Category: News

Tactical Emergency Medical Services (TEMS) Providers Deploy Butterfly Ultra-Sound Monitors To Conduct On-Site Patient Assessments

The Maryland-National Capital Region Emergency Response System (MDERS) procured ten Butterfly IQ+ Ultrasound devices for Tactical Emergency Medical Services (TEMS) practitioners in Montgomery and Prince George’s Counties. These ultrasound devices will aid TEMS practitioners in diagnosing internal injuries and improving visual capabilities to monitor internal care.

TEMS practitioners operate in austere and hostile environments supporting police operations. They render initial care to patients and subsequent medical support from Emergency Medical Services (EMS) providers is limited based on the duration and threat posed during law enforcement deployments. With reduced medical support, it is essential to outfit TEMS practitioners with the needed equipment to administer advanced medical aid to a patient before transport to definitive medical care.

The Butterfly IQ+ Ultrasound device fills a gap in immediate medical care provided by TEMS practitioners. The ultrasound probe connects to a mobile device and interfaces with their mobile application to allow users to visualize the internal anatomy of a patient. The small and easily maneuverable components allow great latitude for TEMS practitioners to use the ultrasound imaging in a variety of different situations.

The integration of the Butterfly IQ+ Ultrasound device will augment the current medical capabilities of TEMS practitioners. The device will bolster identification of significant internal bleeding, cardiac abnormalities, dyspnea, and other internal injuries. Also, it will facilitate easier intravenous access, accurate hypodermic needle penetration, and artery identification. Beyond the on-scene capabilities, TEMS practitioners can share the ultrasound imaging for medical consultation and provide preliminary notification of a patient’s injuries to hospital personnel.

This emerging technology enhances TEMS practitioners’ ability to obtain an integrated imaging solution for critical medical assessments and guided procedures increasing the survival rate of patients experiencing life-threatening injuries.

For more information on this initiative, please contact William Abuelhawa at William.Abuelhawa@Maryland.gov.

 

Enhancing Sniper Capabilities in Prince George’s County | Members of Prince George’s County Police Department Emergency Support Team Attend Positional Shooting Clinic

Prince George’s County Police Department has built a comprehensive training program for its Emergency Support Team (EST). With support from the Maryland-National Capital Region Emergency Response System (MDERS), three officers from PGPD EST participated in the Modern Day Sniper Positional Shooting Clinic in southwest Virginia. The course provides law enforcement with field-based training in non-traditional shooting positions often encountered in real-world situations.

The two-day training combines marksmanship fundamentals with best practices and methods for positional shooting using the operator’s issued tripod. Students explored considerations for building a supported position while learning techniques for body awareness and natural points of aim. The course emphasized wobble zone management, recoil management, and the use of a post-shot checklist. Instruction was provided by industry-leading precision riflemen who have extensive military experience in long-range shooting and sniping.

The training incorporated multiple scenarios conducted in several disparate locations to test students’ ability to operate in high-stress environments using their newly acquired skills. The officers who completed the course indicated that the training expanded their ability to utilize improvised shooting positions, develop a stable stance, and acquire targets down range faster.

Over the last several years, PGPD has expanded its sniper capability to ensure that a cadre of instructor-level officers is available on each shift to train EST members desiring to bolster their sniping skills. With the completion of the Positional Shooting Clinic, PGPD understands the need to build/enhance competency in key areas of positional shooting for long-range and precision sniping operations.

/ In News / By nicole.markuski1@maryland.gov / Comments Off on Enhancing Sniper Capabilities in Prince George’s County | Members of Prince George’s County Police Department Emergency Support Team Attend Positional Shooting Clinic

Improving Decision Making for Public Safety Leaders in the National Capital Region.

