Section 10 - References

Table of Contents

Specific References:

10.1. Emergency Management Concepts (Section 2) 10 - 1

10.2. Emergency Management Program Development Process (Section 3) 10 -
3

10.3. Decontamination (Section 5, Part 1) 10 - 3

10.4. Biological Event and Terrorism Readiness (Section 5. Part 2) 10 -
3

10.5. Radiological Event and Terrorism Readiness (Section 5, Part 3)
10 - 4

10.6. Chemical Event and Terrorism Readiness (Section 5, Part 4) 10 - 5

10.7. Trauma Readiness (Section 5, Part 5) 10 - 6

10.8 . Education, Training and Exercises (Section 9) 10 - 7

10.9. General Local Agencies 10 - 12

10.10. Directives/Handbooks 10 - 12

10.11. Miscellaneous Publications 10 - 13

Section 10 - References

10.1. Emergency Management Concepts (Section 2)

1\. American Society of Testing and Materials, Committee F30 on
Emergency Medical Services, ASTM 1288, Standard Guide for Planning for
and Response to a Multiple Casualty Incident, Washington, DC, 1990.

2\. Barbera, Joseph, MD; Macintyre, Anthony, MD; *Health and Medical
Incident Management System: A Comprehensive Functional System
Description for Mass Casualty Medical and Health Incident Management*,
The George Washington University, Washington, DC, 2002.

3\. Boatright, Connie, RN, *Expert Guidance for Complex Issues*,
[Veterans Health System Journal]{.underline}, June/July 2001, page 30.

4\. Canada, Ben; *Homeland Security: Standards for State and Local
Preparedness*, U.S. Congressional Research Service, Library of Congress,
Washington, DC, January, 2003.

5\. Dynes, Russell, *Community Emergency Planning: False Assumptions and
Inappropriate Analogies*, [International Journal of Mass Emergencies and
Disasters]{.underline}, Vol. 12, No. 2, 1994, pp.151-2.

6\. Jane's Mass Casualty Handbook: *Hospital Emergency Preparedness and
Response*; Joseph A. Barbera, MD, and Anthony G. Macintyre, MD; 2003,
Jane's Information Group, Ltd; ISBN 0710625928
(<http://catalog.janes.com/catalog/public/index.cfm?fuseaction=home.ProductInfoBrief&product_id=72997>).

7\. [Joint Commission on the Accreditation of Healthcare Organizations,
Environment of Care News]{.underline}, Comparing JCAHO and NFPA 99:
Emergency Management Standards Dovetail, Chicago, IL, March/April, 2002,
p. 10-11.

8\. Macintyre, Anthony, MD, *Weapons of Mass Destruction Events with
Contaminated Casualties, Effective Planning for Health Care Facilities*,
[Journal of the American Medical Association]{.underline}, 2000; 283, p.
242-249.

*9. Medical Surge Capacity and Capability: A Management System for
Integrating Medical and Health Resources During Large-Scale
Emergencies*. Copyright 2004, The CNA Corporation, 4825 Mark Center
Drive, Alexandria, VA 22311-1850. This document was prepared under
Contract Number 233-03-0028 for the Department of Health and Human
Services (<http://www.cna.org/documents/mscc_aug2004.pdf>).

10. National Emergency Management Association*, Capability Assessment
    for Readiness (CAR) and Emergency Management Accreditation Program
    (EMAP)*, Council of State Governments, Lexington, KY, 1997, 2001
    (<http://www.fema.gov/rrr/car.shtm> and
    <http://www.emaponline.org/>).

11\. National Fire Protection Association, Standard 99/12, *Health Care
Facility Emergency Management*, Boston, MA. 2002.

12\. National Fire Protection Association, Standard 1600, *Emergency
Management and Business Continuity Programs*, Boston, MA, 2002.

13\. Natural Hazards Research and Information Applications Center,
University of Colorado, 2003.

14\. Nunn-Lugar-Domenici Act, as referenced by the First Annual Report
to the President and Congress by the Advisory Panel to Assess Domestic
Response Capabilities for Terrorism Involving Weapons of Mass
Destruction (Draft), December, 1999.

15\. Quarantelli, Enrique; *Preparedness and Disasters: A Very Complex
Relationship*, Conference Presentation, Disaster Research Center, 1994.

16\. State of California, Governor's Office of Emergency Services,
Standardized Emergency Management System, Part One: *System
Description*, Sacramento, CA, 1994.

17\. State of California, Emergency Medical Services Authority, Hospital
Emergency Incident Command System, 2003.

18\. Tierney, Kathleen; *Conceptualizing Disasters and Their Impacts,
Facing the Unexpected: Disaster Preparedness and Response in the United
States*, Joseph Henry Press, Washington, DC, 2001, p. 22.

