Surveillance and Disaster Planning

This study highlights the importance of organizing a response and the execution of the response in a real life scenario. Good communication and adherence to a predetermined plan would allow for a quick evacuation of the injured people within the incidents hot zone.

Running head: SURVEILLANCE AND DISASTER PLANNING 1
Surveillance and Disaster Planning
Student’s Name
Institutional Affiliation

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Table of Contents
Executive Summary...................................................................................................................................2
Introduction...............................................................................................................................................3
Critical Analysis of the Simulation...........................................................................................................4
Reflection on Initial Chaos....................................................................................................................4
Response Plan........................................................................................................................................5
Field Triage Classification....................................................................................................................5
Errors in Response................................................................................................................................6
Professional Role.......................................................................................................................................6
Communication.....................................................................................................................................6
Type of Incident.....................................................................................................................................7
Mental Health of the Driver..................................................................................................................7
Emotional and Psychological Support.................................................................................................8

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Executive Summary
Paramedics, fire brigades, police, security forces, and other stakeholders play an
important role in ensuring quick response to disasters in our communities. Possessing the right
training and preparedness reduces the chances of preventable fatalities in the event of an
emergency. This study highlights the importance of organizing a response and the execution of
the response in a real life scenario. The simulation allowed the researcher to identify critical
areas that are necessary for the correct formulation and implementation of a response plan. Good
communication and adherence to a predetermined plan would allow for a quick evacuation of the
injured people within the incidents hot zone. The longer paramedics and other response team
take within the vicinity of the accident the higher the risks of secondary injuries. A good
response plans ensures that all actions are undertaken swiftly and professionally hence
preventing further endangerment of live while ensuring maximum support is provided to the
victims. A key element stressed by the study is an identifiable hierarchy of command and
communication which ensures all the teams and members work in tandem.
Keywords: Response, Critical, Injured, Paramedics

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Introduction
Surveillance and disaster planning have recently garnered increased attention as efforts
towards curbing the ever increasing natural and manmade disasters around the globe take center
stage. Surveillance and disaster planning can in ensuring minimal loss of life through adequate
training of the personnel tasked with administering fast rescue efforts such as paramedics and
fire brigades. In this paper, the researcher will discuss the implementation of a rescue plan by
paramedic students and paramedics in a simulation exercise with an aim of identifying areas for
potential improvement. Simulation exercises play a critical role in preparing student paramedics
and other stakeholders for real-life scenarios where their skills and fast action can save countless
lives.
Critical Analysis of the Simulation
The simulated disaster was an accident which occurred when a car crashed into a
shopping mall. This is a man-made disaster as it has no external influences from the environment
and occurred by the hands of the driver of the vehicle. The simulation occurred at night with the
lights cut off at the simulation site intentionally for the exercise. The exact cause of the accident
was not immediately discernable but loss of control was considered a possibility while terror
attack was not ruled out as well. The simulated car crash caused 3 deaths, 5 victims in critical
condition, 8 with minor injuries, and 12 who had not been injured. The defense force was
present, as well as paramedic students and ambulance service who arrived at the scene to help
with the evacuation of the injured people.
Reflection on Initial Chaos
The simulation was in chaos when the paramedics arrived at the scene of the accident, as
the emergency response from the paramedics seemed to be uncoordinated. The white tape used
to cordon off the deceased was frequently disregarded by the paramedics as they moved about in

