Category: News

MedStar Montgomery Medical Center Tabletop: Initial Response and Unified Command to An Active Assailant

In recent years, medical facilities have experienced an uptick of threats and violent events.[1] Within this increased threat landscape, it is imperative that medical facilities and emergency response agencies jointly prepare for active assailant incidents. The Maryland-National Capital Region Emergency Response System (MDERS) facilitated a Tabletop (TTX)-In-A Box with partners from MedStar Montgomery Medical Center (MMMC), Montgomery County Fire and Rescue Services (MCFRS), Montgomery County Office of Homeland Security and Emergency Management (OEMHS), and Montgomery County Police Department (MCPD). The exercise was designed to examine the initial actions of each participating entity and their ability to establish a Unified Command (UC) during an active assailant incident. This exercise will help bolster the response capabilities for each discipline to respond to an active assailant incident in a medical setting.

To test each discipline’s response capabilities, participating agencies determined that a discussion based TTX would be the best approach. MDERS’s TTX-In-A-Box program is a systematic, scalable, and economical approach for developing and enhancing critical capabilities that foster interdisciplinary and interjurisdictional collaboration and coordination. The tool consists of a portable kit containing all materials required to run the hybrid exercise. For these exercises, work groups are formed and comprised of subject matter experts (SMEs) from relevant disciplines. In this exercise, the work group consisted of SMEs from MMMC, MCFRS, OEMHS, and MCPD. The work group provided invaluable input to craft a scenario to test the participants’ ability to adequately respond to an active assailant incident occurring in a hospital setting.

Eleven participants served as players during the exercise and were joined by over 45 observers. The exercise was guided by injects from a master scenario exercise list (MSEL) to simulate a realistic, continuous flow of information. Participants had to sift through pertinent and irrelevant information to determine the appropriate response in a dynamic situation. In the early stages of the exercise, each entity was responding within the framework of their discipline-specific policies and plans. As the scenario progressed, the entities formed a UC to make collaborative decisions and delegate tasks to the appropriate agency.

Overall, this exercise produced useful conversations about communication channels between participating agencies, triage care to victims, establishing a unified command, positioning of fire and police staging areas, dissemination of information to the public, reunification processes, reestablishment of healthcare within the facility, and patient movement to other healthcare facilities. These conversations will continue between partners to resolve identified gaps to enhance response operations.

MDERS remains committed to providing ongoing exercise support to our stakeholders in Montgomery and Prince George’s Counties. These exercises are tailored to bolster response capabilities and fortify the resilience of our communities. Through these ongoing efforts, our goal is to ensure readiness and efficiency in handling emergencies while safeguarding the well-being of our residents.

[1] Glatter, R., & Papadakos, P. (n.d.). The Epidemic of Violence in American Hospitals [Review of The Epidemic of Violence in American Hospitals]. Time.com; Time. Retrieved February 13, 2024, from https://time.com/6337450/the-epidemic-of-violence-in-american-hospitals/.

Algerian Delegation Explores MDERS Operations in Collaborative Exchange

In November 2023, the World Trade Center Institute (WTCI) presented the Maryland-National Capital Region Emergency Response System (MDERS) with a unique opportunity to meet with a delegation from Algeria. The Algerian delegation participated in the United States Department of State’s flagship International Visitor Leadership Program (IVLP). The program theme for the visiting group was “Disaster Preparedness, Emergency Management, and Volunteerism.”

Handpicked by the United States Embassy in Algeria, all participants in the program traveled to the U.S. with the aim of learning best practices in their respective fields. The Algerian delegation expressed a specific interest in exploring topics such as the Incident Command System (ICS), Emergency Medical Services (EMS), and various training and exercise programs.

The MDERS staff warmly welcomed the Algerian delegation upon their arrival at the Prince George’s County Public Safety Firearms Range. Following the introductions, Acting Co-Director Lauren Collins and Senior Emergency Response Specialist Hannah Thomas presented the delegation with a comprehensive overview of MDERS capabilities. The presentation delved into MDERS’ involvement in the Urban Area Security Initiative (UASI) grant process and highlighted MDERS’ robust training and exercise programs. Representatives from the Prince George’s County Police Department (PGPD), including Major Charles Magee, Commander of the Training and Education Division, and Sergeant Nicholas Fiore, Training and Education Division, shared valuable insights during their presentation on a full-scale active shooter and barricade exercise conducted in April 2022. Major Magee praised MDERS for their dedication and attention to detail during the eight-month process in which the full-scale exercise was planned and executed. Sergeant Fiore delivered a comprehensive overview of the exercise, highlighting the sequence of actions, skills utilized, and areas of improvement identified during response operations. Senior Project Manager William Abuelhawa provided additional perspective on law enforcement response operations to enhance the presentation based on his previous role as the Tactical Commander in the Special Operations Division of PGPD. Fully engaged in the presentations, the Algerian delegation asked many insightful questions.

