This lesson discussed what it means to be prepared for mass casualty incidents.

Key topics included:

• Low chances, high impact
• Important lessons from past incidents
• Challenges for your environment
• Whole community preparedness

Low Chances, High Impact

Despite the attention given to isolated instances of extreme violence, the chances of such an attack occurring in any particular location are quite low. Nonetheless, the potential impact  on the entire community is tremendous, and it is vital that each school, campus, and house of worship be prepared.

Important Lessons From Past Incidents

Important lessons from past incidents can help you prepare.

• There is no single profile that can predict who will become an assailant. However, behaviors and communications may indicate someone might be planning or preparing for an attack.
• Potential assailants exhibited warning signs that caused concern or indicated a need for help.
• Attackers make plans in advance.
• Attackers talk about their plans.
• Attackers often have easy access to weapons.
• Because attacks are over quickly, people already at the scene are typically the first to respond.

Challenges

Challenges for schools, institutions of higher education, and houses of worship include:

• Vulnerability of places where people congregate.
• Difficulty predicting incidents.
• A need to balance the need for greater security with the desire for an open, welcoming environment.
• “It can’t happen here” mindset.
• Far-reaching impact when an incident does occur.

Whole Community Preparedness

This lesson described steps to take to begin developing an emergency plan or annex for mass casualty incidents.

Key topics included:

• Planning: Partnerships - Process - People - Pace - Plan
• Planning team
• Planning guidance

Planning Overview

Planning is a continuous process, not a one-time event. Planning for a safer, more secure environment involves:

• Partnerships: A partnership approach to planning fosters a whole community commitment to enhancing safety and security.
  
• Process: The process of creating the plan leads to the ability to function as a team during a crisis.
  
• People: Involving the right people is a key to successful planning. Include anyone who will be involved in implementing the plan, and don’t overlook expertise within your own organization.
  
• Pacing: Be realistic in pacing your planning activities and capability building. Allow adequate time for information gathering, assessment, consideration of alternatives, exchange of ideas, and thorough analysis.
  
• Plan: Develop a customized plan—one that’s right for your facility and your organization.

Planning Team

Your planning team should include members from within your organization as well as community partners.

Members from your organization may include administrators and leaders, staff and volunteers, and household/family members.

Community planning partners should include emergency management, response organizations, health and mental health, social services, and others who may play a role in response and recovery.

Planning Guidance

Guidance for planning is available in the following documents:

• CPG-101, Developing and Maintaining Emergency Operations Plans
• Emergency Management and Planning for Schools
• Emergency Management and Planning for Institutions of Higher Education
• Emergency Management and Planning for Houses of Worship

This lesson discussed protective measures you can take before an incident occurs to identify and mitigate vulnerabilities.

Key topics included:

• Conducting security assessments
• Fostering a secure and safe environment
• Addressing vulnerabilities

Conducting Security Assessments

Security assessments: Conducting a security assessment can help you identify vulnerabilities in your facility and operations. A security assessment includes:

• Reviewing past incidents, threat assessments, and existing policy and procedures.
• Considering how risk factors in your own organization and in the surrounding community impact your security.
• Walking through the facility to identify physical vulnerabilities.
• Interviewing key personnel to assess effectiveness of procedures.
• Identifying existing resources and capabilities that can be used to address a vulnerability.
• Reporting the findings, including positive observations, vulnerabilities, and recommended corrective actions.

Standard approach: A standard assessment approach should be used. When planning the physical assessment, it is helpful to think in terms of layers of security:

• Layer 1: The property perimeter
• Layer 2: The outside property from the property line to the building
• Layer 3: The building exterior and interior
  

Operations: Assessing operations involves looking at how access control and visitor management measures are being put into practice.

Fostering a Secure and Safe Environment

People: People are your greatest resource. They are what make your security and safety measures work.

Environment: Analysis of past incidents suggests that the environment can be made more secure by:

• Heightening security awareness—making people aware of, and partners in, your security policies and procedures.
• Identifying warning signs—being alert to behaviors or remarks that may cause concern.
• Establishing procedures for reporting and investigating threats—developing policies on threat reporting and training for adults in how to properly respond to such information.
• Identifying and assessing potential threat indicators.

