CHAPTER 10

ORGANIZATIONAL EMERGENCY RESPONSE

This chapter discusses the ways in which community emergency response
organizations must perform the four principal functions---emergency
assessment, hazard operations, population protection, and incident
management---during disaster response. Community organizations,
especially government agencies, perform these functions to accomplish
tasks that are beyond the capabilities of any households and businesses
(e.g., detecting and classifying hazmat threats) or to assist the
households and businesses needing special assistance (e.g., providing
buses for households lacking their own personal vehicles).

**Introduction**

The previous chapter described how communities prepare for disasters on
the basis of the anticipated disaster demands. This chapter will explain
how community emergency response organizations use their trained
personnel, facilities, equipment, and materials to execute an emergency
response. The demands of any specific incident can never be predicted
with perfect accuracy, so the emergency response organization must
always improvise to some extent. As Chapter 9 indicated, planning and
improvisation accomplish four functions---emergency assessment, hazard
operations, population protection, and incident management. These
functions are defined by specific activities whose performance is
divided among the incident scene, the EOC, and other locations (see
Table 10-1). Major emergency facilities include mass care facilities,
hospitals, and Joint Information Centers (JICs) for the release of
public information. In addition, there can be other locations such as
staging areas where emergency responders can mobilize near the incident
scene and assembly areas where transit dependent population segments
gather to board evacuation buses. The four emergency response functions
provide a framework for organizing the activities involved in responding
to a wide variety of emergencies, whether natural hazards, technological
accidents, or deliberate attacks of sabotage or terrorism. The
interrelationships among these functions can be seen in Figure 10-1,
which has been adapted from earlier versions presented by Lindell and
Perry (1992, 1996b).

The emergency is defined by a *chain of events* beginning with an actual
(or potential) release of energy or hazmat that is currently (or will in
the future) be transmitted through the environment to an impact area
within the community. The hazard agent acts together with community
characteristics and environmental conditions to produce exposures of
persons and property. In turn, these exposures produce consequences (the
physical and social impacts discussed in Chapter 6). To avoid these
consequences, incident managers use the information available at
different stages of the chain of events to perform *emergency
assessment* actions (indicated by the dotted lines) that allow them to
assess the impact area, exposure, and consequences. In turn, incident
managers can draw upon these emergency assessments to select emergency
response interventions. These interventions include hazard operations
actions and population protection actions. Moreover, if incident
managers can project future disaster demands, they can anticipate the
tasks that will need to be performed. In turn, this allows them to
request additional resources and deploy them before they are needed
rather than long afterward.

Hazard operations measures are preventive if they avoid a release to the
environment. For example, spraying water on a tank car of chlorine that
is next to a burning tank car of propane will prevent the chlorine from
expanding and rupturing its tank. Hazard operations measures are
corrective if they reduce the magnitude or terminate a release in
progress (e.g., plugging a leaking tank car). Other hazard operations
measures avoid property exposure by protecting or strengthening building
envelopes (putting up shutters before a hurricane or shutting doors and
windows and turning off HVAC systems before a toxic chemical release),
securing building contents (e.g., in anticipation of earthquake
aftershocks), or turning off utilities (to prevent escaping gas from
being ignited by downed power lines).

# Table 10-1. Emergency Response Functions and Specific Actions.

+------------+------------------+------------------+------------------+
| Function   | Incident scene/  | EOC              | Other locations  |
|            |                  |                  |                  |
|            | Command Post     |                  |                  |
+------------+------------------+------------------+------------------+
| *Emergency |                  |                  |                  |
| A          |                  |                  |                  |
| ssessment* |                  |                  |                  |
+------------+------------------+------------------+------------------+
|            | Local threat     | Regional threat  |                  |
|            | detection and    | detection and    |                  |
|            | emergency        | emergency        |                  |
|            | classification   | classification   |                  |
+------------+------------------+------------------+------------------+
|            | Local hazard     | Regional hazard  |                  |
|            | monitoring       | monitoring       |                  |
+------------+------------------+------------------+------------------+
|            | Damage           | Environmental    |                  |
|            | assessment       | monitoring       |                  |
+------------+------------------+------------------+------------------+
|            |                  | Population       |                  |
|            |                  | monitoring and   |                  |
|            |                  | assessment       |                  |
+------------+------------------+------------------+------------------+
| *Hazard    |                  |                  |                  |
| O          |                  |                  |                  |
| perations* |                  |                  |                  |
+------------+------------------+------------------+------------------+
|            | Hazard source    |                  |                  |
|            | control          |                  |                  |
+------------+------------------+------------------+------------------+
|            | Protection works |                  |                  |
+------------+------------------+------------------+------------------+
|            | Building         |                  |                  |
|            | construction     |                  |                  |
|            | practices        |                  |                  |
+------------+------------------+------------------+------------------+
|            | Contents         |                  |                  |
|            | protection       |                  |                  |
|            | practices        |                  |                  |
+------------+------------------+------------------+------------------+
| *          |                  |                  |                  |
| Population |                  |                  |                  |
| P          |                  |                  |                  |
| rotection* |                  |                  |                  |
+------------+------------------+------------------+------------------+
|            | Protective       | Protective       | Population       |
|            | action selection | action selection | warning          |
+------------+------------------+------------------+------------------+
|            | Population       | Population       | Protective       |
|            | warning          | warning          | action           |
|            |                  |                  | implementation   |
+------------+------------------+------------------+------------------+
|            | Search and       |                  | Reception and    |
|            | rescue           |                  | care of victims  |
+------------+------------------+------------------+------------------+
|            | Impact zone      |                  | Emergency        |
|            | access control   |                  | medical care     |
|            | and security     |                  |                  |
+------------+------------------+------------------+------------------+
|            | Hazard exposure  |                  |                  |
|            | control          |                  |                  |
+------------+------------------+------------------+------------------+
|            | Emergency        |                  |                  |
|            | medical care     |                  |                  |
+------------+------------------+------------------+------------------+
|            | Environmental    |                  |                  |
|            | surety           |                  |                  |
+------------+------------------+------------------+------------------+
| *Incident  |                  |                  |                  |
| M          |                  |                  |                  |
| anagement* |                  |                  |                  |
+------------+------------------+------------------+------------------+
|            | Agency           | Agency           | Public           |
|            | notification and | notification and | information      |
|            | mobilization     | mobilization     |                  |
+------------+------------------+------------------+------------------+
|            | Mobilization of  | Mobilization of  | Mobilization of  |
|            | emergency        | emergency        | emergency        |
|            | faci             | faci             | faci             |
|            | lities/equipment | lities/equipment | lities/equipment |
+------------+------------------+------------------+------------------+
|            | Communication/   | Communication/   |                  |
|            | documentation    | documentation    |                  |
+------------+------------------+------------------+------------------+
|            | A                | A                |                  |
|            | nalysis/planning | nalysis/planning |                  |
+------------+------------------+------------------+------------------+
|            | Internal         | Internal         |                  |
|            | direction and    | direction and    |                  |
|            | control          | control          |                  |
+------------+------------------+------------------+------------------+
|            |                  | Logistics        |                  |
+------------+------------------+------------------+------------------+
|            |                  | Financ           |                  |
|            |                  | e/administration |                  |
+------------+------------------+------------------+------------------+
|            |                  | External         |                  |
|            |                  | coordination     |                  |
+------------+------------------+------------------+------------------+
|            |                  | Public           |                  |
|            |                  | information      |                  |
+------------+------------------+------------------+------------------+

Incident managers can provide population protection by preventing people
from being exposed to the hazard. This can be accomplished by initiating
evacuation, sheltering in-place, and access control. Finally, if people
have been exposed, incident managers can reduce consequences such as the
severity of injury or probability of death by conducting search and
rescue operations to locate and

**Figure 10-1**. Chain of events model

extricate victims. Once this has been done, medical actions can be
initiated such as first aid, transport to medical facilities, and
definitive care.

When an incident takes place at a single scene, the emergency response
functions are performed under the supervision of an Incident Commander
operating within ICS/IMS. However, community-wide disasters typically
require a response by a network of agencies. In such situations, the
jurisdictional EOC coordinates the agencies' execution of the emergency
response functions. This condition raises three important points. First,
each emergency response organization maintains standard operating
procedures (SOPs) containing the detailed sequence of actions (often
checklists) for executing its assigned tasks within a given function.
Emergency managers should be familiar with and retain a library of such
SOPs (particularly a summary form for EOC coordinators to use).

Second, for functions involving multiple organizations, the emergency
manager should ensure a lead organization will assume responsibility for
mobilizing all component organizations and will monitor the performance
of all tasks needed to accomplish that function.

Finally, emergency managers should ensure the planning, training, and
exercising activities involved in emergency preparedness do not inhibit
the initiative of emergency response personnel. It is not possible for
even the most thorough planners to anticipate every contingency arising
from every type of hazard agent and devise the appropriate SOPs for each
contingency. Consequently, the EOP and SOPs should *guide* the emergency
response. Within these guidelines, field response personnel should be
given sufficient freedom to improvise responses as specific conditions
dictate. Extremely detailed and specific emergency plans tend also to be
very long and complex, are unworkable in the field, and are usually left
on a shelf. Thus, the following discussion of emergency response
functions focuses on the objectives to be achieved rather than
prescribing very specifically how these objectives are to be achieved in
every conceivable type of emergency.

## *Emergency Assessment*

Emergency assessment activities in the response phase are directed
toward intelligence--- understanding the behavior of the hazard agent
and the people and property at risk. This function involves the use of
classification systems, protocols, and equipment that are developed or
acquired prior to the threatened impact. Specific threats, their
probabilities of impact, and decisions to manage are derived from the
jurisdictional hazard/vulnerability analysis. The four specific
emergency assessment activities identified in Table 10-1 are described
below.

*Threat detection and emergency classification.* This activity involves
recognizing that a threat exists, assessing its magnitude, location, and
timing of impact, and using this information to determine the required
scope of the emergency response. A discussion of the classification
criteria logically starts with the onset of the threat. Onset is defined
as the point at which a local emergency manager either detects or is
otherwise notified of an environmental threat. The source of an external
notification received depends upon the nature of the threat agent. For
example, a local emergency manager would frequently receive notification
of riverine floods and tornadoes from the National Weather Service,
hazmat transportation accidents from the carriers, and toxic chemical
releases from the plant operators. Terrorist incidents involving
biological agents or epidemics can be detected through disease
surveillance and reported to emergency managers via the public health
system. Some times, an emergency manager will receive the notification
from external sources via the local 911 system. In municipalities and
counties having independent emergency management departments, emergency
calls for police or fire department assistance will usually activate the
local emergency notification system, thereby reaching the emergency
manager. Residents and passersby also report apparent incidents,
especially when the threat agent has visible cues.

Once a threat is detected, a timely and effective emergency response is
facilitated by using an emergency classification system. An emergency
classification system provides a small set of categories, usually two to
five, that are used to link the threat assessment to the level of
activation of the emergency response organization. Emergency
classification systems are specific to each type of hazard and their
implementation depends upon the state of technology regarding that
hazard. The National Weather Service defines a *hurricane watch* as
indicating the possibility of hurricane conditions (sustained winds of
at least 74 mph) within a designated section of coast within 36 hours,
whereas a *hurricane warning* indicates the possibility of hurricane
conditions within 24 hours or less (www.nhc.noaa.gov/HAW2). The watches
and warnings are supplemented by other information such as the
Saffir-Simpson scale, which categorizes levels of damage from impact.
This scale ranges from *Category 1* (minimal damage) through *Category
5* (catastrophic damage). In addition, there are strike probabilities
describing the estimated likelihood that a storm will pass within 75
miles of a designated location within the next 72 hours.

