Public Safety Agencies Research Articles

Urban Campers as a New Population for Community Impact Assessment: Case Study of US-301 in Sarasota, Florida

All states and cities and most towns have urban communities. Urban camper is a working term for homeless people who live in urban or suburban areas. The term helps differentiate campers with stable, minimally developed night locations from those homeless who have nowhere consistent to go. Camper populations vary from one to several hundred. They live in tents or shanties without services or utilities. Many residents work, access shopping and services, and send their children to school. Their camp communities are their homes. Public safety and social service agencies know these people, but they are invisible to the average citizen. Many urban campers are U.S. citizens, but the mainstream community has traditionally overlooked their legal and personal rights. Acknowledging their rights may cause legal problems for local governments. Land development and land use changes can force campers out of campsite locations. Sometimes they find out about changes the morning bulldozers arrive. A widening of U....

From the bush to the beach: water safety in rural and remote New South Wales

To describe the types of aquatic locations attended by residents of rural and remote New South Wales (NSW), to record self-reported water safety-related behaviour, and identify preferred communication mediums for water safety messages. A stratified random telephone survey was conducted of 500 NSW residents aged greater than 15 years residing in moderately accessible, remote and very remote locations in NSW. Results indicate that around two-thirds of respondents had been in or on the water at a pool, beach, lake, river or dam in the past 6 months. The most common type of aquatic facilities used were rivers, creeks or streams (53.5%), beaches (45.7%), public pools (45.5%), private pools (40.7%), dams (40.6%) and lakes (27.0%). Time spent at each of these locations and time of day each location was visited varied. Overall, the majority of respondents reported practicing water-related safe behaviour. Preferred communication mediums for water safety messages included television, schools and newspapers. Water safety education, especially in relation to beach conditions, remains just as important a topic for public health authorities and key water safety agencies in regional and remote NSW as it is in coastal suburbs. Responses from the survey, along with key stakeholder advice, will be used to inform the development of appropriate strategies aimed to reduce drowning deaths in rural and remote locations in NSW.

Improving Emergency Preparedness and Public-Safety Responses to Terrorism and Weapons of Mass Destruction

This article, written from the perspective and based partially on the experience of law enforcement and public health practitioners, explores the very real public-safety threat posed by terrorists' use of weapons of mass destruction (WMDs). More specifically, it provides an overview of various types of WMDs and their properties; outlines the general policies, procedures, and protocols characterizing current police, fire, emergency medical service, and other public-safety agency responses; and illuminates potential gaps and lapses in current practice. Arguing the need for a more focused, integrated, and holistic approach that involves a broader array of personnel and resources from public- and private-sector entities and that emphasizes preparedness and prevention, the article concludes by describing a more effective strategic and operational process. Based on the highly effective Compstat crime control management model, this process involves the timely and accurate analysis of terrorist intelligence, effective tactical and strategic responses to various types of WMD events, rapid deployment of necessary personnel and resources, and relentless follow-up to ensure a more effective and integrated response to future WMD events. Language: en

Disaster medicine and the emergency medicine resident

Disaster medicine and the emergency medicine resident

Simulation techniques for training emergency response

The Institute for Simulation and Training (IST), University of Central Florida, in conjunction with the US Army and the Orange County (Florida) Fire Rescue Department, have developed and fielded a series of simulation techniques for conducting disaster exercises and training public safety personnel to respond to disasters. Simulator training offers several important advantages, including cost and safety. We are also gathering persuasive evidence that training effectiveness is substantially improved by the use of simulation as compared with traditional field exercises. Our programme is now in its seventh year and has concentrated on training for two main skill domains: emergency management incident command, and emergency medical care performed in the field. We provide a programmatic overview, including descriptions and illustrations of the following projects: Project Plowshares, sponsored by the US Army, involved conversion of a war game simulation to support civilian emergency management exercises; the Combat Trauma Patient Simulator, a project funded by the US Army and the manufacturer (METI), uses a highly realistic medical simulator connected to the internet to model treatment of battlefield casualties; crisis management field exercises have been supported by the use of simulation techniques and technology, in conjunction with the US and Swedish military and local public safety agencies, particularly the Orange County Fire Rescue Department.

