Worst-Case Scenario

first_imgThe nexus is a communications system that has seen important enhancements since Sept. 11. Staffers watching the disasters unfold in New York and Washington that day began to poll Maryland hospitals, via voice and fax channels, to see if they were ready for more mass casualties in the region. The volume of communications soon choked the system. If local departments are overwhelmed, the state agencies can call in more ambulances, rescue teams, police and fire fighters under an interstate aid agreement. “I believe emergency planning is a never-ending loop,” Bass said. “There’s always a bigger ‘what if.’ I think we do well. As their counterparts elsewhere cope with earthquakes and tornadoes, the Marylanders charged with planning for the unimaginable say the state’s emergency response infrastructure, communications networks, first-responders and hospitals are much improved since the events of Sept. 11, 2001. Although ER crowding and the resulting diversion of ambulances away from the nearest hospital remain a problem here, data released last summer suggested it’s no longer getting worse, at least in Baltimore. That is not the case nationally, said Emory University’s Kellermann. “We weren’t as prepared as we thought we were,” said Susan K. Dohony, vice president for performance improvement at Calvert Memorial Hospital in Prince Frederick. “What do you do when profoundly more people need health care than we can provide? … We’ve never had to face that,” said Dr. Robert R. Bass, executive director of the Maryland Institute for Emergency Medical Services, which manages statewide emergency medical services day-to-day. MIEMSS is also working with the state on a new, statewide communication system using 700 MHz frequencies that TV broadcasters will vacate next year when they switch to digital transmissions. The challenge would be far greater if the disaster struck during an outbreak of seasonal flu. “We might not have any ICU [intensive care] beds in Baltimore,” Bass said. Plain hospital beds might be scarce, too. Dallas told the committee that we “only have a fraction of the potential health care and security personnel that we’ll need. A lot of people … will be on their own in the first 24 hours. There won’t be anyone there to help them.” Franklin Square Hospital, in eastern Baltimore County, has focused on catastrophes that could arise from nearby interstate highways, the Amtrak rail corridor, Baltimore’s chemical plants or the Aberdeen Proving Ground. JEMS.com Editor’s Note: How does your system compare to the one in Maryland? Read this story and comment below. Outside experts largely agree. The list of calamities that could send hundreds of casualties to Maryland hospitals is limited only by the human imagination. “Maryland has long been regarded as probably the exemplar in the country for understanding, valuing and organizing emergency medical services … and, very significantly, the state has not backed off from that commitment,” said Dr. Arthur L. Kellerman, associate dean for health policy at the Emory University School of Medicine. Mass burn casualties from, say, a plane crash or a terrorist’s bomb are another worry, Bass said. Improved fire safety engineering has reduced the number of burn cases, but also the number of available burn unit beds. Since then MIEMMS has developed and deployed an all-digital, Web-based network called “Facility Resources Emergency Database,” or FRED. Today, controllers can poll every hospital in the state for readiness and occupancy in 90 minutes, compared to the 24 hours the task once required. “Decontamination equipment, and personal protective equipment for our staff is key,” said Christine Hughes, the hospital’s emergency preparedness coordinator. Coupled with a statewide network of microwave towers and computer-controlled “trunking” technologies, Bass said, the new channels will allow Maryland to link the incompatible radio systems used by law enforcement, fire departments, hospitals, public health services, public works and highway crews. Franklin Squareis considering additional negative pressure and decontamination capacity a new patient-care tower scheduled for completion in 2010, Hughes said. It also has portable equipment available to convert existing space to such purposes. MIEMSS can alert emergency rooms to incoming ambulances or helicopters, or warn hospitals and health departments of emerging threats, from flu to tainted heroin. “The amount of information, and the number of folks we can send out to, went up exponentially,” Bass said. “But … you can’t have a plan for everything. You try to identify the most likely scenarios, and plan for those.”