The same principles apply when dealing with technological hazards,
especially those generated by fixed site facilities. Often such
facilities routinely monitor their internal systems for changes in plant
conditions indicating increased danger. Such monitoring can detect
hazardous conditions long before they threaten people and property
(McKenna, 2000). In turn, this enables onsite and offsite personnel to
rapidly activate the onsite emergency response organization and, if
necessary, activate the offsite emergency response organization as well
(Lindell & Perry, in press, c). However, plant systems monitoring does
not always produce the intended outcomes unless an emergency
classification system has been established. There are four reasons why
plant operators sometimes respond ineffectively when there is a
significant potential for escalation to a major emergency. First,
monitoring devices present confusing or conflicting information, so
plant operators focus on trying to understand what is happening rather
than notifying others of the problem. Second, plant operators fail to
understand the implications of meter readings and mistakenly believe the
situation is less serious than it actually is. Third, plant operators
are sometimes unrealistically optimistic that they can control the
emergency (even if they have correctly assessed its severity). Fourth,
plant operators can grossly underestimate the amount of time local
populations need to implement offsite protective actions. An emergency
classification system combats these problems by providing specific,
objective criteria for determining the severity of an emergency. In
turn, the emergency class prescribes appropriate actions for emergency
assessment, hazard operations, population protection, and incident
management actions. If the situation is urgent, the incident management
actions will include recall of offduty personnel, notification of the
offsite emergency response organization, and mobilization of onsite and
offsite emergency response facilities.

Three factors are used in defining emergency classes. The first factor
is the physical magnitude of the hazard. Measurements can be the
magnitude of the energy released in an earthquake or explosion, the
amount of rain in a river basin, or the amount of a hazmat release. The
second factor is the nature of the impact transmission (however
measured) into the surrounding environment. The more direct the
transmission and the more limited the ability of the environment to
absorb the impact, the greater the potential consequences. In most
cases, energy (from earth fault movement, hurricanes, etc.) is
dissipated and hazardous chemicals are dispersed with increasing
distance from the source. The third factor is the vulnerability of the
people and property in the community to the magnitude of impact to which
they will be exposed. Ground shaking in earthquakes is devastating for
unreinforced masonry construction. High population density communities
produce higher levels of human injury in floods and hurricanes than
places with low population density. Epidemics move much more quickly
through unvaccinated, high density populations. Each of these
factors---hazard generation, hazard transmission, and community
vulnerability---should be accounted for in an emergency classification
system.

In general, an emergency classification system will be most reliably
implemented only if each emergency class is clearly defined by emergency
action levels (EALs). An EAL is a specific observable event or
objectively measurable condition that can be immediately recognized by
observers as an indicator of the severity of the emergency. The US
Nuclear Regulatory Commission and Federal Emergency Management Agency
(1980) defined four classes of nuclear power plant emergencies. An
*Unusual Event* is defined as involving potential degradation of plant
safety; no releases are expected unless other events occur. An *Alert*
involves substantial degradation of plant safety; releases are expected
to be well below EPA exposure limits (protective action guides---PAGs).
A *Site Area Emergency* involves major failures of plant safety
functions; releases might exceed EPA PAGs onsite, but not offsite.
Finally, a *General Emergency* involves substantial core degradation
with potential for loss of containment integrity; releases might exceed
EPA PAGs offsite. (See Table 10-2 for further details).

######### **Table 10-2**. Definition of a Nuclear Power Plant *General Emergency.*

[Class Description]{.underline}

Events are in process or have occurred that involve actual or imminent
substantial core degradation or melting with potential for loss of
containment integrity. Releases can be reasonably expected to exceed EPA
Protective Action Guideline exposure levels offsite for more than the
immediate site area.

[Purpose]{.underline}

Purpose of the general emergency declaration is to

1\. Initiate predetermined protective actions for the public,

2\. Provide continuous assessment of information from licensee and
offsite organization measurements,

3\. Initiate additional measures as indicated by actual or potential
releases,

4\. Provide consultation with offsite authorities, and

5\. Provide updates to the public through offsite authorities.

######## Licensee Actions (partial list)

1\. Promptly inform State and local offsite authorities of general
emergency status and reason for emergency as soon as discovered
(Parallel notification of State/local).

2\. Augment resources by activating onsite Technical Support Center
(TSC), onsite Operational Support Center (OSC), and near site Emergency
Operations Facility (EOF).

3\. Assess and respond.

4\. Dispatch onsite and offsite monitoring teams and associated
communications.

5\. Dedicate and individual for plant status updates to offsite
authorities and periodic press briefings (perhaps joint with offsite
authorities).

6\. Make senior technical and management staff onsite available for
consultation with NRC and state on periodic basis.

######## State and/or Local Offsite Authority Actions (partial list)

1\. Provide any assistance requested.

2\. Activate immediate public notification of emergency status and
provide public periodic updates.

3\. Recommend sheltering for 2 mile radius and 5 miles downwind and
assess need to extend distances. Consider advisability of evacuation
(projected time available vs. estimated evacuation times).

4\. Augment resources by activating primary response centers.

5\. Dispatch key emergency personnel including monitoring teams and
associated communications.

6\. Dispatch other emergency personnel to duty stations within 5 mile
radius and alert all others to standby status.

Each emergency class has a specific definition and is measured by
specific predetermined EALs that have been developed by the nuclear
utility and approved by the NRC inspectors. In turn, each emergency
class defines the actions to be taken when that emergency class is
declared. The most important consequence of the emergency classification
system is that it replaces unilateral subjective judgments made during
an emergency with consensual objective judgments made before an
emergency.

Establishing a set of emergency classes does not itself provide a useful
emergency classification system. For example, the initial version of the
Homeland Security Advisory System (HSAS---the five colored terrorist
threat alert system) had little utility as an emergency classification
system because no one but the Office of Homeland Security knew what
conditions were used to determine the announced terrorist threat level
(e.g., Yellow). It is understandable that this information was withheld
to prevent terrorists from using it to their advantage. Nonetheless, the
population at risk had no way to determine the practical significance of
any given change in threat level. For example, people had no way to know
what was the meaning of an increase in threat when the classification
changed from Yellow to Orange. Even worse, the initial formulation of
the HSAS failed to indicate what actions households, businesses, and
communities should take in response to each threat level. The system
became more useful after the different levels were linked to specific
actions that should be taken by state and local government, airports and
other critical facilities, and ordinary households and businesses (see
www.redcross.org).

These principles of emergency classification systems are important for
local emergency managers who have chemical facilities located in, or
chemical transportation routes passing through, their communities.
Unlike the case with nuclear power plants where the Nuclear Regulatory
Commission has examined the emergency classification system that plant
personnel have devised, local emergency managers must work directly with
chemical facilities to develop their own systems.

Finally, another important emergency assessment activity arises from the
need to determine when and incident has been stabilized and, thus, when
to declare the emergency has ended. The apparent simplicity of such a
declaration is misleading because there are many criteria for defining
that an incident has been stabilized. One termination criterion is the
time when it is safe for the public to end protective actions such as
evacuation or sheltering in-place. A different termination criterion is
the time at which emergency response personnel can reduce levels of
personal protective equipment use. Still another criterion for
termination of an emergency is when response personnel can be
demobilized and returned to quarters.

Emergency managers must be aware of alternative criteria for deciding
when to terminate an emergency and be able to explain why different
termination points are being used for different emergency response
functions. For example, the onscene Incident Commander might discontinue
the use of personal protective equipment by response personnel when s/he
concludes an acid spill has been neutralized to the point that it is no
longer a threat. However, the EOC Coordinator might wait to reopen the
impact zone to evacuees until after police are ready to resume routine
patrols some hours later. As another example, an earthquake with
multiple structural collapses might have emergency conditions at
different incident scenes terminate at different times. Clearly the
nature of the impact agent, in addition to specific scientific expertise
and monitoring, should be incorporated into all such decisions. In a
hazmat emergency, one criterion for deescalation is termination of the
release, coupled with dissipation of the plume, as confirmed by
monitoring teams that have assessed exposure levels at selected sampling
points. In other types of incidents, the end of the danger may come much
later than the immediate termination of emergency response operations.
In some incidents involving persistent chemical hazards, environmental
remediation is needed to reduce contamination to a level that is safe
for population reentry. Thus, the emergency assessment procedures should
include explicit criteria for incident termination. They should also
specify measures to be used in communicating such decisions within the
emergency response organization, to affected households and businesses,
and to the general public.

*Hazard and environmental monitoring*. The second element in emergency
assessment involves tracking the hazard agent over time and monitoring
other environmental conditions that might alter the hazard impact or the
success of emergency response actions. Hazard and environmental
monitoring are closely linked because, as noted earlier, some hazards
*originate in* the atmosphere (e.g., hurricanes and tornadoes), whereas
other hazards are only *transmitted through* it (e.g., volcanic ash,
toxic chemicals, radiological materials). In the case of hurricanes,
emergency managers can forecast the likely population impact by
monitoring data on the storm's current location, projected track, strike
probability, intensity (Saffir-Simpson category), size, and forward
movement speed. In the case of toxic chemical releases, emergency
managers can forecast the likely population impact by modeling the
release rate and duration together with the wind speed, wind direction,
and atmospheric stability. In addition, they should anticipate the
possibility of fires and explosions that could produce additional
releases, as well as precipitation (e.g., rain that could "wash out"
chemical aerosols) and wind shifts (e.g., approaching weather fronts
that change wind speed, wind direction, and atmospheric stability).

Emergency managers should address the technical and organizational
provisions for monitoring the actual magnitude of the hazard at any
point during the emergency and for projecting the magnitude that is
likely to occur later. The technological capability for performing this
task varies considerably from one environmental hazard to another.
Monitoring and projection is not possible for earthquakes due to the
current lack of predictability of the hazard onset, but this capability
has long been present for riverine flood hazards. For hazards of
regional scope of impact (hurricanes, severe storms, epidemics), such
monitoring is provided by federal agencies such as the National
Hurricane Center, Alaska and West Coast Tsunami Warning Center, and the
Centers for Disease Control and Prevention. For these hazards,
communities need to maintain staff expertise and equipment needed to
receive, interpret, and act upon hazard information provided by these
federal agencies. In the case of radiological and other hazmat
incidents, potential release sources are located within communities and
the scope of impact quite localized. For these hazards, communities need
to maintain staff expertise and equipment needed to receive, interpret,
and act upon hazard information (e.g., release quantities and rates)
provided by plant operators or hazmat carriers. In addition, they need
to be able to acquire data regarding current and forecast meteorological
conditions (wind speed, wind direction, and atmospheric stability).
Finally, they also need to have the personnel and equipment to track
plumes and measure the level of hazmat agents. Particularly with respect
to hazmat threats, substance detection and identification equipment is
becoming increasingly sophisticated, compact and mobile. The
Nunn-Lugar-Domenici Act of 1996 began the process of making such
equipment more affordable for local governments, and subsequent
equipment grants from the US Department of Justice have sustained the
acquisition process.

An active program of plume monitoring will allow incident managers to
assess the magnitude of any human or animal exposures during a release.
The capability for plume monitoring also makes it possible to determine
more precisely when it is safe to release people from sheltering
in-place, return them from evacuation, or terminate other protective
measures. A key benefit of effective monitoring is identification of the
political jurisdictions at risk from plume exposure. This information
facilitates the notification and mobilization processes, as well as the
offsite areas that require protective actions.

Recording downwind concentrations of a release within the site
boundaries is important for hazmat releases from fixed site facilities.
Specific locations for plume monitoring from such facilities can be
designated in advance and a standardized recording form established.
This process can also be used in the detection of biological hazards. In
the Arizona, the State Division of Health Services has retrofitted fixed
site air quality monitors to detect levels of specified biological
substances. Monitoring should include estimating current and projected
plume exposures from information about the magnitude of the release
(e.g., from plant operations personnel), accounting for the current and
forecasted meteorological conditions.

