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There were several mass shootings this summer which resulted in multiple deaths throughout the country. In June, nine people were killed when an assailant opened fire in a Charleston, S.C. church. In July, five members of the military were killed when a shooter opened fire on a military recruiting center in Chattanooga, Tenn. A second mass shooting in July occurred inside a movie theater in Lafayette, La., where two women were fatally wounded and nine other people injured. And in August, a Virginia television news reporter and her cameraman were shot and killed when a shooter opened fire on them during a live broadcast.

According to a report released last year by the Federal Bureau of Investigations, there were 160 active shooter incidents in this country between 2000 and 2013. Forty-four of those attacks occurred in business settings and resulted in the deaths of 124 victims. Fifteen of the active shooting attacks took place in open space areas, with 45 victims killed. Houses of worship were targets in six of those attacks, and took the lives of 21 victims.

During an active shooter or mass shooting attack, a combined law enforcement, fire, and EMS response is critical. All of these active shooter incidents have led to a change in law enforcement response tactics; however, fire and EMS also need to understand the dangers that lurk at these incidents and how to protect themselves from a shooter determined on taking as many lives possible.

Emergency Film Group’s Active Shooter: Rapid Response DVD is a safety training program for school administration, law enforcement, emergency management and others who may be involved in the response to a mass shooting. This compelling program shows how preparedness for and response to these fast-breaking and dangerous events is a joint effort between police, fire, EMS, community and facility emergency management. The role of trained and equipped tactical medics is depicted as well as the more traditional activities of EMS during mass casualty incidents: scoop and run rescue, triage, treatment, and transport. In addition to providing emergency medical service, firefighters are also depicted assisting law enforcement in forcible entry, firefighting, and managing building sprinkler systems.

Several months ago, media and the Internet were saturated with stories about the potential for an Ebola outbreak in the US. For weeks, that was the lead story and then suddenly, the reports stopped. However, recent events should serve as a reminder that contagious diseases like Ebola still pose the potential for life-threatening conditions.

There have been at least nine patients who have been tested for the virus over the past several weeks, including patients in Ohio and New York. Two known Ebola patients are currently being treated in an Atlanta hospital. Both of those patients were actually transferred there from Liberia, where they had both been working with Ebola victims.

The Ebola-stricken Americans will be treated in this isolation rooms and others similar to it.

These incidents serve as a serious reminder that these contagious diseases still pose a serious – if not fatal – threat to those who work in emergency response and the medical field.

Emergency Film Group’s PPE for Ebola & Other Hazards: Protecting Healthcare Workers describes how to select the proper type of Personal Protective Equipment (PPE), as required by OSHA, to use in order to protect healthcare workers from exposure to patients contaminated with Ebola or other infectious diseases, industrial chemicals, and biological and chemical warfare agents.

This program is designed to provide training and information about the use of protective clothing and equipment to EMS and hospital staff, first receivers, hazmat teams, law enforcement, and waste management workers.

Topics covered include:

• Routes of exposure;
• Respiratory protection;
• Details of PPE;
• Different ensemble classes;
• Proper donning and doffing protocols;
• Fitting storage and inspection of PPE;
• Avoiding heat injuries while wearing PPE; and
• Decontamination.

Jihadist attacks against a Paris magazine office, a kosher market in that city, and the Canadian Parliament in Ottawa seem to signal a new reliance by terrorists on conventional weapons. But you would have to have a short memory not to remember the Mumbai Massacre and the Fort Hood Shootings.

Maybe it is because in France, Canada, and the U.S. assault weapons are easier to come by than the explosives that are the deadly force in countless IED attacks in the Middle East. Despite the best efforts of law enforcement, the military, the intelligence community, and others designated with the task of protecting us from terrorist attacks, the likelihood is that the attacks will continue.

This is not lost on Americans. A recently released poll by the Pew Research Center, shows the public puts fighting terrorism above all other policy concerns for the first time in five years, edging out improving the nation’s economy which finished second in the poll.