[email protected] “By and large … hospitals are in an aggressive state of denial about access to emergency care, crowding and diversions,” he said. Meanwhile, local disaster planners and hospitals are bringing emergency operations into conformity with state and federal guidelines. If a high-rise building collapses in downtown Baltimore, city police and firefighters would establish a command structure at the scene, while MIEMSS would instruct hospitals to launch their emergency plans. Maryland pioneered the system in the late 1960s. The state has tested, improved and used it every day since then, Bass said. “You have to be able to function well day-to-day to be able to ramp up when something bad happens.”center_img Maryland’s safety net is a complex web of state, county and local agencies, hospitals, private companies and nonprofits. Bass’ agency — known as MIEMSS – plays a central role. Staff in its downtown Baltimore control center already gather information from incident scenes and waiting hospitals, then coordinate the dispatch and destinations of ambulances and MedEvac helicopters. The state Department of Health and Mental Hygiene would open its command center on West Preston Street. Its job might include ensuring sufficient cold storage for bodies and mental health support for firstresponders as well as vaccines, respirators, power and water for hospitals. “Candidly, that is one of our Achilles heels,” he said. At the same time, the Maryland Emergency Management Agency (MEMA) would activate its Emergency Operations Center in Reisterstown, providing a central location for state and local agencies, utilities and the Red Cross. MEMA could also manage the acquisition of cranes, bulldozers and other heavy equipment needed to deal with wreckage. The department also is continuing to enroll and train doctors, nurses, pharmacists, radiologists and other providers for the state’s Medical Resources Corps, which would deploy full-time, part-time, retired, or on-leave personnel as needed. The federal government has insisted that hospitals throughout the United States re-evaluate and address their vulnerabilities in the wake of Sept. 11. Infectious isolation rooms and burn-unit beds are not abundant here. And radiation decontamination facilities are slow. All could quickly be overwhelmed by a major disaster. BALTIMORE– A bomb explodes. An airliner crashes. Fire engulfs an office tower. “A lot of those patients might have to be distributed to other [more distant] burn centers,” he said. Hospitals without burn units might be asked to improvise space for burn care. The hospital has stockpiled radiation detectors and drugs and improved training. The first drill with the new decontamination room was held in December. “You empty the beds that you can” and prepare to expand treatment areas into hallways, cafeterias and even nearby schools if necessary, said Frank Monius, assistant vice president for administration at the Maryland Hospital Association.. Last fall, Calvert Memorial completed renovations to its emergency department, including a dedicated entrance where people injured in a nuclear accident at the Calvert Cliffs nuclear power plant can be decontaminated before treatment. Even so, he said, “we’ve got to continue to look at scenarios and at how to improve things, and we’ve got to do that every day.” But worrisome vulnerabilities remain, they concede. A radioactive “dirty bomb,” a bioterrorist attack or even an outbreak of pandemic flu would add huge numbers and complexity to the management of our worst nightmares. “We needed more information, more quickly, about what their status was, and they wanted more information about what was going on, and what was expected from them,” Bass recalled. Another is crowded emergency rooms that back up regularly under normal conditions because there are too few beds available to receive patients admitted through the ER. Cham E. Dallas, director of the Institute for Health Management and Mass Destruction Defense at the University of Georgia, told the committee that such a blast near the White House would kill 100,000 people, seriously injure and burn another 150,000, and put 100,000 in immediate need of decontamination. Of course, a truly cataclysmic event, such as the detonation of a small nuclear device as envisioned in recent testimony before the U.S. Senate Committee on Homeland Security, would likely overwhelm state and local plans and demand a federally-led response. Short of a calamity on that scale, Maryland’s disaster planners say their plans are flexible enough to deal with the most likely events the future may throw at them. Disaster planners acknowledge they still face vulnerabilities. For example, Bass worries about the limited capacity of negative-pressure isolation rooms, designed to prevent the escape of toxic or infectious agents. When disaster strikes, hospitals may have to convert space inside the hospital or in nearby schools or hotels to provide patient care. Some people may be have to be cared for at home. That does not minimize the state’s challenge, Bass said. “A mass-casualty, major incident is a scary deal. But in terms of our ability to handle it, I feel comfortable. We’re probably as prepared as any state, and I would argue better than a whole lot of others.” “In the span of a day, we could activate 500 ambulances,” Bass said. Volunteer medical teams mobilized under the National Disaster Medical System could be transported to Baltimore with their equipment within 48 to 72 hours.last_img read more