In addition, a mobile plume monitoring team should be established to
document the location and directional movement of the hazardous plume.
The plume monitoring team should be guided by a specific protocol that
indicates how emergency personnel should monitor concentrations of CBR
agents released to the atmosphere. In communities with established
hazmat response teams, the problem is substantially reduced. Most large
fire departments take sophisticated equipment "on board" to the scene,
including biological agent detection kits. In smaller and geographically
isolated communities lacking such specialized expertise, the nature of
the emergency response will be shaped by the speed with which detection
and monitoring equipment can reach the scene. In some incidents,
knowledge of the material being transported, together with the visual
inspection of the integrity of the container, can reliably confirm that
no threat exists. In other situations, only the use of the appropriate
sensing instruments can clearly identify the location and magnitude of
the hazard. Until the appropriate monitoring equipment arrives,
emergency responders should establish a perimeter around the scene,
prevent entry into the "hot zone", decontaminate anyone who has been
exposed, and maintain medical observation and isolation until released
by a competent medical authority.

*Population monitoring and assessment.* This element consists of
activities involved in assessing how many people are in the hazard
impact area at any given time and how many casualties have occurred.
Population monitoring includes observing the current and forecast
behavior of the risk area population. Census data are readily available
to document the size and composition of the permanent population.
However, it is important to break down these data by age and ethnic
composition, as well as to supplement them with estimates of the number
of workers, tourists, and other transients (Perry & Lindell, 2003). Each
of these population segments can be expected to respond differently
during an emergency. Some are distinctive in terms of their *motivation*
to comply with protective action recommendations, whereas others differ
in their *ability* to comply. For example, permanent residents are less
likely to be willing to evacuate than vacationers. However, school
children, hospital patients, occupants of assisted living units, and
other institutional residents have a limited ability to evacuate.
Effective management of population protection requires accurate
information about the number of people remaining in the risk area as the
time of hazard impact approaches.

Two other aspects of population monitoring---casualty assessment and
responder accountability---become important in the postimpact stage of
emergency response. *Casualty assessment* is needed to determine how
many people are missing and where they might be in the impact zone. This
information is, of course, essential for the direction of search and
rescue (SAR) teams. Such teams operate in earthquake or tornado
devastated urban areas where time consuming searches are being conducted
through the wreckage of collapsed buildings to look for survivors.
Accountability information allows for the "triage" of structures and
focusing of response operations (Olson & Olson, 1985). Clearly, if
available information indicates some buildings are empty, SAR teams can
bypass these locations and devote their limited resources to those areas
where rescue is possible. *Responder accountability* is needed for
similar reasons but, of course, the emergency response
organization---and especially the Safety Officer---should have a
personnel roster and duty assignment chart that facilitates this
function. It is also important to ensure emergency personnel comply with
a shift rotation that allows adequate rest (e.g., 12 hours on/12 hours
off). An "adrenaline high" can keep someone awake for 36-48 hours, but
the quality of their work will suffer before they are aware their
performance is deteriorating.

*Damage assessment*. The fourth emergency assessment element measures a
hazard's impacts on the community's public and private property. This
function is most often thought of in terms of disaster recovery and,
indeed, will be discussed more thoroughly in Chapter 11. However, damage
assessment is a continuing process that begins during emergency response
and is not completed until well into short term recovery. *Rapid damage
assessment* is used to define the boundaries of the physical impact area
and the intensity of damage within that impact area. This first stage of
the damage assessment process is used to provide emergency managers with
information they need to determine if they have adequate resources for
the incident demands. If available resources are inadequate, they must
recall off duty personnel, request assistance from neighboring
jurisdictions, or request assistance from higher levels of government.

In addition, emergency managers use rapid damage assessment to decide
how resources should be initially deployed and how to redeploy resources
as conditions change. For example, during response to a riverine flood,
a damage assessment party can identify weak spots in a levee that need
to be reinforced. As an incident progresses, a broader physical impact
assessment should examine the potential for secondary threats. For
example, emergency managers should explore the possibility that
earthquake aftershocks would cause landslides, collapse previously
damaged buildings, and disrupt additional infrastructure.

### Hazard operations

In Chapter 7, hazard mitigation was characterized as a strategy for
providing passive protection at the time of disaster impact. However,
some of these actions can also be implemented during an emergency
response. That is, hazard operations actions have the same purpose as
preimpact hazard mitigation, but are implemented only when the need
arises. Like the permanently implemented hazard mitigation measures
addressed in Chapter 7, the applicability of hazard operations actions
vary considerably from one hazard to another. Similarly, hazard
operations actions can be grouped into the same categories as the
permanent hazard mitigation measures. The principal difference is that
hazard operations actions must be able to be implemented rapidly, which
generally eliminates all land use practices (see Table 10-2). In
addition, most hazard operations actoins are infeasible for tornadoes
and earthquakes because of insufficient forewarning.

There are *expedient* *hazard source control* actions that can be used
to intervene at the stage of hazard generation. For example, wildfires
can be suppressed by extinguishing them with water and corrective
actions---such as injection of cooling water, repair of leaking pumps
and valves, and patching of damaged storage tanks---can be performed at
nuclear power plants and chemical production facilities to terminate the
conditions that could lead to offsite releases. In addition, *expedient
protection works* can be used to alter the hazard transmission process.
For example, floods can be controlled by sandbagging and other methods
of levee reinforcement. Similar tactics can be used in connection with
some technological hazards, such as the construction of dikes to capture
or direct runoff in the event of a liquid hazmat spill. *Expedient
building construction* actions can be illustrated by the last minute
installation of plywood shutters over windows to protect them from wind
and debris. Because these block the transmission of sunlight, shutters
are installed only when absolutely necessary. *Expedient building
contents protection* actions include the last minute wrapping of water
pipes when cold weather is forecast. Other measures of this type include
movement of furniture, equipment, and clothing away from windows of
structures threatened by wildfires and movement of such items to higher
floors when flooding is forecast.

**Table 10-2. Applicability of Hazard Operations Actions, by Hazard.**

  -------------------- ---------- ------------ ----------- -------------- ------------
  Hazard               Source     Protection   Land Use    Building       Contents
                       Control    Works        Practices   Construction   Protection

  Severe storms/cold                                                      X

  Extreme heat                                                            

  Tornado                                                                 

  Hurricane                                                X              

  Wildfire             X          X                        X              X

  Flood                X          X                        X              X

  Storm surge                     X                        X              X

  Tsunami                         X                        X              X

  Volcanic eruption               X                        X              X

  Earthquake                                                              

  Landslide            X          X                                       

  Structural           X                                   X              
  fire/conflagration                                                      

  Explosion            X                                   X              

  Chemical spill or    X                                   X              
  release                                                                 

  Radiological release X                                   X              

  Biological incident  X                                   X              
  -------------------- ---------- ------------ ----------- -------------- ------------

Emergency managers should establish guidelines for choosing hazard
operations actions. Decision rules or policies defining the conditions
under which each action should be used or avoided should be listed
together with a reference to any checklists required in implementing the
actions. As a specific example, one method of controlling a release of a
flammable gas is deliberate ignition. Emergency managers should be clear
about who can authorize such action and describe the decision rules for
implementation, particularly the conditions under which ignition
definitely should be attempted, when discretion is permitted, and when
it definitely should not be attempted. The authority for such decisions
during an incident at a fixed site facility that is under the control of
plant personnel is clearly different from that involved in response to a
transportation incident on a public highway.

### Population Protection

Emergency managers must oversee the technical and organizational
mechanisms by which the community emergency response organization will
protect its own personnel and the public. Specific tasks include
protective action selection and warning the affected population,
protective action implementation, hazard exposure control, impact zone
access control and security, reception and care of victims, search and
rescue, and emergency medical services. Information collected through
the emergency assessment function is the basis for choosing population
protection actions. Much of the focus is upon determining which actions
are appropriate in a specific situation and, thus, should be recommended
to those at risk. In addition, emergency managers must ensure the
resources needed to implement those measures are available.

*Protective action selection.* Emergency managers must determine which
population protection measures are likely to be effective and the timing
at which households and businesses should be advised to undertake them.
As indicated in Chapter 9, the appropriate protective strategy varies
with the type of environmental threat, as well as with the certainty,
severity, immediacy, and duration of the projected impact. In general,
the threat decreases as distance from the point of maximum impact
increases. Consequently, protective action is recommended close to the
point of impact but, beyond a certain distance, no protective action is
required. For example, people should evacuate from areas close to a
river that is expected to flood, but no action would be required outside
the expected flood zone. However, there are situations in which the
recommended protective action will differ from one location to another
for a single threat. In the case of volcanic eruptions, people in areas
threatened by heavy ash fall or mudflows should be advised to evacuate.
However, people in areas threatened by light ash fall should be advised
to shelter in-place and wear protective masks. It is only outside the
ashfall zone that no action is required. In such situations, those
receiving a warning that recommends different protective actions in
different areas must be able to identify the geographic area in which
they are located. However, people's perceptions of the risk gradient
(the rate of decrease in risk as a function of distance, see Lindell &
Earle, 1983) are not necessarily accurate even when they are given maps
to identify their risk areas (Arlikatti, et al., in press; Zhang, et
al., 2004). Thus, emergency managers might need to use warning
mechanisms that clearly target the geographic areas in which each
protective action recommendation is advised.

*Population warning.* Warning is usually the first emergency response
task to directly involve the public (although some members of the public
are sometimes the source of the initial detection). Emergency managers
should ensure the continuous availability of one or more personnel who
have the legal authority to issue public warnings. Other warning tasks
requiring explicit assignment include:

-   The person or committee responsible for constructing a warning
    message and choosing a dissemination mode;

-   The organizations involved in warning dissemination, including a
    contact list; and

-   The person or committee responsible for constructing and ordering
    the dissemination of an all clear signal.

Some jurisdictions construct "fill-in-the-blanks" messages for each
hazard to which the community is exposed. These messages can be
completed at the time a warning must be issued by filling in the
information that is specific to that incident. During an emergency, the
warning process should follow the principles described in Chapter 4.
That is, specific warnings should be disseminated by expert and credible
sources who describe the threat in terms of its location, severity, and
expected time of impact; recommend a protective action (e.g.,
evacuation, shelter in-place); and indicate how to obtain additional
information. These warnings must be conveyed in a timely and effective
manner to all who are likely to be in the disaster impact area.
Emergency responders should disseminate these warnings using the
mechanisms (sirens, face-to-face, mobile public address, etc.) that the
Planning, Training and Exercising Committee identified in the population
protection analysis conducted during the emergency preparedness phase.
However, the choice of warning mechanism and warning message content
must reflect the current emergency assessment. Consequently, emergency
response personnel need to have been trained so they can exercise
effective technical judgment or promptly contact knowledgeable technical
experts.

*Protective action implementation* focuses upon the performance of tasks
that ensure those who want to comply with the authorities' protective
action recommendations can, in fact, do so. In general, people might
need money, knowledge, physical skill, facilities, vehicles,
tools/equipment, time and energy, and social cooperation to implement
protective actions (Lindell & Prater, 2002). These resources are not
distributed uniformly in the population of any jurisdiction, so
emergency managers need to have some idea of which population segments
lack the resources needed to implement protective action. As indicated
in the discussion of social vulnerability in Chapter 6, it is especially
helpful to know which demographic groups have limited emergency response
resources and to be able to identify the neighborhoods in which they
live.

When seeking to shelter in-place from toxic chemicals, the principal
resource needed is an airtight structure. Thus, households living in
newer homes will find adequate protection because these structures
generally provide better protection against air infiltration. Building
occupants only need to know to shut doors and windows, turn off the HVAC
system, and close the chimney flue. However, older homes in mild
climates are less airtight and will not provide as much protection.
Consequently, households in these buildings can obtain additional
protection by using duct tape and plastic sheets to seal an interior
room, but these materials must be purchased and stored in advance.
Similarly, households seeking to shelter in-place against hurricane or
tornado wind need structures that will resist extreme wind pressure.
They will be adequately protected if they have basements or---better
yet---safe rooms. By contrast, residents of mobile homes might need
community shelters in their neighborhoods. If this is the way they are
to protect themselves, mobile home residents will need enough
forewarning to reach these shelters before a dangerous wind speed
arrives.

