Auf der Heide, Erik. (1995). COMMUNITY MEDICAL PLANNING AND EVALUATION GUIDE. Dallas, TX: American College of Emergency Physicians.
________. (1989). DISASTER RESPONSE: PRINCIPLES OF PREPARATION AND COORDINATION. St. Louis, MO: The C. V. Mosby Company.
Drabek, Thomas E, and Gerard J. Hoetmer, eds. (1991). EMERGENCY MANAGEMENT: PRINCIPLES AND PRACTICE FOR LOCAL GOVERNMENT. Wasington, DC: International City Management Association.
U. S. Federal Emergency Management Agency. Emergency Management Institute. (1993). IS-1 THE EMERGENCY PROGRAM MANAGER. Washington, DC: U. S. Government Printing Office.
THE ELECTRONIC JOURNAL OF EMERGENCY MANAGEMENT is an on-line peer reviewed journal. We solicit review comments from all readers, including both academics and practitioners. The peer review process strengthens articles by requiring the author, editor, and reviewers to seriously consider an article and incorporate material and viewpoints that might otherwise be overlooked. We have chosen to use on-line review in order to allow a continuing dialog and to solicit the widest range of comments. To comment for peer review, use the address in the last section of this page to send the Editor an e-mail. Please include your name, organization, academic or field practitioner qualifications, and your comments. Comments may be edited for brevity and clarity. Each comment will be provided to the article's author for reply, if appropriate.
(1) PEER COMMENT: For a state with "some 35,000 providers in over 700 agencies," I recommend considering a larger sampling, if possible. I think a larger sample, especially as your population is skewed, would give your arguments more impact.
AUTHOR'S REPLY: This survey was deliberately restricted to agency officers as a population most likely to be more experienced and privy to any jurisdiction level planning in which the agency had participated. I agree that a larger sample of agency officers would be desirable, but that would require sampling a population of somewhere in the vicinity of 5,000 officers, a project that would require a larger investment of time, funding, and staff than a preliminary study would justify. The limitations of the study are described in some detail in the article.
(2) PEER COMMENT: I thought the survey was a good basic start for researching such a hypothesis, except for the question about having visited the emergency operations center. Being able to identify the role of the emergency operations center and when it might be needed are good questions to ask the repondents. Since these officers would be emergency medical services responders, I do not think that their having visited the emergency operations center would be as significant as their knowing what it is and for which situations it is utilized.
AUTHOR'S REPLY: In many jurisdictions in Virginia when a disaster is declared the emergency medical services function is represented in the jurisdiction emergency operations center by one of the rescue agency's officers. This individual becomes the locality's staff expert on emergency medical services operations. Experience in three Local Emergency Operations Exercises conducted for Virginia jurisdictions during 1997 and 1998 shows that an average of 85% of the staff of localities--those well enough prepared to be willing to have their operation examined by state experts--have never physically been in the emergency operations center prior to the exercise. Having visited serves as an indicator that officers who may be assigned as the jurisdiction's medical manager can at least find the facility if called. Once there, coaching, plans, and checklists will provide an answer to the other questions.
(3) PEER COMMENT: My understanding of the state's disaster plan is that it incorporates a mass casualty plan. Aren't most local governments operating on some version of the Simple Triage and Rapid Treatment system? Aren't they integrated with and using the state plan to formulate their own plans? If so, a more important test of the EMS providers' ability to respond during a disaster would be their knowledge of the Incident Command System and triage.
AUTHOR REPLY: This comment raises two issues. First, it is important to understand that mass casualty incidents are rare. It is even more rare that a mass casualty incident is declared to be a Local Emergency within the meaning of the VIRGINIA EMERGENCY SERVICES AND DISASTER LAWS. Events declared as Local Emergencies in Virginia are almost uniformly either natural events or major, protracted hazardous materials incidents, with no mass casualty component. The last mass casualty disaster in Virginia (actually a mass fatality event) was Hurricane Camile in 1969. The second issue is that procedures, such as Simple Triage and Rapid Treatment, and organizational structures, such as the Incident Command System, do not address roles and missions or how an agency manages its resources and logistics over an extended period of time as part of a community level response. I agree that discovering how well triage and the incident command system are understood and applied in the field would be an important study. However, I believe that it more properly would fit in a study of routine emergency and mass casualty response.