IPRED IV Drill – Lessons Learned

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1. The response teams should comprise of multi-sector, interdisciplinary and multi-organizational representatives. They should undergo joint training in routine, so that the unique strengths and added values of each entity is well known and acknowledged by all members in order to ensure efficient collaboration.

2. Communication systems should be unified and allow connectivity between different type of responders.

3. Reporting to the Emergency Operation Centers – EOC - is vitally important; communication between the different EOCs should be initiated as early as possible, in the initial stage of the event and maintained continuously throughout.

4. In every event there needs to be an incident commander; it is important that the appointment be made prior to the event. In Israel the police is responsible for the command and coordination in all routine events and the army takes command in war/conflict times or in specific emergency scenarios (e.g earthquake or radiological events).

5. First responders may themselves be impacted and/or injured, due to the difficulty to differentiate between a conventional mass casualty event and a mass toxicological event.

6. The initial detection and identification, in most toxicological events, will most probably rely on clinical symptoms of the casualties, therefore it is vital to sustain the knowledge, preparedness and awareness of the medical teams.

7. Protective gear should be immediately available and accessible to the first responders during routine times due to existent and emerging threats.

8. In every toxicological event the first step should be security and sealing of the arena in order to prevent another evolving event.

9. When a mass toxicological event occurs in the vicinity of a hospital, the casualties should be evacuated as soon as possible to the medical facility, without decontamination which will be conducted at the hospital level.

10. Driving an ambulance while wearing protective gear should be practiced.

11. The arena and the toxic hot zone must be decontaminated in order to prevent spread of the hazardous material.

12. Efficient and early alert of the population, along with clear risk communication should be provided, utilizing variable methodologies (media, speakers, door to door etc.).

13. In a multi casualty toxicological event, evacuation of casualties should be directed to as many medical facilities as possible. If possible, these medical entities should receive prior notice that the casualties are being evacuated to their facilities.

14. When a mass toxicological event occurs in a location in which there is only a single hospital, this medical facility should operate as a decontamination and triage hospital, and following the stabilization of the casualties, they should be evacuated to other medical facilities.

15. Contamination of the emergency department (ED) needs to be taken into account as the identification of an event as involving hazardous materials may be delayed; thus, some of the evacuees may present independently to the ED.