If those in the hazard impact area continue to shelter in-place after a
hazmat plume has passed outdoors, they will continue to be exposed to
the accumulation of contaminated air that has infiltrated into the
structure but has not yet exfiltrated (Rogers, et al., 1990; Wilson,
1989). Indeed, once the plume has passed, the roles of the indoor and
outdoor air are reversed. Now it is clean air infiltrating into the
structure that mixes with the contaminated air that is already there.
Following the same logic as before, exfiltration of a mixture of clean
air and contaminated air will take longer to exhaust the contaminated
air in a structure than will exfiltration of contaminated air alone.
Consequently, sheltering in-place after plume passage prolongs
inhalation exposure and ultimately results in a cumulative exposure that
is identical to the exposure that would have been received by remaining
outdoors during the entire period of plume passage. This problem can be
avoided by providing an "all clear" signal that lets those in the hazard
impact area know when it is safe to come out. That is, when the
concentration outdoors is lower than the concentration indoors, people
should open their doors and windows and ventilate the building to remove
the remaining contaminated air as rapidly as possible.

Evacuation is a more complex response and, therefore, requires more
resources. First, people need a mode of transportation so the emergency
response organization must be able to provide *evacuation transportation
support* for those who lack personal vehicles (and mobility support for
those who cannot walk to evacuation bus pickup points). Second, people
need a route of travel so the emergency response organization must be
able to provide *evacuation traffic management* to direct people to the
appropriate evacuation routes and facilitate the orderly movement of
vehicles along these routes. Third, people need an evacuation
destination so the emergency response organization must be able to
provide *mass care* for those who do not have friends or relatives to
stay with or who lack the funds to pay for commercial facilities.
Whether or not a household obtains material support from the emergency
response organization, it will need information. For example, households
taking evacuation buses must know where the pickup points are located
and when the buses will depart. Those who are evacuating in their own
vehicles should be told about the evacuation routes before an incident
occurs.

An effective evacuation protocol establishes a lead agency for the
relocation effort and lays out evacuation traffic management procedures.
It must also coordinate the timing and direction of evacuee movement
with the agency or group responsible for establishing reception centers
and mass care facilities. Emergency managers should work with
transportation officials and law enforcement personnel to select
evacuation routes and establish procedures for maintaining a steady flow
of private vehicles. The procedures should designate the personnel and
resources that might be needed in traffic management (e.g., tow trucks,
refueling tankers, barricades, traffic cones), the locations where such
resources are stored, and contact information for the persons authorized
to release and deploy resources.

Provisions should also be made for those who need transportation
support, which routinely involves three population segments. The first
segment consists of *transit dependent households* that do not have
their own vehicle or access to another private vehicle. This usually
requires emergency managers to provide buses and, in addition, to
disseminate information about what personal effects may be taken on
these buses (usually one suitcase per person and one caged pet per
household). In addition, emergency managers must broadcast information
about locations where the buses can be boarded. It is common to stage
evacuation buses from local elementary schools because these are
typically within easy walking distance of most households and their
locations are well known. The second segment consists of *household
members who have mobility limitations* that require physical assistance
or even medical support. These people are distributed throughout the
community but, in many case, authorities do not know their locations in
advance. Home nursing providers probably will be willing to provide
counts of the number of their homebound patients, even if their patient
confidentiality policies will not permit them to disclose those
patients' home addresses. The third population segment consists of
*institutionalized populations*. In most cases, the staffs of jails,
hospitals, and nursing homes will manage the evacuation of their own
clients, but such movements should be coordinated by the jurisdiction's
lead evacuation agency to ensure multiple institutions are not relying
on the same buses for evacuation or the same host facilities for
reception of their clients. One subset of the institutionalized
population, school children, requires advance planning to determine if
students will be picked up by parents from school, returned to their
homes, or evacuated as a group to a reception center where they will be
reunited with their parents. Emergency managers, school officials, and
parents should discuss the alternatives in advance and be sure parents
and students are reminded of the selected procedure at the beginning of
each school year.

The other population protection option, sheltering in-place, is somewhat
simpler than evacuation but does have some complications. In a tornado,
a basement, bathtub, or even a low spot on the ground can provide better
protection than remaining in a home---especially a mobile home---during
the short period of impact. For toxic chemical, radiological, or
biological hazards, those in the risk area might need to seek safety in
an existing structure or enhance an existing structure. In some cases,
people can implement additional personal protection actions such as
expedient respiratory protection. In the case of airborne chemical or
radiological threats, for example, sheltering in a home may require
turning off heating, ventilating and air conditioning systems, sealing
doors and windows with plastic sheets and duct tape, and breathing
through a wet towel to filter out airborne particles or water soluble
gases. Successful implementation of in-place protection depends upon
effective communication by emergency authorities. Emergency managers can
produce a timely reaction by the risk area population by explaining what
structures provide the greatest protection, how long people should
shelter in-place, and whether any expedient respiratory protection is
needed. If people are to shelter in-place for an extended period of
time, authorities must broadcast information about the need to remain
indoors. This is particularly important in public health threats
(biological hazards and epidemics), where periods of quarantine might be
long (Perry & Lindell, 2003).

*Impact zone access control and security.* This element of population
protection can be challenging, depending upon the scope and duration of
impact of the hazard agent. The first step is to establish traffic
control points on major routes at the perimeter of the impact area to
prevent people from entering without authorization. The second step is
to provide security patrols within the impact area to the extent that
this can be done without unnecessarily exposing law enforcement
personnel to the hazard (e.g., contamination by radiological materials
or persistent toxic chemicals).

There are four reasons for implementing access control and security. The
most obvious reason is, of course, to prevent looting. As noted in
Chapter 8, people commonly overestimate the incidence of looting after
disasters in the US, but visible control points are a helpful deterrent
and also reassure evacuated property owners. Second, access control and
security ensures people are not exposed to the hazard agent by
inadvertently entering the impact area. Third, securing the impact area
also allows emergency responders to implement hazard operations and
perform population protection tasks without being impeded or having to
be concerned about additional victims. Finally, controlling access to
the impact area limits the number of responders and risk area residents
that might be affected by secondary devices (usually explosives) planted
as part of a delayed terrorist attack. This makes access control an
essential part of exposure control for secondary hazards.

For the most part, impact zone access control and security should be
referenced in the EOP but should not be allocated a large share of the
emergency response organization's staff. In part, this is because the
methods of addressing this task are usually addressed in the SOPs of the
law enforcement units assigned to this duty. It is particularly
important that the lead agency's authority be respected and that clear
lines of communication are maintained among all organizations involved
in security. In most cases, law enforcement is usually designated as the
lead agency for this element, while other agencies coordinate with this
lead agency before dispatching their personnel into the impact area. In
a terrorist incident, the impact zone will be considered a crime scene,
with the FBI designed as the lead agency. In such cases, effective
coordination among local and federal agencies is critical both for
maintaining security during emergency response operations *and* for
preserving evidence that is retrieved from the impact area.

Minimally, emergency managers should follow a security protocol that
contains four elements. First, the authority of the local agency in
charge access control and impact area security should be respected and
rules for relinquishing control to other agencies should be observed.
Second, the type of controlled access described in the EOP should be
implemented as it has been planned and exercised unless conditions
require it to be modified. In general, there will be a conflict among
four goal

-   Protecting emergency responders and risk area residents from hazard
    exposure,

-   Protecting risk area residents' property from theft,

-   Protecting risk area residents' property from further damage, and

-   Allowing risk area residents to resume their normal activities.

The first two goals can best be achieved by minimizing the number of
people in the impact area, whereas the last two goals are best achieved
by giving risk area residents unrestricted access to the impact area.
The access control policy that is implemented during the emergency
response should be based on preimpact plans and procedures but must be
adapted to the conditions identified in the emergency assessment
function. For example, changes might be made to the extent of control
(ranging from complete exclusion to loosely controlled entrance and
exit), the length of time the control will be in place, and the sizes
and types of areas (residential, commercial, industrial, agricultural)
that are controlled. A volcanic eruptive sequence might require
controlled entrance and exit to residences for weeks or months. This
level of control requires planning not just for perimeter security, but
also for the escort and safety of residents given temporary access.

Third, the type of patrol or security surveillance system needed to
provide access control must be determined by the consequences of
uncontrolled access. If radiological or chemical exposure creating
severe negative health consequences is possible, access should be
tightly controlled. However, hazard exposure control must also be
maintained to protect patrol personnel. Finally, particularly when
access control will be prolonged, emergency authorities must specify
procedures for allowing residents of the restricted area to return
temporarily to their homes. Emergency managers should widely publicize
the policy for determining whether they will permit entry to retrieve
medicines, care for farm animals, and other critical activities.
Moreover, they should implement predetermined procedures (e.g., escort
by security personnel with radio communication) for implementing the
access policy.

In addition to providing access control and security for the impact
area, law enforcement should also establish a secure perimeter at the
jurisdictional EOC. In addition, law enforcement will also provide
security for other agencies within its jurisdiction (e.g., county
morgue, public health, or state public health). Hospitals will generally
have their own security personnel, although this is sometimes
supplemented by local law enforcement officers. In extreme cases,
hospitals must establish onsite independent treatment areas or offsite
centralized treatment areas to meet the demands for treatment capacity.
In such cases, local law enforcement should also establish secure
perimeters at each of these areas.

*Reception and care of victims*. This population protection element is a
common operational demand in community-wide disaster events. Emergency
authorities provide short term support---from a few hours to a week or
more---in the form of food and accommodations for victims. Many
operational personnel and disaster researchers (Kramer & Bahme, 1992;
Quarantelli, 1982a) use the terms *emergency shelter* and *temporary
shelter* to describe this function. However, as indicated earlier, the
term *sheltering* frequently refers to in-place protection from hazard
impact (Glickman & Ujihara, 1989; Sorensen, et al., 2004). To avoid
confusion, the following sections use the terms *reception center* to
refer to a location where evacuees are registered and *mass care
facility* to indicate places that provide food and temporary
accommodations for disaster victims. Sometimes reception and mass care
are located in a single facility, but many jurisdictions, especially
host counties for hurricane evacuations, establish a reception center on
the major evacuation route. From there, evacuees are directed to the
nearest mass care facility that has space to accommodate them.

During an incident, the emergency responders should observe the EOP's
designation of the reception and care coordinator---usually the Red
Cross or Salvation Army, but sometimes a local government agency or
church related organization---that operates the reception center and
mass care facilities. They should also follow the local IMS protocol
linking the reception and care function with the emergency medical
function and the search and rescue function. Many large municipal fire
departments operate emergency medical services, ambulance
transportation, and technical rescue units. In these cases, the
connection is straightforward, but whether or not the local government
controls all the functions, coordination is usually managed through the
jurisdictional EOC. Personnel should follow the predetermined decision
protocol for determining the number and location of the reception
centers to be opened. Of course, the nature of the disaster impact
should be used to estimate the number of people who are displaced (Texas
Governor's Division of Emergency Management, 2004). These data can be
combined with estimates of the proportion of evacuees who typically use
mass care facilities---an average of 15% (Mileti, et al., 1992).