19\. US Department of Health and Human Services, Health Resources and
Services Administration, *Bioterrorism Hospital Preparedness Program*,
Washington, DC, 2002
([www.hrsa.gov/bioterrorism](http://www.hrsa.gov/bioterrorism)).

20\. US Department of Health and Human Services, Centers for Disease
Control and Prevention, Public Health Preparedness and Response to
Bioterrorism, Atlanta, GA, 2003
([www.bt.cdc.gov](http://www.bt.cdc.gov/)).

21\. US Department of Health and Human Services, Office of Emergency
Response, Metropolitan Medical Response System, Rockville, MD, 2002
([www.oep-ndms.dhhs.gov](http://www.oep-ndms.dhhs.gov/)).

22\. US Department of Justice, Domestic Preparedness Program,
Washington, DC, 2003 ([www.usdoj.gov](http://www.usdoj.gov/)).

23\. US Department of Veterans Affairs, Veterans Health Administration
(VHA) Directive 2003-045, Steps Required to Establish a Practical
Medical Center Emergency Mass-Casualty Decontamination Capability,
Washington, DC, June, 2002
(<http://vaww1.va.gov/vhapublications/ViewPublication.asp?pub_ID=272>).

24\. US Department of Veterans Affairs, Veterans Health Administration
(VHA) Emergency Management Program Guidebook, Washington, DC
([www.va.gov/emshg](http://www.va.gov/emshg)).

25\. US Environmental Protection Agency, Letter Concerning Containment
of Runoff, Jim Makris, September 17, 1999.

26\. US Federal Emergency Management Agency, *Exemplary Practices in
Emergency Management, The California FIRESCOPE Program*, Monograph
Series No. 1, National Emergency Training Center, Emmetsburg, MD, 1986
(<http://www.fema.gov/library/partnrprep.shtm>).

27. US Government Accounting Office, *Emergency Care: EMTALA
    Implementation and Enforcement Issues*, Report to Congressional
    Committees, Washington, DC, GAO-01-747, June, 2001
    (<http://www.emtala.com/062001.pdf>).

28\. US Occupational Safety and Health Administration (OSHA), Letter
Concerning OSHA Requirement of Certain Personal Protective Equipment,
Richard Fairfax, September 5, 2002
(<http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPRETATIONS&p_id=24516>).

29\. US OSHA, Interpretive Letter, *Hospitals and HAZWOPER*, June 1991
(<http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPRETATIONS&p_id=20470>).

30\. US OSHA, Interpretive Letter, *Risk Assessment*, October 1992
(<http://www.osha.gov/pls/oshaweb/owasrch.search_form?p_doc_type=INTERPRETATIONS&p_toc_level=0&p_keyvalue>=).

31\. OSHA, Interpretive Letter, *Hospital Preparedness for Receiving
Contaminated Victims*, October 1992
(<http://www.osha.gov/pls/oshaweb/owasrch.search_form?p_doc_type=INTERPRETATIONS&p_toc_level=0&p_keyvalue>=).

32\. Whittaker, Hilary; *Comprehensive Emergency Management: A
Governor's Guide, National Governor's Association*, Washington, DC,
March 1979, p. ii.

10.2. Emergency Management Development Process (Section 3)

1\. Joint Commission on the Accreditation of Healthcare Organizations,
Environment of Care, Emergency Management Standards.

2\. Continuity of Operations (COOP) Planning Guidance, Federal
Preparedness Circular 65
(<http://www.wasc.noaa.gov/wrso/oep-coop/fpc-65.pdf>).

3\. National Fire Protection Association (NFPA) 1600: Standard for
Disaster/Emergency Management and Business Continuity Programs.

4\. NFPA Standard 99, Chapter 11, Health Care Emergency Management
Programs.

3.  Decontamination (Section 5, Part 1)

OSHA Best Practices for Hospital-Based First Receivers of Victims
(<http://www.osha.gov/dts/osta/bestpractices/html/hospital_firstreceivers.html>).

10.4. Biological Event and Terrorism Readiness (Section 5, Part 2)

1\. Association for Infection Control Practitioners
([http://www.apic.org](http://www.apic.org/)).

2.  Biological Terrorism General Guidance Pocket Card
    ([http://vaww.sites.lrn.va.gov/vacatalog/Attachments/PTCAREESJ061/BioPocket%20Card.pdf](http://vaww.sites.lrn.va.gov/vacatalog/Attachments/PTCAREESJ061/BioPocket Card.pdf)).

3\. CDC Biologic Agent Categories
(<http://www.bt.cdc.gov/agent/agentlist.asp>).

4\. CDC Bio-terrorism ([www.bt.cdc.gov](http://www.bt.cdc.gov/)).

5\. CDC Smallpox Recommendations
([www.bt.cdc.gov/agent/smallpox/index.asp](http://www.bt.cdc.gov/agent/smallpox/index.asp)).