After the presentations, Instructor Lou Williams led the delegation on a tour of the Prince George’s County Public Safety Firearms Range. Mr. Williams showcased the live fire ranges and thoroughly reviewed the capabilities that this state-of-the-art facility has to offer. The delegation then explored the equally impressive less lethal aspects of the facility, including the Tactical Maze, designed for tactical room clearing exercises with movable walls for varied scenarios. The catwalk feature of the maze allowed instructors to provide immediate feedback to trainees.

Next, the hosts provided the Algerian delegation an overview of the outdoor training area, featuring realistic settings such as an apartment building, a townhouse, and simulated businesses, all furnished to enhance the training environment. The extensive camera system enabled observation of training evolutions from the control room.

At the conclusion of the Firearms Range tour, the Algerian delegation expressed their admiration for MDERS’ capabilities and extensive training and exercise programs. Their active participation throughout the visit fostered an exchange of ideas and perspectives beneficial to all parties. The Algerian delegation visit was a tremendous success, and MDERS eagerly anticipates future opportunities to engage in global counterparts.

Enhancing Preparedness Through Innovative Training: Montgomery County Police Department Supervisor’s In-Service Tabletop Series

In a proactive approach to bolster the preparedness capabilities of the Montgomery County Police Department (MCPD), the Maryland-National Capital Region Emergency Response System (MDERS) collaborated with MCPD representatives to develop and conduct a series of eight Incident Command System (ICS) refresher training sessions and tabletop exercises (TTXs) from July to October 2023. These sessions, an integral component of the Supervisor’s Annual In-Service training, aimed to evaluate and enhance the ability of MCPD supervisors to employ ICS principles, during the first 30 minutes of a critical incident.

The success of these training sessions was rooted in meticulous planning by a collaborative team consisting of MDERS and MCPD personnel. To ensure the authenticity and effectiveness of these exercises, MCPD representatives selected as subject matter experts (SMEs) participated in the planning and facilitation process. MDERS leveraged the knowledge and experience of MCPD representatives to develop two active assailant scenarios, intentionally designed to escalate in complexity. The development of the master scenario events list (MSEL) drew upon MCPD’s directives, policies, and procedures, including the Active Assailant Emergency Response Protocol, ensuring alignment with real-world scenarios.

The planning team, meeting consistently throughout the spring and summer of 2023, crafted a comprehensive program that included a thirty-minute ICS refresher training followed by a two-and-a-half-hour tabletop exercise. Prior to the first delivery, the planning team, accompanied by additional MDERS and MCPD Training Academy staff, conducted a thorough dry run of the TTX scenarios. This allowed for the identification of any pitfalls in the scenarios or inject delivery, ensuring a seamless and realistic experience for participants.

All eight training sessions took place at the Montgomery County Public Safety Training Academy (PSTA) in Gaithersburg, MD. The training series was scheduled to accommodate the shift-work schedules of the 149 participants. MCPD and MDERS intentionally created an open, low stress, no fault environment to encourage meaningful discussions among facilitators and players. Participants were equipped with situation manual (SitMan) slick sheets, props, aerial maps, floorplans, easels, markers, notepads, and writing utensils, which helped foster a comprehensive and immersive learning experience.

The collaborative efforts between MDERS and MCPD in executing these TTXs exemplify a commitment to enhancing the capabilities of law enforcement supervisors, at the sergeant level, in managing incidents effectively. The comprehensive planning, incorporation of subject matter experts, and emphasis on realistic scenarios contribute to a successful training initiative that ensures the preparedness of MCPD supervisors in the face of critical incidents within Montgomery County.

Impacts of AI on Public Safety and the Homeland Security Enterprise | Benefits

Artificial intelligence (AI) continues to revolutionize the world. For as many threats as AI poses, it has the potential to create just as many benefits. This article is the third and final in a three-part series on artificial intelligence from the Maryland-National Capital Region Emergency Response System (MDERS) that will explore a few beneficial applications of AI.

Damage Assessments: After Hurricane Ian devastated Florida in 2022, FEMA utilized a machine learning model from aerial imagery to review and assess the magnitude of structural damage to buildings. The AI platform was taught to analyze terrain, compare historical and recent images, and classify damage. This resulted in a reduction of the structures needing review to 77,000 from over a million initially identified as damaged (DHS, 2023). Utilizing AI for damage assessments would ensure a more effective allocation of resources post-disaster.