Impact of impulsiveness, venturesomeness, and empathy on driving by older adults

Problem: Although personality characteristics such as impulsiveness have been linked to the driving safety and driving habits of young and middle-aged adults, little research has focused on the role of personality in older driver behavior. Method: Using the IVE questionnaire in an exploratory study, three personality dimensions (impulsiveness, venturesomeness, and empathy) were measured in 305 older drivers (ages 57–87 years old). In addition, the Driving Habits Questionnaire was used to estimate driving exposure, and the Driver Behavior Questionnaire (DBQ) was used to estimate driving errors and violations. State-recorded crash data were made available by the state public safety agency. Results: Subjects who reported four or more driving errors had higher impulsivity and empathy scores and lower venturesomeness scores. Subjects reporting driving violations were more likely to have high impulsivity scores. Driving six or more places per week was associated with lower levels of impulsivity. Impact: These results suggest that a comprehensive understanding of driving problems among older adults should also include a consideration of personality dimensions. In doing so, the challenges faced in the interpretation of self-report instruments on driving behaviors must be acknowledged, with a move in research toward greater reliance on more objective measures of driving behavior when assessing the impact of personality variables.

OK-FIRST: An Example of Successful Collaboration between the Meteorological and Emergency Response Communities on 3 May 1999

Abstract The Oklahoma Climatological Survey began an initiative known as Oklahoma's First-Response Information System using Telecommunications (OK-FIRST) in 1996 to support local public-safety agencies (fire departments, law enforcement agencies, and emergency management). OK-FIRST provides participant agencies with a wealth of real-time weather information and instruction for these users on the interpretation and application of the data in their operations. The 3 May 1999 tornado outbreak was a critical test for the OK-FIRST system. Users of OK-FIRST prevented the tragedy from becoming worse by making informed decisions that protected life and property.

Emergency Communications: The Quest for Interoperability in the United States and Europe

When on September 11, 2001, the Pentagon stood ablaze, responding fire companies from Maryland could not communicate with those from Washington, D.C. and Northern Virginia. Runners had to be used instead, stalling rescue efforts: a powerful reminder that even in the age of digital networks and ubiquitous cell phones, communication interoperability, the ability of public safety personnel to communicate by radio with staff from other agencies, on demand and in real time, remains an elusive goal. As almost 60,000 federal, state and local public safety agencies plan to upgrade their communications systems in the wake of 9/11, this essay takes a hard look at communications interoperability and its implementation, here in the United States and in Europe. Three steps have been seen as requirements for interoperability: inventing the appropriate technology, setting common standards and frequencies, and providing adequate funding. This essay looks at each of these steps in the U.S. and European contexts and analyzes successes and failures, rendering a fuller picture both of the challenges for interoperability and of best practices to meet them. Over the last few years (and surprisingly given the complex political structures) the Europeans have pulled ahead of the U.S. in implementing interoperability, although with determination and the right set of strategies, U.S. policymakers can easily make up lost ground. Enhanced Federal Communications Commission (FCC) leadership in defining frequencies and standards and a clearly formulated and thoroughly executed comprehensive funding strategy, based either on public funds or innovative public-private partnerships, would go a long way toward enabling communications interoperability to take hold. Yet, this essay is not simply about how to overcome obstacles on the path to interoperability. The case of interoperability, its elusiveness in the United States and its successes elsewhere, reveals a deeper, more troubling story - a story not so much of technical hurdles, as of structural and political hurdles, as more of perceived than actual constraints, unduly limiting the nation?s ability to cope with an important public policy need in these uncertain times. There are no abstract silver bullets to overcome the problem. Instead, policymakers have to look carefully at how well the policy strategy they select is aligned with their means and the policy context. In the United States, interoperability has suffered from strategic misalignment and haphazard implementation. European interoperability policies have fared better, not because of a general advantage in the strategies chosen, but because of a better fit between means and ends. Thus interoperability also provides an intriguing test case, highlighting the transcending importance of strategic alignment, agency innovation, and leadership.

Evaluating the effects of information technology on problem-oriented-policing. If it doesn't fit, must we quit?

Technologies promise to make our organizations more productive, efficient or effective. But our experience does not always fulfill this promise. Public safety agencies are the target of a barrage of new information technologies offering better performance, many of which are attractive because they can be financed through federal grants. But when evaluations are performed of these technologies, improvements do not always result. This article describes the experiences of a state police agency (SPA) during its use of cellular digital packet data (CDPD) systems to support its problem-oriented policing (POP) project. The CDPD system should have improved the SPA's POP operations; in practice, it was not as clear. Although participants believed the CDPD technology worthwhile, there were only a few minor differences between POP officers that did and did not use it. This evaluation suggests the need for better databases to measure performance as well as more informed federal funding of ways to assess the impact of technologies.