6\. CDC Bio-terrorism Readiness Plan: A Template for Healthcare
Facilities
(<http://www.cdc.gov/ncidod/hip/Bio/13apr99APIC-cdcBioterrorism.PDF>).

7\. EMA KM Library - Provides an ever-changing/evolving list of
satellite broadcasts on bio-terrorism and WMD issues that have been
developed by EMSHG and their educational partners. We also post the
"happening" broadcasts to the home page with a hot button and a
description of the event
(<http://www.bt.cdc.gov/agent/smallpox/disease/index.asp>).

8\. EMSHG/EES Broadcasts - Disaster Mental Health: Dealing with the
Aftereffects of Terrorism (<http://www.ncptsd.org/disaster.html>).

9\. VA Intranet Laboratory Bio-hazardous Materials Issues
(<http://vaww.lab.med.va.gov/>).

10\. Responding to the Threat of Anthrax Contaminated Mail in VHA. A
Summary of Issues
(<http://vaww.ceosh.med.va.gov/specialreports/clinical/anthraxfinal.ppt>).

11\. US Army Medical Research Institute of Inf. Dis. Physician Handbook
For Management of Biologic Casualties
([www.usamriid.army.mil/education/bluebook.htm](http://www.usamriid.army.mil/education/bluebook.htm)).

12\. Smallpox Recommendations from CDC (Advisory Committee on
Immunization Practices)
(<http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5010a1.htm>).

13\. VHA Prepares for Biological, Chemical, and Radiological Terrorism,
VHANOW, Nov 2001
(<http://vaww.va.gov/med/vhanow/document/VHANOW110101.doc>).

> 14\. National Association of County and City Health Officials
> ([www.naccho.org](http://www.naccho.org/)).

15\. CDC The Public Health Response to Biological and Chemical Terrorism
(<http://www.bt.cdc.gov/Documents/Planning/PlanningGuidance.PDF>).

16\. From Morbidity and Mortality Weekly Report (MMWR) April 21, 2000 /
49(RR04); 1-14 Biological and Chemical Terrorism: Strategic Plan for
Preparedness and Response. Recommendations of the CDC Strategic Planning
Workgroup (<http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4904a1.htm>).

17\. Disaster Mental Health: Dealing with the Aftereffects of Terrorism,
EMSHG/EES Broadcast (<http://www.ncptsd.org/disaster.html>).

18\. VHA Laboratory Biosafety and Biosecurity Handbook, 1106.2, July
2004
(<http://vaww1.va.gov/vhapublications/ViewPublication.asp?pub_ID=438>).

10.5. Radiological Event and Terrorism Readiness (Section 5, Part 3)

1.  Disaster Preparedness for Radiology Professionals: Response to
    Radiological Terrorism. A Primer for Radiologists, Radiation
    Oncologists and Medical Physicists; Version 2.1, ACR Disaster
    Planning Task Force, American Association of Physicists in Medicine
    (<http://www.acr.org/s_acr/bin.asp?TrackID=&SID=1&DID=13945&CID=968&VID=2&DOC=File.PDF>).

2\. American College of Radiology ([www.acr.org](http://www.acr.org/)).

3\. American Society for Therapeutic Radiology and Oncology
([www.astro.org](http://www.astro.org/)).

4\. CDC Fact Sheet - Radiation Emergencies: Radioactive Contamination
and Radiation Exposure
([www.bt.cdc.gov/radiation/contamination.asp](http://www.bt.cdc.gov/radiation/contamination.asp)).

5\. CDC Fact Sheet - Radiation Emergencies: Dirty Bomb
([www.bt.cdc.gov/radiation/dirtybombs.asp](http://www.bt.cdc.gov/radiation/dirtybombs.asp)).

6\. City of Houston briefing document addressing weapons of mass
destruction incidents outlined in the Nunn-Lugar legislation; City of
Houston Office of Emergency Management, May 29, 1997.

7\. *Distribution and Administration of Potassium Iodide in the Event of
a Nuclear Incident*; National Research Council of the National
Academies; David J. Tollerud et.al; 2004.

8\. Department of Homeland Security Working Group on Radiological
Dispersal Device (RDD) Preparedness; Medical Preparedness and Response
Sub-Group, 12/09/03 Version.

9\. Guidance for Radiation Accident Management, Radiation Emergency
Assistance Center/Training Site (REAC/TS)
(<http://www.orau.gov/reacts/detect.htm>).

10\. *Hazardous Materials Management Desk Reference*, Academy of
Certified Hazardous Materials Managers; Doye B. Cox; McGraw-Hill, Inc.;
2000.

11\. *Medical Management of Radiological Casualties Handbook*, Second
Edition; Military Medical Operations; Armed Forces Radiobiology Research
Institute; April 2003
(<http://www.afrri.usuhs.mil/www/outreach/pdf/2edmmrchandbook.pdf>).