Public safety leaders from across the National Capital Region (NCR)  recently participated in a four-part leadership seminar series on approaches to improving decision-making. The Maryland-National Capital Region Emergency Response System (MDERS) partnered with the National Preparedness Leadership Institute (NPLI) to host this professional development opportunity on behalf of the NCR. MDERS collaborated closely with NPLI to tailor this program to the unique characteristics and nuances of the Maryland-National Capital Region’s emergency response enterprise. The series was facilitated by Eric McNulty, Harvard

University’s National Preparedness Leadership Institute Associate Director and Co-Author of the book “You’re It,” and featured guest facilitators:

  • Anne Kronenberg, Affiliated Faculty, National Preparedness Leadership Initiative, Harvard T.H. Chan School of Public Health
  • Peter Neffenger, Distinguished Senior Fellow, National Preparedness Leadership Initiative, Harvard T.H. Chan School of Public Health
  • Richard Serino, Distinguished Senior Fellow, National Preparedness Leadership Initiative, Harvard T.H. Chan School of Public Health
  • Darrell Darnell, Affiliated Faculty, National PreparednessLeadership Initiative, Harvard T.H. Chan School of Public Health

This interactive program introduced participants to the building blocks of sound decision-making and the tangible ways in which decision quality can be improved over time. The program explored various decision-making methods available to leaders and how to become more intentional about the use of each. Participants gained a

better understanding of how to instill and maintain decision discipline even in the challenging environment of a major incident. The series concluded with a “master class,” where participants applied the concepts and tools they learned using a scenario-based exercise highlighting a complex organizational leadership challenge currently faced within the NCR.

At the conclusion of the program, attendees highlighted the need for continued leadership development opportunities for emergency response leaders in the NCR. MDERS plans to contribute to the leadership

development of NCR stakeholders through

future training offerings.

For more information on leadership training opportunities, please contact mders.training@maryland.gov.

Eric McNulty, Associate Director Harvard University National Preparedness Leadership Initiative
Anne Kronenberg, Affiliated Faculty National Preparedness Leadership Initiative, Harvard T.H. Chan School of Public Health
Peter Neffenger, Distinguished Senior Fellow, National Preparedness Leadership Initiative, Harvard T.H. Chan School of Public Health
Richard Serino, Distinguished Senior Fellow, National Preparedness Leadership Initiative, Harvard T.H. Chan School of Public Health   
Darrell Darnell, Affiliated Faculty Member Harvard University National Preparedness Leadership Initiative

Adapting to Emerging Trends and Leadership Training

As COVID-19 cases began to rise in early 2020, the world shut down in hopes of slowing the spread of this unknown and deadly infection. Non-essential workers worldwide transitioned to working from home, an option not available for essential workers within the Homeland Security Enterprise. Doctors and nurses continued to work at inundated hospitals, police and firefighters never stopped responding to emergency calls, and other essential workers continued to do their job while entering an even more dangerous and unknown situation. Additionally, leadership training has become an important aspect to personnel recruitment and retention, following the massive resignations and layoffs following the COVID-19 shutdown.

In the wake of the COVID-19 pandemic, many public safety officials expressed feeling of being burnt out or overworked. Due to these ongoing issues, many organizations within the Homeland Security Enterprise began reevaluating staff training and retention strategies. Leadership trainings have recently been utilized to ensure that an organization’s human capital is supported in any way possible. Organizations such as the United States Capitol Police and the United States Environmental Protection Agency have created a Human Capital Strategic Plan to ensure all workforce members are utilized effectively and supervisors are provided with leadership training. These leadership classes are offered online, allowing participants to attend without leaving their desks. Such courses have proved to be beneficial, including a master class titled Leadership and Change Management featured in the FireRescue1 Academy. Maryland Emergency Response System (MDERS) continues to work with its stakeholder representatives to ensure the courses offered benefit the stakeholder, agency, and community.

To further support their personnel, many public safety agencies moved to a hybrid learning or meeting style once COVID-19 restrictions began to lift. Out of necessity, some ICS courses are offered online and in person. State Emergency Management organizations, such as Oklahoma, Florida, the District of Columbia, and California, have created online curricula for G-300: Intermediate ICS for Expanding Incidents & G-400: Advanced ICS, which were hosted exclusively in person prior the pandemic. Additionally, programs such as the Texas A&M Engineering Extension Service’s (TEEX) Active Attack Event Response Leadership course, which was previously exclusively taught in person, can now be accessed completed entirely online.  MDERS is constantly researching different options for courses which can be provided to its stakeholders in a fully online or hybrid format.  The Training and Exercise Team at MDERS has coordinated courses from the National Preparedness Leadership Institute, and the National Association of Counties High Performance Leadership Academy, which are offered online.  Additionally, the National Tactical Officers Association online course, teaches police personnel on the legalities and challenges faced when responding to suicidal subjects.

