person, called a lone wolf, or terrorist organizations such as the Islamic State (ISIS). The person or groups can be citizens of the country they live in or outside agents who enter a country with the intent of committing an act of terrorism. No matter what kind of terrorist attack, responding to terrorism is the same as responding to any disaster and occurs at different levels. responders addressing equipment, standardized incident management processes, protocols, and procedures. It is developing a smart identify credentialing system for emergency response officials to enhance the ability of the United States to manage domestic incidents. ● Region X: Alaska, Idaho, Oregon, and Washington. FEMA’s goals are five-fold and aim in helping to (FEMA, 2020a): ● Prepare: prevention aims at avoiding, preventing, or stopping an imminent, threatened, or actual act of terrorism or manmade disaster. If such an event does occur, FEMA then advances to the protection goal where it protects our citizens, residents, visitors, assets, systems, and networks against the greatest threats and hazards in a manner that allows our vital interests and way of life to thrive. ● Mitigate: mitigation reduces the loss of life and property by lessening the impact of disasters, and response is designed to save lives quickly. ● Respond: respond by protecting property and the environment and meeting basic human needs after an incident. ● Recover from a disaster in the United States: FEMA’s last goal is recovery. The organization assists communities affected by an incident to recover through a focus on timely restoration, strengthening, and revitalization of the infrastructure; providing housing; helping the local economy to recover; and ensuring the health, social, cultural, historical, and environmental fabric of the communities affected survive as intact as possible. The healthcare responder must be mindful of the various aspects of caring for victims’ physical needs and the psychological needs of the victims and communities. Disasters can have a lasting emotional toll on a community. This is evidenced by the years of recovery following Hurricane Katrina and other disasters and acts of terrorism. Within the different levels of response, volunteers play an important role. It is important to note that, when a disaster occurs, disaster training is necessary to be an effective volunteer. One cannot just walk up to a disaster and expect to volunteer immediately. Taking classes from FEMA or the Red Cross is a start. Volunteering with local disaster groups that do yearly training adds to one’s competencies. One needs to register with some governmental agency so that licenses and training records are maintained in an accessible database by a responding disaster agency. The volunteer should also physically have on them a hard copy of their license and any training records. Even with all this, the volunteer will find that it will take hours for the disaster incident command administrators to verify licensure and skills, meaning time will be spent sitting out of the way waiting for a role assignment. Legal ramifications and protective federal laws are discussed further under Standards of Care below. The USDHS established several volunteer agencies and added to those already existing in the wake of the 911 terrorist attacks: The Medical Reserve Corps (MRC), the Community Emergency Response Team (CERT), the Volunteers in Police Service (VIPS), the Neighborhood Watch (NW), and the Citizens Corps. These volunteer groups work with a specific local governing body to train volunteers in disaster response. For example, the MRC works with local public health departments, training healthcare volunteers in disaster triage, mass health care, and administering
There are many forms of terrorism, including biological agents, weapons of mass destruction, chemical agents, and radiological terrorism. No matter the form, terrorism is a type of disaster that is always manmade. The intent is to cause panic, fear, and other psychological responses in addition to the physical damage that impacts the victims. Terrorist attacks can result from one Chemical, biological, radiological, nuclear, and explosives The term chemical, biological, radiological, nuclear, and explosives (CBRNE) represents a broad classification of five different forms of terrorism and disasters. These categories will be discussed in this course. The U.S. Department of Homeland Security (2022) and the U.S. Department of Health and Human Services (2021b) provides standards and guidelines for first
LEVELS OF DISASTER RESPONSE
Responding to a disaster takes place at several levels. The local emergency management response teams will always handle the initial response. If the initial responders cannot handle the emergency, it becomes a disaster for the local EMS teams, who may be at the city or county level. When the local EMS response is not enough, what was an emergency for them becomes a disaster, and other local or state government authorities turn to the broader state EMS system for help. The governor becomes involved and often asks the state public health department and state EMS agency to respond. If needed, the governor can call in the state's National Guard units to assist. This process exists in all states in one form or another, and some states even have formal compacts with other states to send EMS help when needed. Depending on the nature of the emergency, its size, and available EMS help, this level of response may be all that is needed. However, emergencies can also become disasters at the state level when needed resources are depleted or the emergency response is too widespread to address all needs (Veenema, 2018). When this happens, the governor can turn to the president of the United States to ask for help. Depending on the nature of the disaster, federal agencies may already be present and assisting, even at the emergency level. An example of this would be the Las Vegas shooting in October 2017. Because of the nature of the shooting, the Federal Bureau of Investigation (FBI) entered the response to assist local police in investigating the crime. To date, no United States disaster has called for an international response, though disaster agencies at that level can respond to international-level disasters and terrorist attacks; additionally, other countries have called the president and offered to assist in response to terrorist attacks. Through FEMA (Federal Emergency Management Agency), the federal government divides the country into regions. This allows disaster relief to be organized by regions (FEMA, 2020b). The following is a list of the ten FEMA regions: ● Region I: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont. ● Region II: New Jersey, New York, Puerto Rico, and the Virgin Islands. ● Region III: Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, ● and West Virginia. ● Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee. ● Region V: Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin. ● Region VI: Arkansas, Louisiana, New Mexico, Oklahoma, and Texas. ● Region VII: Iowa, Kansas, Missouri, and Nebraska. ● Region VIII: Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming. ● Region IX: Arizona, California, Hawaii, Nevada, American Samoa, Guam, Commonwealth of the Northern Mariana Islands, Republic of the Marshall Islands, and the Federated States of Micronesia.
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