12\. *Medical Management of the Acute Radiation Syndrome*:
Recommendations of the Strategic National Stockpile Radiation Working
Group; Jamie K. Waslenko, MD, et.al; [Annals of Internal
Medicine]{.underline}, Vol. 140, Number 12, June 2004.

13\. NCRP Report 65, *Management of Persons Accidentally Contaminated
with Radionuclides*, National Council on Radiation Protection and
Measurements, Bethesda, MD; 1980.

14\. NCRP Report 138, *Management of Terrorist Events Involving
Radioactive Material*, National Council on Radiation Protection and
Measurements, Bethesda, MD; 2001.

15\. The Medical Basis for Radiation-Accident Preparedness: The Clinical
Care of Victims; Robert C. Ricks, et.al; The Parthenon Publishing Group;
2002.

16\. Radiation Emergency Response Training at Oak Ridge Associated
Universities (<http://www.orau.org/conftrng.htm>).

10.6. Chemical Event and Terrorism Readiness (Section 5, Part 4)

1\. EMA KM Library - Provides an ever-changing/evolving list of
satellite broadcasts on bio-terrorism and WMD issues developed by EMSHG
and their educational partners. Also posted are the "happening"
broadcasts to the home page with a "hot" button and a description of the
event (<http://www.bt.cdc.gov/agent/smallpox/disease/index.asp>).

2\. Biological and Chemical Terrorism - *A Guide for Healthcare
Providers and First Responders*; Raymond S Weinstein and Kenneth Alibek;
Thieme Publishers, New York, 2003, (ISBN 3-13-136681-8).

3\. *Emergency Care For Hazardous Materials Exposure*; Alvin C. Bonstein
and Phillip L. Currance; Mosby Publishers, St. Louis, MO; 2^nd^ Edition,
1994, (ISBN 0-8016 -7813-7).

4\. *Jane's Chem-Bio Handbook*; Frederick R. Sidell, William C. Patrick
III, Thomas R. Dashiell, Ken Alibek and Scott Layne; Jane's Information,
Alexandria, VA; 2^nd^ Edition, 2002, (ISBN 0-7106-2568-5). (Also see
<http://catalog.janes.com/catalog/public/index.cfm?fuseaction=home.ProductInfoBrief&product_id=72511>).

5\. Centers for Disease Control (CDC) Bio-terrorism
([www.bt.cdc.gov](http://www.bt.cdc.gov/)).

6\. Centers for Disease Control, *Health-Related Hoaxes and Rumors*
(<http://www.cdc.gov/doc.do/id/0900f3ec80226b9c>).

7\. EMSHG/EES Broadcasts - *Disaster Mental Health: Dealing with the
Aftereffects of Terrorism* (<http://www.ncptsd.org/disaster.html>).

8\. VA Intranet, Laboratory Bio-hazardous Materials Issues
(<http://vaww.lab.med.va.gov/>).

9\. Office of Human Resources Management (OHRM) Emergency Guidebook
(<http://vaww1.va.gov/ohrm/EmergencyPrep/EmerPrep.htm>).

10\. *The Journal of Homeland Defense*
([www.homelanddefense.org/journal/](http://www.homelanddefense.org/journal/)).

11\. National Library of Medicine, National Institute of Health (NIH)
Medline Plus Health Information: Biological and Chemical Weapons
(<http://search.nlm.nih.gov/medlineplus/query?FUNCTION=search&PARAMETER=Biological+and+Chemical+Weapons&DISAMBIGUATION=true&SERVER1=server1&SERVER2=server2&START=0&END=25&MAX=500&ASPECT=0>).

12\. *VHA Prepares for Biological, Chemical and Radiological Terrorism*;
VHANOW, Nov 2001
(<http://vaww.va.gov/med/vhanow/document/VHANOW110101.doc>).

13\. *Rapid Contingency Plans for Responding to Victims of a Chemical
Attack - Handling Casualties and Decontamination* - Published in October
2001 by VA's Office of Public Health and Environmental Hazards, this
brochure outlines immediate steps that hospitals can take to protect
their facilities, staff and patients as well as provide healthcare to
casualties in the event of a chemical or biological terrorist attack
(<http://vaww1.va.gov/environagents/docs/WPRapid_Contingency_Plans_.pdf>).

14\. *Chemical Terrorism General Guidance Pocket Card* - VHA Reference
Pocket cards for recognition of management of biological, chemical and
radiation incidents showing symptoms, signs and treatment for various
potential threat agents
(http://vaww.sites.lrn.va.gov/vacatalog/Attachments/DXCLNEESA190/Chemical%20Terror%20pocket%20card.pdf).