The world has changed more quickly and abruptly than imagined, and due to these changes, the workforce and training methods need to evolve. Leaders are adapting the way they lead, and trainings are adjusting to ensure they are accessible to everyone safely. However, whether it is a hybrid learning model or all online, some adjustments must be made to ensure their longevity.  MDERS has expanded their offering to stakeholders and is constantly looking to improve the learning experience and will continue to search for classes that will help the leaders of the Maryland-National Capital Region.

Public Safety Agencies Train to Combat Sophisticated Threats

The homeland security threat landscape is constantly changing, requiring new and innovative approaches to incident response. The Maryland-National Capital Region Emergency Response System (MDERS) stakeholder community aims to regularly reassess their response priorities to adapt to emerging threats facing the community. To support this effort, MDERS provides training, technology funding, and planning support to build and enhance capabilities that ensure a coordinated response to emergency incidents. Threats, including cyber-attacks, active assailants, extreme weather, and mass decontamination remain as significant dangers to stakeholders. Daily reports of data breaches, or ransomware attacks taking place worldwide, show the volume of attacks are on the rise while hackers are adapting to circumvent new security measures. These attacks have proven to be economically crippling, time-consuming, and expensive to resolve.

On May 7, 2019, Baltimore City was attacked by a ransomware strike when city workers’ screens suddenly locked, and a message demanding cryptocurrency appeared on their screen. City files were encrypted and could only be accessed and opened with an access key provided by the attackers following the ransom payment. As a result, local public safety organizations began working with their Information Technology (IT) Departments to limit security vulnerabilities and prepare recovery plans. Baltimore City redirected 18 million dollars in city funds to harden its IT protocols following the attack. Even with constant updates and 24-hour surveillance, hackers are becoming more sophisticated and can infiltrate systems at almost any agency.

With the help of the MDERS, stakeholders had the opportunity to participate in a virtual cybersecurity workshop facilitated by three subject matter experts from the University of Maryland Center for    Health and Homeland Security (CHHS) and Montgomery County Office of Emergency Management and Homeland Security (OEMHS). This workshop allowed stakeholders to learn effective organizational preparedness and response capabilities, which could be applied to their agencies. In addition, MDERS continues to offer training opportunities providing its stakeholders with cutting-edge techniques to help protect their agency.

As mass shooting events around the United States are occurring more regularly, active shooter training has become a higher priority for public safety agencies. MDERS has continued to facilitate tabletop exercises, full-scale exercises, and training for all stakeholder disciplines to ensure members of the Maryland-NCR community are prepared for such an event. Within the past year, MDERS has facilitated tabletop exercises and a full-scale active assailant exercise at Prince George’s County Police Department (PGPD) Training Facility and Firing Range. Additionally, MDERS worked with Prince George’s County Police Department and Montgomery County Police Department (MCPD) Special Operations Division’s (SOD) leadership to create a tabletop series to ensure a cohesive response in an interdisciplinary multi-jurisdictional incident.

Over the past decade, weather challenges in the Maryland-NCR have become more unpredictable due to increasing in intensity. However, public safety agencies have learned to adapt and become resilient to climate change. More importantly, MDERS ensures to provide climate resiliency training opportunities and fund traveling expenses to allow stakeholders to attend climate emergency preparedness conferences. Participants learned about best practices from a variety of organizations and disciplines throughout the United States. In preparation for the winter weather, regional agencies have also conducted extensive tabletop exercises to ensure no gaps in their plans or capabilities.

Mass decontamination, the removal of dangerous substances or radioactivity by scrubbing a patient with soap and water, is becoming one of the essential facets of hospital, law enforcement, and fire/rescue/EMS preparedness and response. The training and equipment used for decontamination are highly adaptable, which allows public safety agencies and healthcare facilities to adjust their use for specific response operations. Decontamination shelters can be rapidly deployed in any location and easily stored away. Stakeholders may use decontamination shelters to establish incident command posts, support field triage, and other public safety response operations.