Threat assessment: The Secret Service, FBI, and others recommend a threat assessment process conducted by an interdisciplinary team of trained professionals that consists of evaluating a threat, reaching a conclusion regarding threat level, and determining an effective response.

Addressing Vulnerabilities

After identifying potential vulnerabilities, it is important to develop practical strategies for enhancing protective measures. Potential security measures include:

• Access controls: Controlling the access of vehicles and people to the grounds and building.
• Visitor management: Having a strategy for controlling and monitoring who comes into the building.
• Screening: Screening those who enter the building to eliminate hidden risks.
• Communications: Ensuring staff, volunteers, and occupants can receive instructions in case of an emergency.
• Law enforcement partnerships: Working closely with law enforcement to keep the facility safe.

This lesson discussed the types of response procedures that should be established for a mass casualty incident.

Key topics included:

• Situation variables
• Notification and communication
• Response actions:
• Evacuation
• Reverse evacuation
• Preventive or emergency lockdown
• Seeking shelter
• Room clear
• Developing procedures

Situation Variables

A crisis plan provides the framework and overall procedures for responding to a crisis, but individual judgment will also be needed. The choice of appropriate response actions will depend on the situation and your local conditions. Key factors include:

• Type of event.
• Weapon used.
• Characteristics of the population.
• Characteristics of the site.

Notification and Communication

When an incident occurs, notification and communication are critical and often need to occur within seconds. Staff or volunteers need to be informed immediately about what response actions are to be taken, and law enforcement should be notified as soon as possible.

Response Actions

Response actions that may be appropriate in a potential mass casualty incident include:

• Evacuation: Leaving the building if doing so would be safer than remaining inside. Evacuations may be full or partial (e.g., a part of the building away from the action).
• Reverse evacuation: Moving people into the facility from an unprotected outside location.
• Preventive lockdown: A limited lockdown for use where there is no indication of imminent danger but a heightened level of security may prevent a situation from escalating.
• Emergency lockdown: Moving to portions of the building that can be secured, locking doors, and remaining out of sight. Various degrees of lockdown are possible.
• Seeking shelter: Hiding behind protective barriers, especially when caught in open spaces where evacuation and lockdown are not possible.
• Room clear: Moving people to a safer location within the facility in a prompt and organized manner.

If a crisis happens, those onsite may need to give emergency first aid to injured people. To make this possible, people at your site should be trained in emergency first aid, including stopping blood loss, CPR, and use of automated external defibrillators. Emergency first aid supplies need to be on hand.

Developing Procedures

Your plan should clearly spell out how response actions will be used to manage the situation until law enforcement arrives. The plan should also address what to do when law enforcement arrives and after the situation is under control.

Procedures need to be presented in a way that enables personnel to use them in a moment of crisis. This includes:

• Providing the right amount of information to comprehend quickly.
• Using clear, common language appropriate for diverse audiences.
• Presenting procedures in user-friendly formats.
• Posting procedures prominently throughout the site.

This lesson described planning considerations for managing the recovery process following a mass casualty incident.

Key topics included:

• Recovery procedures:
  • Reunification
  • Information management
  • Counseling and support services
  • Managing donations
• Crisis recovery teams
• Preparing for the return to routine

Recovery Procedures

Procedures should be developed for supporting key recovery functions, including the following:

Reunification: After a mass casualty incident it is important to quickly reunite survivors with their loved ones. Often, the best approach is to relocate survivors to a location away from the incident scene. Key planning considerations include:

• Site selection and security.
• Transportation logistics.
• Resources.
• Protocols for notification, information release, orderly check-in, check-out, record keeping, and release of minors to adults.

Information management: After a mass casualty incident, people need clear, timely, and factual information to avoid relying on rumors. Great distress can make it hard for people to process information, so it is important to word messages simply, repeat them often, and provide regular updates. Be sure to:

• Keep staff and volunteers informed.
• Be proactive in fighting rumors with facts.
• Manage media involvement by channeling information through a public information officer.