In 1998, Osama bin Laden said that the acquisition of weapons of mass destruction (WMD) was a “religious duty.” In 2003, a fatwa by a radical cleric said it was legitimate to use such weapons to kill millions. There have been more than 50 reported attempts to acquire, create, or deploy WMD. Clearly, the possession of such weapons would give jihadists power on the world stage and lead to further recruitment of fighters.

This idea is still very much alive. A German journalist who imbedded with ISIL in Mosul for ten days, recently returned to report that Islamic State fighters are committed to killing millions who do not share the radical Islamists’ religious beliefs.

A major concern is the instability of certain nations that possess WMD as part of their military arsenal. Despite efforts to remove WMD from Syria, U.S. government sources have expressed fears that President Assad may have held back a small stash of chemical weapons.

In Iraq, it has been reported that ISIL fighters removed forty kilos of uranium from the University of Mosul. While the uranium was not enriched sufficiently to be a nuclear threat, it could well be used as in a radiological dispersion device. In the ISIL stronghold of Fallujah, a water treatment plant uses chlorine to treat sewage. Al Qaeda used chlorine cylinders in IEDs against coalition troops, but without much success. The laptop of an ISIL fighter, who had formerly been a university chemistry student, had plans for weaponizing bubonic plague and making ricin from castor beans. His whereabouts are unknown. Nor do we know if other chemists and scientists have joined ISIL’s cohort.

As hundreds of foreign fighters join ISIL every day there number now exceeds 15,000 including, it is estimated, some 2000 westerners. A top security concern is the potential return of these westerners to their native countries after having been groomed to carry out attacks in their homeland. The Charlie Hebdo attackers are a case in point.

As ISIL controls large swathes of land, the probability grows that people with the appropriate set of skills will find the right raw materials to fashion a WMD. It is an escalating threat which makes, “not if, but when” a prescient prediction. What we can do is train and prepare.

Emergency Film Group WMD Response Package II provides training and response guidelines to emergency personnel who would be called upon to respond to a WMD incident. This package contains four DVDs, two Resource CD-ROMs, and two Leader Guides.

Recently, the media and many politicians have focused a great deal of attention on the Ebola outbreaks in West Africa, where at this writing, some 10,000 have died, and on the few cases that have surfaced in the United States. This has led to some false assumptions, misinformation, and confusion, particularly about the appropriate protection for healthcare workers and others who might come in contact with the Ebola virus.

When two health care workers at a Texas hospital were exposed and subsequently developed symptoms of Ebola, hospital management was called before a congressional committee. It was learned that the workers had been provided with personal protection, but had received no training or supervision in the use of the equipment. Another revelation was that the Centers for Disease Control’s (CDC) recommendations were based on the World Health Organization’s (WHO) model. The WHO model was designed for situations in which “care is given in remote places,” where it would be likely “intensive training would not be available for health care workers,” such as remote villages in Liberia, Sierra Leone, and Guinea.

This begs the question of why the WHO model would be put forth by the CDC here in the United States where we have the world’s most comprehensive standards on personal protective clothing and equipment. The standards have been developed by government agencies and national standards making organizations and products that meet or exceed the standards are well known and widely available. Subsequently, in late October 2014, the CDC revised its recommendations. The latest CDC recommendations are a vast improvement, yet it seems likely that more revisions will follow.

The major mover in the field of protective clothing continues to be the National Fire Protection Association (NFPA) headquartered in Quincy, MA. They have two standards that apply, NFPA 1991, Standard on Vapor Protective Ensembles for Hazardous Materials Emergencies and NFPA 1994, Standard for Protective Ensembles for First Responders to CBRN Terrorism Incidents. In case there is any question here, the Ebola virus is a hazardous material, Hazard Class 6, Type A – an infectious substance. As far as the aforementioned CBRN (chemical biological, radiological, nuclear), Ebola has long been thought of as a potential biological agent that could be used as a weapon by terrorists.

Here is the bottom line- protective clothing certified to NFPA 1991 and NFPA 1994 is reliable for protection against Ebola, provided that proper donning and doffing protocols are followed as well as appropriate decontamination and waste management procedures for viral and bacterial threat contaminants.

