

12. Incident Objectives Minimize risk to responders and public
Provide operational and logistical support to individual commands in affected area
Prioritize, direct and supervise all SAR operations
Support distribution of food and water
Coordinate and manage all aviation resources
“Map,” by Richard N. Bradley. CC BY-NC-ND 4.0

13. Turnback goals from the authority having jurisdiction are part of the delegation of authority to the incident management team. They provide clear objectives, but must be achievable. Reporting percentage of completion helps to communicate the amount of time and resources needed to accomplish the goals.

14. Incident Medical Plan

16. “Never Again”
Source unknown.

17. Rescue Lily Pad Place of Safety
Delivery of Survivors
Rescue Lily Pad Place of Safety

18. Place of Safety Rescue operations are considered to terminate
The lives of survivors are no longer threatened
Basic human needs (food, shelter, and medical needs) can be met
Transportation arrangement can be made for the survivor’s next or final destination

19. Lily Pad Interim Stopping Point
Account for survivors
Provide basic needs
Transport to a place of safety
The SMC is responsible to arrange and coordinate the use of lily pads and places of safety with appropriate authorities.
Utilize pre-event time to identify and prepare lily pads and places of safety.
The SAR Mission Coordinator (SMC) responsibilities include: “Arranging for and coordinating the use of lily pads and places of safety with appropriate authorities.” (p. 42)
Pre-event actions for notice events include to “Identify and ensure that lily pads and places of safety are ready.” (p. 45)

20. Survivor Registration
Bradley, Richard. Survivor registration. Sept. 14, 2013.

21. Reasons to Register
Bradley, Richard. Missing person notice. Sept. 14, 2103.

22. World Trade Center Attack
“Missing Persons 2,” by Keith Tyler. Licensed by CC BY 2.0.

23. Emergency Medical Service
Bradley, Richard. Neck injuries from the Colorado Flood. Sept. 14, 2013.
Bradley, Richard. Finger injuries from the Colorado Flood. Sept. 14, 2013.

24. Water, Snacks, and Blankets
Bradley, Richard. Meeting basic human needs. Sept. 16, 2013.

25. Companion Animals
Bradley, Richard. Providing for companion animals. Sept. 14, 2013.

26. Outbound Transportation
Bradley, Richard. School bus. Sept. 14, 2013.

27. Supporting Functions ESF-1 - Transportation ESF-2 - Communications
ESF-6 - Mass Care, Emergency Assistance, Housing and Human Services
ESF-7 - Logistics Management and Resource Support
ESF-8 - Public Health and Medical Services
ESF-13 - Public Safety and Security

28. Organization Group supervisor Ambulance (ground) Law enforcement
Animal control
Radio communicator
Buses (transportation & sheltering)
Scribes
Fuel tender
Mass Care Manager (Food, Water, Blankets)
Consider the need for a special response team.

29. Registration By Family Unit Date, Time and location of Registration
Means of arrival
Pre-incident address
Are all occupants of that address accounted for?
Destination
Means of onward travel
For each individual
Name
Age
Gender

31. State Urban Search and Rescue
“Texas Task Force 2 equipment staged in San Antonio, Texas,” by Don Jacks. FEMA photo.

32. US&R Medical Priorities
US&R task force personnel
Trapped victims
US&R task force canines
General disaster victims

33. Hurricane Katrina, Day 1 Photo credit: Jocelyn Augustino/FEMA.

34. Treatment of Working Dogs
“Rogue,” by Richard N. Bradley. CC BY-NC-ND 4.0

35. Treatment of Working Dogs
“Oso SearchDog,” by Richard N. Bradley. CC BY-NC-ND 4.0

36. Food Safety
“Handwashing,” by Richard N. Bradley. CC BY-NC-ND 4.0

37. Food Safety
“Food Delivery,” by Richard N. Bradley. CC BY-NC-ND 4.0

38. Food Safety
“Potato Salad,” by Richard N. Bradley. CC BY-NC-ND 4.0

39. EMS Augmentation to US&R
“Grapevine Fire,” by Richard N. Bradley. CC BY-NC-ND 4.0

40. Help Wanted Texas Task Force One – https://usar.tamu.edu
Texas Task Force Two –
“Medical Specialist,” by Richard N. Bradley. CC BY-NC-ND 4.0

41. Questions?