Merger of Hohenzollerische Landesbahn and SWEG approved

first_imgGERMANY: Plans to merge local transport operators Hohenzollerische Landesbahn and Südwestdeutsche Verkehrs with effect from January 1 2018 were approved on July 24 by the Sigmaringen and Zollernalbkreis district authorities which hold 14% stakes in HzL. Approval had already been granted by the Land of Baden-Württemberg which owns 100% of SWEG and 72% of HzL.The merger is intended to create a regional transport company with the strength and scale needed to bid for public transport operating contracts, said Land Transport Minister Winfried Hermann. SWEG has more than 80 rail vehicles, 350 buses and 800 employees, and carries 61 million passengers/year. HzL has 300 staff, 60 rail vehicles and 50 buses, and carries 14 million passengers/year. The two companies are to operate as a consortium until the merger is completed. SWEG will be overall group brand, with the SWEG and HzL names used locally. The legally required separation of rail infrastructure and operations will be retained, and the group’s bus and rail activities will be restructured as new subsidiaries. Maintenance may be restructured around centres of competence for different activities.last_img read more

Asia Talent Cup 2015: Sasaki wins in Zhuhai

first_imgAyumu Sasaki leads an all-Japanese podium in Asia Talent Cup 2015 Round 4 Race 1 in Zhuhai, China. –Ads– The fourth round of the Shell Advance Asia Talent Cup 2015 got underway earlier today for Race 1 in Zhuhai, China. Once again, drama unfolded towards the later stages culminating in one of the closest race finishes in the series once more.As the lights turned green, the 17-lap quickly turned into a tight five-way battle for supremacy between Japanese riders Ayumu Sasaki, Ai Ogura, Yuta Date and Takuma Kunimine with Malaysian pole-sitter Adam Norrodin in the mix as well. The melee also saw Japanese rookie Kazuki Masaki in the mix early on, but a mistake saw Masaki crash out after just three laps, leaving the other five to slug it out across the 4.3km-long Zhuhai International Circuit (ZIC).Despite having the advantage of pole position, Adam was working hard fending off the charges from the four front-running Japanese riders. Alas, Adam’s luck ran out on the penultimate lap after a mistake during corner braking saw the Batu Pahat youngster making contact with one of the four Japanese riders, forcing him into the gravel trap. Adam would recover only to cross the line all the way down in 11th.The climax of the close five-way battle then came at the exit of ZIC’s final turn towards the start-finish straight. This was when championship leader Sasaki and his well-devised race tactic allowed him the advantage to overtake second-placed countryman Ai Ogura down the straight and claim victory with just 0.032 seconds separating them. Claiming the final podium spot in third was Yuta Date who crossed the line just 0.870 seconds behind Sasaki.Sasaki’s victory today was indeed a solid redemption from his DNF in the last race in Sepang, with his defence for the 2015 title strengthened further too. Sasaki continues to lead the standing with 126 points in total. Kunimine retains his second place in the standings with a total of 91 points so far whilst Thai rider Nakarin ‘Chip’ Atiratphuvapat ranks third with 89 points in total.Team Malaysia was hit with a huge blow today. Besides Shafiq Rasol sitting out due to injury and Adam’s costly final lap error, rookie Azroy Anuar’s day ended early after crashing out on lap 3 while Helmi Azman was plagued with bike setup issues that hampered is pace.Despite starting strongly from fourth, Helmi would eventually settle for an 8th place finish, making him the best performing Malaysian today. Also the up-side, towering Pasir Gudang youngster Fakhrusy Rostam ended the day in 10th despite difficulties he faced due to his still healing leg injury. Wildcard rookies Ahmad Idham Khairuddin and Luth Harith Erwan, on the other hand, charted yet another successful race finish with Idham classifying 13th and Luth in 16th. The two would once again amass more mileage and race experience, further increasing their chances on becoming full-time series riders for next year.As far as the points standings go for Team Malaysia, things look difficult as Adam and Helmi, who are ranked 9th and 10th respectively, are in danger of losing their top 10 ranking. Fakhrusy is ranked in 11th and ties with Shafiq Rasol in 12th for points. You can see the full points standings in the results gallery below.Race 2 is slated to take place tomorrow at 12:30pm local time, with both Adam and Helmi determined to redeem themselves as they still hold strong starting positions in pole and fourth respectively. Stay tuned to our site as we bring you more updates after tomorrow’s race.last_img read more

