11 Chapter 11 Critical Incident Stress Debriefing, Responder Safety and Health, Volunteer management,
Critical Incident Stress
11.05 Discussion Forum 1: CISD and You-Link to Canvas Site
For this discussion, you will look at the hearing risks that concerts pose. You will then compose a response to several prompts and share it with your group on a discussion forum.
Pre-Discussion Work
To begin this assignment, review the following resources:
- This discussion board is based upon the video and discussion on Critical Incident Stress Debriefing
Drafting Your Response
Next, prepare your forum post by creating a Google document. On your document, answer the following questions:
- What was one thing that stood out to you from the video by John Mitchell
- Thinking about yourself, was there a time that such a debrief might have be of value to you?
- Thinking about where you work or worked previously, where there situations where such a debrief would have been helpful and when what that time?
Be sure to support your responses by referencing materials from this module. Also, once you have answered the questions, be sure to proofread what you wrote before you share it.
Discussing Your Work
To discuss your findings, follow the steps below:
Step 01. After you have finished writing and proofreading your responses, click on the discussion board link below.
Step 02. In the Discussion Forum, create a new thread and title it using the following format: Yourname’s and the topic of the discussion board.
Step 03. In the Reply field of your post, copy and paste the text of your composition from the Document you created.
Step 04. Add bolding, underlining, or italics where necessary. Also, correct any spacing and other formatting issues. Make sure your post looks professional.
Step 05. If you need to upload a document or image you can do so by clicking on the Upload image (photo image button) or Upload document (Document button) in the text editor and locating and selecting your document from your computer.
Step 06. When you have completed proofreading, fixing your post formatting, and attaching your file, click on the Post Reply button.
CRITICAL INCIDENT STRESS INFORMATION SHEETS ©
You have experienced a traumatic event or a critical incident (any event that causes unusually strong emotional reactions that have the potential to interfere with the ability to function normally). Even though the event may be over, you may now be experiencing or may experience later, some strong emotional or physical reactions. It is very common, in fact quite normal, for people to experience emotional aftershocks when they have passed through a horrific event.
Sometimes the emotional aftershocks (or stress reactions) appear immediately after the traumatic even. Or they may appear a few hours or a few days later. And, in some cases, weeks or months may pass before the stress reactions appear.
The signs of symptoms of a stress reaction may last a few days, a few weeks, a few months, or longer, depending on the severity of the traumatic event. The understanding and the support of loved ones usually cause the stress reactions to pass more quickly. Occasionally, the traumatic event is so painful that professional assistance may be necessary. This does not imply mental instability or weakness. It simply indicates that the particular event was just too powerful for the person to manage by himself.
Here are some common signs and signals of a stress reaction:
| Physical* | Cognitive | Emotional | Behavioral |
| chills | confusion | fear | withdrawal |
| thirst | nightmares | guilt | antisocial acts |
| fatigue | uncertainty | grief | inability to rest |
| nausea | hypervigilance | panic | intensified pacing |
| fainting | suspiciousness | denial | erratic movements |
| twitches | intrusive images | anxiety | change in social activity |
| vomiting | blaming someone | agitation | change in speech patterns |
| dizziness | poor problem solving | irritability | change in appetite |
|
weakness |
poor abstract thinking |
depression |
hyperalert to environment |
|
chest pain |
poor attention/decisions |
intense anger |
increased alcohol consumption |
|
headaches |
poor concentration/ memory |
apprehension |
change in usual communications |
|
elevated BP |
disorientation of time, place or person |
emotional outbursts |
|
| rapid heart rate |
difficulty identifying objects or people |
loss of emotional control |
|
|
muscle tremors |
heightened or lowered alertness |
inappropriate emotional response | |
| grinding of teeth | increased or decreased awareness of surroundings |
emotional shock
|
|
| visual difficulties | |||
| profuse
sweating |
|||
| difficulty breathing |
THINGS TO TRY· WITHIN THE FIRST 24 – 48 HOURS: periods of appropriate physical exercise, alternated with relaxation will alleviate some of the physical reactions.
- · Structure your time; keep busy
- · You’re normal and having normal reactions; don’t label yourself crazy.
- · Talk to people; talk is the most healing medicine
- · Be aware of numbing the pain with overuse of drugs or alcohol. You don’t need to complicate this with a substance abuse problem.
- · Reach out; people do care.
- · Maintain as normal a schedule as possible
- · Spend time with others
- · Help your co-workers as much as possible by sharing feelings and checking out how they are doing.
- · Give yourself permission to feel rotten and share your feelings with others.
- · Keep a journal; write your way through those sleepless hours.
- · Do things that feel good to you.
- · Realize those around you are under stress
- · Don’t make any big life changes.
- · Do make as many daily decisions as possible that will give you a feeling of control over your life; i.e., if someone asks you what you want to eat, answer them even if you’re not sure.
- · Get plenty of rest.
- · Don’t try to fight reoccurring thoughts, dreams, or flashbacks – they are normal and will decrease over time and become less painful.
- · Eat well-balanced and regular meals (even if you don’t feel like it).
FOR FAMILY MEMBERS AND FRIENDS·
- Listen carefully
- · Spend time with traumatized person
- · Offer your assistance and a listening ear if they have not asked for help
- Reassure them that they are safe
- Help them with everyday tasks like cleaning, cooking, caring for the family, minding children
- Give them some private time
- Don’t take their anger or other feelings personally
- Don’t tell them that they are ‘lucky it wasn’t worse;’ a traumatized person is not consoled by such statements. Instead, tell them that you are sorry such an event has occurred, and you want to understand and assist them.
© ICISF 2022 Permission granted [1]
Crisis Intervention Definition ©
Countertransference: The personal reactions that the crisis interventionist experiences and projects based on their own personal values and experiences.
Crisis: An acute emotional reaction to a powerful stimulus or demand. The characteristics of a crisis are: 1) the usual balance between thinking and emotions is disturbed. 2) The usual coping mechanisms fail. 3) There is evidence of distress, impairment or dysfunction in the individual or group involved in a crisis.