Cybersecurity: AI can be utilized to detect and even prevent cyber threats to critical infrastructure. Machine learning models can identify abnormal activity and flag it. The Cybersecurity and Infrastructure Security Agency (CISA) developed the Cyber Sentry program to assist their threat-hunting analysts in monitoring critical infrastructure networks in the U.S. CISA is also utilizing AI to reverse engineer malware, ensuring the U.S. stays up to date on techniques utilized by threat actors and how to counter them (DHS, 2023).

911 Centers: 911 Call Center usage of AI systems has substantially increased in the U.S. AI is being used for a multitude of purposes in these centers to ensure faster response times and more accurate use of emergency resources. AI has also been used to have live, two-way translation for call takers and callers. Callers who do not speak English often face delays in service due to the need to connect with translation services. Additionally, 911 call centers often field non-emergency calls in addition to their 911 duties. Numerous jurisdictions across the U.S.  utilize AI services that answer non-emergency calls and connect callers with the right resources, allowing trained dispatchers to stay available to take emergency calls (Hernandez, 2023).

Advances in AI have the ability to positively contribute to public safety and homeland security. AI can potentially pose significant risks and threats to the world, but it can also enable more efficient, proactive, and responsive solutions to problems.

References

Hernandez, A. (2023, October 19).  AI moves into overworked 911 centers. Stateline.org https://www.ems1.com/technology/articles/ai-moves-into-overworked-911-centers-nQ0TiXT0robghbfd/

U.S. Department of Homeland Security. (2023). Artificial Intelligence Use Case Inventory. U.S. Department of Homeland Security. https://www.dhs.gov/data/AI_inventory

 

MDERS Staff Provide PATC Training at the USG Campus

In October, the Maryland-National Capital Region Emergency Response System (MDERS) led two Public Access Trauma Care (PATC) training events at the Universities at Shady Grove (USG). The trainings provided instruction on identifying severe medical injuries and applying the proper treatment for those injuries. Hosting these training opportunities provided participants with invaluable experience in practicing the basic PATC skills, empowering them to provide immediate aid to an injured victim.

Prior to instruction on medical aid, the course began with an overview of key aspects to consider before rendering care to a victim. First, participants learned how to communicate effectively with 9-1-1 dispatchers by directly calling 9-1-1 or commanding another bystander to do so. Participants were urged to be proactive and not assume someone has already called 9-1-1. Articulating clear information and responding to dispatchers’ questions will help them allocate the appropriate resources to the correct location to respond to the emergency properly. Second, participants learned about the importance of maintaining situational awareness to ensure their safety. Emergency scenes are often dynamic, and threats may evolve as they transpire. If in an emergency, participants were taught to use all their senses to remain vigilant to any factor that could jeopardize their or the victim’s safety.

 The course then transitioned to basic medical education. Participants were taught about indicators of severe blood loss and the ramifications of major, life-threatening bleeding. Potential signs of life-threatening bleeding include but are not limited to blood spurting from the wound, blood pooling on the ground, and clothes soaked with blood. A victim exhibiting any of these symptoms needs immediate medical care.

To treat these significant injuries, participants were instructed about the medical techniques and equipment associated with the PATC program, as detailed below:

  • Direct pressure can be used to treat wounds anywhere on the body. An emergency trauma dressing should be used to provide constant pressure to provide initial hemorrhage control.
  • Tourniquets should be applied to major wounds on the arm or leg. The tourniquet should be placed as high as possible on the injured limb and tightened to ensure that the bleeding stops.
  • Wound packing is used to treat an injury in a junctional area of the body, such as the armpit. Compressed gauze should be formed into a small ball that can be inserted into the wound cavity to help minimize blood loss.

Beyond addressing life-threatening bleeding, course participants learned about early care to treat a pneumothorax. This medical condition occurs when excess air enters the chest cavity, which causes additional pressure on the lung that can lead to shortness of breath and a collapsed lung. A PATC kit contains a chest seal that can be placed over a wound on the chest, torso, or back to limit extra air in the chest cavity.

Lastly, after medical care has been administered, participants were encouraged to place a victim into the recovery position. This helps with a victim’s breathing cycle and is an easy position to cover a victim with a mylar blanket to lessen the risk of hypothermia.

A benefit of this training was it also allowed participants to practice all these skills with all the required medical equipment. MDERS has a training cache with surplus supplies that are identical to the equipment in an individual PATC kit. This allowed participants to get a positive experience with the PATC equipment and be prepared to help a victim suffering from a medical emergency.

Bystander intervention in the immediate aftermath of a major injury is paramount to help prevent a significant medical complication and possibly death. MDERS will continue its outreach to the public for educational opportunities and support our partners with additional training and equipment acquisition to grow the PATC program in Montgomery and Prince George’s Counties. More information about the PATC program can be found by visiting our website, viewing the PATC training videos on YouTube, or downloading the PATC mobile app. If you have any questions about the PATC program, please contact MDERS at mders.training@maryland.gov.