Emergency authorities can also address a variety of routine demands
associated with provision of accommodations. Most of these issues are
detailed in the standard operating procedures of the organizations
providing care, especially the Red Cross. However, there are
circumstances---an exceptionally large numbers of victims, for
example---under which local governments could be forced to establish
their own mass care facilities in addition to those established by the
customary provider organizations. A prime concern in the operation of
mass care facilities is the development of a system for registering
evacuees. Some jurisdictions use laptop computers with simple database
management systems for this function. Evacuee registration provides
authorities a link to the population monitoring function, especially
accountability and casualty assessment. It also promotes the
reunification of separated families and provides accurate counts for
feeding and sleeping facilities. The EOP should require a procedure for
assessing whether victims need clothing and sleeping facilities during
their time at mass care facilities and, if so, how to handle the
logistics of obtaining such materials. Feeding demands also require
attention. The number of meals served, the places for service, cooking
arrangements, food storage arrangements, and food transportation
arrangements are important logistical challenges. Sanitation, bathroom
facilities and shower facilities must also be considered when mass care
facilities are established. More specific arrangements are required for
the presence of children in these facilities; games, toys, and nursery
facilities are commonly provided. The arrival of family pets can be
problematic if not anticipated in the facility's operating procedures.
Operational experience has shown that eliminating pets from mass care
facilities discourages families from using them. Consequently, facility
managers typically house pets in the facilities of local animal
protection organizations. Finally, facility managers should provide
victims with frequent updates about the status of the incident,
emergency response activities, and the condition of evacuated areas.

*Search and rescue.* This population protection element can pose special
challenges for emergency authorities because SAR activities often take
place in loosely structured situations with uncertain exercise of
authority (Quarantelli, 1980). The time pressures are severe (trapped
victims are unlikely to survive more than 24 hours if they are injured)
and an effective effort is largely dependent upon preincident planning.

In most disasters, victims and bystanders initiate improvised SAR
activities immediately after impact. In some cases, especially in
developing countries, these volunteers might be the only source of SAR
personnel who can extricate live victims. (International SAR units
frequently arrive too late for any activity other than body recovery.)
If the impact area is small, few victims are trapped in rubble, and the
structural debris is easy to remove (e.g., single family wood frame or
unreinforced masonry homes), bystanders can rescue many victims. For
most urban disasters in developed countries, professional responders
will reach the scene and quickly contribute to the SAR effort. If the
impact area is large, many victims are trapped, and the collapsed
buildings are steel reinforced concrete, only emergency responders
trained and equipped for technical and heavy rescue will be successful.
*Heavy rescue,* which uses specialized equipment to detect trapped
victims and jack up the debris from steel reinforced concrete
structures, is an important capability in both earthquake and terrorist
emergency response. Unfortunately, few US fire departments currently
deploy heavy rescue units as part of their normal response. For this
reason, emergency authorities should directly address the need for heavy
rescue. This includes assigning a lead agency, maintaining a list of
available heavy rescue equipment, establishing decision criteria for
prioritizing buildings in the event of multiple collapses, and creating
a protocol for quickly obtaining services of victim location specialists
(using either search dogs or infrared or audio devices).

In these efforts---especially when SAR is organized within a fire
department IMS---the Incident Commander directs the emergency response
while the Dispatch Center or EOC manages the resources. In major
incidents, the Incident Commander should designate a SAR coordinator who
will use a call list to activate public and private SAR organizations.
Although it is generally desirable to clear victims and bystanders as
part of providing access control and security at the incident scene,
time pressures and a shortage of professional personnel might require
the incorporation of volunteers into the professional SAR organization.
If volunteers are to be effectively involved, authorities need a
procedure for registering and organizing them into work groups. The
volunteer SAR teams should be assigned to tasks appropriate to their
skill level. In particular, there is considerable risk to rescuers
working in collapsed high rise buildings, so this task should be limited
to professional responders. Similarly, volunteers might become
contaminated during incidents involving hazmat (whether the release is
accidental or terrorist initiated). At best, untrained volunteers should
be considered only for lower risk tasks. Otherwise they risk becoming
additional victims whose need for rescue, decontamination, transport,
and treatment will slow the emergency response. In any event, the SAR
coordinator should maintain communications with mass care facilities,
the emergency medical care function, and the morgue.

Drabek, et al. (1981) reported unplanned contacts with the mass media
during SAR are an important operational problem resulting in the
inappropriate release of victims\' names, harassment of victims, and
inappropriate release of information about the progress of disaster
operations. To minimize such difficulties, SAR personnel should strictly
follow procedures for managing media relations. In some cases, the media
can be excluded from rescue operations by controlling access. An onscene
public information officer can be assigned to oversee media, or
reporters can be directed to an offsite location and given special
briefings. It is also standard operating procedure to brief SAR workers
about limitations on the release of information.

*Emergency medical care.* This element of the population protection
function varies across jurisdictions. In many cases, fire departments
house the EMS function as well as the ambulance function. Medical care
for victims of major disasters is provided by three components of the
emergency response: emergency personnel in the field, the network of
local hospitals, and the National Disaster Medical System (NDMS). The
NDMS is a system of military aircraft equipped to sustain treatment and
move patients anywhere in the United States for extended care.

At the incident scene, victims receive the initial medical intervention
in a chain of care that continues to hospital emergency rooms and on to
definitive care. Casualty assessments are aimed at appropriately
distributing and managing patients to insure quality care. Medical
management at the scene serves four functions: triage, medical
treatment, mental health support, and patient transportation to
definitive care. The objective of triage is to sort victims to preserve
the maximum number of lives through rapid and effective utilization of
medical treatments (Auf der Heide, 1994). Depending upon the hazard
agent, victims are classified in terms of their likelihood of responding
successfully to medical treatment and pharmaceuticals. Triage tags
indicate patient treatment classification (critical, catastrophic,
urgent, minor, dead---Auf der Heide, 1994). The tag, which identifies
the injury type and treatment administered in the field, should be the
initial patient tracking system. In incidents with many victims, triage
may be indicated initially by marking the priority on the patient's
forehead with a felt pen. A triage tag would then be attached to the
patient as soon as feasible. As noted previously, many victims are
transported, either by themselves or others, before triage procedures
are implemented. This emergent victim transport system reduces the
burden of onscene medical treatment and transportation, but can create
major problems in victim distribution across hospitals in mass casualty
incident.

The IMS Medical Branch establishes treatment areas away from the
immediate threat to begin treatment at the scene. The treatment
administered should be appropriate for the hazard agent and supported by
consultation with specialized personnel. Medical treatment addresses
patients' basic life support needs (airway/respiratory and
cardiovascular). Treatment might also involve administration of an
antidote in the case of chemical hazards or of potassium iodide in the
case of radiological hazards. Areas should be designated near treatment
areas to serve as collection points for patients' emergency
transportation (ambulance) to hospitals. Treatment personnel will
oversee patients in such zones to monitor their physical conditions and
deliver any needed continuing care. Ambulatory victims---once given
initial assessment, decontamination, and treatment---can be transported
*en mass* in buses.

It is important to attend to the mental health needs of victims and
their families, particularly in terrorist incidents. Some local fire
departments maintain Behavioral Health Units to respond to such needs.
In addition, the Red Cross and other voluntary associations maintain
both volunteer rosters and regular staff with mental health
specialization. Behavioral health support to victims and their families
is likely to be needed both during operations at the scene and later. At
the incident scene, behavioral health personnel are present (in
appropriate personal protective equipment) at the decontamination lines,
in the treatment areas, and at the Transportation Branch's staging area.
These personnel should attend to the crisis mental health needs of
victims, thereby assuring a continuous flow of patients through
decontamination, treatment, and transportation. Behavioral health units
can also be deployed to receiving hospitals to support hospital
behavioral health professionals in caring for short term victim needs,
including debriefings. If mass care facilities are opened, behavioral
health personnel provide similar services at those locations. After the
incident, the behavioral health units can serve as referral resources to
victims and families by linking those in need with appropriate community
resources including medical or mental health care.

Disaster victims may be moved from the scene to either receiving
hospitals or mass care facilities as appropriate to their medical
assessments. In terrorist incidents involving CBR, only patients who
have been decontaminated are transported unless severe threats to life
safety arise. This reduces the load on decontamination teams at
hospitals and also reduces the probability that a health facility will
itself become contaminated. Victims are transported in a variety of
vehicles, depending upon victim condition and medical need. The options
include ambulances, multiple occupant vehicles and, if the situation is
particularly urgent, by helicopter. If a patient's injuries are
particularly severe or the local hospital system is overloaded, patients
can be moved to the NDMS directly from the scene.

Hospital disaster response is guided by each institution's disaster
plan. These plans address six issues.

-   Internal and external hospital security,

-   Lockdown procedures,

-   Decontamination,

-   Tracking for walk in patients (not registered at the scene and
    transported in official vehicles),

-   Decisions to treat patients inside the facility and/or in treatment
    areas outside the hospital, and

-   Triage for walk in patients.

A relevant Dispatch Center notifies *receiving hospitals*, those
designated to receive patients from an incident scene, that a disaster
is in progress. Hospital disaster plans usually require that receiving
hospitals go to *lockdown status*---securing all doors to control access
to the facility---and notify hospital staff and physicians. Through
individual disaster plans, hospitals determine the need to mobilize
out-of-hospital areas for mass casualty incidents. Hospitals can open
prearranged onsite areas (e.g., hospital parking garages and adjacent
medical buildings) or the jurisdictional EOC can establish off-hospital
site medical care facilities (commonly known as Medical Aid Stations).
Factors in the decision to treat outside the hospital include the number
of victims, the nature of injuries, the types of treatment/antidote
administration required, and the potential for victims to contaminate
the facilities.

In the case of chemical and radiological incidents, emergency managers
work through the EOC to ensure drugs, antidotes, and equipment are moved
to the receiving hospitals from a jurisdictional cache. The EOC
Pharmaceuticals Representative monitors pharmaceutical needs and obtains
additional drugs and resupply through EOC's links to local pharmacies,
drug distributors, and the National Pharmaceutical Stockpile.

In addition to patients transported from the scene, hospitals expect
"walk ins" or self-referred patients who transport themselves or are
transported to the facilities by bystanders (Auf der Heide, 1994).
Hospitals must decontaminate, triage, and treat such patients. This
includes outfitting hospital personnel in personal protective equipment
and establishing a decontamination line. Depending on the demand at
hospitals and the availability of fire department units, emergency
authorities might assign jurisdictional resources to support hospitals
in decontamination and treatment as demands deescalate at the incident
scene.

Hospital medical staff determine patient treatment needs and, if
appropriate care is not available in the local area, refer the patient
to the NDMS for transportation to definitive care. Each hospital must
determine its patient capacity and coordinate that information with
emergency authorities. When a hospital reaches its maximum patient load,
any additional arriving victims are transported to other receiving
hospitals. If all area hospitals are filled, victims from the scene will
be transported to the NDMS receiving area for transport to care.

In most jurisdictions, the establishment of morgues and the handling of
dead in disasters are regulated by law (Hershiser & Quarantelli, 1976).
EOPs normally specify the location of temporary and permanent morgues,
the procedures for moving dead to the morgues, and the procedures for
claiming bodies. Also, provisions are routinely made for maintaining
records of both identified and unidentified bodies. In the US, the
County Medical Examiner's Office typically performs the morgue function,
which involves seven specific activities:

-   Receive human remains;

-   Safeguard personal property;

-   Identify the deceased;

-   Prepare and complete case file records on each decedent;

-   Photograph, fingerprint, and collect DNA specimens as appropriate;

-   Provide death certificates; and

-   Coordinate and release remains for final disposition.

The medical examiner is responsible for handling remains and, thus,
assumes an important role in the *chain of custody* (the documentation
of control) for evidence related to the prosecution of criminal acts. If
the number of fatalities exceeds the capacity of the established morgue
facilities, capacity can be expanded as long as the additional
facilities have adequate security, utilities, and access to
transportation. Alternate sites must accommodate the rapid mobilization
of multiple examination stations. This includes partitioning into
principal areas for:

-   Receiving bodies (and instituting accounting/tracking),

-   Decontamination if appropriate,

-   Examination/autopsy,

-   Toxicological chemical laboratory examination, and

-   Assignment for disposition, including issuance of a death
    certificate.

Most medical examiners' offices maintain a permanent force of vehicles
and personnel to move deceased victims from their places of death to the
morgue. In mass casualty incidents, emergency authorities should plan to
supplement that transport capability. Law enforcement normally provides
security for all morgues.