Testing carried out under NFPA 1991 (totally encapsulating garments, also called vapor protective clothing) includes chemical resistance – how well the fabric repels the movement of the chemical though the CPC material. Each material is tested against a battery of 21 chemicals. No permeation is allowed for a minimum of one hour. One of the chemicals tested is chlorine. A chlorine molecule is about 5000 times smaller than an Ebola virus. So clearly, any ensemble that meets the standard will provide excellent protection against Ebola.

The ensembles designated Class 2 under NFPA 1994 are tested in a similar manner as the 1991 suits, but undergo separate tests for resistance to viral substances in liquid form. In one test, the entire garment is mounted on a mannequin and then sprayed with water from every direction for twenty minutes. If any water penetrates the ensemble, it fails. So, clearly these Class 2 ensembles are excellent barriers against Ebola.

Although it is likely that any garments used in the treatment and care of patients who have or are expected to have the Ebola virus will be of a disposable type, any re-useable equipment will have to be decontaminated. The U.S. Army Medical Research Institute of Infectious Diseases recommends decontamination of Ebola with a solution of five percent sodium hypochlorite, common household bleach, for three to five minutes followed by washing with soft liquid soap and rinsing. Contaminated run-off must be collected. The latest CDC recommendations advise cleaning with an EPA registered disinfectant wipe “with a label claim of potency at least equivalent to that of non-envelope virus.”

While the latest CDC recommendations focus on the hospital environment, it is important to understand that protection is required in any healthcare setting where there is potential for exposure to patients or infected materials including body substances, contaminated medical equipment, contaminated surfaces, or aerosols generated by certain procedures. Potentially at risk are EMTs, members of hazmat teams involved in transporting patients, mortuary personnel, and those involved in handling medical waste.

In the face of this uncertainty, because no FDA approved vaccine or anti-viral drug is available for Ebola, and because of the high morbidity of these infected with the disease, it is important to learn the most basic lesson of self-protection – that those whose duty calls them to work with Ebola patients can do so safely provided they have adequate protective clothing and equipment and are trained to use it.

At Emergency Film Group, we have been training emergency responders and medical personnel how to carry out potentially dangerous tasks safely for more than 35 years. Several years ago, we created a four part series called Hospital First Receiver which is now in use in more than 1,000 hospitals throughout the country. One program in that series is entitled “Self Protection.” It was designed to provide a comprehensive examination of the protective clothing and respiratory protection issues which OSHA says every user of the equipment must be aware.

While designed for the first receiver, the lessons apply equally to any person who is expected to be involved in the care of Ebola patients.  We have re-issued the program in a new edition to speak directly to the protective clothing issues raised by Ebola. More information about the updated program,  PPE for Ebola and Other Hazards: Protecting Healthcare Workers,  can be found here. . .

A 26 year-old California man was killed after a hole he dug on a Northern California beach collapsed and trapped him under the sand.

Adam Pye, a recent college graduate, was at Half Moon Bay Beach, located outside San Francisco, with friends, when they decided to dig holes in the sand. Pye dug a hole approximately 10 feet deep and was standing in it when the walls of the hole began to collapse, burying him.

Friends and bystanders tried digging him out, using hands, shovels and other tools. After five minutes of digging, they managed to get Pye’s head above the sand, but he was already unconscious. Emergency responders began arriving at the scene, and paramedics did manage to open up the young man’s airways.

Emergency crews and volunteers working frantically to rescue Adam Pye from a sand hole.

It took 30 firefighters, with the help of bystanders, another 35 minutes to dig Pye out and remove him from the hole. However, attempts at reviving him were unsuccessful and he was pronounced dead at the scene.

Just one month ago, another man, 49 year-old David Frasier of Fredericksburg, Virginia, died in a similar accident at a beach in Cape Hatteras, North Carolina. Frasier was standing in a four feet hole when its walls collapsed on top of him.