Critical Incidents: An unusually challenging event that has the potential to create significant human distress and interfere with one’s usual coping mechanisms.
Critical Incident Stress: A state of cognitive, physical, emotional, behavioral and spiritual arousal that accompanies the crisis reaction.
Critical Incident Stress Debriefing (CISD): A seven step group crisis intervention tool designed to assist a homogenous group after an exposure to a significant traumatic event. The Critical Incident Stress Debriefing is not a stand-alone process and it should be provided within an integrated package of interventions within the critical incident stress management program. Group crisis intervention is not psychotherapy or a substitute for psychotherapy.
Critical Incident Stress Management (CISM): A comprehensive, integrated, systematic, and multi- tactic crisis intervention approach to managing critical incident stress after traumatic events. CISM is a coordinated program of tactics that provide individual and group support, stress education and coping techniques.
Crisis Intervention: Temporary but active and supportive entry into the life of individuals or groups during a period of extreme distress.
Crisis Management Briefing (CMB): A structured large or small group meeting designed to provide information about an event. The CMB provides an opportunity to identify and control rumors and educate about symptoms of distress and stress management techniques. Available resources are offered for continued support.
Defusing: A small group process provided shortly after a traumatic event and/or before a group leaves the workplace. A Defusing offers an opportunity to begin exploration of the individual reactions to an event and is an opportunity to provide immediate information on healthy coping.
Rest, Information, and Transition Services (RITS): Formerly Demobilization. A quick informational and rest session conducted when operational units have been released from service after a major or prolonged incident. Also serves a secondary function as a screening opportunity to assure that individuals who may need further assistance are identified.
© ICISF 2022 Permission granted[2]
After A Critical Incident ©
Below are some basic stress management principles that have been shown to help ease or moderate some of the reactions to a critical incident.
- Eat nutritious foods: fresh fruits, vegetables, and a balanced diet.
- Get plenty of physical exercise to reduce some of the physical/psychological effects of stress.
- Moderate your intake of caffeine.
- Avoid alcohol or other depressants.
- Keep rested; remain on a schedule for sleep and other relaxing activities.
- Avoid changes in your daily routine.
- Find a friend or a support source to talk to about the incident.
- Do not make any significant life altering decisions for at least 30 days.
- Try to find time, perhaps just an hour to do something that you enjoy.
- If the symptoms of stress do not lessen, seek additional assistance.
Common Immediate Stress Reactions
Many of those family members exposed to a critical incident may develop noticeable symptoms within 24 hours. Most of these will disappear within three weeks’ time. If symptoms worsen, or if they do not begin to dissipate after two weeks, additional intervention is recommended.
- Tension: physical and emotional tension, muscle tremors or twitches, unable to sit still for any length of time.
- Fatigue: decreased energy, ability to sleep, or a desire to sleep continuously.
- Sleep Disturbances: insomnia, bad dreams, nightmares, or waking up too early.
- Diet: change in eating or drinking habits. Increased or decreased intake.
- Nausea: queasiness, nausea, vomiting other gastrointestinal problems.
- Recurring Memories: thinking about the incident or some associated recurring memory.
- Negative Feelings: unpleasant feelings that may come without warning: profound sadness, helplessness, fear, anxiety, anger, rage, discouragement, frustration, sense of vulnerability, depression.
- Self-Blame: vague feeling of self-blame, fixed on some aspect of the event.
Interpersonal Problems: increased irritability, insensitivity, blaming others for your problems, wanting distance instead of closeness.
© ICISF 2022 Permission granted[3]
Peritraumatic Predictors and Warning Signs of Posttraumatic Distress©
- Neuromuscular immobility, “freezing”
- Severe dysfunctional time distortion
- Psychogenic analgesia
- Traumatic psychogenic amnesia
- Dissociation, depersonalization, derealization
- Sympathetic nervous system dysfunction, e.g. panic attacks, malignant arrhythmias
- Dysfunctional parasympathetic nervous system arousal
- Guilt reactions (survivor guilt, responsibility guilt)
- Giving up, e.g. helplessness, hopelessness
- Self-destructive ideation, e.g. suicidal and/or homicidal ideation.
© ICISF 2022 Permission granted[4]
Staff Support in the Healthcare Setting Guidelines for Peer Support in High-Risk Organizations: An Internal Consensus Study Using the Delphi Method©
Mark C. Creamer, Tracey Varker, Jonathan Bisson, Kathy Darte, Neil Greenberg, Winnie Lau, Gill Moreton, O’Donnell, Don Richardson, KJoe Ruzek, Patricia Watson, David Forbes
ISTSS: April 012, 25, 134-141
Key Recommendations of the Peer Support Guidelines
1. The Goals of Peer Support:
a. Provide an empathetic listening ear
b. Provide low level psychological intervention
c. Identify colleagues who may be at risk to themselves or others
d. Facilitate pathways to professional help
2. Selection of Peer Supporters
a. Be a member of the target population
b. Be someone with considerable experience within the field of work of the target population
c. Be respected by his/her peers
d. Undergo an application and selection process that should include interview by a suitably constituted panel
3. Training and Accreditation
a. Trained in basic skills to fulfill their role (listening skills, psychological first aid, information about referral options)
b. Meet specific standards in that training before commencing their role
c. Participate in on-going training, supervision, review, and accreditation
4. Mental Health Professionals
a. Occupy the position of clinical director
b. Be involved in supervision and training
5. Role: Peer Supporters should
a. Not limit their activities to high-risk incidents but be part of routine employee health and welfare
b. Not generally see ‘clients’ on an ongoing basis: should seek specialist advice and offer referral pathways for more complex cases
c. Maintain confidentiality (except when seeking advice from a mental health professional and/or cases of risk of harm to self or others)
6. Access to peer supporters
- Normally be offered as the initial point of contact after exposure to high-risk incident unless the employee requests otherwise
- In other situations, employees should be able to self-select their peer supporter from a pool of accredited
7. Looking after peer supporters
- Should not be available on call 24 hours per day
- Be easily able to access care for themselves from a mental health practitioner
- Be easily able to access expert advice from a clinician
- Engage in regular peer support supervision within the program
8. Program evaluation
- Programs should establish clear goals linked to specific outcomes
- Evaluated by an external, independent evaluator on a regular basis to include quantitative and quantitative feedback from users
© ICISF 2022 Permission granted[5]
What is Critical Incident Stress Debriefing?
