12/10/2008

Elements of success for police working with other first responders

Ed Note: Two weeks ago, less than a dozen militants held at bay some 800 well-trained police for 60 hours, throwing a major metropolitan area into utter chaos, and leaving law enforcement officers around the globe thinking: “What will we do when this happens on our watch?”

PoliceOne has collected the thoughts of several people in law enforcement with the purpose of kick-starting a dialog about how the events in Mumbai provide an opportunity to consider the nature of the threat we may one day face here in the U.S. We encourage you to read the opinions and analysis here and to participate in this discussion.

The following contribution represents the opinions of the author and does not necessarily reflect the views of PoliceOne, Praetorian Group, or our sponsors.


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Counterterrorism on the front lines

By Paul Forbes, Chief Police Superintendent (Ret.) of the Police National CBRN Centre (UK) and chairman of the Remploy Frontline Technical Advisory Panel
In my years as Chief Police Superintendent of the Police National CBRN Centre (UK), I have seen how increasingly, there are more varied and vicious threats coming from insurgents and terror cells planning attacks in civilian locations. This spans a myriad of groups like the PLO and the Provisional IRA – trying to achieve a defined political agenda through terrorism – to many Jihad organisations that also hit soft targets (i.e. civilians) to achieve unclear religious aims. Our tactics and training for responding to these attacks had to evolve with the new threats.

The Landscape
There means and choice of weaponry is varied, as we saw recently in the Mumbai attacks on several hotels and civilians. More to the point, they will most assuredly use chemical and biological radiological and nuclear (CBRN) weapons because of their lasting and dramatic physical and emotional impact on those being attacked. We saw this with the Sarin gas attacks on Tokyo’s commuter rail system some years ago.

This requires the equipping of military and civilian blue-light services with safe and effective personal protection equipment (PPE) that can be quickly donned, worn for long periods without body burden. However, these light and manoeuvrable suits must still be able to protect against a growing range of “very nasty” CBRN substances used in their usual shock attacks.

In the event of a terrorist incident involving chemical weapons or toxic industrial chemicals (TICs), instant contamination of hundreds of people can occur. Emergency planners know that preparation is the key to increasing survival rates and reducing the damaging effects on people, places, business, and governments. Indeed, this is required by the Civil Contingencies Act within the UK to ensure that they are in a “fit state” of readiness for such events.

New Threats
There are varied threats as evidenced here. As such, we do not even need to stay focused on terrorist activities. In the UK alone, civil contingency planning and expenditure for emergency planning has risen, demonstrating that non-terror incidents – i.e. “accidents” – are equally of concern when planning for emergencies. For first responders arriving on the scene of a CBRN incident, PPE and containment are two things all agree are front-of-mind.

Communication
Although not directly related to PPE, it is crucial that first responders are properly briefed and prepared about an incident they are expected to manage. As well as equipping first-responders effectively and safely, rapid and accurate communication is vital - not only between first-responder services and from experts during and after an incident, but also between civil responders via the media, to the public, so that they are not straying into contaminated areas and risk injury, contaminant spread, or death.

An incident must be evaluated rapidly and information disseminated to stakeholders. During an incident, if the fire service and police have rapid access to analysis, identification of any toxic agent can be made rapidly. In the Tokyo attacks fewer than half of hospitals sought information on Sarin poisoning from the Japan Poison Information Centre. The broadcast media are vitally important information sources for hospitals, and information on toxic agents can be broadcast once the public is aware of an incident. This prevents jamming of switchboards and overloading ambulance services. For example, the UK Government has issued guidance to the public about “Go in, stay in, tune in,” but are reluctant to go much further at the moment based on not wishing to scare the public unnecessarily regarding such incidents.

HAZ-MAT
This might be overly obvious, but surprisingly, first responders arrive on the scene of an incident and only then realise that they do not have the correct PPE for a particular hazardous material situation. However, in many countries, fire services generally take the lead on all HAZMAT incidents with the attitude of initially treating them with an “All Hazards Approach.” This means that they over protect their first responders until they know what they are dealing with. They tend to have the greatest knowledge of HAZMAT codes and how to manage them.