Rescue efforts in confined space areas require special training. Emergency Film Group’s Technical Rescue Package provides in-depth training in multiple rescue disciplines at a significant savings. The package includes six DVDs plus four texts providing a study of the skills and knowledge needed to safely locate and extricate victims.

A recent study released by Federal Emergency Management Agency (FEMA), endorsed by the Obama administration and the International Association of Firefighters (IAFF), recommends guidelines for first responders entering active shooter incident “warm zones.”

The guidelines are based on plans that were developed by the Hartford Consensus, a group of physicians and emergency response officials from the FBI, the Navy, the Dallas SWAT team and elsewhere.

Traditionally, EMS and other medical responders have to wait to enter an active shooter scene until law enforcement has completely cleared it. This delay in being able to respond to the injured frequently leads to victims dying from injuries that are treatable – such uncontrolled bleeding, collapsed lungs, and airway obstructions.

But the new guidelines recommend adopting procedures similar to ones that the military uses in combat – allowing medics quickly onto the battlefield to begin immediate treatment, thereby saving lives.

As active shooter incidents have become more frequent over the past few years, law enforcement has changed and developed policies and strategies on how they respond to these events. Many in the field say it’s also critical for fire and emergency medical services to also change their procedures in these events.

The plan calls for setting up stations in “warm zones” and also recommends increased use of tourniquets to stop bleeding. Widespread training of law enforcement and the general public of the use of tourniquets is also highly recommended. FEMA’s report can be found here. . . .

Emergency Film Group’s Active Shooter: Rapid Response is a safety training DVD program for organization which may be involved in the response to a mass shooting. The program contains a substantial EMS section. More information about this program can be found here. . .

In a previous post, Emergency Film Group covered the details of the safety alert issued by the U.S. Department of Transportation (DOT) regarding the potential high volatility of the crude oil coming from the Bakken oil shale patch in Montana and North Dakota. According to the agency, the crude, which is shipped by rail across the U.S. and Canada, could be more flammable than traditional oil. (See story here).

The Pipeline and Hazardous Materials Safety Administration (PHMSA) has also issued a safety alert about crude oil being transported from the Bakken region. The PHMSA alert states:

Based upon preliminary inspections conducted after recent rail derailments in North Dakota, Alabama and Lac-Megantic, Quebec involving Bakken crude oil, PHMSA is reinforcing the requirement to properly test, characterize, classify, and where appropriate sufficiently degasify hazardous materials prior to and during transportation. This advisory is a follow-up to the PHMSA and Federal Railroad Administration (FRA) joint safety advisory published November 20, 2013 [78 FR 69745]. As stated in the November Safety Advisory, it is imperative that offerors properly classify and describe hazardous materials being offered for transportation. 49 CFR 173.22. As part of this process, offerors must ensure that all potential hazards of the materials are properly characterized.

Proper characterization will identify properties that could affect the integrity of the packaging or present additional hazards, such as corrosivity, sulfur content, and dissolved gas content. These characteristics may also affect classification. PHMSA stresses to offerors the importance of appropriate classification and packing group (PG) assignment of crude oil shipments, whether the shipment is in a cargo tank, rail tank car or other mode of transportation. Emergency responders should remember that light sweet crude oil, such as that coming from the Bakken region, is typically assigned a packing group I or II. The PGs mean that the material’s flashpoint is below 73 degrees Fahrenheit and, for packing group I materials, the boiling point is below 95 degrees Fahrenheit. This means the materials pose significant fire risk if released from the package in an accident.

Read the entire PHMSA alert here. . . .   

Smoke rises from derailed oil train cars in western Alabama on Nov. 8, 2013.

Emergency Film Group’s Crude Oil Spill Response Package provides comprehensive training for emergency personnel to effectively respond to these dangerous incidents. More information about this package can be found here. . .

Multiple incidents of explosive accidents have prompted the U.S. Department of Transportation to issue a safety alert warning the pubic, emergency responders and shippers about the potential high volatility of the crude oil coming from the Bakken oil shale patch in Montana and North Dakota. According to the agency, the crude, which is shipped by rail across the U.S. and Canada, could be more flammable than traditional oil.