Critical Incident Stress Debriefing (CISD) is a facilitator-led group process conducted soon after a traumatic event with individuals considered to be under stress from trauma exposure. When structured, the process usually (but not always) consists of seven steps: Introduction; Fact Phase; Thought Phase; Reaction Phase; Symptom Phase; Teaching Phase; and Re-entry Phase. During the group process, participants are encouraged to describe their experience of the incident and its aftermath, followed by a presentation on common stress reactions and stress management. This early intervention process supports recovery by providing group support and linking employees to further counseling and treatment services if they become necessary.[6]
Tips for Managing and Preventing Stress
A Guide for Emergency Response and Public Safety Workers
Stress prevention and management should be addressed in two critical contexts: the organization and the individual. Adopting a preventive perspective allows both workers and organizations to anticipate stressors and shape responses, rather than simply reacting to a crisis when it occurs. Suggestions for organizational and individual stress prevention and management approaches are presented below.
Organizational Approaches for Stress Prevention and Management 1. Provide effective management structure and leadership. Elements include:
• Clear chain of command and reporting relationships.
• Available and accessible supervisors.
• Disaster orientation for all workers.
• Shifts of no longer than 12 hours, followed by 12 hours off.
• Briefings at the beginning of shifts as workers enter the operation. Shifts should overlap so that outgoing workers brief incoming workers.
• Necessary supplies (e.g., paper, forms, pens, educational materials).
• Communication tools (e.g., mobile phones, radios).
2. Define a clear purpose and goals.
3. Define clear intervention goals and strategies appropriate to the assignment setting.
4. Define roles by function.
5. Orient and train staff with written role descriptions for each assignment setting. When a setting is under the jurisdiction of another agency, inform workers of each agency’s role, contact people, and expectations.
6. Nurture team support.
7. Create a buddy system to support and monitor stress reactions. Promote a positive atmosphere of support and tolerance with frequent praise.
8. Develop a plan for stress management. For example:
• Assess workers’ functioning regularly.
• Rotate workers among low-, mid-, and high-stress tasks.
• Encourage breaks and time away from assignment.
• Educate about signs and symptoms of worker stress and coping strategies.
• Provide individual and group defusing and debriefing.
• Develop an exit plan for workers leaving the operation, including a debriefing, reentry information, opportunity to critique, and formal recognition for service
Individual Approaches for Stress Prevention and Management1. Manage workload.
• Set priority levels for tasks with a realistic work plan.
• Delegate existing workloads so workers are not attempting disaster response in addition to their usual jobs.
2. Balance lifestyle.
• Get physical exercise, and stretch muscles when possible.
• Eat nutritiously, and avoid excessive junk food, caffeine, alcohol, or tobacco.
• Get adequate sleep and rest, especially on longer assignments.
• Maintain contact and connection with primary social supports.
3. Apply stress reduction techniques.
• Reduce physical tension by activities such as taking deep breaths, meditating, and walking mindfully.
• Use time off for exercise, reading, listening to music, taking a bath, talking to family, or getting a special meal.
• Talk about emotions and reactions with coworkers during appropriate times.
4. Practice self-awareness.
• Learn to recognize and heed early warning signs for stress reactions.
• Accept that you may need help to assess problematic stress reactions.
• Avoid overly identifying with survivors’ and victims’ grief and trauma, which may interfere with discussing painful material.
• Understand differences between professional helping relationships and friendships.
• Examine personal prejudices and cultural stereotypes.
• Be mindful that vicarious traumatization or compassion fatigue may develop.
• Recognize when a personal disaster experience or loss interferes with effectiveness.
Normal Reactions to a Traumatic Event
• No one who responds to a mass casualty event is untouched by it.
• Profound sadness, grief, and anger are normal reactions to an abnormal event.
• You may not want to leave the scene until the work is finished.
• You likely will try to override stress and fatigue with dedication and commitment.
• You may deny the need for rest and recovery time.
Signs That You May Need Stress Management Assistance
- Disorientation or confusion, and difficulty communicating thoughts.
- Difficulty remembering instructions. Difficulty maintaining balance.
- Becoming easily frustrated and being uncharacteristically argumentative.
- Inability to engage in problem solving and difficulty making decisions.
- Unnecessary risk taking.
- Tremors, headaches, and nausea.
- Tunnel vision and muffled hearing.
- Colds or flu-like symptoms.
- Limited attention span and difficulty concentrating.
- Loss of objectivity.
- Inability to relax when off duty.
- Refusal to follow orders or to leave the scene.
- Increased use of drugs or alcohol.
- Unusual clumsiness.
Ways to Help Manage Your Stress
- Limit on-duty work hours to no more than 12 hours per day.
- Rotate work from high-stress to lower stress functions.
- Rotate work from the scene to routine assignments, as practicable.
- Use counseling assistance programs available through your agency.
- Drink plenty of water, and eat healthy snacks such as fresh fruit, whole grain breads, and other energy foods.
- Take frequent, brief breaks from the scene, as practicable.
- Talk about your emotions to process what you have seen and done.
- Stay in touch with your family and friends.
- Participate in memorials and rituals, and use of symbols as a way to express feelings.
- Pair up with another responder so that you may monitor one another’s stress.[7]
Capability 14 Responder Safety and Health
Definition: Responder safety and health is the ability to protect public health and other emergency responders during pre-deployment, deployment, and post-deployment.
Functions: This capability consists of the ability to perform the functions listed below.