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the crash site. The paramedics were constantly moving about taking notes and not attending to
the patients, some of the injured persons could not understand the paramedics due to a language
barrier and they were not effectively attended to. Some of the injured patients could also not find
their family members. However, the paramedics were able to provide support to the victims by
sorting them into different groups according to the severity of their injuries. A white sheet was
used for the deceased, red sheet for those in critical condition, a yellow sheet for those who had
minor injuries and a green sheet for those who were not injured but needed just a little first aid. A
chaplaincy was also set up at the site to help provide emotional support for the families of the
injured.
Response Plan
The response plan prepared by the paramedics was not executed well and is seen from the
initial disorganization of the personnel. The operation seemed to lack coordination as the
paramedics moved around taking notes while other responders chatted in the vicinity of the
accident. This increases risk within an incidents hot zone, Smith, Burkle, Gebbie, Ford &
Bensimon (2018) highlight the high risk associated with first responders as seen in the 9/11
incident. A coordinated effort would have ensured that the area was quickly evacuated by
ensuring that all the responders were working in tandem and hence execute the plan as quickly as
they could (Alotaibi & Ibrahim, 2018). Karagiannis (2017) posits that it is important for the
response team to evacuate all the injured people from an accidents hot zone before executing a
field triage. In the simulated accident, the paramedics and other rescue personnel did not
evacuate the patients from the accidents hot zone. This can be an issue if a conflict arises
between the paramedics and fire responders (FitzGerald et al., 2016). Power (2018) states that
paramedics have expertise in the treatment of patients while fire responders have authority on the
safety of the hot zone, the simulation exercise did not address this potential conflict adequately.

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Field Triage Classification
Some aspects of the plan were well executed but still needed further modifications. The
field triage process implemented by the paramedics was in accordance with the requirements of
emergency response. Lampi (2017) states that field triages classifies injury victims according to
the severity of injury while in the case of disaster triages, paramedics try to provide the best
effort for most of the affected people. According to Lampi (2017), field triage is a dynamic
process where revaluation of patients after classification is important to minimize errors due to
lack of adequate information about the patient. While the victims of the accident in the
simulation were classified in accordance with field triage standards, a reevaluation of the victims
was not done adequately.
Errors in Response
A major error observed in the simulation process was the disregard the paramedics had
for the white sheet that was set out to demarcate the deceased. The paramedics had to crisscross
the line in their effort to evacuate those who required immediate medical attention. The
paramedics also failed at providing emotional and psychological support to those who were in
shock due to the accident. While as first responders the priority is ensuring that the quick first aid
and medical support is provided to victims, the paramedics should have made an effort to direct
them to the chaplaincy. This highlights a handicap inherent to paramedic training, provision of
emotional and psychological help is virtually nonexistent.
Professional Role
Communication
Being in command of the operation in such a situation, I would first ensure that all the
teams involved in the rescue operation have a way of communicating their individual efforts to
the group as a whole (Ramchurn et al., 2017). Communication of responsibilities is important at
the site, as this would ensure quick action. A communications center will be set up on arrival to

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the site of the disaster or accident while the commanders of first responders needed at the scene
such as police, fire brigade or paramedics formulate an action plan. I will ensure that the crash
site is safe by conferring with experts from this field such as the fire brigade. I would only
commence rescue efforts once the safety of the hot zone has been ascertained. A field triage will
then be performed with priority given to the patients in critical conditions. This triage will also
be reevaluated by different paramedics from those on the ground and the ambulatory service
(Long, Maguire & Clarke, 2015). This will ensure that all the critical cases are identified and
attended to quickly.
Type of Incident
Another issue was that the paramedics did not ascertain the nature of the incident, if it
was a terror attack or if it was just an accident. This represents a risk in a real-world scenario as
the car could have been easily used by terrorist to perpetrate mass murder. The police should
have investigated the scene of the accident first to ensure that there was no further risk to the
paramedics and those not critically injured. However, Tierney (2016) argues that there is a
downside to waiting for the police to clear the accident scene as this could result deaths due to
the length of time it takes for law enforcement to clear the hot zone. The small force of 2 NSW
officers would have been inadequate if the accident was due to a terrorist attack. Only after the
police had ensured that the accident did not involve terrorism would the paramedics be called on
to help the injured victims (Fleştea, Fodor, Curşeu, & Miclea 2017).) Exposure to harmful
chemicals and radiations is also a risk for first responders; the team should have ensured that a
quick but thorough sweep of the site of the accident was carried out before commencing support
for the injured. I will take the necessary precautions to ensure that the safety of my team is not
compromised in such an event.