Counseling and support services: In the wake of a traumatic incident, a significant part of the recovery effort will be devoted to providing counseling and support services to help with the process of emotional recovery. Establish recovery plans that employ the principles of psychological first aid, including:

• Engaging staff in initially assessing emotional needs.
• Identifying individuals who need mental health referrals.
• Providing limited interventions, such as group discussion, for those not in need of urgent mental health services.
• Identifying available services for families, loved ones, and community members who may want to seek assistance for their children or themselves.
• Providing support for staff and volunteers.
• Planning healing events and memorials:

Managing donations: After a mass casualty incident, donations may pour in from near and far. Have a plan in place to manage donations

Crisis Recovery Teams

Crisis recovery teams manage the impact of serious incidents. A crisis recovery team can help in the healing process by:

• Reducing fear
• Facilitating grieving
• Supporting loved ones
• Promoting the primary mission
• Planning for post incident response actions
• Establishing a casualty and fatality process
  

Crisis recovery teams should include members of your organization who are trained to handle emotional response issues. Qualified mental health professionals in the community that can assist during recovery should be identified. It is advisable to establish agreements with them in advance of an incident.

Preparing for the Return to Routine

Establishing a routine and striving to achieve a “new normal” can help those impacted by an incident to recover. While things will never be quite the same, they will come to realize a new equilibrium can be achieved. During this phase:

• Work toward restoring the academic or worship environment.
• Continue mental health support.
• Regularly communicate with families and loved ones.
• Meet as needed with key stakeholders to identify questions, quell rumors, and provide accurate and timely information.
• Maintain structure and stability.

This lesson described ways to stay prepared, including compiling and communicating the plan, conducting training and exercises, and keeping the plan updated.

Key topics included:

• Compiling and communicating the plan
• Conducting training and exercises
• Keeping the plan updated

Compiling and Communicating the Plan

The first step in communicating the plan is to develop a written plan document that can be shared among the various stakeholders. Your plan should have the following characteristics:

Communicating the plan also involves:

• Getting buy-in for the plan—gaining acceptance and commitment from key stakeholders, including:
  • Those in your organization who will have a role in implementing the plan.
  • Community partners, including law enforcement and first responders.
  • Leadership in your organization with approval authority.
• Getting approval—presenting the plan to the appropriate individuals for review, approval, and dissemination.
  
• Sharing the plan with the community—letting all stakeholders know that a complete plan exists and enabling them to become familiar with any part of it that involves their participation. There are many simple ways to communicate plan elements, from pamphlets to Web sites.

Conducting Training and Exercises

• Training should be provided to:
  • Develop awareness of the plan.
  • Underscore the importance of preparedness.
  • Prepare personnel to carry out the planned procedures effectively.
• Exercises should be designed to provide practice implementing the procedures laid out in the plan. Plan to conduct regular response drills for any response actions that are included in your plan. Drills and other exercises should be conducted at least annually, and whenever procedures are developed or revised. To gain the benefit of each exercise, the team should conduct an after-action review to analyze lessons learned and identify steps for improvement.

Keeping the Plan Updated

Effective plans are never finished. They can always be updated based on experience, research, and changing vulnerabilities. Community stakeholders and experts should be included in the updating process. At a minimum, plans and procedures should be updated:

• At least annually.
• Following drills or other exercises.
• After an incident.

You can use the links below to access the resources presented in this course.

Select this link to print an Abode PDF file containing the course job aids.

Select this link to access the outside resources identified in previous lessons.

Select this link to access a list of references for the entire course.

To learn more about increasing your preparedness, you may also wish to complete the following courses:

• IS-36: Multihazard Planning for Childcare
• IS-100: Introduction to Incident Command System
• IS-909: Community Preparedness: Implementing Simple Activities for Everyone
• IS-362.A: Multi-Hazard Emergency Planning for Schools

You have now completed Preparing for Mass Casualty Incidents. As you work to increase your organization’s preparedness for such incidents, remember to collaborate with your community partners. A whole community commitment to enhancing safety and security will produce the most effective results.

The final screen provides instructions for completing the course knowledge exam.