- Function 1: Identify responder safety and health risks
- Function 2: Identify and support risk-specific responder safety and health training
- Function 3: Monitor responder safety and health during and after incident response
For the purposes of Capability 14, partners and stakeholders may include the following:
- agriculture agencies
- emergency management agencies
- emergency responders12
- environmental health agencies
- environmental protection agencies
- health care agencies
- immunization programs
- incident safety officers
- mental/behavioral health providers
- occupational health subject matter experts
- occupational safety and health agencies
- public health agencies
- responder representatives
- social services
- state radiation control programs
- state epidemiology and communicable disease programs
- veterinary public health programs
- volunteer organizations
- wildlife agencies
Function 1: Identify responder safety and health risks
Function Definition: Identify and prioritize responder safety and health risks, and determine the protection and control measures, medical services, including the provision of medical countermeasures, and mental/behavioral health support services necessary to protect and support responders.
This capability is normally assigned to the Safety Officer in the ICS structure
Task 1: Identify and prioritize safety and health risks . In conjunction with partner agencies, identify and prioritize the potential medical, environmental, and mental/behavioral health
risks responders may encounter during an incident with public health consequences based on jurisdictional risk assessment findings.
Task 2: Identify, prioritize, and recommend protection and control measures, medical services, and mental/behavioral health support services for responders . Use a hierarchical approach in coordination with partners and stakeholders to identify, prioritize, and recommend protection and control measures, medical countermeasures, such as vaccinations, mental/behavioral health support services, and other resources to protect and support incident responders.
Task 3: Develop or refine incident safety plan . Use identified safety and health recommendations to develop or refine incident safety plan.
Task 4: Support responder eligibility confirmation . Provide recommendations and guidance to support pre-incident screening and verification of responder credentials, training, and health status, such as vaccinations, physical fitness, and mental health, to ensure suitability for deployment role.
Preparedness Resource Elements
P1: (Priority) Safety and health risk scenarios for public health responders, identified in consultation with partners and coordinating agencies. Scenario characteristics to consider before, during, and after an incident or event may include
• Exposure limits or injury risks necessitating a response
• Job-specific worker safety guides to address risks and hazards from radiation, heat, fire, infectious disease vectors and exposures, infrastructure damage resulting in hazardous material release, and other sources
• Potential for medical and mental/behavioral health assessments during and after the event
• Health care facilities
• PPE or other protective actions, behaviors, or activities required to execute potential response assignments
P2: (Priority) Defined public health agency roles and responsibilities for responder safety and health, such as conducting public health assessments, potable water inspections, field interviews, and points of dispensing staffing, related to identified jurisdictional risks established in conjunction with partner agencies.
P3: (Priority) Incident safety plans, such as site safety and control plan and medical plan (ICS 206 and 208) that include clear and concise statements for safety message(s), priorities, and key command emphasis, decisions, and directions. Plans should include mutual aid agreements (or similar agreements) to access and provide backup equipment for incident response, including intra- and inter-jurisdictional sources of additional equipment and personal protective resources.
(See Capability 3: Emergency Operations Coordination and Capability 9: Medical Materiel Management and Distribution)
P4: (Priority) Procedures in place to determine responder eligibility for deployment based on medical readiness, physical and mental/behavioral health screenings, background checks, and verification of credentials and certifications. Conduct additional screening according to the nature of the work and identified individual risk factors. Factors to consider in screenings and background checks may include
• Medical health, such as pre-existing conditions, immunization status, and medications
• Physical fitness
• Mental/behavioral health
• Criminal records, such as sexual offender registry
(See Capability 15: Volunteer Management)
P5: (Priority) PPE recommendations for responders, including public health responders, developed in conjunction with partner agencies and risk-specific subject matter experts, such as physicists within radiation control programs.
Skills and Training Resource Elements
S/T1: Public health personnel who fill the role of Incident Safety Officer trained to perform core functions, such as coordination, communications, resource dispatch, and information collection, analysis, and dissemination. Recommended trainings may include
• National Incident Management System (NIMS) ICS-300 and ICS-400 courses
• NIMS ICS All-Hazards Position Specific Safety Officer (E/L 954)
• FEMA Safety Orientation (IS-35.18)
S/T2: Personnel trained to use various types of PPE and decontamination procedures when responding to chemical, biological, and radiological incidents.
S/T3: Personnel trained on jurisdictional systems for population monitoring to identify risks and recommendations for PPE. Training is recommended for various responder types, including
environmental health personnel, preparedness personnel, epidemiologists, and other disciplines, such as HazMat Teams who will participate in planning and identifying responder risks.
Equipment and Technology Resource Elements
E/T1: Responder registration system that is scalable, secure, and compliant with NIMS.
E/T2: Information technology and cybersecurity safeguards and practices to prevent unauthorized access to personally identifiable information of responders or unauthorized use of social media.
(See Capability 6: Information Sharing)
E/T3: PPE consistent with the identified risks and associated job functions of public health response personnel. Equipment may include
• Coveralls
• Gloves
• Boots or shoes that are chemical-resistant with steel toe and shank
• Outer, chemical-resistant (disposable) clothing• Safety glasses or chemical splash goggles
• Hard hat
• Face shield
• Goggles
• National Institute of Occupational Safety and Health (NIOSH)-approved or FDA-approved filtering facepiece respirators
• FDA-approved surgical masks
• Gowns
Function 2: Identify and support risk-specific responder safety and health training
Function Definition: Support responder safety and health training that accounts for physical safety, mental/behavioral health, use of hierarchical controls, such as administrative controls, engineering controls, and PPE, and other responder safety and health topics based on identified risks and recommendations.
Tasks
Task 1: Determine responder safety and health training needs . Conduct a training needs assessment to determine the types and frequency of training(s) required to support responder safety and health, such as physical safety, mental/behavioral health, pre-deployment requirements, such as immunization needs, and hierarchical protection and control measures.
Task 2: Support safety and health training initiatives . Support provision of just-in-time, initial, and ongoing emergency response safety and health training in partnership with jurisdictional emergency management, other agencies, and partnering organizations.