It is also important that the PPE being deployed meets both the HAZMAT requirements and has cross-contamination prevention protocols, such as being able to clean it on site before transporting the team, samples, or casualties to another uncontaminated location, e.g. a nearby A&E.

Furthermore, the PPE suits should be able to reduce body burden and be worn for extended periods of time, in the event that the haz-mat is particularly widespread or dense. Therefore, it is vitally important that the PPE being used protects against as broad of a spectrum of the threats that a HAZMAT crew or first responder team is likely to encounter.

Uniform Protocols
First-responders and hospital and ambulance personnel at the accident site must have adequate PPE to take care of victims exposed to chemicals, and victims who are still not properly decontaminated. The main lesson learnt from the Tokyo Sarin subway attacks in March 1995 was first-responders being severely affected as they were inadequately protected. They also had no known protocols in respect of approach to such incident.

The UK developed through the Police National CBRN Centre something called STEP 123 - Safety Triggers for Emergency Personnel.

When the cause of an incident is unknown, emergency personnel use these colour-numbered safety triggers:

STEP 1: ONE CASUALTY = Approach using normal procedures

STEP 2: TWO CASUALTIES = Approach with caution
Consider all options
Report on arrival
Update control

STEP 3: THREE CASUALTIES or MORE = Do NOT Approach
Withdraw
Contain
Report
Isolate yourself and send for specialist help

PPE Integration
Protection to face today’s threats is necessary against a wide range of both TICs as well as chemical warfare contaminants; most of the earlier generation PPE suits and respirators are designed for protection against warfare agents only. Incremental levels of protection are recommended, where each layer not only performs an individual function but also integrates with other layers to enhance collective performance. Properly sourced PPE allows for enhanced wearer duration and if properly managed and maintained will allow the user to have an operational exposure time of 48 hours within a 40 day period, once removed from the protective vacuum seal.

The hallmark of good protection is integration of all the basic PPE elements: the CBRN suit with boots, gloves, masks, helmets, body armour and bomb vests and the availability of the kit from one source or supplier. Today’s PPE manufacturers have rapidly moved from supplying the military to equipping civilian blue light services and treatment centres, including casualty or hospital A & E departments. The potential market includes public and private sector organisations that might encounter a CBRN incident as well as pharmaceutical and haz-mat leaks or medical waste disposal accidents.

Maintenance
This is a crucial subject as improper maintenance of PPE can reduce the shelf life or field life of the product. Each manufacturer should have training and procedures related to PPE maintenance that ensures the products efficacy in the field. This includes going to the extent of having “use by” dates and serial/lot numbers to help guarantee quality control.

In one case we encountered, an emergency response authority in Australia have their own testing facilities and took it upon themselves to initiate a best practices programme that allows them to internally extend the shelf life for up to four years. I do not condone surpassing manufacturer’s recommendations on shelf-life safety; however, it does bear worth mentioning that the maintenance of CBRN is paramount and that if stored and treated properly, it can serve out its life expectancy without problems. The end user needs to have 100 per cent confidence in their ability to safely and effectively use their PPE in the field. If they know it is stored and maintained properly, they will be able to perform better because they trust in the integrity and reliability of their PPE when the time comes to use it.

Training
The adage should be for CBRN professionals “Fail to prepare, and you prepare to face extensive injuries, pain and possibly death.” Training – or, one could say “practice” – is critical for first responders and anyone related to the CBRN emergency management response team, such as A&E triage and casualty treatment staff.

They must be fully briefed and trained in the use and maintenance of PPE and other vital equipment such as detectors. Preparation is essential to reducing the worsening of a CBRN situation; such as the contamination of colleagues (a chief problem in the Tokyo incident) and preventing the exposure of casualties to greater harm, or further spreading contaminants. Purchasers and planners must ensure the supplier / manufacturer offers a training programme with their CBRN products or they will fail in their mission – with serious injuries or deaths the likely result.

There are a number of organisations worldwide – not to mention PPE manufacturers – that can provide advice on helping managers of CBRN and emergency response teams explore best practices options that are best for them.

I would be pleased to take enquiries through the Remploy Frontline Technical Advisory Panel at frontline@remploy.co.uk.

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