Biological incidents (whether naturally occurring epidemics or terrorist
attacks) require emergency authorities to make special efforts because
biological agent management requires medical and epidemiological
expertise that is found in public health agencies. Unfortunately, these
agencies usually have little or no history of collaboration with
emergency managers because they play a limited role in other types of
disasters. Local public health departments monitor clinics and hospital
records for evidence of epidemics, conduct scientific investigations
aimed at biological agent identification and control, and specify
preventive measures for exposed populations. It is desirable to have
local public health advisors available to provide medical guidance in
the jurisdictional EOC during any large scale disaster. In the case of
biological threats managed from the EOC (where the threat is not
restricted to a specific incident scene), the public health department
plays a central role. Two special powers are vested with public health
departments and used in biological incident management: mass prophylaxis
and quarantine.

The need for administration of mass immunizations or prophylactic
medicine could arise with biological agents where medical therapy
(beyond supportive therapy) is indicated or vaccines exist in sufficient
quantity for mass treatment. An order for mass prophylaxis or
immunization must come from a state or local health department. Thus,
the decision to initiate mass prophylaxis or immunization is a medical
decision, based on confirmed biological agent identification, the known
efficacy of the medicine, the time available, and the availability of
medicine. After a recommendation from medical personnel based in the
EOC, public health authorities will either issue the order for
implementation or decide not to concur. Drugs or vaccines can be
obtained locally from a government cache, normal wholesale stocks, or
the National Pharmaceutical Stockpile. Although there are jurisdictional
variations, public health departments usually oversee the mass
prophylaxis/immunization. Public information is critical to the success
of such programs and is usually coordinated with jurisdictional PIOs.

The definition of quarantine varies among states in the US, but
generally refers to the confinement of citizens or property in the
context of a significant public health threat. Recall from Chapter 5
that the CDC distinguishes between *isolation* as the confinement of
symptomatic patients and *quarantine* as the confinement of the
asymptomatic exposed. Whatever distinction a particular state makes (if
any) between these two types of cases, only public health authorities
can legally impose such confinement and they must determine the area and
timing of implementation. Police will conduct any evacuation that is
necessary to implement quarantine. In most states, citizens under a
quarantine order may legally be forcibly removed from their homes and
transported to mass care facilities, if this is necessary for the
preservation of public health. If a quarantine order confines residents
in place, police establish and maintain an appropriate perimeter and
oversee access control. If a quarantine order confines residents to an
offsite location, police usually implement the evacuation and maintain
security at offsite shelters. Just as public health authorities are the
only legal source of a quarantine order, they are the only ones that can
legally rescind it.

*Hazard exposure control*. As its name implies, this population
protection element seeks to reduce people's hazard exposure to a level
that is *as low as reasonably achievable* (ALARA) to accomplish the
emergency response mission. This ALARA principle should be adjusted for
the importance of the objectives for which exposure will be incurred.
For example, it is more appropriate to incur a high level of exposure to
terminate a release (by patching or plugging a leaking tank of toxic
gas) or to save a life than to protect property or recover a dead body.
Emergency personnel can achieve the ALARA objective in three
ways---minimizing the amount of time spent in hazardous areas (*time*),
staying as far away from hazard sources as necessary (*distance*), or
insulating themselves from the hazard (*shielding*). It should be
obvious that incident zone access control, as discussed previously,
provides hazard exposure control by reducing time in the risk area to
zero. In addition, hazard exposure control is the reason why it is so
important to limit the amount of time residents spend in the risk area
if they are allowed to return to salvage property. Moreover, the
provision of police escorts enables emergency managers to rapidly
communicate any unexpected increase in hazard level and order a quick
return to safety. This also minimizes exposure time. Emergency response
personnel also observe these principles of hazard exposure control when
they use personal protective equipment while working in an impact area.
Air filters or bottled air, chemical protective suits, gloves, and boots
all provide shielding against exposure to hazmat agents.

*Environmental surety.* This population protection element is an issue
whenever a hazard agent, most likely CBR, leaves a dangerous residue in
the water or soil. Hazmat incidents involving the accidental release of
even small quantities of some CBR agents can create major contamination
problems. Moreover, as noted earlier, a variety of natural hazards---as
well as fires and explosions---can cause hazmat releases as a secondary
hazard. Finally, a terrorist attack could involve a deliberate hazmat
release---perhaps even a very unusual CBR agent. In all of these cases,
population exposure after reentry into the impact area could cause long
term health consequences. Thus, many jurisdictions use hazmat response
teams to test for, abate, and monitor such contamination.

Environmental surety is a complex issue that can arise at many stages of
incident management. However, it becomes a major priority in the later
phases of the emergency response and often continues into disaster
recovery. When a contaminated area might also be a crime scene, the goal
of reducing contamination to a safe level must be balanced with the goal
of recovering and preserving evidence. Thus, the FBI must be involved in
threat assessment and evidence collection throughout all phases of the
environmental surety process.

For incidents having one or more contaminated areas, particularly where
hazmat technicians have conducted operations, the IC usually ensures the
decontamination of all personnel, equipment, and apparatus in the hot
zone and warm zone. In addition, all other personnel, equipment, and
apparatus that might have been exposed should also be decontaminated.
Following completion of the decontamination processes, hazmat
technicians should collect samples of runoff from the decontamination
corridors and then shut them down following local SOPs. Runoff water
from decontamination should be collected so any unknown CBR agents can
be identified and treated, if necessary. Testing the water to verify
that any acids or caustics have been neutralized may require laboratory
testing (unless an onscene assessment can verify there was no
contamination).

For all contamination incidents, site threat assessment and remediation
(including hazard monitoring and reentry determination) follows local
procedures which, in most cases, are consistent with FEMA guidelines. In
most jurisdictions, this process is accomplished through the coordinated
efforts of several different agencies (usually at a county or state
level, assisted by federal agencies). The state department of emergency
management normally oversees the coordination of consequence management
and serves as the direct contact with FEMA if the latter is acting as
the Lead Federal Agency for consequence management in a terrorist
incident. The county (or state) health department (which provides
laboratory services and epidemiological investigation), the National
Guard, and state transportation department can all support threat
assessment and monitoring by using their hazard monitoring devices
(e.g., Geiger counters for radiation hazard). These agencies typically
have specialized roles in the collection and analysis of samples for
agent identification and for monitoring the extent and nature of
contamination.

County or state environmental protection departments use either internal
or contract personnel and equipment to collect environmental samples to
produce their initial hazard assessments. In CBR events defined under
the Comprehensive Environmental Response Compensation and Liability Act
(CERCLA), these agencies coordinate with the EPA to implement the
National Contingency Plan (NCP). The NCP coordinates environmental
response, including site assessments, consultation, agent
identification, environmental monitoring, environmental decontamination,
and long term site restoration (see *Federal Response Plan, Terrorism
Incident Annex, Section 5E4* "Environmental Protection Agency").
Additional support---including epidemiological investigation, public
health, and medical and pharmaceutical operational resources---is
available from the US Department of Health and Human Service (HHS)
Health and Medical Services Support Plan. This support is obtained from
the Centers for Disease Control and Prevention (CDC), National
Institutes of Health (NIH), Agency for Toxic Substances and Disease
Registry (ATSDR), and the Food and Drug Administration (FDA).

Environmental samples of air, water, or soil---as well as unknown
powders or substances---are usually collected and packaged by onsite
hazmat technicians. In most cases, county or state resources are used to
conduct air sampling. Environmental samples are collected and prepared
for transport according to the instructions contained in the CDC
standard operating procedures for containerization. Emergency response
teams communicate with the local FBI office regarding transportation to
the laboratory conducting the analysis. For security purposes, and to
ensure a continuous chain of custody for the evidence, transportation is
handled by an appropriate law enforcement office (FBI, local, county or
state police force) as approved by the local FBI office. Chain of
custody paperwork is required unless otherwise determined by the FBI.
Responsibility for the samples is transferred to laboratory staff
through the chain of custody paperwork. The laboratory is required to be
a secure facility as determined by the FBI. Once samples are received,
the laboratory tests the samples or will confer with or refer the sample
material to the CDC. Before transporting any unknown material, onscene
hazmat teams should assess it for stability, calling on the FBI for
assistance if necessary. Transported samples should be accompanied by an
assessment of the probability that the unknown material is explosive or
might release some gas when the container is opened in a laboratory.

### Incident Management

Successful response to a community-wide disaster requires the local
emergency response system to be able to mobilize its personnel and
resources rapidly. This, in turn, requires a predetermined concept of
operations and its elaboration in the jurisdiction's EOP. The *concept
of operations* is a summary statement of what emergency functions are to
be performed and how they are accomplished. In almost every case, this
demands centralized planning for command and control across a variety of
local public sector, private sector, and NGOs. It also requires a
strategy for coordinating their collective response, as well as
specification of how extra-community resources will be mobilized and
integrated into the response effort. This section discusses seven
specific functions that are the core of the incident management
function. As noted in the previous chapter, the local emergency response
organization is defined by the EOP in terms of the emergency functions
performed, assignment of responsibility for emergency function
performance to local organizations, and an explicit identification of
functions performed by external organizations upon which local response
is dependent. In addition, the organizational structure must be defined
in terms of the title and duties of each of the positions within the
emergency response system and the reporting relationships among these
positions.

*Agency notification and mobilization.* This element of incident
management initiates the emergency response. Notification to the
jurisdictional authorities comes from different sources, depending upon
the nature of the threat. Federal agencies (NWS, FBI, USGS, CDC, and
others) usually notify a predetermined warning point---the local
emergency manager or the police or fire department dispatch center. For
"routine" emergencies (or for apparently routine emergencies that
escalate to community-wide disasters, such as some hazmat incidents or
terrorist events), dispatch centers are the most common warning points.
Once the warning point is notified, it must notify other members of the
emergency response organization and mobilize appropriate resources. The
EOP should specify the channel (e.g., telephone, radio, fax) and title
of all personnel to be contacted. The principal emergency response
agencies (police, fire, and public works) operate 24 hours a day;
relevant departments that do not operate around the clock should
maintain continuous accessibility by assigning agency personnel to serve
shifts as on call duty officers. Whatever agency notification procedure
is ultimately selected, it should be explicitly defined in the EOP and
elaborated through each agency's SOPs---including the mobilization of
personnel to activate the jurisdiction's EOC. This notification process
should end only when all parties having a duty or capacity to respond
have been informed. The fundamental aims of notification are to identify
the organizations needed in the response, alert them to begin their own
activation processes, and prepare them to initiate the emergency
response. Thus, it is necessary for emergency managers to establish
explicit criteria for determining who is likely to initiate the
notification process, which parties they should notify, which
communications channels are available and should be used, and what
information should be transmitted.

This notification process should be expected to differ among
jurisdictions (i.e., whether a city, county, or state is involved),
among different types of hazard (natural, technological or terrorist
attack) and, in some cases, among hazard agents of a given type. As an
example, consider the problem---and likely flow of events---associated
with a hazmat transportation accident. In most cases, the driver of the
truck or crew of a train will, as employees of the carrier, attempt to
notify their dispatcher and a local or state police office. In any
event, it is quite likely that local or state police will be the "first
agency onscene." The first onscene will, in turn, notify other local and
state agencies including the lead state agency, which will inform still
other agencies at the local and state level and make the link to the
federal emergency response system. In view of the preeminent
responsibility of the states for the health and safety of their citizens
and the role of the carrier as an agent of the shipper, it is common for
these parties to play leading roles in responding to transport
incidents. The length of time it takes to notify these lead parties
could, under certain circumstances, take an appreciable period of time.
Even though a serious truck accident in a rural area might be expected
to produce a significant delay, this is not necessarily the case. In a
spill of radioactive materials in southeast Colorado, the shipper was
notified within approximately one hour of the truck wreck by the local
county sheriff\'s office (Hornsby, Ortloff & Smith, 1978). This was in
spite of the fact that the accident took place in a rural area in the
middle of the night and the driver of the truck was pinned inside the
truck cab. Taylor (1978) reported notification times of 10 and 20
minutes for a train derailment and a truck accident, respectively, and
noted a one and a half hour lag in receiving notification of a different
train derailment. In all three cases, these times refer to the length of
time it took to notify the shipper. There was no report of the length of
time that it took to notify the local authorities. Finally, it is
important to recognize that information transmitted to the state\'s lead
agency for hazmat will be coming from personnel who may have little
familiarity with the materials being transported. Consequently, it is
desirable to have standardized forms available to agencies likely to be
first on the scene so the appropriate information can be obtained in a
timely manner.