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Mental Health of the Driver
The paramedics and police should have also looked into the driver’s physical and mental
health so as to understand the cause of the accident. Paramedics are often better versed on
medical care for physical cases but are sorely under equipped at diagnosing mental illness in a
patient (Shaban, 2015); this should however not deter them from attempting such a diagnosis.
Examining the car’s driver for signs of mental illness would have been a challenge for paramedic
students but Shaban (2015) posits that experienced paramedics can easily establish the mental
health of a patient due from experience.
Emotional and Psychological Support
Another aspect of the simulation that could be improved on is the support given to the
vulnerable groups such as children and those with a language barrier. I would ensure that a social
worker is called upon when children are separated from their guardians to help in ensuring that
they are provided with adequate care. The responders also took a lot of time to evacuate the
injured people from the crash site, evacuating the injured from the proximity of the wrecked car
can prevent further accidents as the structural safety of the crash site cannot be adequately
ascertained by the paramedics. Shapiro, Sarani & Smith (2017) posits that rapid evacuation from
hot zone ensures safety of the response teams while also giving the victims a good chance for
recovery without having to worry about the immediate surroundings.
In cases where the community seeks to help, the people will be broken down to teams
and team leaders selected among the groups. I would then charge them with suitable
responsibilities. Cretney (2016) argues that community members can play an important role in
providing support during and after a disaster or accident has occurred as it builds trust. Lastly the
responders should also be provided with food and water during the evacuation process in case

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the exercise was going to take a longer period. Having a designated point for taking refreshment
can help the paramedics remain focused.
Conclusion
The response plan implemented during the simulation was executed well despite the
exercise highlighting the need for improvements. A quick and seamlessly executed response plan
reduces the risk to both the response team and the victims in a disaster. Consequently,
commanders in charge of a response team should ensure that necessary caution is not
overlooked during a disaster.

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References
Alotaibi, M. F., & Ibrahim, D. M. (2018, April). Agent-Based Simulation for Coordination
Emergency Response: A Review Study. In 2018 1st International Conference on
Computer Applications & Information Security (ICCAIS) (pp. 1-5). IEEE. Retrieved from
https://www.researchgate.net/profile/Dina_Ibrahim9/publication/327192043_Agent-
Based_Simulation_for_Coordination_Emergency_Response_A_Review_Study/links/
5bbcc99ca6fdcc9552dceaa2/Agent-Based-Simulation-for-Coordination-Emergency-
Response-A-Review-Study.pdf
Cretney, R. M. (2016). Local responses to disaster: The value of community led post disaster
response action in a resilience framework. Disaster Prevention and Management, 25(1),
27-40. Retrieved from
https://www.researchgate.net/profile/Raven_Cretney/publication/289556081_Local_Resp
onses_to_Disaster/links/59dbf8c4458515e9ab4526df/Local-Responses-to-Disaster.pdf
FitzGerald, G., Tarrant, M., Aitken, P., & Fredriksen, M. (Eds.). (2016). Disaster Health
Management: A Primer for Students and Practitioners. Taylor & Francis. Retrieved from
https://books.google.co.ke/books?
hl=en&lr=&id=dC4lDwAAQBAJ&oi=fnd&pg=PP1&dq=FitzGerald,+G.,+Tarrant,+M.,
+Aitken,+P.,+%26+Fredriksen,+M.+(Eds.).+(2016).+Disaster+Health+Management:
+A+Primer+for+Students+and+Practitioners.+Taylor+
%26+Francis.&ots=uELVJ0sWwA&sig=8YcmhTO1mXjjBomBtO_OMoFWjiI&redir_e
sc=y#v=onepage&q=FitzGerald%2C%20G.%2C%20Tarrant%2C%20M.%2C
%20Aitken%2C%20P.%2C%20%26%20Fredriksen%2C%20M.%20(Eds.).%20(2016).

