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February 2012
The Incident Command System is based on 14 proven management characteristics that contribute to the strength and efficiency of the overall system.

Over the next few issues of the Preparedness Post, we'll cover those management characteristics. 

#3 - Management by Objectives: Management by objectives is communicated throughout the entire ICS organization and includes:
  • Establishing overarching incident objectives.
  • Developing strategies based on overarching incident objectives.
  • Developing and issuing assignments, plans, procedures, and protocols.
  • Establishing specific, measurable tactics or tasks for various incident management functional activities, and directing efforts to accomplish them, in support of defined strategies. 
  • Documenting results to measure performance and facilitate corrective actions.


Visit  for more information or click on the program title to register. 

10th Anniversary of our Annual Preparedness Symposia Series!

(watch for registration info)

April 10-11, 2012 - Gering

May 8-9, 2012 - Norfolk

June 14-15, 2012 - Omaha

July 24-25, 2012 9 Kearney

Radiological/Nuclear Events -
February 9, 2012

Explosive Events -
March 4, 2012

Long-Term Care Tabletop Exercise via Webinar
March 7, 2012

Designing Disaster Exercises: Simplifying the Process - March 13-15 in Scottsbluff

Hospital Tabletop Exercise via Webinar
April 5, 2012 

Basic Disaster Life Support - April 26, 2012 Advanced Disaster Life Support - April 27-28 (note that Basic Disaster Life Support is a prerequisite for Advanced Disaster Life Support)

First Receiver Course - May 16-17 in Blair (watch for registration)

How Best to Protect: Evacuation and Shelter-In-Place

August 1-2 (watch for registration)

First Receiver Course - August 20-30 in North Platte (watch for registration)


Building crisis communication into overall disaster plans makes communicating during a crisis flow more smoothly. We've developed a Crisis Communication Plan workbook to help walk you through the process of developing a crisis communication plan. The workbook is based on materials from the CDC's Crisis and Emergency Risk Communication experts.

Anthrax: A Biologic Agent of Concern

It has been a decade since the anthrax attacks of 2001. In response to that crisis, which began only one week after the 9/11 attacks, America has made major strides in protecting itself from a similar calamity in the future. The Public Health Security and Bioterrorism Preparedness and Response Act of 2002 and the Pandemic and All-Hazards Preparedness Act of 2006 created new capabilities for emergency preparedness and response.

Bioterrorism has many definitions. The Centers for Disease Control and Prevention (CDC) defines bioterrorism as “the deliberate release of viruses, bacteria, or other germs (agents) used to cause illness or death in people, animals, or plants.”

Prior to the 2001 anthrax letter attacks, the most successful bioterrorist attack in the U.S. occurred in Oregon in 1984. Members of the Rajneesh Commune attempted to influence the outcome of an election by infecting the salad bars of ten restaurants with Salmonella bacteria. They believed that if the local population were inflicted with diarrhea, they would not be able to vote. More than 750 people were sickened by the attack. However, had the agent been volatized anthrax spores there could have been hundreds of fatalities.

The use of bacteriological agents in an armed conflict can be dated back to 1346 when the bodies of Tartar soldiers who had succumbed to the plague were thrown over the walls of the besieged city. It is hypothesized by some medical historians that the action resulted in the infamous pandemic that spread over the entire continent of Europe from Genoa via the Mediterranean ports. In our country during the French and Indian War (1754-1767) between France and England both sides relied heavily on the support of Indian allies. An English general provided the Indians loyal to the French with blankets infected with small pox virus. The resulting epidemic decimated the Indians. Needless to say, the tide of the war changed.

Enough of history – other than to say that history repeats itself. Let’s fast forward to the present. Remember, the first diagnosis of anthrax in the 2001 attack was in an emergency department. The salmonella outbreak in Oregon that was later found to be bioterrorism related was discovered after primary care physicians reported to their health department large numbers of patients with diarrhea who ate at two local restaurants. This type of passive surveillance is the early warning system for naturally occurring outbreaks and for bioterrorism events.

The first step in bioterrorism preparedness is personal preparedness. This includes ensuring that your home and family are protected by practicing good hygiene and being up to date with CDC recommended immunizations. The second step is for physicians and first responders to become competent in the clinical aspects of bioterrorism. This includes diagnosing and treating conditions that may be caused by a bioterrorism attack as well as being aware of post-exposure management.

The next step is preparing your facility. One needs to create a convenient and reliable system to report disease to local and state public health departments. Get to know the public health professionals in your area. The last step in bioterrorism preparedness is getting involved in community, state and national programs. (Hint: attend one of the annual Preparedness Symposia offered by the Center for Preparedness Education!).

Bioterrorism remains a threat to all Americans. We must be prepared!

About the Author:

Col. Edward A. Metz, Medical Corp, USA (Ret),  Former State Surgeon-SD National Guard, Physician, Niobrara Health & Life Center, Lusk WY.  During the 2010 Preparedness Symposia Series, Dr. Metz presented on the topic of anthrax.


Here are 5 top things to remember about using Hospital Incident Command Forms:
  1. Customize forms when appropriate, e.g. HIC 251-Facility System Status Report
  2. Introduce one form at a time to your team during training rather than trying to learn all of them at the same time.
  3. Identify a scribe for each of the Command and General staff members. The scribe can be an employee who would not otherwise have a role in the response, an executive assistant for example.
  4. Pre-populate forms with information specific to the most likely hazards that impact your organization as identified by your Hazard Vulnerability Analysis (HVA).
  5. Assemble all the forms needed by a particular position and make them into pads so that after incident a new set of forms are still available without the need to restock the forms.


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