Notification in terrorist incidents is complex because CBR agents have
distinct characteristics and create unusual demands. First, a caller
might inform police or fire department dispatchers about the release of
a CBR agent or the dispatchers might determine from their call screening
protocol that such an agent has been released. A second detection
mechanism consists of fire and police personnel responding to an
apparently routine call who notice "signs and symptoms" of CBR exposure.
The third detection mechanism is a county or state health department's
routine screening of local employers for indications of increased
absenteeism and epidemiological surveillance systems hospitals and
clinics for increased incidence of symptoms consistent with CBR
exposure.

*Mobilization of emergency facilities and equipment.* A major step in
the mobilization of a jurisdiction's emergency response organization is
the activation of its EOCs. As facilities, EOCs are extremely variable.
In more hazard prone (and wealthier) cities and at higher levels of
government, EOCs have full time staff in permanent locations with
extensive communications equipment, powerful computers, and
sophisticated display screens. Such arrangements have the positive
effect of creating stable, visible, ready locations for supporting
disaster response operations. At the other extreme, many communities'
EOCs are temporarily converted from conference rooms by hanging some
status boards on the wall and installing a few additional telephones.
This does not mean that only an expensively equipped permanent EOC is
adequate. In fact, even a very basic EOC can be effective if it is based
on careful analysis of the functions that will be performed there
(Lindell, et al., 1982). Thus, it is more important to build a modest
facility that matches the EOC's design to its function than it is to
build a large expensive facility that provides inadequate support to the
emergency response organization.

There are often multiple facilities in a community that are called EOCs.
One facility might serve as the jurisdiction's EOC, but many fire and
police departments also have their own departmental EOCs. Fire
departments usually locate their EOCs in or adjacent to their dispatch
centers and, though some police departments do the same, others have
stand alone *technical operations centers* (TOCs). It is also common for
public works and transportation departments to maintain their own
departmental EOCs. However, each EOC focuses on managing the response of
its own organization in accordance with directives received from
departmental liaisons at the jurisdiction's EOC. Departmental EOCs
accept such directives, call upon their own standard operating
procedures (or improvise "on-the-spot" procedures), and dispatch their
own personnel and resources.

Although EOC location and design are quite variable among jurisdictions,
they all perform the same function---to serve as the hub of the
emergency information processing within the jurisdiction, as well as
between the jurisdiction and external soruces of assistance. The EOC
requests data, receives it, processes it, and uses the processed
information to coordinate the community's emergency assessment, hazard
operations, and population protection actions. Figure 10-2 describes the
information flow in a typical EOC (Lindell, et al., 1982; Perry, 1995).
The Communications Team requests and receives data from three principal
sources. The first type of source is state and federal hazard detection
agencies such as the National Weather Service and US Geological Survey.
The second type of source is one or more local Incident Command Posts.
The third type of source is a local fixed site facility or hazmat
carrier's dispatch office. These organizations provide data associated
with the hazard and environmental monitoring functions.

[**Figure 10-2**. Information Flow in a Typical EOC.]{.underline}

The Communications Team relays the data to one or more analysis/planning
teams that process the data to predict likely future states of the
hazard and environment as well as the implications of current and future
conditions for the population protection function. These
analysis/planning teams typically address the planning, logistics, and
finance/administration activities defined under ICS/IMS, as well as the
emergency assessment and population protection functions defined under
NUREG-0654 and NRT-1. The analysis/planning teams present the results of
their analyses to the Executive Team (the jurisdiction's CAO, major
department heads, and legal counsel) for their review and action. As the
Communications Team receives updates about the status of the situation
and resource availability and the Executive Team approves the
analysis/planning teams' recommendations to implement emergency response
actions, the PIO and agency liaisons are briefed about the actions being
taken. Then, the PIO uses this information to prepare press releases and
briefings to be delivered to the news media at the JIC. Similarly, the
agency liaisons communicate the information that is specifically
relevant to their agencies, including requests for the activation of
additional resources and the dispatch of mobilized resources to
designated staging areas. At the municipal level, one usually finds
representatives from police, fire service, EMS, public works (streets
and transportation), and public and private utilities. In addition, the
Red Cross or Salvation Army (or other organizations managing mass care
facilities) is also represented. In addition to these, representatives
of organizations associated with higher levels of government (county,
state, federal) might also occupy space in the community EOC. Some
agencies, such as FEMA, can be expected in all major disasters; others
will only be present for certain types of disasters (e.g., the FBI
responding to a terrorist attack). This listing of representatives to a
municipal EOC is suggestive rather than exhaustive. Clearly, the
organizations represented in the jurisdictional EOC depend on the nature
of the threat itself and the particular network of inter- and
intra-governmental resources needed to respond to that threat.

Finally, the EOC Support Team provides administrative and logistical
support to the personnel in the EOC and provides continuing
documentation of the status of the incident and the status of the
response. In addition to the local emergency manager, who usually serves
as the EOC Coordinator, the EOC is also staffed by a variety of
function-relevant officers charged with oversight and coordination of
key features of managing the emergency at hand. Thus, the officers in
charge of the Communications Team, the analysis/planning teams (e.g.,
Emergency Assessment, Planning, Population Protection, Logistics, and
Finance/Administration) report to the EOC Coordinator even though the
persons assigned to these positions do not normally report to the local
emergency manager. (Their permanent positions are in agencies such as
police, fire, or public works.) The reason for this emergency-specific
chain of command is that the EOC officers play roles that are very
different from those of the agency liaisons. Instead of representing the
agencies that employ them, the EOC staff members perform functions that
serve the information needs of all agencies. In addition, the EOC
Coordinator is responsible for ensuring the EOC is fully functional.
This includes maintaining computer hardware and software, display
devices, and communications equipment. It also includes establishing
duty schedules for the EOC personnel (12 hours on/12 hours off) to
ensure continued staffing in a lengthy incident.

*Communication/documentation*. This element of the incident management
function, which is usually assigned to the EOC's Communications Team,
has a much higher profile in the EOC than at the Incident Command Post.
ICS and IMS assign communications the status of a unit within the
Service Branch of the Logistics Section. The reason why communications
has a more salient position within the EOC is that it is a much more
significant activity there. The Communications Team supports the
emergency response organization by using interoperable systems (US
Department of Homeland Security, 2004a) for collecting data on
environmental conditions, casualties, and damage to property and the
environment. For example, the Communications Team obtains hazard data
from the National Weather Service when severe meteorological events
threaten. Such meteorological data are considered to be environmental
data during toxic chemical and radiological releases because wind speed,
wind direction, and atmospheric stability determine the distribution of
the hazard even though they are not hazardous in themselves. During
incidents involving unknown agents (whether accidental or deliberate),
agent identification is often performed onscene and the Incident Command
Post relays the outcome to the EOC. If the analysis/planning teams have
insufficient expertise on staff, the Communications Team might be
directed to contact toxicological, radiological, or epidemiological
specialists to obtain information on recommended medical treatments and
relay this information to receiving hospitals.

As discussed further below, hazard and environmental data are also
communicated to analysis and planning teams so they can determine the
need for population protection activities such as protective action
selection and warning. Such information can also provide emergency
authorities with concrete data upon which to make specific deployment
and strategy decisions for hazard operations. Finally, the
Communications Team is often queried by the EOC's Executive Team, other
EOCs, and interested parties regarding the nature and progress of
community-wide disaster management efforts. Thus, the jurisdictional EOC
must collect and disseminate response relevant information, as well as
preserve it for future use.

It is not uncommon to find, especially in small jurisdictions, that
untrained office staff have been given assignments as emergency
communicators holding open telephone lines to other emergency response
organizations. If clerical staff must be used during emergencies, it is
extremely important that these individuals receive specialized training
in this role. Repeated experience in emergency exercises has shown that
if communicators are unable to understand the messages they receive,
they are quite unlikely to record them accurately. In many ways, an
inaccurate message is more misleading, and ultimately more dangerous,
than no message at all.

Documentation is an important responsibility of all EOC staff rather
than the sole responsibility of a single unit. Thus, the Communications
Team must continually maintain communication logs that record who called
into or out of the EOC, when the call took place, who participated in
the call, and what was the content of the call. The analysis/planning
teams must continually document situation status and resource status.
The PIO must continually document media inquiries and responses to them,
whereas the agency liaisons must document the inquiries they receive and
the responses they make. The EOC Coordinator may choose to establish a
documentation unit within the EOC Support Team or one of the
analysis/planning teams to collate the documents produced by other EOC
teams. This will provide a clear basis for the after action report to
assess the strengths and weaknesses of the emergency response
organization's performance. Documentation must also be established for
activities that take place at the incident scene and at other locations
outside the EOC. Indeed, these will be the only locations where
activities need to be documented when the EOC is not activated. In
addition to the types of documents preserved in the EOC, the Incident
Command Post should save Incident Action Plans and other documents
generated by the ICS.

Documentation is facilitated when a jurisdiction establishes
standardized forms that meet the needs of all the agencies involved.
Local emergency managers should recognize that normal documentation
systems are designed for normal circumstances and, consequently, may be
time intensive or have other characteristics not well suited for
operation during an emergency. Thus, they should work with their
departments of finance and administration to create a documentation
system for resources expended, services performed, and materials
acquired for use in the emergency response. In addition, emergency
managers should also recognize that federal reimbursements for expenses
incurred during Presidential Disaster Declarations (including terrorist
attacks) may demand accounting and documentation processes that differ
from local practices. Thus, they should ensure documents meet these
standards as well.

The need to maintain satisfactory documentation of emergency response
activities does not mean the EOC staff should try to record every single
message transmitted everywhere in the emergency response organization.
However, it should follow basic document management procedures to ensure
there are records of the most important response actions, the basis for
those response actions, and the resources expended to implement those
response actions. This means retaining information on the status of the
incident and the status of the organizational response. It also includes
information on the timing and effectiveness of operational decisions and
deployments. Such data are needed in the short run to adapt response
strategies to disaster demands. However, these data are also needed in
the long run to generate the after action assessments that provide
feedback to improve management of future similar disasters. They also
provide the basis for a defense against litigation by any parties that
believe they were adversely affected by the actions (or inactions) of
the emergency response organization.

### Analysis/planning. As noted above, this element of the incident management function uses information collected by the Communications Team to assess the current status of the situation and project its future status. For example, analysis/planning teams might use an NWS forecast of an approaching weather front to anticipate a change in wind speed and direction that will require evacuation recommendations to be extended to neighborhoods that previously were considered to be safe. In conducting such assessments, these teams may activate technical specialists in specific areas such as toxicologists, radiologists, and epidemiologists for a hazmat incident. Analysis/planning teams also examine anticipated changes in incident demands to determine if they will require additional resources to be mobilized and dispatched to meet these new demands. Conversely, as the incident demands decrease, analysis/planning teams assess the opportunities for demobilizing emergency response units that are no longer needed. Finally, analysis/planning teams are sometimes responsible for posting current data on situation status, resource status, and response activities to status boards. This activity also requires recording such information and documenting it for use in briefing oncoming shifts and for generating after action reports.