Transfer gossip: Cherries linked with Caulker, speculation over Remy’s future

first_imgA round-up of the latest transfer speculation involving the area’s clubs…Bournemouth want to sign Steven Caulker from QPR, the Daily Mail say.West London Sport recently revealed that Sunderland had made an enquiry about the defender, who is currently on loan at Southampton. AdChoices广告The Mail reckon Bournemouth boss Eddie Howe is also keen to sign Caulker during this month’s transfer window.Caulker has failed to impress while at SouthamptonMeanwhile, Chelsea will compete with Tottenham for the signing of Zenit St Petersburg’s Belgium midfielder Axel Witsel, the Mail claim, while The Sun reports that Loic Remy is likely to stay put.Witsel, 26, was touted for a move to Stamford Bridge during the summer transfer window and is again being linked with the Blues.AC Milan are also said to be interested but Witsel is reportedly keen to move to England.MLS linkThere continues to be speculation over the futures of strikers Remy and Radamel Falcao, who have been unable to establish themselves as first-team players at the Bridge.Former QPR forward Remy has been told he is almost certainly staying, according to The Sun, while the Mirror say Falcao is wanted by MLS side Columbus Crew.Remy has struggled to establish himself in Chelsea’s first teamChelsea are competing with Manchester United for the signing of Southampton star Sadio Mane, again according to the Mirror.Mane, 23, is said to be keen to leave St Mary’s and has reportedly told Southampton he does not want to sign a new contract. His current deal expires in 2018.Bayern Munich have also been linked with the Senegal forward, who apparently expects to stay until the end of the season.‘Three-way battle’The Mirror also claim Chelsea are in a ‘three-way battle’ with Manchester City and Juventus for the signing of Real Madrid midfielder Isco.There is also more speculation over the future of Chelsea’s Eden Hazard. The Evening Standard declare that Real will step up their apparent interest following Zinedine Zidane’s appointment as the Spanish club’s head coach.And Lokomotiv Moscow striker Oumar Niasse has again been linked with a possible move to Chelsea, this time by the Guardian.A number of Premier League clubs are said to be interested in the 25-year-old, who has been tipped to move for £15m. Follow West London Sport on TwitterFind us on Facebooklast_img read more

Sweeps round up criminal

first_imgIn what federal authorities are calling the largest sweep of criminal immigrants, federal agents over the last two weeks have arrested more than 1,300 Southland immigrants in their homes, in jails and at work, officials announced Wednesday. As part of a stepped-up national crackdown on criminal and fugitive immigrants, five teams of Immigration and Custom Enforcement agents raided homes in Los Angeles, Orange, Riverside, San Bernardino and Ventura counties from Sept. 19 through Tuesday. Some arrests were easy, while others involved agents peering into clothes dryers or squeezing deep into crawl spaces to find hidden suspects. “Too often in the past, (deportation) orders were ignored and aliens thought that after getting an order of removal they could slip back into society,” said Julie Myers, assistant secretary for ICE. “Those days are no longer.” Some of the inmates were sexual predators or gang members, officials said. About 600 – most of them Mexican – have already been deported. Immigration officials said they have alerted Mexican officials of the deportations. The crackdown is part of a national effort dubbed the Fugitive Operation Program to decrease the 597,000 immigrants who have been ordered to leave the country but still remain. Officials say that since October, they have reduced the number of immigrants evading deportation by 35,000, marking the first-ever decline in the immigrant backlog. “This is a war against immigrants,” said Jorge-Mario Cabrera, spokesman for the National Alliance of Latin American and Caribbean Communities. “In this war, there is collateral damage. The U.S. seems to be blind to the suffering of family members and anyone else who happens to be in their way. Those that are not criminal are getting arrested.” Cabrera noted one call he received last week from a UCLA student whose father was deported as part of the raid. He said the family has since moved, and he suspects others are being driven further underground. Since the program began in 2003, 61,000 illegal immigrants have been arrested. Slightly less than a third had criminal records. Over the past year, immigration officials have added 23 teams of about 10 agents to the national program, including a new one created this summer in Orange County. “It’s the kind of deterrent methods that we need to be sending instead of the message of encouragement that we have been sending for two decades,” said Rick Oltman, a spokesman for Californians for Population Stabilization, a group advocating tighter borders and fewer immigrants – legal or illegal. “It lets the worst of the worst know that there is no sanctuary anymore. This is the kind of thing that local law enforcement should be anxious to participate in.” The U.S. Attorney’s Office is prosecuting about a dozen of those arrested in the two-week operation for re-entering the U.S. after being deported. Most of those suspects are facing three to five years in federal prison. [email protected] (818) 713-3636160Want local news?Sign up for the Localist and stay informed Something went wrong. Please try again.subscribeCongratulations! You’re all set! Immigrant-rights groups decried the raids for stirring fear in the community, noting that more than 100 of those arrested had no criminal or court record. But amid heated public debate and increased political pressure to enforce the country’s immigration laws, the agency has waged a high-profile campaign across the country to clamp down on illegal immigrants, last month arresting dozens at McDonald’s restaurants in an identity-theft operation. In the most recent effort, agents combed through law-enforcement and online databases and worked with local officials to identify hundreds of criminals in the country illegally and fugitives who have ignored deportation orders. Fanning out across the region in day-long raids, agents arrested 530 illegal immigrants – 269 of whom were identified as criminals and 115 of whom had been ordered deported. The rest were undocumented immigrants who had no criminal records. Officials said 797 inmates were taken from local jails, including 240 from those overseen by the Los Angeles County Sheriff’s Department. Ventura County turned over 125 inmates, and the state prison in Lancaster had 41. last_img read more