Preparedness Resource Elements
P1: (Priority) Procedures in place to ensure the completion, verification, and documentation of responder safety and health training prior to and during an incident to ensure jurisdictional public health personnel and supporting surge capacity personnel are prepared to respond to emergencies and understand the jurisdictional Incident Command System.
Skills and Training Resource Elements
S/T1: (Priority) Responder safety and health training topics may include
• Safety awareness
• Self-care or buddy care
• Communications
• Incident Command System
• Site operations
• Hazard communication
• Decontamination
• Respiratory protection
• PPE• Hazardous waste operations
• Medical record management
• Responder tracking and use of registries
• Immunization needs
• Relevant information systems, such as immunization information systems and registries
S/T2: (Priority) Personnel qualified to conduct trainings for public health responders.
S/T3: (Priority) Personnel trained, as appropriate for their roles, in level A, B, or C OSHA PPE standards awareness and technical response trainings.
S/T4: (Priority) Personnel trained on safely donning and doffing various types of PPE and safe handling and disposal of infectious or contaminated waste (depending on role).
S/T5: (Priority) Personnel who are required to use N95 or other respirators as part of their job duties, including response roles, enrolled in a respiratory protection program that is established and maintained by their employer. This program would include medical clearance and fit testing for respirator wear.
Equipment and Technology Resource Elements
E/T1: PPE consistent with the identified jurisdictional risks and job functions for public health response personnel.
E/T2: Respirator fit testing kit with a certified fit for public health responders.
E/T3: Immunization information systems (IISs) that include demographic records for all responders prior to an event. Equipment and software to assess immunization status and document immunizations administered before, during, and after incident response.
Function 3: Monitor responder safety and health during and after incident response
Function Definition: Coordinate with the Incident Safety Officer or others to conduct and participate in monitoring or surveillance activities to identify potential adverse health effects on public health responders, communicate identified hazards and control measures, and provide medical support services, as necessary.
Tasks
Task 1: Conduct responder safety and health monitoring and surveillance . Ensure the appropriate level of safety monitoring and health surveillance for responders based on identified risks, jurisdictional responder roles, and subject matter expert recommendations.
Task 2: Document additional incident-specific safety and health risks . Identify potential responder safety and health risks based on responder monitoring and surveillance findings.
Task 3: Update incident safety plan . Update and revise the incident safety plan, as needed, based on responder monitoring and surveillance findings.
Task 4: Conduct responder in-processing . Ensure appropriate badging and rostering during on-site incident responder in-processing.Task 5: Conduct exposure assessment activities . Execute or provide guidance on exposure assessment activities to identify evidence and documentation of hazardous exposures.
Task 6: Provide mental/behavioral and medical support services . Coordinate with health care partners to facilitate access to and promote the availability of mental/behavioral and medical support for responders, as necessary.
Task 7: Track responder demobilization and out-processing . Conduct post-deployment responder out-processing and track responder physical and mental/behavioral health status upon demobilization.
Preparedness Resource Elements
P1: (Priority) Documentation of incident-specific responder safety and health risks, threats, and necessary precautions identified by the jurisdictional public health agency in collaboration with partner agencies.
P2: (Priority) Public health responder on-site rostering and badging to facilitate visual identification of responders and ensure access to appropriate resources and facilities based on responder roles. Rostering and badging procedures should address
• Computer or other technological resource access
• Collection of demographic information
• Collection of personal information, including emergency contact information
• Collection of pre-incident health assessment information
• Incident and organization badging
• Job assignment
• PPE dispensing
• Physical location access
• Site-specific training
• Verification of valid, current professional licenses and trade certifications
• Visual identification
P3: Procedures in place to support volunteer needs during the response. Volunteer needs may include
• Housing
• Safe food and potable water
• Medical countermeasures, including vaccinations
• First aid and emergency medical care
• Mental/behavioral health services
(See Capability 1: Community Preparedness and Capability 2: Community Recovery)
P4: (Priority) Procedures in place for monitoring, exposure assessment, and sampling activities to assess levels of environmental exposure and effects on individual responders and procedures in place for surveillance activities to assess actions, practices, and trends that contribute to incident-related physical and behavioral illnesses and injuries.
(See Capability 13: Public Health Surveillance and Epidemiological Investigation)
P5: (Priority) Incident safety plans, such as site safety and control plan and medical plan (ICS 206 and 208) updated to reflect monitoring, exposure assessment, sampling, and surveillance findings.(See Capability 3: Emergency Operations Coordination and Capability 9: Medical Materiel Management and Distribution)
P6: (Priority) Communication strategy for disseminating detailed results of responder safety and health monitoring and surveillance to responders, the public, and the media. CDC recommends that communications be cleared, as appropriate, and address
• Known pre-incident risks
• Risks encountered during the response to the incident
• Considerations to manage identified risks and update incident safety plan
• Morbidity and mortality related to the incident
(See Capability 4: Emergency Public Information and Warning)
P7: (Priority) Procedures in place to ensure responders are properly demobilized after a response. Demobilization procedures may include
• Formal check-out or out-processing activities to document responders’ health status including physical and mental/behavioral health before they leave the worksite
• Documentation of contact information for each responder
• Procedures developed or modified for the incident to identify responders with incident-related delayed or long-term adverse health effects. Indicators for delayed or long-term adverse health effects may include
· Hazardous work exposures
· Hazardous work activities
· Injuries and illness incurred during deployment
· Concerns, such as political and public, expressed by others
• Collection of after-action information during out-processing to identify lessons learned and support corrective action planning
(See Capability 3: Emergency Operations Coordination)
P8: Procedures in place to provide long-term support for responders and conduct periodic assessments of responder safety and health measures. Procedures may include
• Exposure assessments
• Environmental sampling
• Long-term mental health considerations
• Medical examination results
• Medical monitoring and surveillance
• Out-processing interview and data collection
• Pre-deployment baseline assessments and review of activity logs
(See Capability 2: Community Recovery and Capability 3: Emergency Operations Coordination)
Equipment and Technology Resource Elements
E/T1: Registry or database created in coordination with emergency management entities to document responders exposed to hazards or injured during an incident.