The success of the PATC program is due in large part to the work of our partners. MDERS would like to thank Michael Wahl and Phillip Tou for their help coordinating the logistics of hosting the PATC trainings at USG. Also, MDERS would like to extend their gratitude to Montgomery County Police Department Sgt. Lyndon Jones for providing his medical expertise to support the PATC program.

References

Harvard Health. (2017, February 14). Emergencies and first aid – recovery position. https://www.health.harvard.edu/staying-healthy/emergencies-and-first-aid-recovery-position.

Mayo Foundation for Medical Education and Research. (2021, May 21). Pneumothorax. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/pneumothorax/symptoms-causes/syc-20350367#:~:text=A%20pneumothorax%20(noo%2Dmoe%2D,a%20portion%20of%20the%20lung.

MDERS Steering Committee Members Convene to Elect New Officers and Showcase Response Capabilities

The Maryland-National Capital Region Emergency Response System (MDERS) conducted an in-person Steering Committee meeting to allow stakeholders and staff to reconvene after engaging in numerous virtual forums due to the restrictions of the COVID-19 pandemic. In this opportunity, MDERS Steering Committee stakeholders elected new chair officers, reviewed innovation fund proposals, and showcased current response capabilities to attendees.

The MDERS Steering Committee serves as a platform for multidisciplinary stakeholders to share ideas, discuss pertinent topics, and provide recommendations on diverse proposals, with the aim of garnering consensus, raising awareness, and securing approval for distinctive public safety capabilities that enhance emergency response operations. Comprised of inter-jurisdictional leadership from fire/rescue/EMS, law enforcement, emergency management, public health, hospital, and regional/state agencies, these partnerships ensure the enhancement of interoperability in Montgomery and Prince George’s Counties.

Over the past several years, the MDERS Steering Committee has been guided by Chair, Major Charles Magee of Prince George’s County Police Department (PGPD) and Vice Chair, Assistant Chief Tracy McDonald of Montgomery County Fire Rescue Service (MCFRS), who provided invaluable structure and profound influence during their four-year tenure in these roles.

MDERS and its partners express sincere gratitude to both individuals for their steadfast dedication in navigating unprecedented times marked by the COVID-19 pandemic, financial adjustments, and abnormal work conditions. With the conclusion of their terms, members of the Steering Committee had the opportunity to elect new officers to fulfill the Chair and Vice Chair roles. MDERS congratulates newly appointed Chair MCFRS Assistant Chief Tracy McDonald and Vice Chair PGPD Sergeant Nicholas Fiore on their election.

Following the conclusion of the election, principal stakeholder agencies provided comprehensive presentations showcasing their recently integrated response capabilities. The presentations aimed to highlight specific functions and procedures that contribute to enhancing public safety operations. Each agency demonstrated how these sophisticated tools, designed for managing incidents of varying scales, play a crucial role in preserving lives, reinforcing coordinated responses, elevating training standards, and enhancing productivity during emergencies. The following is a list of the capabilities presented.

Prince George’s County Office of Homeland Security and Emergency Management (OHS/EM)

  • Community Lifeline Application enables users to obtain real-time incident information on assets, services, and capabilities essential to community needs. The lifeline application created by PG OHS/EM to support Continuity of Operations Planning (COOP) gives users access to pertinent topics affecting human health, including safety/security, communication, food/shelter, water systems, energy, and hazardous materials.

Prince George’s County Police Department (PGPD)

  • EST Medic LIFEPAK equips tactical medics with the capacity to identify, evaluate, and treat cardiac emergencies. Medics can use the defibrillator to treat unstable cardiac patients and monitor alterations to their vital signs.
  • First Line Supervisors Command Book provides first-line supervisors with the tools and resources to effectively respond to diverse incidents. This guide contains a series of job aids, checklists, and worksheets for high-impact events, including barricaded suspects, bomb threats, active shooters, kidnappings, civil demonstrations, wounded officers, and rescue task force.
  • Public Order Equipment contains full-body protective gear, helmets, and ballistic shields that increase officer safety at the forefront of active violence, mass gatherings, and hazardous materials. When deployed, public order teams wear full body armor covering their legs, arms, torso, and facial area.

Montgomery County Department of Health and Human Services (MCDHHS)

  • Medical Resource Officer (MRO) Program provides logistical, medical, and other critical functions to support response efforts to public health crises. The MRO oversees the Medical Reserve Corp (MRC) administration and coordination to reinforce response efforts to public health events.