The Need for a Coordinated and Strategic Local Police Approach to Terrorism: A Practitioner's Perspective

The terrorist attacks of September 11, 2001 have had a profound impact on American policing, requiring that police agencies substantially modify various elements of their policies, operations, and training. This article examines several types of changes local American police agencies will have to implement if they are to effectively meet the challenges of preventing, deterring, responding to, and investigating terrorist acts. Police agencies face a compelling need for more sophisticated intelligence gathering and analysis, as well as better dissemination of terrorism intelligence among local, state and federal agencies. There is also the need for more sophisticated operational policies with regard to terrorism response, greater cooperation and sharing of resources among local public safety agencies, and more comprehensive training that educates police officers to the realities of contemporary terrorist methods and activities. Finally, the need for effective investigation and prosecution of terrorist acts demands that agencies ignore or overcome the traditional organizational boundaries and rivalries that impede the achievement of these and other goals. The article also points some of the difficulties involved in implementing the necessary changes within a highly decentralized system of thousands of relatively autonomous local agencies, and it illuminates some of the initiatives undertaken by the New York Police Department (NYPD) to overcome these obstacles and more effectively prepare for the terrorist threat.

OK–FIRST: A Meteorological Information System for Public Safety

The Oklahoma Climatological Survey has supported local public safety agencies (fire departments, law enforcement agencies, and emergency management) through its OK-FIRST program since 1996. OK-FIRST provides real-time use of weather data to help public safety agencies fulfill their respective operational missions. Users are taught how to interpret and apply weather data in their operations. The OK-FIRST system has been applied during a wide variety of weather events, including severe weather, floods, wildfires, and hazardous materials incidents.

Successful Outcomes of an Ergonomics Process using an Ergonomics Task Force

With the first state ergonomics regulation in place and more on the way, employers are now being held accountable for ergonomic compliance. Employers are increasingly interested in realizing benefits with ergonomics, despite regulations. In this study, an ergonomics process is introduced which includes a participatory approach through the development of an Ergonomics Task Force. This participatory approach using labor and management to apply ergonomic principals demonstrates significant and substantia] benefits for a variety of organizations from a public safety agency to an educational facility (2) to a banking entity, a hospital and a biotechnology firm. This study identifies the numerous ways that organizations are benefiting from an ergonomics process using an ergonomics task force as the source of in-house expertise.

“Medical Miranda”—Improved Emergency Medical Dispatch Information From Police Officers

Medical Miranda, also called Secondary Emergency Notification of Dispatch (SEND), is a low cost, effective, and welcome addition to emergency medical dispatching systems. The benefits are recognized by emergency medical dispatchers who receive feeder calls from associated public safety agencies that have trained both their field staff and call-takers in the Medical Miranda protocol. The dispatchers would be more satisfied with feeder agencies that used the SEND protocol. A survey was conducted and analyzed, taking advantage of a situation in which two agencies (one used SEND) fed calls to the same communication center. Dispatchers were more satisfied with the information gained from the feeder agency that used the SEND protocol and believed that the officers and dispatchers of that agency had a far better understanding of the emergency medical dispatcher's needs. When the emergency medical dispatcher does not talk directly with the reporting scene personnel or caller, Medical Miranda increases the usefulness of the information the dispatcher receives, helps the dispatcher better understand the reported medical emergency, and improves response appropriateness in emergency medical service (EMS) systems where responses routinely are prioritized.

Poison center planning for mass gatherings: the Georgia Poison Center experience with the 1996 Centennial Olympic Games.

The host city for the Olympic Games needs to prepare for "the world" to visit. This article is the first published report describing the impact of an event such as the Olympics on poison center services. We evaluated our operations and identified potential new demands. Operational aspects reviewed included: staffing; communication with foreign language callers; knowledge of international drug products; telephone access; procedures for disaster response and recovery; poison treatment protocols; and handling of hazardous material releases. We collaborated with local, state, and federal planners to delineate the poison center role and to develop protocols for use in a poisoning, including a hazardous material's release at a densely populated site. We enhanced our capability to respond to unusual incidents by forming new alliances. Fortunately, no such events occurred; these plans were therefore not tested. The Georgia Poison Center developed and implemented new capabilities for the Centennial Olympic Games. Immediate access to poison center resources would have facilitated the care of poisoned patients at multiple hospitals if this had become necessary. Communities preparing for mass gatherings should capitalize on the common interests of poison centers, hazardous materials specialists, and public safety agencies. Preparations should emphasize the most likely events, while recognizing the possibility of the unexpected. Planning an integrated response allows the talents and resources of participating agencies to be maximally utilized.