13\. Presidential Decision Directive 39, Counterterrorism Policy, 1995.

10.7. Trauma Readiness (Section 5, Part 5)

1\. *Advanced Trauma Life Support for Doctors*^^ Student Course Manual
7th Edition; 2004 American College of Surgeons; ISBN 1-880696-14-2.

2\. The American Association for the Surgery of Trauma
(<http://www.aast.org/> and <http://www.aast.org/injury/injury.html>).

3\. Centers for Disease Control and Prevention: Mass Trauma Data
Instrument
(<http://www.bt.cdc.gov/masstrauma/pdf/rapidassessmentform.pdf>).

4\. Centers for Disease Control and Prevention, Coping With a Traumatic
Event. More about post-traumatic stress disorder and what you can do
(<http://www.bt.cdc.gov/masstrauma/copingpub.asp>).

5\. Centers for Disease Control and Prevention, Explosions and Blast
Injuries: A Primer for Clinicians
(<http://www.bt.cdc.gov/masstrauma/explosions.asp>).

6\. Centers for Disease Control and Prevention, Traumatic Incident
Stress: Information For Emergency Response Workers
(<http://www.cdc.gov/niosh/unp-trinstrs.html>).

7\. Center for Mental Health Services/Division of Prevention, Traumatic
Stress and Special Programs/Emergency Mental Health and Traumatic Stress
Services Branch, Emergency Mental Health and Traumatic Stress
(<http://www.mentalhealth.org/cmhs/EmergencyServices/links.asp>).

8\. Community Emergency Response Team (CERT) Training, March 2004,
Module 4, Disaster Medical Operations, Lesson 15: Patient Assessment and
Treatment (FEMA Self-Assessment and Study Guide)
(<http://training.fema.gov/EMIWeb/downloads/is31715PatientAssess.pdf>).

9\. *Current Emergency Diagnosis and Treatment*, Stone KC, Humphries RL;
2004 5^th^ edition; Lange Medical Books/McGraw-Hill.

10\. National Center for Post Traumatic Stress Disorder (PTSD),
Department of Veterans Affairs (<http://www.ncptsd.org/>).

11\. Disaster Mental Health: Dealing with the Aftereffects of Terrorism.
Brief Information for the Public and the Professional. National Center
for PTSD, Veterans Affairs (<http://www.ncptsd.org/disaster.html>).

12\. DePalma R, et al.; *Blast Injury: Clinical Consequences and
Immediate Management Strategies*, New England Journal of Medicine; In
Press 2005.

10.8 Education, Training and Exercises (Section 9)

1\. *Terrorism and Disaster Management: Preparing Healthcare Leaders for
the New Reality,* McGlown, K. Joanne; Health Administration Press,
American College of Healthcare Executives, Chicago, IL. 2004, ISBN
1-56793-218-5. (This text was distributed to VAMC and VISN Directors and
key staff along with a cover memo from the Deputy Under Secretary for
Health for Operations and Management on October 28, 2004. Additional
copies are available from EMSHG Area Emergency Managers.

2\. VHA\'s Employee Education System (EES) provides emergency management
education and training programs via the VA Knowledge Network (VAKN).
VAMC and VISN Education Coordinators receive information from EES about
VAKN programs, useful web-based training programs and other resources.
The EES catalog can be accessed at
<http://vaww.sites.lrn.va.gov/vacatalog/>.

3\. Emergency Management Program Guidebook Training Resource. Training
materials for the Emergency Management Program Guidebook are available
(<http://vaww1.va.gov/EMSHG/page.cfm?pg=92>). The module provides an
understanding sufficient to be able to develop and manage an effective
all-hazards Emergency Management Program at a VA Medical Center or VISN
office. The course modules include:

-   Course Overview

-   VA EM Authorities, Programs and Guidance

-   Health and Medical Activities

-   Introduction to Emergency Management

-   Incident Management Strategies for Health Care Systems

-   EM Program Guidebook: Overview

-   Establishing Program Direction

-   Developing the Emergency Operations Plan

-   Hazards Vulnerability Analysis Process and Recovery Planning

-   Developing Incident-Specific Guidance

-   Mitigation and Preparedness Strategies

-   Working with the Emergency Management Committee

-   Training Staff

-   Managing Incidents

-   Reporting, Critiques, Evaluations and Corrective Actions

4\. FEMA Emergency Management Training Courses
(<http://www.fema.gov/tab_education.shtm>). The FEMA website is
continuously updated and provides an excellent resource for ongoing
educational materials. The Professional Development series includes
seven Emergency Management Institute independent study courses providing
a well-rounded set of fundamentals for those in the emergency management
profession. The courses are self-paced independent studies, and each
takes between 8 and 15 hours to complete. After working through the
material, the student takes a final exam. Passing score is 75 or better.
When a student has completed all courses, the Independent Study Program
Office (ISPO) automatically sends a Certificate of Completion directly
to the student.

a\. IS-230 - Principles of Emergency Management. This course is designed
to provide a basic framework of understanding of emergency management in
the following areas:

-   Overview of the Integrated Emergency Management System.