Montgomery County Fire Rescue Services (MCFRS)

  • PerSim software can simulate various medical emergencies to enhance training opportunities for first responders. Participants wear a headset that produces a 3-D holographic patient overlaid on a training manikin. Participants can initiate and perform medical procedures through the simulated emergency, prompting them to assess the situation and apply life-saving techniques imperative for resolving real-world incidents.

Montgomery County Fire and Rescue Service (MCFRS) and Prince George’s County Fire Department (PGFD)

  • Leader Search Bluetooth Listening sensor allows structural collapse teams to listen for trapped victims and detect those in confined spaces to enhance search and rescue efforts during a structural collapse incident.
  • Paratech Rescue Guardian system monitors structural changes to a collapsed building and gathers on-scene intelligence to alert fire personnel of sudden shifts. The system provides instantaneous notification upon sensing building alterations to allow fire personnel to exit the compromised structure before a potential secondary collapse and reevaluate the scene to adjust the device accordingly.

Montgomery County Police Department (MCPD)

  • ICOR Robots contribute to reducing potential threats to officer safety due to the ability to operate from a safe distance and reach vulnerable positions that do not expose officers to hazardous conditions. These robots contain cameras and audio systems that capture on-scene intelligence for decision-making while allowing law enforcement personnel to communicate with individuals.

Holy Cross Hospital

  • Healthcare Capabilities revolve around response and preparedness necessary to support personnel in providing optimal patient care. Hospital systems improved emergency response to active threat events by obtaining a transport truck to mobilize mass casualty incident supplies. The super duty box truck ensures medical cache movement and replenishment of critical supplies to healthcare facilities experiencing an acute surge. In addition, hospitals have enhanced their preparedness for mass casualty incidents associated with hazardous materials through procuring Zumro decontamination shelter systems. These efforts have been imperative to recover quickly from all-hazard events and maintain the quality of medical treatment operations.

Members of the Steering Committee uphold distinctive public safety initiatives that reinforce their overall response procedures, plans, and policies to achieve departmental objectives. MDERS will continue to serve as the single point of collaboration between all disciplines involved in emergency response to integrate capabilities to provide superior service to residents in Montgomery and Prince George’s Counties.

Impacts of AI on Public Safety and the Homeland Security Enterprise | Threats and Challenges

Artificial intelligence (AI) has the potential to change the world for the better, but it is not without risk. The director of the Cybersecurity and Infrastructure Security Agency (CISA), Jen Easterly, provided an assessment of AI that recognized it’s potential to be the “most powerful capability of our time” while highlighting its equal potential to be the “most powerful weapon of our time” during a May 2023 security summit at Vanderbilt University (Vasquez, 2023). This characterization of AI by one of the nation’s top cyber experts as not just a weapon, but the “most” powerful weapon of our time speaks to the endless potential for threat actors to utilize AI to harm life and property. This article is the second in a three-part series on artificial intelligence from the Maryland-National Capital Region Emergency Response System (MDERS) that will explore a few emerging threats posed by AI.

Generative AI, a form of narrow AI, is the focus of a large portion of the concern with narrow AI. Narrow AI is any artificial intelligence that has been trained or developed to perform specific tasks or analyses (IBM, 2023). Generative AI is AI that can create numerous forms of content, from images to computer code to human voices. AI created media is commonly referred to as a “deepfake”, and while earlier versions of deepfakes were riddled with errors, as the technology advances, so does the quality of deepfake media. For example, in April of 2023, a song titled, “Heart on My Sleeve” showed up online supposedly written and performed by popular musicians Drake and The Weeknd. The song was so similar to the style and vocals of the two artists that their music label had to make statements that they did not release new songs (Coscarelli, 2023).

The ability of AI to mimic well known voices could be utilized by threat actors to create audio bites of politicians or world leaders (Allen, 2023). ChatGPT, a form of generative AI that was discussed in the previous article, recognizes the concerns homeland security leaders have with AI. When prompted to respond to questions regarding the cybersecurity concerns of AI, ChatGPT provided numerous responses that included recognition of the potential for deepfakes to spread disinformation or even impersonate individuals (Steed, 2023).

Considering the possible concerns that generative AI will be used by threat actors to develop computer code or change existing malware, this capability can generate a damaging impact in the digital realm. During the same summit at Vanderbilt, Easterly also raised concerns that generative AI could provide instructions to terrorists for developing chemical and bioweapons (Steed, 2023).

The advances in AI pose significant risks and threats to numerous fields. Fortunately, there is ongoing research on how to use AI to counter these sophisticated threats to create opportunities for the betterment of society. The next and final article in this series will cover promising beneficial uses for artificial intelligence by the homeland security and public safety industry.