Officials say the oil coming from the Bakken's oil patch is lighter than traditional heavy crudes, making it prone to ignite at lower temperatures. Lighter crudes contain more natural gas, giving it a much lower flash point - the temperature at which vapors given off by the oil can ignite.

Earlier this month, in New Brunswick, Canada, a train carrying the crude oil in one of its cars and propane in three others, derailed in and exploded. The fire that ensued burned for days and residents needed to be evacuated.

Another incident occurred in December, near Casselton, N.D. when a train carrying the crude crashed into another train which had derailed. The crash triggered a massive explosion and witnesses described seeing a “giant fireball” upon impact. Responders arrived on the scene to find 10 of the 106 cars on the oil train fully engulfed in flames. The second train, which was transporting grain, did not catch fire.

No one was injured in the accident, but because of the toxic fumes being released by the fire, the 2400 residents of the town were evacuated to Fargo, about 25 miles away.

In November, a train transporting oil coming from North Dakota derailed and exploded near Aliceville, Ala. There were no injuries but an estimated 749,000 gallons of oil spilled from 26 tanker cars.

In July, a train transporting the oil derailed in Lac Megantic, Quebec, causing a massive explosion. Forty-seven people were killed and more than 30 buildings in the downtown area were destroyed.  About 1.6 million gallons of crude oil being transported was spilled.

Lac Megantic, Quebec explosion.

No explosions or fires in the latest incident which occurred last week when a train carrying the crude oil derailed over the Schuylkill River in Philadelphia. The area where the derailment occurred is near the University of Pennsylvania. There are also three hospitals and a major highway close by. There were no injuries and no oil was spilled when the more than 100 car train left the tracks.

The Bakken oil boom has created another boom – the number of train cars that transport the product. In 2009, there were just 100,000 tanker cars which delivered the crude oil throughout the country. But that number quadrupled in 2013 to 400,000.

Industry experts say the dangers of crude have long been underappreciated and need to be communicated to the hundreds of counties and cities that have seen a surge in crude oil trains.

Emergency Film Group’s Crude Oil Spill Response Package provides comprehensive training for emergency personnel to effectively respond to these dangerous incidents. More information about this package can be found here. . .

A stolen truck that was carrying radioactive medical equipment has been recovered by Mexican authorities. The dangerous cargo was being hauled to the Radioactive Waste Storage Center in Maquixco when the truck was stolen while parked at a gas station in Tepojaco.

The radioactive material, Cobalt-60, is used for medical reasons, but can also be used to make “dirty bombs” - weapons where conventional explosives are used to disperse radiation from a radioactive source.

The equipment containing Cobalt-60 shown here as it was loaded onto a vehicle that was later stolen.

The driver of the truck reported he was sleeping in the truck when he was awoken by two men, armed with guns, at around 1:30 a.m. They forced him out of the vehicle and tied his hands and feet and left him in the parking lot as they drove off in the 2007 Volkswagen cargo truck.

The truck was located in a remote area about 25 miles from where it was stolen. The Cobalt-60 was located about a half-mile away from the vehicle, along with the empty protective lead container. Authorities believe they recovered most of the radioactive material.

Officials said they don’t believe the radioactive material was the target of the thieves and believe the two men had no idea what they were stealing. The two men are most likely suffering from radiation exposure.

The International Atomic Energy Agency (IAEA), the Vienna-based UN nuclear body, says there are more than 100 incidents of thefts and other unauthorized activities involving nuclear and radioactive material each year. IAEA Director General Yukiya Amano, at a 2012 nuclear security summit, spoke about the effects dirty bombs can have. In his speech, Amano said, “These materials, such as cobalt-60, could be used along with conventional explosives to make so-called dirty bombs. A dirty bomb detonated in a major city could cause mass panic, as well as serious economic and environmental consequences.”

Emergency Film Group’s, Radiation Monitoring, teaches emergency personnel in mission specific Operations Level competencies regarding monitoring for radiation at WMD events as well as natural disasters and industrial accidents. To learn more, read here. . .