### Internal direction and control. This element of the incident management function provides the answer to the question "Who is in charge?" There are three basic ways to answer this question. In some jurisdictions, the CAO is the Emergency Director, with or without an executive committee of department heads and legal counsel as advisors. This strategy has the advantage of maintaining continuity with the way in which the jurisdiction is managed under normal conditions. However, it can have the disadvantage of overloading the CAO with operational decisions for which s/he has little training or experience. In addition, provisions must be made for an alternate (e.g., assistant city manager or agency head) to provide regular rest periods. In the second management strategy, the CAO delegates incident management responsibility to the head of one of the disaster-relevant departments---usually police, fire, or public works. The advantage of this strategy is that these officials have training and experience that is more directly relevant to emergency response. However, they will still need to consult the CAO if they need clarification on some policy issues. Of course, they also need to make arrangements for an alternate (e.g., the assistant department head or one of the other department heads).

In the third strategy, the CAO delegates the direction and control of
the emergency response to the local emergency manager. This places
authority in the hands of the person who generally has the most disaster
training and experience. However, this strategy requires someone else to
assume the duties of EOC Coordinator and, in some jurisdictions, would
create conflicts with normal reporting relations. The problem here is
that some jurisdictions establish emergency management as a division
within another department, usually fire or police. Consequently,
delegating authority for overall incident management to the local
emergency manager would result in having him/her give orders during an
emergency to someone who is normally her/his superior. In other
jurisdictions, there is no difference between the second and third
management strategies because the local emergency manager is also the
department head (i.e., police or fire chief).

The appropriate management strategy depends in part upon the
jurisdiction's normal organizational structure. In addition, it could be
made contingent on the magnitude of the emergency. For example, minor
emergencies that mostly involve administrative and logistical support
for an Incident Commander at a single incident scene might be handled
quite satisfactorily by the emergency manager serving as EOC
Coordinator. This person would consult with EOC staff, devise policy for
immediate disaster response, consult with the CAO and agency heads for
policy approval when appropriate, and implement approved policy. For
major disasters, EOC management would shift to the CAO supported by a
disaster management committee comprising the heads of the major
disaster-relevant agencies---police, fire, and public works. The EOC
coordinator would alert this group to the need for policy decisions and
would implement the policies they formulate.

Internal direction and control of the emergency response organization
involves three specific activities identified in Figure
10-2---management oversight, policymaking, and coordination with local
agencies. The first activity, *management oversight* of disaster
operations, essentially involves monitoring the performance of field
units to verify they are responding in accordance with the EOP and
agency SOPs. This does not mean the EOC assumes tactical direction of
onscene operations; the Incident Commander is best positioned for such
decisions. Instead, the EOC focuses on providing information and
resource support to the Incident Commander and monitoring the response
to ensure the agent generated and response generated demands are being
addressed. Often, these demands change over time. The demands of initial
impact might decline while new demands arise from secondary threats. For
example, in large floods, the initial concern with evacuation and rescue
gives way to public health concerns about sewer systems overflowing and
contaminating drinking water systems. The changes in disaster demands
cause changes in emergency response operations which, in turn, produce
changes in incident management activities. Hence to properly manage the
incident, the EOC must continually monitor the Incident Commander's
response to the threat and continually review the need to redeploy
resources (including personnel) to effectively respond to the changing
disaster demands.

The second activity in internal direction and control is *policymaking*.
When a disaster strikes, the jurisdiction's EOP ordinarily serves as the
framework for coordination. It defines the mechanisms for implementing a
coordinated multiagency response by defining the functional assignments
for different response organizations, chains of command, procedures for
requesting mutual aid, and listing of available resources. If a disaster
generates demands that are not adequately addressed in the EOP or SOPs,
incident managers might need to improvise solutions to these unforeseen
problems and the Executive Team (including legal counsel) will need to
authorize the improvised procedures to ensure they are coordinated among
the appropriate responding agencies. For example, the Executive Team
would need to authorize a reassignment of an emergency response function
from one response agency to another, an improvised procedure for
requesting external resources, and the like.

The third activity in internal direction and control is *direction of
local response agencies*. This involves ensuring that local emergency
response agencies not reporting directly to the Incident Commander
receive current information about the status of the incident and the
status of the response. In addition, it involves giving each agency
instructions to perform unplanned activities that evolve from the
policymaking process.

*External coordination*. This element of the incident management
function addresses the relationship between the jurisdiction's emergency
management organization and outside organizations such as adjacent
jurisdictions and state and federal agencies. Many of these contacts
will be made through telephone and an increasing number come through
emails. There is considerable potential for Web based Crisis Information
Management software to support EOCs (US Department of Justice, 2002).
However, there are many problems with compatibility of different systems
and some provide inadequate support to ICS/IMS (Hunt, 2005). In
addition, much of the commercially available software is too expensive
for smaller jurisdictions, so widespread adoption is likely to occur
only if no- or low-cost systems such as CAMEO are distributed.

In a major disaster, state and federal agencies dispatch liaison
personnel to local EOCs to coordinate operations. Consequently, local
emergency managers will need to provide space in or near the EOC for
some of these personnel. Other personnel from outside the jurisdiction
may be dispatched to the incident scene or other locations (e.g.,
Disaster Medical Assistance Teams to local hospitals). It is in the
relationships with extra-community organizations that internal direction
and control is most clearly distinguished from external coordination.
Specifically, all employees of agencies within a jurisiction ultimately
report to the same person---for example, the city mayor. This person, or
his/her designated representative can issue a direct order that resolves
a conflict between two agencies (e.g., police and fire). Such is not the
case when personnel from multiple jurisdictions, each having a
legitimate basis of authority. For example, Drabek, et al. (1981)
studied a situation in which a showboat overturned on a lake in a state
park. In all, 78 different city, county, state, federal, NGO, and
private sector organizations responded to the incident scene. In such
operations, all agencies must collaborate if the incident is to be
managed successfully.

In addition to its other responsibilities, the EOC must host visitors
without disrupting response operations. EOC managers often fail to
anticipate the desires of senior elected and appointed officials, but
also news media personnel, to visit the EOC and be briefed on the
incident response. Some of these visitors have legitimate disaster
related functions, but others have no purpose other than a desire to
provide a public display of concern. Unfortunately, the larger the scale
of a disaster, the larger the number of VIP visitors is likely to be.
Because they are difficult to turn away, it is important to develop a
procedure for hosting them. The EOC Coordinator can assign a PIO to
escort visitor tours, preferably in groups, that explain emergency
response operations. It is also helpful to designate a space near the
EOC where these VIPs can receive special briefings and ask questions
without becoming an impediment to EOC operations.

*Public information.* This element of the incident management function
can be located in the Incident Command Post, EOC, or a JIC that serves
multiple agencies (or multiple levels of government). Emergency managers
should follow the EOP's procedures for communicating public information
through the news media and other channels such as routine briefings of
evacuees in mass care facilities. Many aspects of public information
were addressed in Chapter 4, but this chapter will address several
issues that arise during emergency response. First, what are the
locations from which public information is disseminated? Second, what
are the specific duties of those who must perform this activity?

First, the location from which public information is disseminated
depends upon the size of the incident and whether or not there is a
defined geographic scene. In small, short duration incidents with a
defined scene, the public information function is often based at the
scene, attached to the Incident Commander, and administered by a PIO. In
incidents that are large enough to require activation of the
jurisdictional EOC or where there is no defined incident scene, public
information is handled through the EOC. In major disasters affecting
multiple jurisdictions or, especially, multiple levels of government,
the principal site for dissemination of public information will be a
JIC.

Second, regarding specific duties of those who must perform this
activity, it is important to recall that incident managers should
designate a broadly knowledgeable chief spokesperson, usually the
jurisdiction's PIO, who can call upon specialists to respond to specific
technical questions as necessary. All other emergency response personnel
should direct media inquiries to the spokesperson. In addition, the PIO
must keep emergency authorities (the Incident Commander, the EOC
Coordinator, and the Executive Team) informed about the information
demands of the public and the news media, as well as the number of news
media personnel covering the incident. The information demands of the
public can be determined by routinely monitoring the content of calls to
the jurisdiction's Rumor Control Center. Any questions that are asked
repeatedly should be addressed in press conferences. The information
demands of the media can be determined by the specific questions that
reporters ask. In addition, however, other issues can be identified by
monitoring news media broadcasts (both radio and television) to identify
issues being raised by reporters and their expert sources, as well as
inaccuracies in news media reports.

In addition, the PIO should formalize the public information function by
scheduling regular media briefings. Provisions should be made for the
rapid preparation of graphic materials such as maps, process diagrams,
and organization charts to be used in emergency press briefings. Such
materials will describe the location of the hazard impact zone and
assist those conducting briefings in describing the organizational
response to the emergency.

Moreover, the PIO facilitates all requests for media orientation tours.
The PIO is responsible for providing appropriate personal protective
equipment to the scene for media and ensuring its proper use. Finally,
the PIO advises the emergency authorities when conditions have reached
the point that, either due to the size of the media contingent or the
scope of information needs, the public information function should be
moved from the Incident Command Post to the EOC or from the EOC to the
JIC.

*Administrative and logistical support.* This element of the incident
management function is handled at the Incident Command Post during minor
events, but is assumed by the EOC during a community-wide disaster. This
function comprises the Logistics and Finance/Administration Sections
recognized by all formulations of ICS and IMS. Thus, the jurisdictional
EOP should recognize that the emergency response organization, like all
other organizations, requires support services. EOC staff need clerical,
purchasing, accounting, and legal support staff, routine office
equipment repairs, and office supplies such as printer paper. Moreover,
the EOC can support the Incident Command Post by assuming many of the
responsibilities of the Logistics Section's Service Branch (Medical and
Food) and Support (Supply, Facilities, and Ground Support). The EOC can
also assume much of the burden of the Finance/Administration Section
(Time, Procurement, Compensation/Claims, and Cost).

**Case Study: Emergency Response**

The April 10, 1979, a tornado struck Wichita Falls (Drabek, et al.,
1981). At the time the tornado struck, most victims were in their homes
(67%) or cars (12%). Almost all of them received at least one warning
(91%) and the majority received two or more (58%). Most were warned by
sirens (44%) and the news media (television, 34%; radio, 12%), but a few
were warned by peers (10%). Consistent with the recommendations of
authorities, 73% responded to the warnings by staying where they were.
Many who remained in structures that were destroyed by the wind (25% of
victims) needed to be rescued. Of these, 87% were rescued by peers and
only 13% were rescued by authorities. Of those victims who were
uninjured, 59% assisted others in need.

As time went on, local, state, and federal agencies supplemented the
spontaneous SAR activities of peers. The city's police, fire, traffic,
civil defense, and public works departments were all actively involved
in the response. Other local government units included fire departments
from inside and outside the county, as well as police helicopter units
from Dallas and Houston. State resources included the National Guard,
Highway Patrol, Parks and Wildlife, and Highway Department. Federal
agencies included military units from nearby Sheppard Air Force Base and
Fort Sill Army base in Oklahoma. Private resources included a rescue dog
unit, an amateur radio unit, the local Red Cross chapter, and a local
ambulance company. This convergence of outside resources was difficult
for the local emergency management system to coordinate but ultimately
made major contributions to the SAR effort.

Unlike some of the other cases Drabek and his colleagues studied, the
decisionmaking structure was relatively flat. That is, the lead agencies
(the Wichita Falls police department and the Texas Highway Patrol) did
not dominate the decisionmaking process. In part, this might have been
because emergency response activities were hampered by loss of electric
power and telephone service. As a result, SAR teams operated more
autonomously than in other disasters. In fact, the researchers found
evidence of three distinct decisionmaking structures. City personnel
thought the Highway Patrol and the city Civil Defense agency were the
primary decisionmakers, whereas the county agencies viewed the county
civil defense agency as the dominant decisionmaker. Finally, the state
personnel considered the city police department to be the lead
decisionmaker. Despite the loss of electric power and telephone service,
the city EOC was able to operate with backup generators and emergency
managers improvised radio communications with the support of federal
resources. These resources became increasingly important as SAR units
shifted to more challenging missions, such as large collapsed structures
and water bodies (river and lakes), that exceeded the capabilities of
emergent SAR teams staffed by impact area residents.