Answer to the Previous Article: The second to last paragraph of the previous article on artificial intelligence was written with the assistance of ChatGPT.

References

Allen, G. (2023, September 19). Advanced Technology: Examining Threats to National Security. Center for Strategic and International Studies. https://www.csis.org/analysis/advanced-technology-examining-threats-national-security

Coscarelli, J. (2023, April 24). An A.I. Hit of Fake “Drake” and “The Weeknd” Rattles the Music World. New York Timeshttps://www.nytimes.com/2023/04/19/arts/music/ai-drake-the-weeknd-fake.html

IBM. (2023). What is Artificial Intelligence (AI)? IBM. https://www.ibm.com/topics/artificial-intelligence

Steed, M. (2023, August 23). Responsible AI: The Solution To Generative AI’s Threats. Forbes. https://www.forbes.com/sites/forbesfinancecouncil/2023/08/23/responsible-ai-the-solution-to-generative-ais-threats/?sh=4ccff2e03cac

Vasquez, C. (2023, May 5). Top US cyber official warns AI may be the ‘most powerful weapon of our time.’ CYBERSCOOP. https://cyberscoop.com/easterly-warning-weapons-artificial-intelligence-chatgpt/

 

PGPD Rescue Task Force Train to Enhance Response Operations for Active Violence Incidents

Over the last year, the Maryland-National Capital Emergency Response System (MDERS) has supported the Prince George’s County Police Department (PGPD) and Prince George’s County Fire Department (PGFD) in their effort to integrate response capabilities for active violence incidents. The cohesion between PGPD and PGFD has created a Rescue Task Force designed to enable medical care to victims near a threat while maintaining a robust security posture. MDERS has supported this initiative with personal protective equipment (PPE) for first responders. The totality of this effort will enhance response efforts to active violence incidents in Prince George’s County.

An active violence incident involves an individual actively engaged in killing or attempting to kill people in a confined and populated area (Northwestern University, 2023). These incidents are often dynamic and can evolve rapidly, demanding immediate action from law enforcement and fire/rescue/EMS resources. During an active violence incident, fire/rescue/EMS providers are often faced with the issue of waiting for victims to be extracted from warm and hot zones, prior to beginning medical care. The delay of medical intervention can be fatal for victims confined in these zones.

The urgency to remove and treat victims requires a unified response from law enforcement and fire/rescue/EMS personnel. Nationally, Rescue Task Force (RTF) training has been established to create this unity amongst disciplines to create a cohesive extrication of victims in life-threating circumstances, leading to the Prince George’s County Police and Fire Department recently adopting this practice.

The Rescue Task Force training empowers Prince George’s County first responders in active violence situations by creating realistic scenarios to build structure and confidence. MDERS staff visited PGPD’s state-of-the-art training facility during their police in-service RTF training to observe the session. Establishing command, mitigating threats, and organizing casualty collection points (CCP) are all key components in RTF training and require teamwork from all personnel on scene. MDERS observed the ability of 45 participants, including 10 fire/rescue/EMS present and 35 police officers, in back-to-back scenarios to maintain focus and agility in rescue operations while being met with obstacles and learning to overcome strenuous conditions. The operational coordination that is required to assess the situation and plan for action was proven throughout these exercises by each department.

MDERS Acting Co-Director, and Deputy Director of Finance & Administration, Lauren Collins expressed the following:

  • “I thoroughly enjoyed witnessing the collaborative efforts of Prince George’s County Police and Fire/EMS departments as they joined forces to engage in comprehensive Rescue Task Force (RTF) training. The dedication and substantial investments made by the Maryland Emergency Response System (MDERS) in the RTF program were unmistakably evident throughout this training session, and it was gratifying to see these endeavors manifest into a successful reality.”

In an effort to enhance preparedness, MDERS assisted PGPD with procuring tactical vests and a variety of ballistic protection equipment for PGFD. The acquired ballistic protection allows fire/rescue/EMS personnel the ability to deploy inside warm zones to treat and extract potentially critical patients while protecting providers from injury. Medical supplies can also be attached to tactical vests for easy access to essential medical supplies. The PPE allows first responders to execute their mission more safely in dangerous situations.

Active violence incidents are a growing threat to the Maryland-National Capital Region that involves the interoperability of police, fire, rescue, and EMS personnel to increase the response effectiveness to mass causality incidents. The RTF training is an indispensable resource for Prince George’s County, structuring first responders to work as a unified team.