E/T2: Equipment and software to collect, analyze, and report responder safety and health data during and after incident response.
(See Capability 6: Information Sharing)
Capability 15 Volunteer Management
10.07 Assignment:-FEMA Course IS244.b – FEMA Estimate 4 hours- Link to Canvas Site
For the assignment this week you will complete the Interactive Web Based FEMA Course: Developing and Managing Volunteers IS-244.b from the U.S. Department of Homeland Security.
The course was developed by the Emergency Management Institute for FEMA’s Independent Study (IS) Program. The overall course goal is to promote effective response by familiarizing you with how National Incident Management System (NIMS) are used to manage incidents and prepare you to coordinate with response partners from all levels of government and the private sector.
Course Date
3/29/2013
Course Overview
The goal of this course is to strengthen abilities to prepare for and manage volunteers before, during, and after a severe emergency or major disaster. This course will:
- Provide strategies for identifying, recruiting, assigning, training, supervising, and motivating volunteers.
- Include discussion of spontaneous volunteers as well as those affiliated with community-based, faith-based, and nongovernmental organizations (NGOs).
Course Objectives:
At the completion of this course, participants should be able to:
- Identify situations in which volunteers can be a useful addition to response and recovery operations.
- Define skill and knowledge requirements for volunteers.
- Develop a volunteer program that includes strategies for recruiting and managing volunteers within the whole community.
- Develop a plan for setting up a Volunteer Reception Center.
- Identify special issues involving the use of volunteers.
Primary Audience
This course is for emergency managers and related professionals working with all types of volunteers and coordinating with voluntary agencies.
Prerequisites
None
CEUs:
0.4
Course Length:
4 hours
Important Note
Completing this FEMA training is a requirement for this course, and is critical knowledge that will allow you to complete the upcoming group assignments and Final Exam.
Registering for the Training
At the end of the FEMA training, you will be required to take an exam. In order to take the exam, you will need a student ID number issued by FEMA. This is NOT your Boise State student ID number. Therefore, prior to beginning the course, please register for a FEMA student ID number by going to the Student Identification System website and registering.
Completing the Course
After registering for your FEMA Student ID number, click on the IS 244.b Developing and Managing Volunteers link to go to the course.
To navigate the course, use the arrows at the bottom of the page. Throughout the course you will be given short knowledge check questions. You should try to pass them because similar questions will appear on the exam at the end of the course.
At the completion of the course, there is a test. To complete the text, follow the steps below:
Step 01. Click on the test link
Step 02. Enter your FEMA Student ID and your last name, then click on the Enter button.
Step 03. On the next page, enter your home address, select the Other option in the Business Information section, then click on the Continue to Exam button.
Step 04. Take the Final exam.
Note: You must receive 75% correct to pass. If you do not pass, you can retake the exam.
Step 05. Once you pass the exam, you will receive a certificate in a PDF format in your email. Save the PDF to your computer using the following naming convention: IS700_Certificate_YourLastName_YourFirstNameInitial.
Submitting Your IS 244.b Certificate
Submit your certificate by clicking on the assignment link below. Then, click on the Browse My Computer button and locate and select your IS 700.b Certificate on your computer. Next, click on the Open button. Once you document is attached to the assignment, click on the Submit button.
Definition: Volunteer management is the ability to coordinate with emergency management and partner agencies to identify, recruit, register, verify, train, and engage volunteers to support the jurisdictional public health agency’s preparedness, response, and recovery activities during pre-deployment, deployment, and post deployment.
This capability is normally under the Liaison portion of the ICS structure
Functions: This capability consists of the ability to perform the functions listed below.
• Function 1: Recruit, coordinate, and train volunteers
• Function 2: Notify, organize, assemble, and deploy volunteers
• Function 3: Conduct or support volunteer safety and health monitoring and surveillance
• Function 4: Demobilize volunteers
Summary of Changes: The updates align content with new national standards, updated science, and current public health priorities and strategies. Listed below are specific changes made to this capability.
• Addresses the need to monitor volunteer safety, risks, and actions during and after an incident
• Strengthens and clarifies volunteer eligibility considerations, such as medical, physical, and emotional health, during the volunteer selection process
• Promotes use of Emergency Responder Health Monitoring and Surveillance™ (ERHMS™)
For the purposes of Capability 15, partners and stakeholders may include the following:
• academic institutions
• emergency management agencies
• faith-based organizations
• government agencies
• health care coalitions
• health care organizations
• professional associations
• volunteer programs and organizations13
14 For example, the Emergency System for Advance Registration of Volunteer Health Professionals (ESAR-VHP), the Medical Reserve Corps (MRC), the National Voluntary Organizations Active in Disaster (NVOAD), the American Red Cross, Radiation Response Volunteer Corps (RRVC), community emergency response teams (CERTs), and other jurisdictional nongovernmental or community service organizations.
Function 1: Recruit, coordinate, and train volunteers
Function Definition: Identify, recruit, register, verify, and train volunteers to support the jurisdictional public health agency incident response.
Tasks
Task 1: Identify needs for volunteers and other supporting resources . Identify the types and numbers of volunteers and other supporting resources needed to address potential public health responses based on jurisdictional risk assessments.
Task 2: Recruit volunteers . Support the pre-incident recruitment of volunteers needed in a potential jurisdictional public health response by coordinating with existing volunteer programs and partner organizations.
Task 3: Verify volunteer credentials . Ensure pre-incident screening and verification of volunteer credentials through jurisdictional ESAR-VHP, MRC, or other volunteer programs.
Task 4: Support volunteer emergency response training . Support provision of just-in-time, initial, and ongoing emergency response training, including access and functional needs training,
for registered volunteers in partnership with jurisdictional MRC unit(s) and other partner groups.