MDERS is regularly advised of new training and equipment requested by its five stakeholder disciplines: law enforcement, fire, rescue, EMS, emergency management, public health, and the hospital systems in Montgomery and Prince George’s Counties. Together these disciplines, and MDERS, collaborate to provide the Maryland-NCR with innovative training and exercise initiatives to combat the ever-changing threats facing the Homeland Security Enterprise.

First Receivers Utilize Online Training to Maintain Mass Decontamination Preparedness

The Maryland-National Capital Region Emergency Response System (MDERS), through its affiliation with Yale New Haven Health, recently implemented online First Receiver Operations Training (FROT) courses to assist local healthcare facilities maintain Occupational Safety and Health Administration (OSHA) requirements. MDERS is supporting first receiver awareness, safety, and annual review training at various hospitals in the National Capital Region, including Suburban, Holy Cross Health, University of Maryland Capital Region Health, Medstar Montgomery, Luminis Health Doctors Community Medical Center, and Adventist Health.

First receiver awareness level training is a 30-to-60-minute introductory course engaging participants in principles and procedures of decontamination, protection from specific chemical agents, respiratory protection, and personal safety issues. This training is required for healthcare personnel who work in the contaminant-free hospital post-decontamination area. Participants include emergency department clinicians, clerks, triage staff, and security staff members responsible for notifying hospital authorities of arrivals. An estimated 1,050 hospital-based first receivers will participate in the online training course to obtain contemporary awareness of mass decontamination operations.

The best practices for the protection of healthcare facility-based first receivers operations level training is an intermediate 8-hour online and instructor-led course providing healthcare personnel who have direct patient contact with lessons on decontamination topics. At the culmination of the course, participants acquired a comprehensive understanding of exposure to hazardous substances, hazard awareness, personal protective equipment (PPE), and special decontamination considerations. The practical session consisted of a demonstration of ambulatory and non-ambulatory decontamination during a mass casualty incident. A total of 1,125 healthcare workers will receive the training course to enhance the care of patients before and after thorough decontamination.

Ensuring the consistent training of hospital-based first receivers is reinforced by an annual 5-hour refresher for all hospital staff and healthcare personnel who completed the awareness and operations level courses. The online and instructor-led review will be provided to 1,125 participants who can be directly or incidentally exposed to a contaminated victim.

With the support of MDERS, hospital stakeholders have online access to the following courses:

  • EM120: Best Practices for the Protection of Healthcare Facility-Based First Receivers, Awareness Level
  • EM220: Best Practices for the Protection of Healthcare Facility-Based First Receivers, Operations Level
  • EM220R: Best Practices for the Protection of Health Care Facility-Based First Receivers, Operations Level Refresher

Facilitating an online learning platform to a large and diverse staff audience in an accessible manner enhances emergency preparedness operations necessary to effectively respond to mass decontamination at various levels. While building on this effort, MDERS aims to expand the continuing education and training of healthcare personnel to uphold the quality of patient care.

Montgomery County Police Department Trains on Sniper Response Operations

The Montgomery County Police Department (MCPD) upholds a mission to equip, prepare, and bolster the response  capabilities of their Sniper Response Team to provide enhanced public safety and security at national special security events, as well as respond to active-threat incidents in Montgomery County and the National Capital Region. The Sniper Response Team is additionally tasked with reinforcing the response activities of law enforcement officers, including conducting surveillance to share intelligence with responding agencies on the ground. To accomplish this mission, the MCPD Sniper Response Team requires specialized tools, tactics, and capabilities.

For several years, the Maryland-National Capital Region Emergency Response System (MDERS) has collaborated with MCPD to ensure their cadre of sniper-trained officers are experts in the field and ready to deploy at a moment’s notice. In May 2022, MDERS funded the High Angle Sniper Training for nine members of the MCPD Sniper Response Team in Oregon with Anchor Risk, LLC. MCPD worked with the instructors to ensure the class was tailored to the specific needs of the department.. The multi-day course provided students with hands-on instruction to gain an understanding of non-standard shooting techniques, engagement methods, mission planning, and ballistic characteristics.