SURVEILLANCE AND DISASTER PLANNING 11
%20Disaster%20Health%20Management%3A%20A%20Primer%20for%20Students
%20and%20Practitioners.%20Taylor%20%26%20Francis.&f=false
Fleştea, A. M., Fodor, O. C., Curşeu, P. L., & Miclea, M. (2017). ‘We didn’t know anything, it
was a mess!’Emergent structures and the effectiveness of a rescue operation multi-team
system. Ergonomics, 60(1), 44-58. Retrieved from
https://www.researchgate.net/profile/Petru_Curseu2/publication/299985157_'We_didn't_
know_anything_it_was_a_mess'_Emergent_structures_and_the_effectiveness_of_a_resc
ue_operation_multi-team_system/links/570ce15908aed31341cef75b.pdf
Karagiannis, G. M. (2017). A socio-technical systems approach for the analysis of emergency
services. Retrieved from
https://www.researchgate.net/profile/Georgios_Marios_Karagiannis/publication/
319955303_A_socio-
technical_systems_approach_for_the_analysis_of_emergency_services/links/
59c38e390f7e9b21a82fcb9e/A-socio-technical-systems-approach-for-the-analysis-of-
emergency-services.pdf
Lampi, M. (2017). TRIAGE: Management of the trauma patient (Doctoral dissertation,
Linköping University Electronic Press). Retrieved from
http://www.diva-portal.org/smash/record.jsf?pid=diva2:1075521
Long, J., Maguire, M., & Clarke, J. (2015). Advanced Remote Field Triage of Car Crash
Victims. Retrieved from https://arrow.dit.ie/cgi/viewcontent.cgi?
article=1024&context=beschspcon

SURVEILLANCE AND DISASTER PLANNING 12
Power, N. (2018). Extreme teams: Toward a greater understanding of multiagency teamwork
during major emergencies and disasters. American Psychologist, 73(4), 478. Retrived
from http://eprints.lancs.ac.uk/88335/1/POWER_AP_PRE_PRINT.pdf
Ramchurn, S. D., Huynh, T. D., Wu, F., Ikuno, Y., Flann, J., Moreau, L., & Reece, S. (2016). A
disaster response system based on human-agent collectives. Journal of Artificial
Intelligence Research, 57, 661-708. Retrieved from
https://www.jair.org/index.php/jair/article/download/11037/26208/
Shaban, R. (2015). Accounting for assessments of mental illness in paramedic practice: A new
theoretical framework. Australasian Journal of Paramedicine, 3(3). Retrived from
https://ajp.paramedics.org/index.php/ajp/article/download/321/320
Shaban, R. (2015). Paramedics’ clinical judgment and mental health assessments in emergency
contexts: Research, practice, and tools of the trade. Australasian Journal of
Paramedicine, 4(2). Retrieved from
http://ajp.paramedics.org/index.php/ajp/article/download/369/369
Shapiro, G., Sarani, B., & Smith, E. R. (2017). Tactical Emergency Casualty Care (TECC):
Principles and Practice. In Front Line Surgery (pp. 711-725). Springer, Cham. Retrieved
from https://doi.org/10.1007/978-3-319-56780-8_41
Smith, E., Burkle, F., Gebbie, K., Ford, D., & Bensimon, C. (2018). A qualitative study of
paramedic duty to treat during disaster response. Disaster medicine and public health
preparedness, 1-6. Retrieved from
https://www.researchgate.net/profile/Frederick_Burkle/publication/
324417155_A_Qualitative_Study_of_Paramedic_Duty_to_Treat_During_Disaster_Resp

SURVEILLANCE AND DISASTER PLANNING 13
onse/links/5ad26df2458515c60f51dc9b/A-Qualitative-Study-of-Paramedic-Duty-to-
Treat-During-Disaster-Response.pdf
Tierney, M. T. (2016). Facilitating the medical response into an active shooter hot
zone (Doctoral dissertation, Monterey, California: Naval Postgraduate School). Retrieved
from https://calhoun.nps.edu/bitstream/handle/10945/49402/16Jun_Tierney_Martin.pdf?
sequence=1