Preparedness Resource Elements
P1: (Priority) Volunteers and other resources identified as necessary to respond to public health incidents or events based on jurisdictional risks. Considerations for volunteers may include
• Functional roles, assignments, and corresponding competencies
• Description of necessary skills, knowledge, such as language proficiency and expertise on access and functional needs, or credentials for each volunteer task or role
• Timeline for mobilizing and assembling volunteers
• Plan and triggers for when to activate volunteers including deployments
• Jurisdictional authorities that govern issues of volunteer liability and scope of practice
(See Capability 1: Community Preparedness and Capability 14: Responder Safety and Health)
P2: (Priority) Written agreements, such as contracts or memoranda of understanding (MOUs), established with jurisdictional or regional volunteer sources, as needed, to address potential public health responses. Recommended partnership agreements may include
• Partner organizations’ promotion of public health volunteer opportunities
• Registration requirements for ESAR-VHP, MRC, or other pre-identified partner groups, such as the American Red Cross or CERTs
• Liability protection for volunteers
• Recognition of qualifications and certifications
• Efforts to continually engage volunteers through routine community health promotion activities
• Identification and administration of appropriate trainings for volunteers
• Documentation of the volunteer affiliations, such as employers and volunteer organizations at federal, state, local, tribal, and territorial levels to assist in minimizing “double counting” of prospective volunteers
P3: Verification of professional volunteer diplomas, licenses, certifications, credentials, and registrations in accordance with federal and state laws using the state’s ESAR-VHP or other programs, as appropriate.P4: Deployment eligibility for pre-identified volunteer responders based on medical, physical, and mental/behavioral health screenings and background checks. Eligibility criteria may include
• Medical health, such as immunization status, medications, and pre-existing conditions
• Physical fitness
• Mental/behavioral health
• Criminal records, such as sexual offender registry
(See Capability 14: Responder Safety and Health)
Skills and Training Resource Elements
S/T1: Documentation of completed training(s), as required by the jurisdiction, to prepare volunteers for their assigned responsibilities. Recommended trainings may include those addressing
• Cardiopulmonary resuscitation (CPR)
• Basic first aid skills
• Medical countermeasure dispensing roles
• Incident Command System training
• Basic triage skills, psychological first aid, and self-care
• Basic and advanced disaster life support (American Medical Association’s [AMA] National Disaster Life Support Program)
• Cultural competency
• Access and functional needs during a disaster response
• HazMat awareness
• MRC TRAIN (as applicable to the jurisdiction)
• Privacy and confidentiality of information collected during emergency response
• Other skills and courses identified by the jurisdiction for specific roles
S/T2: Personnel trained in volunteer management. Recommended training may include FEMA IS244.B: Developing and Managing Volunteers.
S/T3: Prospective volunteers trained in jurisdictional incident management or National Incident Management System (NIMS) trainings, which may include
• Introduction to Incident Command System (IS-100)
• NIMS- An Introduction (IS-700.a)
• Incident Command System for Single Resources and Initial Action Incidents (IS-200.b)
• Incident Command System (IS-300) and Advanced ICS Command and General Staff (IS-400) for volunteer leaders that will hold key leadership positions
• MRC Volunteer Orientation
Equipment and Technology Resource Elements
E/T1: Access to a system or registry for volunteer managers to track the number of registered volunteers by profession and skill level, the number of hours of volunteer services performed, and previous volunteer activities in incident responses. The system or registry should be capable of reporting data to the Volunteer Reception Center (VRC).
Function 2: Notify, organize, assemble, and deploy volunteers
Function Definition: Notify, organize, assemble, and deploy volunteers participating in the jurisdictional public health agency response efforts based on identified assignments and incident characteristics.
Tasks
Task 1: Identify incident-specific volunteer needs . Identify the number of volunteers, skills, and resources needed to support an incident based on existing volunteer registration lists.
Task 2: Identify volunteers . Contact volunteer organizations to support the identification of volunteers based on incident-specific needs.
Task 3: Notify registered volunteers of incident-specific assignment details . Notify pre-incident registered volunteers who are able and willing to respond and share assignment details using multiple modes of communication.
Task 4: Request additional volunteers as needed . Notify partner organizations of any additional volunteer needs and request additional volunteers.
Task 5: Manage or support spontaneous volunteers . Manage spontaneous volunteers by incorporating them into the incident response or triaging them to other potential volunteer agencies, as applicable.
Preparedness Resource Elements
P1: Procedures in place to coordinate with partners, inter- and intrajurisdictional agencies, and other relevant organizations, contact registered volunteers, identify volunteers willing and able to respond, identify supporting resources needed for volunteers, and share incident-specific assignment details. Recommended procedures may include
• Processes to describe how the jurisdictional public health agency requests volunteers
• Processes to determine the best use of available volunteers based on mission and capabilities
• Processes for the jurisdictional public health agency to request federal resources, such as personal protective equipment (PPE), response-specific vaccinations, and response teams, that include a clear statement of need, list of requested asset(s), and role of the requested asset(s), if applicable
• Plans for communications between state and local health departments about volunteer needs and assignments during an incident
• Plans to provide volunteer pre-deployment briefings that describe incident conditions and assignment details. Briefing topics should include
· Incident or event details
· Volunteer roles and responsibilities
· Health safety risks
· PPE
· Local weather
· Liability protection
· Living and work conditions· Nature of the work site
· Personal security risks
· Required immunizations or prophylaxis
· Required identification for rostering and badging volunteers
• Procedures to assign volunteers to other response agencies
(See Capability 3: Emergency Operations Coordination, Capability 4: Emergency Public Information and Warning, Capability 6: Information Sharing, and Capability 14: Responder Safety and Health)
P2: Procedures in place to identify public health agency personnel and their roles and responsibilities in volunteer management.
P3: Procedures in place to coordinate with agencies and organizations involved in the identification of volunteers.