References

Active violence: Emergency management – Northwestern University. Active Violence: Emergency Management – Northwestern University. (2023). Retrieved from https://www.northwestern.edu/emergency-management/how-you-can-prepare/active-violence.html#:~:text=An%20active%20violence%20incident%20involves,a%20vehicle%20into%20a%20crowd

MDERS Fiscal Year 2020 – An Overview

The Maryland-National Capital Region Emergency Response System (MDERS) recently finalized their annual report for Fiscal Year 2020 (FY20). The period of performance for this cycle spanned from June 1, 2021, through May 31, 2022. During this period, the MDERS Fiscal Year 2020 – 2022 Strategic Plan served as a road map for carrying out the development and enhancement of capabilities through the execution of training and exercises. In FY20, MDERS in collaboration with stakeholder partners, continued its mission of developing and further enhancing response capabilities for law enforcement, fire/rescue/EMS, public health, emergency management, and the hospital systems in Montgomery and Prince George’s Counties. Those capabilities include:

 Training and Exercise Program

  • MDERS supported diverse training and exercise opportunities for stakeholders to collectively strengthen their response operations. MDERS sponsored 37 trainings for 565 total participants, planned and executed a Full-Scale Exercise (FSE) for Prince George’s County Police Department (PGPD) with 98 participants, planned and executed several tabletop exercises for Montgomery County Police Department (MCPD) and PGPD with 58 participants from MCPD and 23 participants from PGPD. These trainings and exercises have enhanced the MDERS stakeholder partners’ collective preparedness and response capabilities, thereby ensuring the safety and security of our first responders and the communities they serve.

Ballistic Protection for Fire, Rescue, and EMS

  • MDERS assisted Prince George’s County Fire/EMS Department (PGFD) in outfitting their providers who are deployed into hot, warm, and cold zones with personal protective equipment (PPE). PGFD providers were equipped with ballistic body armor, vest-mounted medical supplies, ballistic eye and face protection, and ballistic plate carries.

Incident Command Tools

  • MDERS focused on advancing the use of the incident command structure among Montgomery County Fire and Rescue (MCFRS), PGFD, and PGPD to minimize threats to public safety. For instance, MDERS supported the enhancement of incident command competency to better prepare frontline supervisors and command-level officers, building confidence in their decision-making. This was achieved through the development of static and dynamic immersive simulation training environments, acquisition of virtual reality (VR) tools, and the creation of command guidebooks. All PGPD command-level personnel were provided command guidebooks to serve as a resource when establishing command during an incident.

Emergency Management Support

  • MDERS supported Prince George’s County Office of Homeland Security Emergency Management (PG OHS/EM) with their planning, training and exercise support program, response and recovery training program, and volunteer and donations management program. This funding strengthened various aspects of emergency management efforts, including community engagement, emergency preparedness, and medical training for personnel and civilians. Montgomery County Office of Emergency Management Homeland Security (MC OEMHS) also received funding for their emergency management support for planning, training, and exercise support, as well as volunteers and donations management. This funding supported increased preparedness training, a full-scale exercise for MC OEMHS’s Emergency Operations Center (EOC) and community engagement events.

Emerging Homeland Security Technology Pilot

To identify new opportunities for advanced response, MDERS allocated funding  to evaluate and procure innovative equipment aimed at addressing evolving threats. During FY20, the acquired technologies and equipment helped enhance training for mass casualty triage, search and rescue, and situational awareness. First responders can sharpen their skill sets while implementing these innovations during response operations. The procured the technologies and equipment include:

  • Augmented Training Systems (ATS) Virtual Reality Platforms: Allow responders to experience and train for a large flow of patients suffering from a diverse set of injuries.
  • PerSim: Participants wear a headset that produces a 3-D holographic patient that is overlaid on a training manikin.
  • Leader Search Bluetooth: Enable structural collapse teams to listen for trapped victims during a response.
  • Vehicle Mounted Camera: Stream real-time footage of an incident scene back to the incident command post.
  • Smartboard: Allow supervisors to use multiple platforms to monitor resource deployment and increase on-scene situational awareness.
  • Manikins: Support in replicating an actual person during training events.

Mass Casualty Incident Supplies Transport Truck

  • MDERS in partnership with Holy Cross Hospital System procured a Ford F-650 Super Duty Box Truck to expedite the retrieval and distribution of critical medical supplies during acute surge events in the Maryland-National Capital Region. This transport truck has enhanced accessibility, deployment, and storage of medical consumables for MDERS hospital stakeholders, thus improving regional healthcare response efforts.

Medical Resource Officer

  • To bolster public health operations, MDERS continued to fund essential roles within Montgomery County Department of Health and Human Services (MC DHHS) and Prince George’s County Health Department (PGHD). The Medical Resource Officer (MRO) position provides logistical, medical, and other critical functions to support response efforts to public health crises. In FY20, the MRC for MC DHHS participated in community engagement activities and vaccination clinics to educate the public on the COVID-19 vaccines. The MRO for PGHD used their resources to furnish COVID-19 testing kits to the public and increase their volunteer operations to serve vulnerable community members from diverse backgrounds.