-   The emergency management cycle.

-   The Plan as program centerpiece.

-   Planning and coordination.

-   Functions of an emergency management program.

-   Emergency management program participants.

-   Applying emergency management principles.

b\. IS-235 - Emergency Planning. This course is designed to prepare
planners to use the standard terminology and concepts of a properly
structured Emergency Operations Plan in the following areas:

-   The planning process.

-   Hazard analysis.

-   The Basic Plan.

-   Annexes and appendices.

-   Implementing instructions.

c\. IS-242 - Effective Communication. This course is designed to improve
your communication skills. It addresses:

-   Basic communication skills.

-   How to communicate in an emergency.

-   How to identify community-specific communication issues.

-   Using technology as a communication tool.

-   Effective oral communication.

d\. IS-241 - Decision Making and Problem Solving. This course is
designed to improve your decision-making skills. It addresses:

-   The decision-making process.

-   Decision-making styles.

-   Attributes of an effective decision maker.

-   Ethical decision-making and problem solving.

e\. IS-240 - Leadership and Influence. This course is designed to
improve your leadership and influence skills. It addresses:

-   Leadership from within.

-   How to facilitate change.

-   How to build and rebuild trust.

-   Using personal influence and political savvy.

-   Fostering an environment for leadership development.

f\. IS-244 - Developing and Managing Volunteers. This course is for
emergency managers and related professionals working with all types of
volunteers and coordinating with voluntary agencies. The course provides
procedures and tools for building and working with voluntary
organizations. Topics include:

-   Benefits and challenges of using volunteers.

-   Building a volunteer program.

-   Writing job descriptions.

-   Developing volunteers through recruitment, placement, training,
    supervision and evaluation.

-   Coordinating with voluntary agencies and community-based
    organizations.

g\. IS-139 - Exercise Design. This course is designed to develop their
exercising skills in the following areas:

-   Comprehensive exercise program.

-   The exercise process.

-   Exercise design steps.

-   Tabletop, Functional, and Full-scale exercises.

-   Exercise evaluation.

-   Exercise enhancements.

-   Designing a Functional exercise.

5\. Emergency Management Program Awareness Level Seminar. A 90-minute
seminar on emergency management programs and incident management
strategies is available for VAMC and VISN staff through the Area
Emergency Managers. This seminar will assist those responsible for the
VHA healthcare system to gain an understanding of concepts and
principles useful for their roles and responsibilities. Modules include:
How Disasters are Different; Developing the Emergency Operations Plan;
the Incident Management System; Emergency Operations Centers and
Managing an Incident (through use of a short tabletop exercise).

6\. "Terrorism and Disaster Management: Preparing Healthcare Leaders for
the New Reality;" McGlown, K. Joanne; Health Administration Press,
American College of Healthcare Executives (ACHE), Chicago, IL. 2004,
ISBN 1-56793-218-5. This text was distributed to VAMC and VISN Directors
and key staff along with a cover memorandum from the Deputy Under
Secretary for Health for Operations and Management on October 28, 2004.
Additional copies are available from EMSHG Area Emergency Managers.

7\. Medical Response to Weapons of Mass Destruction (WMD). In accordance
with Section 3 of the Department of Veterans Affairs (VA) Emergency
Preparedness Act of 2002, also known as Public Law 107-287, VA was
directed to develop and disseminate to VA healthcare professionals a
series of comprehensive educational and training modules on medical
response to a potential attack with weapons of mass destruction (WMD)
(<http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=107_cong_public_laws&docid=f:publ287.107.pdf>).
As part of this effort, the Employee Education System (EES) has produced
a series of modules intended to provide all VA and DoD healthcare
providers, facility leadership and network leadership with a
comprehensive resource in case of an actual incident involving weapons
of mass destruction \[chemical, biological, radiological, nuclear and
explosives (CBRNE)\]. This training program consists of the following
modules:

Module 1 - Role of Leadership. The main objective of this module and the
supporting video/CD-ROM is to describe the role of clinical leadership
in the implementation of a Comprehensive Emergency Management plan for
the medical response to WMDs at the local facility; formation of the
emergency management committees; and discusses how to coordinate with
the community linkages. It defines related concepts and terminology such
as incident command system and emergency operations center/command post.
The four phases of comprehensive emergency management (CEM) that include
mitigation, preparedness, response, and recovery are covered. This
section, the video/CD-ROM and subsequent modules addresses the legal
mandate, identifies various agents that can be used in acts of terrorism
and recognizes issues such as the mental health impact and stress
management in such emergencies. The video/CD-ROM, titled Medical
Response to Weapons of Mass Destruction, raises awareness among the
senior VHA management. Thus, the initial distribution of this
tape/CD-ROM is aimed at VISN and all VAMC Directors, as well as VISN
Clinical Managers.