P4: (Priority) Procedures in place to support additional and spontaneous volunteers, meaning volunteers not pre-identified. Recommended procedures may include
• Informing volunteers how to report to appropriate incident management leads, such as volunteer coordinators or off-site incident command
• Ensuring all volunteers follow standardized, in-processing requirements
• Identifying duties spontaneous volunteers can perform
• Verifying credentials of spontaneous volunteers
• Managing spontaneous volunteers who are not assigned to the appropriate job functions or tasks based on their skills and the needs of the response
• Registering spontaneous volunteers for future emergency responses
• Referring spontaneous volunteers who are not aligned with an identified partner organization to other organizations, such as nonprofits or MRC
(See Capability 4: Emergency Public Information and Warning and Capability 14: Responder Safety and Health)
P5: Procedures in place to support volunteer needs during the response. Volunteer needs may include
• Housing
• Safe food and potable water
• Medical countermeasures or vaccination
• First aid and emergency medical care
• Mental/behavioral health services
(See Capability 1: Community Preparedness and Capability 2: Community Recovery)
Equipment and Technology Resource Elements
E/T1: Communication equipment for public health agency personnel to contact volunteer organizations. Communication equipment may include
• Phones
• Computers
• HAM or hand radios
(See Capability 6: Information Sharing and Capability 10: Medical Surge)
E/T2: Volunteer registries and rosters that are maintained with the appropriate IT security measures to safeguard PII.(See Capability 6: Information Sharing)
E/T3: (Priority)PPE consistent with incident risks and associated job functions of volunteers.
Function 3: Conduct or support volunteer safety and health monitoring and surveillance
Function Definition: Conduct or support monitoring and surveillance activities to identify potential volunteer safety and health needs.
Tasks
Task 1: Communicate incident-specific safety and health risks to volunteers . Identify potential volunteer safety and health risks based on incident characteristics and communicate identified risks and recommended precautions to volunteers.
Task 2: Conduct volunteer safety and health monitoring and surveillance . Ensure volunteer safety and health monitoring and surveillance are conducted according to volunteer role risk profile(s).
Preparedness Resource Elements
P1: (Priority) Documentation of incident-specific volunteer safety and health risks, threats, and precautions identified by the jurisdictional public health agency and lead partners, such as occupational health and safety, environmental health, and radiation control programs.
P2: (Priority) Procedures in place to conduct standardized assessments of the identified safety and health risks and threats as well as the effectiveness of precautions and mitigation measures used, such as training effectiveness and PPE compliance.
(See Capability 14: Responder Safety and Health)
P3: (Priority) Surveillance activities to assess trends in actions and practices that contribute to incident- related physical illness or injury and mental/behavioral trauma.
(See Capability 13: Public Health Surveillance and Epidemiological Investigation)
P4: Procedures in place to communicate the results of volunteer safety and health monitoring and surveillance to responders, the public, and the media (as applicable). Communicated risks should include both known pre-incident risks and risks encountered during the incident response.
Equipment and Technology Resource Elements
E/T1: Surveillance and monitoring systems or databases to track volunteer health and safety.
(See Capability 13: Public Health Surveillance and Epidemiological Investigation and Capability 14: Responder Safety and Health)
Function 4: Demobilize volunteers
Function Definition: Support the release of volunteers based on evolving incident needs or incident action plans and coordinate with partner agencies and organizations to support the provision of any medical and mental/behavioral health support for volunteers.
Tasks
Task 1: Manage volunteer demobilization and out-processing . Conduct post-deployment volunteer out-processing and track volunteer physical and behavioral health status during demobilization.
Task 2: Provide post-incident support to volunteers . Determine need for long-term medical and mental/behavioral health support for volunteers based on information collected from volunteers during the response and at demobilization.
Task 3: Conduct after-action reviews and develop after-action reports and improvement plans . Conduct after-action reviews and develop after-action reports (AARs) and improvement plans (IPs) that identify corrective actions specific to volunteer management to improve future operations.
Preparedness Resource Elements
P1: (Priority) Procedures in place to ensure proper demobilization of volunteers after a response, which may include
• Procedures to collect contact information from each volunteer responder
• Formal check-out or out-processing activities to document volunteer health status including physical and mental/behavioral, as applicable, before volunteers leave the worksite
• Procedures to identify volunteer responders with incident-related delayed or long-term adverse health effects. Identification criteria may include
· Hazardous material exposures
· Hazardous work activities
· Adequacy of control measures
· Injuries and illness incurred during deployment
· Other risks identified by jurisdictional stakeholders
• After-action processes to identify corrective actions and lessons learned
(See Capability 2: Community Recovery, Capability 3: Emergency Operations Coordination, and Capability 14: Responder Safety and Health)
P2: Procedures in place to provide long-term support for volunteers and conduct periodic assessments of volunteer responder safety and health measures. Procedures may include
• Exposure assessments
• Environmental sampling
• Long-term mental health considerations
• Medical examination results
• Medical monitoring and surveillance
- Out-processing interview and data collection
- Pre-deployment baseline assessments and review of activity logs
(See Capability 3: Emergency Operations Coordination and Capability 14: Responder Safety and Health)
Equipment and Technology Resource Elements
E/T1: Registry or database created in coordination with emergency management entities and used to document volunteer responders exposed to hazards or injured during an incident or response.
E/T2: Equipment and software to collect, analyze, and report volunteer responder safety and health data during and after an incident or response.
(See Capability 6: Information Sharing)
- https://icisf.org/wp-content/uploads/2020/06/CRITICAL-INCIDENT-STRESS-INFORMATION-SHEETS_Page_1.jpg ↵
- https://icisf.org/wp-content/uploads/2020/04/Crisis-Intervention-Definition.jpg ↵
- https://icisf.org/wp-content/uploads/2020/04/After-A-Critical-Incident.jpg ↵
- https://icisf.org/wp-content/uploads/2020/04/Peritraumatic-Predictors-and-Warning-Signs-of-Posttraumatic-Distress.jpg ↵
- https://icisf.org/wp-content/uploads/2020/04/Guidelines-for-Peer-Support-in-High-Risk-Organizations-.jpg ↵
- https://www.osha.gov/emergency-preparedness/guides/critical-incident-stress ↵
- https://store.samhsa.gov/sites/default/files/d7/priv/sma11-disaster-18.pdf ↵