Disaster preparedness: an analysis of public safety agency and community preparedness during the northridge earthquake

It is a “given” within the emergency management field that preparedness is absolutely essential for disaster survival. It is also a “given” that preparedness for disasters is frequently accorded a low priority by public safety agencies and citizens, particularly in light of the low frequency over time that disasters impact the local community. The purpose of this article is to highlight the importance of preparedness by public safety first responders and community residents through analysis of the dynamics of the most costly disaster in the history of the United States. This article, through participant observation of the public safety agency response and through surveying of the community within the epicenter, illuminates the lessons learned during the Northridge earthquake in order to enhance the management of future catastrophic events by those destined for such experiences.

Firearm injury surveillance at the local level: From data to action

Public health surveillance seeks answers to five questions: who, what, when, where, and why? For most health events, answers can be readily obtained from the patient’s medical record. Injuries are a different story. Medical records are generally adequate for telling us who was injured, what type of injury was sustained, and when the injury occurred. Unfortunately, the medical record is less useful for telling us where the injury took place, and most importantly, why.1 This is particularly true of injuries caused by firearms. There are several reasons why medical records alone are inadequate for local surveillance of firearm injuries. First, emergency physicians and trauma surgeons rarely bother to record information that is not immediately relevant to the care of their patients. The location and circumstances of an incident may be interesting to an epidemiologist or a police investigator, but they have little bearing on the decision to take a patient to the operating room. Second, many shooting victims are too injured, or too chemically impaired, to provide a reliable history at the time they are brought to the emergency department (ED). When confronted with a critically injured patient, ED personnel treat first, and worry about the history later. Finally, some victims provide inaccurate or misleading information to avoid arrest or retaliation. In one study, 25% of firearm assault victims claimed that their shooting was unprovoked.2 The difference between “victim” and “offender” is sometimes defined by who shot first, or had better aim. Without detailed information about the location and the circumstances surrounding each shooting, firearm injury surveillance provides little more than wound and body counts.3 This may suffice for national and statelevel surveillance, but it is inadequate for local problem-solving. Community officials (especially heads of public safety agencies) need more complete data to plan, implement, and evaluate counter-measures. To generate this level of detail, hospital records must be supplemented by other sources of data.2,4,5 Emergency Medical Services (EMS) records can provide useful information about patients who were transported by ambulance, but EMS records miss victims who reached the hospital by foot or private vehicle. Medical examiner records capture detailed information about victims who are found dead on the scene, but ME records are limited to fatalities. In urban areas, nonfatal shootings outnumber firearm suicides, homicides, and unintentional deaths by a ratio of four to one.2 Law enforcement records are the best source of information about what happened on the scene. Police respond to the vast majority of shootings, and they have a legal responsibility to determine what happened. They routinely interview witnesses and others who have information about the shooting, and they document their findings. As a result, police reports contain valuable information about incident location, the circumstances surrounding the shooting, victim-offender relationship, and the type of weapon involved.5 Unfortunately, it is not always easy to gain access to police files. Law enforcement agencies are notoriously reluctant to share information, especially to “outsiders.”6 In the absence of a legal obligation to share data, it may be difficult to convince them that the effort is worth the trouble. Once access is granted, logistical barriers may hamper acquisition and linkage of data. Many law enforcement agencies lack sufficient resources to computerize their records,7 and budget cuts have forced many police departments to reduce the size and scope of their crime analysis units. Manual retrieval of records is a tedious and uncertain process. Since most departments do not allow outsiders to search their files, this can greatly prolong the time required to answer requests for data. The high cost of photocopying, and the poor legibility of hand-written records pose additional problems. The task is much simpler when reports are stored in an electronic format. Officials at the California Department of Public Health obtained computerized copies of their state’s Federal Bureau of Investigation (FBI) Uniform Crime Reports (UCR) Supplemental Homicide Reports (SHR), and linked these records to state death certificates.8 Unfortunately, UCR data cannot be used to supplement documentation of nonfatal firearm injuries, because the UCR From the Center for Injury Control, Rollins School of Public Health of Emory University, Atlanta, Georgia 30322. Address Correspondence to: Arthur L. Kellermann, MD, MPH, Center for Injury Control, Rollins School of Public Health, 1518 Clifton Road, NE, Atlanta, Georgia 30322.

Use of restraints in ambulances: a state survey.