Module 2 - Chemical Warfare Agents. This module provides a brief
description of chemical agents; how people might be exposed to them;
what sign and symptoms they may cause; how to diagnose and treat these
conditions; and, reports on long-term health consequences from exposure
to these chemical agents.

Module 3 - Biological Warfare Agents. Attacks with biological agents
remain a concern for U.S. military planners. VA and Department of
Defense (DoD) healthcare providers may be required to respond to
casualties who have been exposed to biological warfare agents, including
cases in which the initial injury is unrelated to that exposure.
Furthermore, domestic terrorist attack with biological warfare agents
could involve many casualties, as well as the "worried well" who may
have been exposed to or fear they have been exposed to the agents.

Module 4 - Radiological Warfare Weapons. Ionizing radiation is one of
the public\'s greatest fears, which makes it an especially attractive
weapon for terrorists. However, in some ways it is easier for medical
staff to care for individuals exposed to radiation than casualties of
chemical or biological agents. The information contained in this module
will help you and your VA facility better respond to a terrorist attack
or other events involving radiation exposure.

Module 5 - Mental Health Response. In planning a response to WMD, and
indeed any disaster, we cannot ignore the psychological impact. Anything
this devastating will affect patients, care providers and the community
at large. Mental health interventions for individuals after mass
violence or disaster may take many forms, may be introduced at a variety
of time points, and may serve a variety of functions. Goals will differ,
depending on the stage of intervention and amount of time passed since
the trauma. For example, goals in the immediate aftermath may revolve
around crisis stabilization and access to basic resources (e.g., food,
shelter, safety), while later-stage goals may involve reduction of
psychological symptoms or improvement in coping abilities.

Module 6 - Blast and Explosive Weapons. Although much of the focus of
terrorism education and awareness has been directed at chemical,
biological and radiation events, the vast majority of terrorism occurs
with bombs, leading to blasts and explosions. Because no recent reviews
of this topic are available to non-surgeons, the authors will summarize
the mechanisms of blast injury, describe the clinical consequences and
management strategies, outline some considerations for the immediate
management of trauma, and present an algorithm to support triage.

8\. Other Important Independent Study Courses:

a\. IS-100 - Introduction to the Incident Command System for Federal
Disaster Workers. This course specifically discusses major ICS functions
and their primary responsibilities, ICS organizational units, span of
control, major incident facilities and the function of each, what an
Incident Action Plan is and how it is used, and the common
responsibilities associated with incident assignments from the Federal
disaster response workforce perspective.

b\. IS-195 - Basic Incident Command System. The Incident Command System
(ICS) is recognized as an effective system for managing emergencies.
Several states have adopted ICS as their standard for emergency
management, and others are considering adopting ICS. As ICS gains wider
use, there is a need to provide training for those who are not first
responders (i.e., law enforcement, fire or emergency medical services
personnel) who may be called upon to function in an ICS environment. The
course includes a large number of scenarios, examples and opportunities
for students to apply what they have learned.

c\. IS-700 - National Incident Management System (NIMS). This course
introduces NIMS and takes approximately three hours to complete. It
explains the purpose, principles, key components and benefits of NIMS.
The course also contains Planning Activity screens giving you an
opportunity to complete some planning tasks during this course; these
screens are printable so that you can use them after you complete the
course.

d\. IS-208 - State Disaster Management. This independent study course
provides fundamental information on the disaster assistance process and
disaster assistance programs. When all the participants have the same
base of program knowledge, the SCO course can focus on management skills
and issues for the SCO. Individuals who serve as SCOs are encouraged to
attend the FEMA State Coordinating Officer Course (E208). This
independent study course must be completed before taking the resident
course.

e\. IS-275 - The EOC's Role in Community Preparedness, Response and
Recovery Activities. This course will provide the reader with the
understanding of the vital role an Emergency Operations Center (EOC)
plays in the overall community's preparedness, response, and recovery
activities. It is a prerequisite for G-275, Emergency Operations Center
(EOC) Management and Operations.

f\. IS-288 - The Role of Voluntary Agencies in Emergency Management.
This course provides a basic understanding of the history, roles and
services of disaster relief voluntary agencies in providing disaster
assistance. It is appropriate for both the general public and those
involved in emergency management operations.

g\. IS-292 - Disaster Basics. This course will provide a wide range of
FEMA personnel with basic knowledge to describe the major requirements,
important features and dynamics of FEMA disaster programs and
activities. After demonstrating successful completion of this course,
participants may become eligible to attend designated advanced or
higher-level FEMA disaster management courses.

