EMS World

SEP 2018

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

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ISSUE FOCUS: MANAGEMENT & OPERATIONS 26 SEPTEMBER 2018 | EMSWORLD.com F ollowing the November 13, 2015 terrorist attacks in Paris, the Unit- ed States Capitol Police issued the following statement: "As with many law enforcement agencies around the nation, the USCP has increased visibility in a number of areas. The increased presence and visibility is a proactive enhancement of our already heightened security posture." 1 Similarly, the FBI said, "At this time, there is no specific or credible threat to the United States. We will not hesitate to adjust our security posture as appropriate." 1 And in a separate article, ABC News quoted New York Gov. Andrew Cuomo: "New York agencies including the State Police, National Guard, Metropolitan Transportation Authority, Port Authority of New York and New Jersey, and Division of Homeland Security and Emer- gency Services were instructed to be on a heightened state of alert." 2 As the examples above show, we are consistently hearing leaders and the media utilize phrases like "heightened security pos- ture" or "stand up our posture" in response to threats facing the United States and pub- lic safety agencies. But what does this mean for EMS agencies and their personnel? How do we fit into this elevated posture? Louis Pasteur observed that fortune favors the prepared mind. This quote is key to understanding how to "lean forward" with emergency preparedness. We must learn to anticipate the threats we face domestically, including manmade incidents such as acts of terrorism, biological epidemics such as an Ebola outbreak, and naturally occurring events such as weather-related scenarios. The concepts and strategies of leaning forward should incorporate an all-hazards outlook into planning for, responding to, and recovering from events. As with our colleagues in law enforcement and across the federal government, we must deter- mine how to elevate our security posture and enhance our capabilities. Elevating the Posture of EMS One of the most effective ways to lean for- ward is to establish a common operating picture for your response area. Understand- ing the risks associated with a community and collaboratively mitigating and manag- ing them promotes a shared perspective and ultimately enhances the situational awareness of all involved. Of course, threats are ever-changing and differ from community to community. Understanding to what point a prepared- ness posture should be elevated requires horizon scanning and understanding vulner- ability. Developing hazard and vulnerability assessments requires working across disci- plines and with multiple partners. This lets those responsible for developing policy and strategy develop informed plans. An example is planning for civil unrest. These events are inherently dynamic and rapidly evolving. The time to determine the role of EMS responders (either alongside, or potentially steps behind, law enforcement) is before, not during, an incident. EMS and its allied agencies should hold pre-incident discussions and develop flexible plans for such events. This not only improves inter- agency relationships but also allows for joint training and, ultimately, increased comfort and understanding across disciplines. If paramedics and police officers have never worked together, they are not likely to start understanding each other's needs or thought processes during a low-frequency, high-consequence incident. Intelligence Work Playing the "what if?" game is important to leaning forward but also largely qualita- By Seth J. Komansky, MS, NRP WHAT'S A SECURITY POSTURE, AND HOW DO YOU HEIGHTEN IT? Situational awareness and anticipatory planning are key ingredients

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