Public Access Trauma Care

  • MDERS supported the Public Access Trauma Care (PATC) program with additional supplies to expand the capability within Montgomery and Prince George’s Counties. MDERS procured 85 training kits for Montgomery County Public Schools (MCPS), which include 15 tourniquets, 15 elastic bandages, 15 gauze bandages, 15 two-pack chest seal trainers, ten wound cube simulators, three emergency trauma dressings, cloth tape, quick litter, two emergency blankets, two shears, two-pack chest seals, two rolls of compressed gauze, two pairs of medical gloves, two sharpies markers, two mini duct tape rolls, and a sealed PATC kit.

Law Enforcement Special Events Response Cache

  • In FY20, MDERS procured 85 special event personal protective equipment (PPE) kits for officers. The kits increase the safety of officers during deployments for active violence and/or public order incidents. Each kit contains full-body protective equipment, helmets, and ballistic shields. In addition to the kits, MDERS supported the participation of MCPD and PGPD in the Civil Disturbance Unit (CDU) Level 1 Training to ensure officers carry out appropriate response procedures and enhance their skillsets on maintaining public safety.

Tactical Equipment for Law Enforcement

  • The tactical equipment for MCPD and PGPD included several types of innovative and advanced equipment. MCPD and PGPD received thermal monocular, night vision goggles, ballistic shields, ICOR Robots, Iris Robots, training supplies, ballistic plates, and tactical cold weather gear. During response operations, MCPD and PGPD use the tactical equipment to increase situational awareness and ensure officer safety.

Fiscal Year 2020 afforded MDERS, and its stakeholder partners the ability to further its mission of building and enhancing response capabilities within Montgomery and Prince George’s Counties.  In the coming fiscal years, MDERS will continue to support its stakeholders and the communities they serve through planning, organizing, equipment acquisition, training and exercising. For more information about FY20 or any of the projects listed above, please contact MDERS by email at mders@maryland.gov.

Public Access Trauma Care (PATC) Instruction Cards and Posters

The Maryland-National Capital Region Emergency Response System (MDERS) has taken a proactive approach to enhancing public safety through the development of informative instruction cards and posters under the Public Access Trauma Care (PATC) program. With a commitment to equipping the community, MDERS has successfully distributed 10,000 instruction cards and 1,000 posters to dedicated partners across Montgomery and Prince George’s Counties. These invaluable resources deliver clear, step-by-step guidance on fundamental life-saving medical techniques, empowering individuals to administer crucial aid to victims grappling with life-threatening bleeding, penetrating trauma, hypothermia, and other severe injuries. By bridging the gap between emergencies and professional medical assistance, creating and disseminating these instructional materials significantly amplify individual preparedness to offer timely, life-saving medical interventions.

As part of the PATC program, medical supplies have been strategically placed in public schools and government buildings throughout the Maryland-National Capital Region (MD-NCR). For those supplies to be effectively utilized, individuals must be able to identify injury patterns and render appropriate aid. MDERS has developed training videos a mobile application and worked closely with regional partners to expand training opportunities related to PATC. However, MDERS staff identified a need for accessible materials that individuals can easily reference.

MDERS determined that instruction cards and posters will allow individuals to review PATC skills in a quick and efficient manner. Working closely with an outside vendor, the MDERS team developed and finalized these materials to distill the needed information into simple instructions supported with detailed illustrations. The foldable instruction cards contain instructions and illustrations on how to apply a chest seal, apply direct pressure, apply a tourniquet, pack a wound, and prevent shock. The posters provide the same information but also include a section on what individuals should do in an emergency situation. Introducing these materials to the public will add an outlet for individuals to learn about and practice PATC skills.

Within the last month, the following entities have received instruction cards and posters:

  • Montgomery College (200 instruction cards and 20 posters)
  • Montgomery County Office of Emergency Management and Homeland Security (500 instruction cards and 50 posters)
  • Montgomery County Public Schools (4,000 instruction cards and 400 posters)
  • Prince George’s County Office of Homeland Security and Emergency Management (500 instruction cards and 50 posters)
  • Prince George’s County Public Schools (4,000 instruction cards and 400 posters)
  • The Universities at Shady Grove (100 instruction cards and 10 posters)
  • The University of Maryland Global Campus (50 instruction cards and 10 posters)

***MDERS has the remaining materials for training and potential delivery to other stakeholders.
Distribution and placement of these educational materials will increase awareness of the PATC program and provide readers with invaluable information to review and implement during an emergency. For more information about the PATC program, please visit publicaccesstraumacare.org or email mders.training@maryland.gov.