To determine the requirements in all states and the District of Columbia for use of restraints on patients in ambulances. A structured telephone survey was conducted with all state Emergency Medical Services (EMS) agencies or the agency responsible for the regulation of ambulances. Questions were asked regarding restraint of patients in ambulances. The age definition of a pediatric patient was also queried. Ambulances are regulated in 47% of states by EMS, 14% by law enforcement, 3% by a public safety agency, and in some states by other agencies such as the Department of Motor Vehicles. In 27% of the states no agency is responsible for ambulance regulations. Most states do not require patients of any age to be restrained in ambulances; however, the drivers and passengers are required to wear seat belts. Most of the states with laws regulating ambulance restraints for infants and children were in the northeast. There is great variance in the age that defines a pediatric patient for EMS. A means of safely restraining infants and children in ambulances is needed. Until new restraints are available, ambulances should restrain infants and children in car seats and on gurneys. A national age standard for defining a pediatric patient using EMS is needed.

The State and Collective Disorders: The Los Angeles Riot/Protest of April, 1992

This article develops a theory of State response to collective disorders on two levels. First, it examines how government agencies must seek both to be accountable and to maintain administrative capacity, but increasing accountability may reduce capacity. Second, it explores a riot situation, where a public safety agency must solve three problems related to capacity : strategy (force versus diplomacy), command (level, location, and unity), and preparation. Failure to solve these problems will render the State unable to limit the size and scope of collective disorders. In examining the response by the Los Angeles Police Department (LAPD) to the April, 1992 riots, the authors discover that many of the more serious problems encountered by the LAPD, such as chaos in a field command post, occurred before the riot expanded to a broad geographic scope

Are scene flights for penetrating trauma justified?

To evaluate the medical efficacy of helicopter scene flights for patients with noncranial penetrating injuries. A retrospective review of 122 consecutive victims of noncranial penetrating injuries evacuated by helicopter from the scene of injury to a level I trauma center. There were no medical criteria for accepting or rejecting a request for a scene flight by any public safety agency or emergency medical service (EMS). Flights were dispatched if the weather permitted and if a helicopter was available. The majority of patients were critically wounded. Their average Revised Trauma Score was 10.6, and 15.6% of the patients died (19 of 122), including all 11 patients who required prehospital cardiopulmonary resuscitation. Helicopter transport from the scene did not hasten trauma center arrival for any of the 122 patients. Ninety-two of the first-responder EMS units (75.4%) were advanced life support units (ALS) with crews of paramedics. The remaining 30 (24.6%) first-responder EMS units were basic life support units (BLS) with crews of emergency medical technicians (EMTs). Six of 122 patients (4.9%) required medical interventions by the medical flight crews beyond the capabilities of the ground EMS personnel. Only 3 of the 92 patients (3.3%) treated by first-responding paramedics received medical interventions by the medical flight crews beyond those authorized for paramedics (one cricothyroidotomy and two needle thoracenteses). Two of the 30 patients (6.7%) treated by first-responding EMTs received medical interventions by the medical flight crews not authorized for the EMTs. The on-scene paramedics performed endotracheal intubation on 10 patients. However, because of subsequent clinical deterioration, the medical flight crews performed endotracheal intubations on nine additional patients. In addition, two patients intubated by the first-responding paramedics required reintubation by the medical flight crews. Scene flights in this metropolitan area for patients who suffered noncranial penetrating injuries demonstrated that these flights were not medically efficacious. This conclusion rests on the findings that arrival at a trauma center was not hastened by scene flights and that only 4.9% of patients required prehospital care by the medical flight crew beyond the capabilities of the first-responding EMS personnel (2.5 and 6.7% for ALS and BLS responders, respectively). Based on this experience, we believe that in metropolitan areas, scene flights for victims of noncranial penetrating injuries should be restricted to critically injured patients likely to require prehospital care by the medical flight crew that is beyond the capabilities of the first responders or when the scene flight is likely to significantly hasten the arrival of the injured patient to an appropriate trauma center.

The Human Health Effects of Pepperspray - A Review of the Literature and Commentary

With widespread use of pepperspray by public safety and corrections agencies, injuries have occurred and questions have been raised about the safety and toxicity of oleoresin capsicum and the active ingredient, capsaicin. There are no published studies of the human health effects of pepperspray used for aerosol restraint. This article reviews current knowledge and experience concerning the health effects of pepperspray and capsaicin. Studies of the effects of capsaicin on human physiology, anecdotal experience with field use of pepperspray, and controlled exposure of correctional officers in training have shown adverse effects on the lungs, larynx, middle airway, protective reflexes, and skin. Behavioral and mental health effects also may occur if pepperspray is used abusively.