At the conclusion of the sniper training, participants provided the following feedback:

  • “This training allowed me to learn how to work on shooting from high angles, which without the trip to the Pacific Northwest, I would have never been able to do.”
  • “I learned observation and intelligence-gathering skills from high-elevation positions to convey to command.”
  • “I gained a better understanding of environmental factors that affect the trajectory of a long-distance shot as well as when shooting at angles. Real-world experience provides us with much ­­­greater confidence if an actual situation occurs.”

The continued partnership between MDERS and MCPD ensures that the Sniper Response Team is capable to expand upon basic sniper techniques and are better prepared to protect the residents and visitors of Montgomery County.

MCFRS and PGFD Train on Structural Collapse Response

In 2019, the Maryland-National Capital Region Emergency Response System (MDERS) identified structural collapse response as a strategic priority for Montgomery County Fire and Rescue Service (MCFRS) and Prince George’s County Fire/EMS Department (PGFD). MCFRS and PGFD determined that to ensure an appropriately robust structural collapse response capability that each department needs to be able to deploy 13 trained personnel with the necessary equipment to the scene of a structural collapse incident within 40 minutes and provide cross-county mutual aid within 90 minutes.

To support this priority, MDERS sponsored personnel from MCFRS and PGFD to participate in a structural collapse specialist course in September 2022. This course trains personnel on the critical duties and activities as outlined in their position task books and is a requirement for any individual participating in structural collapse response. This training program, hosted at the Montgomery County Public Safety Training Academy, began with eight hours of computer-based training (CBT), followed by 80 hours of hands-on training. The specialized techniques learned and practiced that are necessary to perform rescues at structural collapse incidents included:

  • Breaching: Students learned techniques to break through and access obstructed areas. Participants drilled holes in a triangle formation, then chiseled away the surrounding areas, allowing the triangle to be lifted out, revealing an opening for entrance or extraction.
  • Breaking: Students learned the skills and techniques to safely break apart larger pieces of debris to facilitate manual removal without further compromising the structural integrity of a collapse site.
  • Lifting: Students learned building methodology and principles of physics to lift large pieces of cement and other debris without the help of a large crane. These techniques ensure that responders are able to remove large amounts of debris before crane operations can be implemented. Students additionally learned how to coordinate crane operations via hand signals to lift and remove debris.
  • Shoring: Students learned basic stabilization techniques to create supports that prop up surrounding debris to allow safe ingress and egress from collapsed buildings.
  • Burning: Students learned the various characteristics of available torches and the best situations to utilize a particular type to cut through rebar, steel beams, or other metal objects. Students also learned the techniques to effectively cut the metal without comprising the structural integrity in an area of a building.
  • Building Construction: Students learned about basic construction and engineering principles to familiarize themselves with a structure and also to construct apparatus needed for an effective rescue.

With the completion of this course, MCFRS and PGFD further increase their cadre of certified structural collapse specialists, ensuring each department’s ability to deploy a fully staffed response team of 13 individuals on scene of a collapse event within 40 minutes. Additionally, by jointly training across both departments, MCFRS and PGFD can deploy fully interoperable mutual aid within 90 minutes of a large collapse event.

To further bolster structural collapse response capabilities within the Maryland-National Capital Region, MDERS is coordinating with MCFRS and PGFD to host two technical search specialist courses and an additional structural collapse specialist course in 2023. These courses, alongside a robust equipment cache, ensure both departments are able to effectively deploy and respond to structural collapse incidents.

Maryland-National Capital Region Public Safety Agencies Train on Unmanned Aerial System Maintenance Operations

As the deployment of small unmanned aerial systems (sUAS) programs continues to expand across the United States, public safety agencies face challenges in maintaining sUAS platforms. To support stakeholders within the Maryland-National Capital Region, MDERS sponsored pilots from Prince George’s and Montgomery County public safety agencies, as well as MDERS, to participate in the Understanding Unmanned Aerial Systems Maintenance course hosted by Tactical Drone Concepts, Inc. in September 2022. This course combined maintenance theory, best practices, and hands-on application to guide students through potential maintenance issues they may encounter.

The Understanding UAS Maintenance course engaged students in classroom discussion and hands-on instruction to develop the knowledge, skills, and abilities to implement in-house maintenance programs for UAS vehicles. Students attending the course gained a functional understanding of the component parts and software programming used to operate unmanned aircrafts, as well as soldering techniques to repair wire and electronic components on tactical and training aircraft. Upon completion of the course, Maryland-National Capital Region stakeholders enhanced their understanding of diagnosing and troubleshooting maintenance issues associated with sUAS. Students can further apply this knowledge as public safety agencies in both Prince George’s and Montgomery Counties continue to develop their internal maintenance policies and procedures.

