Domestic Bliss


our customers telling us that this is a growing concern for them, as well as the open source literature that reflects this concern as a continuing global threat, compels us to take the logical next step to add bio into the Cobra Training Facility curriculum. By using non-pathogenic anthrax and ricin A chain we can train safely with those materials. The ability to then use the detection equipment, as opposed to training with simulant gives the responder a richer, more rigorous confidence level. And I believe this is consistent with what folks tell us about live agent and simulant: that it provides a confidence building and realism-based experience for learning that drives home the fact that the equipment works, the technology works, that they can do it safely, and that they can knowingly go into a real toxic environment.”


What really impresses the author, who has been around many a training facility in his time, is the Noble Training Facility. Often exercises that have a health element will only use part of a hospital – due to patient concerns – and the ability to do an exercise that swamps a facility is extremely rare. The Noble facility provides this experience without the medical problems, as Dr Jones explained: “Healthcare response to a major disaster implies that there is going to be dead and injured and walking wounded – as well as the walking well. You are a health care administrator of a facility, or the emergency room charge nurse, and you have a capacity of 15-20 people in your ED [Emergency Department] on a given day and now you have 200 people standing outside your door… How do you manage that, bearing in mind that the bed space in your hospital may already be 60-70%. How will you deal with the sub-categories of patient load, with a paediatric ward that is 70% full and you see 100 children come into your ED? These are all Noble facility scenarios. It is not as if you start off with an empty hospital when 200 people turn up outside the door. How do you, as a health care administrator, think through the medical treatment considerations of what your facility is expecting to deal with in terms of the amount of people that you can accommodate in intensive care, the number of people that you might have to


call back, and how are you going to plan your shifts? These are all the critical thinking skills that we are trying to instil in this training in addition to incorporating the use of technology such as human patient simulators, roleplay and actors to simulate patient surge, so that these folks get the experience of what it is to have 50-60 people screaming in your waiting room.” Impressively, the CDP has improved its competence despite the fact that response budgets are being slashed. The centre is still free for local, state and tribal first responders in the U.S., as Jones explained: “If you are a responder in a jurisdiction we will bring you over to CDP, house you, feed you, train you, and ‘put your head back in your bed’ at no cost to you or your jurisdiction. We are not only investing in our facilities but also in the support we offer for responders to come to these facilities at no expense to them or their jurisdiction – especially considering the cost pressures that they are under. If they were paying I don’t think the jurisdictions would be able to have the numbers of people train as it would be cost prohibitive.” Sadly the same pricing is not the case for international first responders, but the UK Ambulance Services HART teams have toured the Cobra and Noble facilities, and the Centre has also worked with other international responders. This teaming is likely to be part of a trend, as Dr Jones explained, “We hope [the HART partnership] will be one of many as we don’t have all the answers. I see us taking advantage of the experience that other people have to offer through these exchanges, as they are very important. The exchanges that we have with other international responders allows us to share their set of experiences that they have because of their geographic location, and they encounter these kinds of events more often than we do. We can learn a lot from all of our partners, and that is a benefit of the partnership: recognising that it humbles us to see what other people have dealt with and get the benefit of innovation and creativity that came from those experiences that are discovered through actually handling the real world event.” The Centre is not sitting still. It’s next


step is to try and bring the whole of government approach in. Dr Jones is committed to see that CDP training works to alleviate the potential disconnects that can happen between response agencies at the local, state and federal levels., What happens when the state response is swamped, and the Homeland Response Force (HRF) turns up? When you appreciate the amount of effort FEMA/CDP puts into integrated training you realise that Dr Jones has a unique experience in understanding the potential disconnect. “If it is catastrophic how will you integrate other components of government in a whole community response? I see us kicking it up to the next level. What happens when you have an event of such size, scope and complexity that it requires a whole nation’s response? What does that look like from a responder, the commander of a National Guard element, or the administrator of a hospital that is now finding itself at the heart of something that is bigger than any local asset can handle? We need to train in these real world scenarios that require a much larger response. We need to train in those scenarios from a ‘boots on the ground’ standpoint, i.e., from those that will be in the thick of it. Then, through technology, we need to take the information back to the jurisdiction and give the mayor, police or fire chief the opportunity to observe four hours of that exercise in their emergency operations centre.” It is not just the scale of the response that the Centre is looking to improve, but also the tactical space. Thanks to the wonders of technology, they have managed to increase their exercisable square footage. For example, in the Noble Centre they have moved controllers out of the room – either handed-off footage to them, or placed them behind one-way glass – to allow the responders a better experience. All of these improvements are towards one aim: to improve not just the physical response, but an understanding of what a good response should look like. “How do you train adaptability, changeability, flexibility decision making,” said Dr Jones. “This is part of the larger vision that we have. It is not just the doing, it has to be the doing in combination with the thinking.”


CBRNe South America 2012, 13-14 March, Rio De Janeiro, Brazil. More information on www.icbrnevents.com 22 CBRNe WORLD February 2012 www.cbrneworld.com


CBRNeWORLD


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