h\. IS-301 - Radiological Emergency Response. This course is a
prerequisite to the resident course, S301, Radiological Emergency
Response Operations (RERO). Its purpose is to provide a learning
experience in which participants demonstrate a comprehensive
understanding of radiological protection and response principles,
guidelines and regulations to prepare them for the operations course
(RERO). Only those approved to attend the RERO course should take this
independent study course.

i\. IS-317 - Introduction to Community Emergency Response Teams. This
course serves as an introduction to CERT for those wanting to complete
training or as a refresher for current team members. I t has six modules
with topics that include an Introduction to CERT, Fire Safety, Hazardous
Material and Terrorist Incidents, Disaster Medical Operations and Search
and Rescue. It takes between six and eight hours to complete the course.
Those successfully finishing it will receive a certification of
completion and .8 CEU's from the Independent Study Office.

j\. IS-324 - Community Hurricane Preparedness. This course is designed
to provide those involved in the decision-making process for hurricanes
with basic information about how hurricanes form, the hazards posed by
hurricanes, how the National Weather Service forecasts future hurricane
behavior and what tools and principles can help emergency managers
prepare their communities.

k\. IS-346 - Orientation to Hazardous Materials for Medical Personnel.
This course is designed to prepare hospital personnel to analyze
hazardous materials situations, take the necessary steps to assure
medical provider safety and identify appropriate resources for
decontamination and medical care. However, additional training is
required in order to diagnose and treat patients who have been involved
in hazardous materials incidents. This course alone does not fulfill all
of OSHA\'s requirements for hazardous materials training at the
awareness level.

l\. IS-393 - Introduction to Mitigation. This course provides an
introduction to mitigation for those who are new to emergency management
and/or mitigation. It is also a prerequisite for a non-resident Applied
Practices Series course called Mitigation for Emergency Managers.

10.9 General Local Agencies

-   Local Public Health Service/State Health Department

-   Centers for Disease Control (CDC)

-   Local FBI Representatives

-   Physician Handbook

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-   Local Firefighters

-   Local Emergency Response Teams

-   Local emergency planning committee (LEPC)

-   SARA Title III reports

-   Local Police

-   State Highway Patrol Office

-   Local Industrial Representative

-   Local transit representative (e.g. railroad, DOT, etc)

-   Local or State FBI representative (see Attachment A in Biologic
    response plan for complete listing of FBI representative, address
    and phone numbers)

-   Local Hazmat Team(s)

-   Local or regional military representatives

-   Publications/Broadcasts:

-   US Army Medical Research Institute of Infectious Diseases (USAMRIID
    ) 1-301-619-2833

-   US Public Health Service 1-800-872-6367

-   Domestic Preparedness Information Line 1-800-368-6498

-   National Response Center 1-800-424-8802

10.10. Directives/Handbooks

1.  VHA Directive 2002-026, Pharmaceutical Caches in a Weapons of Mass
    Destruction Event, dated May 13, 2002
    (<http://vaww1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1134>).

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1.  VHA Directive 2004-046, Inspection of the VHA Pharmaceutical Caches
    by the Emergency Management Strategic Healthcare Group, dated August
    24,2004
    (<http://vaww1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1149>).

2.  VHA Directive 2003-045, Steps Required to Establish a Practical
    Medical Center Emergency Mass-Casualty Decontamination Capability,
    dated August 8, 2003
    (<http://vaww1.va.gov/vhapublications/ViewPublication.asp?pub_ID=272>).

3.  VHA Directive 2004-013, Medical Emergency Radiological Response Team
    (MERRT), dated April 8, 2004
    (<http://vaww1.va.gov/vhapublications/ViewPublication.asp?pub_ID=310>).

4.  VHA Handbook 0320.2, Emergency Management Program Procedures, dated
    June 12, 2000
    (<http://vaww1.va.gov/vhapublications/ViewPublication.asp?pub_ID=326>).

5.  VHA Handbook 0320.3, Disaster Emergency Medical Personnel System
    (DEMPS), dated July 21, 2000
    (<http://vaww1.va.gov/vhapublications/ViewPublication.asp?pub_ID=334>).

6.  Homeland Security Presidential Directive/HSPD-5, Management of
    Domestic Incidents, dated February 28, 2003
    (<http://www.whitehouse.gov/news/releases/2003/02/20030228-9.html>).

10.11. Miscellaneous Publications

1\. The Textbook of Military Medicine.

The U. S. Government Printing Office (GPO) is now the sole source for
the sale of the Textbook of Military Medicine to the public. To order by
telephone, call 202.512.1800, or access the GPO web site at
[http://bookstore.gpo.gov](http://bookstore.gpo.gov/).

2\. Letter to Governors from the US Department of Homeland Security,
regarding NIMS, dated September 8, 2004.