Stakeholders from the Prince George’s County Police Department, the Montgomery County Police Department, the Montgomery County Fire and Rescue Service, and the Montgomery County Office of Emergency Management rated the overall course highly. Participants provided the following feedback:

  • “I believe there are some best practices we can take from this class regarding maintenance. We learned greatly from our classmates about their programs and what works best for them.”
  • “A new appreciation for aircraft maintenance has been instilled in me due to being able to take the class.”
  • “The lessons learned will benefit the day-to-day maintenance of our UAS vehicles.”

Navigating the Environmental and Historic Preservation Review Process

As a subrecipient of the National Capital Region’s (NCR) Urban Area Security Initiative (UASI) award, the Maryland-National Capital Region Emergency Response System (MDERS) complies with federal regulations for grant-funded projects. One such regulation is the Federal Emergency Management Agency’s (FEMA) Environmental and Historical Preservation (EHP) review process. The EHP review process aims to minimize the impacts of any project on the environment and historically designated sites, including floodplains, wetlands, archeological sites, historic structures, protected coastal areas, critical wildlife habitats, clean air and water, and minority and low-income populations among others. In order to ensure the long-term preservation of these sites, any project that could cause permanent impacts must be approved by FEMA through the EHP process.

MDERS, in its support of emergency response partners across Prince George’s and Montgomery Counties, supports numerous projects that fall under the jurisdiction of the EHP review process. Notably, any building modification, including the permanent installation of equipment, must be approved by FEMA. In addition to building modifications, any training opportunity that occurs in a non-designated training facility, as defined by the local agencies, requires FEMA EHP approval to ensure no damage or permanent impacts will be made to the training site.  As the single point of collaboration on multi-disciplinary, multi-jurisdiction emergency response capability enhancement, MDERS manages the EHP review process on behalf of its stakeholders.

The required application includes a FEMA-provided questionnaire that defines the scope of the project in question. The FEMA screening form prompts users to provide a variety of information including grant project names, contact information, estimated cost, project description, and the intended construction to be conducted on the building. Additionally, the screening form must be accompanied by secondary photo documentation. The required photos must include a picture of the structure and if possible, a building sign. This preliminary information is sufficient in most cases but, FEMA requires additional photo documentation for building over 45 years old, as older buildings are more closely associated with potential environmental concerns and an enduring historical significance. The extra photos must clearly identify the area(s) that any alteration to the building will occur so that FEMA can closely assess the environmental and historical ramifications of the specific areas of construction.

Within the MDERS portfolio, the Public Access Trauma Care (PATC) program is most intertwined with the EHP process. As part of the PATC program, MDERS works closely with both Prince George’s and Montgomery Counties to install readily accessible bleeding control kits and medical supplies in public schools and government buildings. These items are stored in PATC cabinets, which are permanently affixed to interior walls similarly to fire extinguishers or automated-external defibrillators (AEDs). Before these cabinets are installed, MDERS must submit the required EHP documentation to ensure that any alteration to a building does not harm the environment and protects its historical significance.

MDERS began the EHP process for the PATC program by coordinating with stakeholders to determine how many buildings would be impacted and their respective ages. By delineating buildings by age, MDERS determined which buildings required additional photo documentation and which did not. MDERS then worked closely with subrecipients to identify the strategic location of PATC kits and cabinets, conduct the needed photography, and compile the information for submission to FEMA for approval.

To better meet the needs of its stakeholders, MDERS developed an EHP checklist for the PATC program. This checklist not only provided all the necessary information to FEMA, but also served as a resource to stakeholders to refer back to for the ultimate installation of the PATC cabinets.

While the EHP process can appear daunting, MDERS is committed to helping its stakeholders through the FEMA review process and ensure that projects are executed in accordance with the Maryland-National Capital Region’s needs and in compliance with federal regulations.

For more information on the EHP review process, please visit: https://www.fema.gov/grants/guidance-tools/environmental-historic.