The Good & Bad of the I-35 Collapse Response

     A federal report on last year's collapse of Minneapolis' Interstate-35 Mississippi River bridge finds lots to like about the way the region's public safety forces responded, but also chronicles some missteps that could have led to trouble.

     The report, I-35W Bridge Collapse and Response, is part of the U.S. Fire Administration's regular examination of fires and other disasters in an effort to distill and disseminate lessons that can benefit other responders in the future. It offers a comprehensive review of the region's overall preparedness; the responses of fire, EMS and law enforcement; recovery operations; emergency management; and hazmat and environmental monitoring. It is available from www.usfa.dhs.gov.

     "The uniqueness of this bridge collapse, and the challenges faced by firefighters and their command staffs, offers an opportunity for firefighters across this nation to learn from the Minnesota response to this event," U.S. Fire Administrator Greg Cade said of the report.

     The collapse, on August 1, 2007, killed 13 and injured 121. Hennepin County Medical Center EMS led the EMS reponse.

Best Practices
     What went right? Lots of things, authors conclude.

• Cooperation among first responders and their metro, state and federal partners was judged to be outstanding. Local players had done ample joint training, including in NIMS, and were familiar with their colleagues, roles and procedures.
• Local EMS plans worked well, including the Metro EMS Incident Response Plan and use of mutual aid.
• Initial EMS response was rapid and of sufficient quantity. Multiple divisions were established, including operations on both sides of the river. EMS Dispatch also ramped up successfully.
• EMS successfully utilized the Incident Command System.
• A new 800 MHz radio system, implemented after a 2002 evaluation found the previous communications system lacking, worked as hoped and generally kept organizations linked.
• Technology—including on-site video cameras, Web-based GIS and traffic management, and municipal Wi-Fi—enhanced response and recovery efforts.

Lessons Learned
     There were, however, problems that arose. They fortunately did not lead to injuries to responders or diminished outcomes for patients. On the EMS front, the report cited:

• Some providers did not follow an early order to evacuate the bridge when fire engineers were concerned about further collapse. "Communities should ensure that all first-responder personnel are cognizant of warning and evacuation signals," the report concludes, "and understand the importance of adhering to such orders."
• The EMS Branch Director lacked staff support to enact full multicasualty operations.
• Multiple transportation groups were established, complicating the challenge of tracking transport units, patients and destinations.
• Many EMS personnel used cell phones—a method normally preferred by emergency physicians due to its convenience—to contact hospitals directly, rather than going through the Medical Resource Control Center, which officially coordinates transports and destinations. This led to a confused big-picture view of how many patients, and what type, were going where.
• Triage ribbons and tags were not universally used.
• No EMS official was at the Emergency Operations Center.

     Most of the concerns raised in the report, authors note, have been recognized and addressed by local authorities.

Physio-Control Clarifies Terms of Consent Decree
     Physio-Control has not been prohibited from making and shipping products under the terms of a federal consent decree, the company emphasized in a May statement from President Brian Webster.

     Seeking to dispel reports that it had been permanently enjoined from continuing business, Physio stressed that it was "clearly permitted to manufacture and ship a limited amount of product for emergency providers under certain conditions according to the consent decree."

     The consent decree followed a complaint by the FDA, and established terms to settle it. A permanent injunction was imposed until Physio met certain requirements, which it has; subsequent provisions additionally provided exceptions by which manufacture and shipping could continue.

     Physio stopped U.S. defibrillator shipments in January 2007 following a 2006 FDA inspection that found problems with its quality systems. A subsequent inspection earlier this year found progress toward resolving the issues, but other problems remain. The consent decree was established in April.

     "We are pleased to reach this stage of the process with the FDA, as it prescribes a formal process for the remaining actions that need to be taken for us to resume unrestricted shipping," Webster said. "The best people in our company are working full-time on the additional improvements to our quality system as their top priority."

     —Physio-Control

FAA URGES SAFETY UPGRADES AFTER WISC. CRASH
     Madison (WI) Fire Department medical director Darren Bean, MD, was among those killed when a University of Wisconsin Med Flight helicopter crashed in May. Other victims were RN Mark Coyne and pilot Steve Lipperer. Following the crash, the FAA called for safety improvements in med-evac services, urging the use of night-vision goggles, terrain-awareness and warning systems, and radar altimeters. It also advised upgrades to flight crew training. These steps are not yet mandatory, but the agency continues to monitor air ambulance safety issues. —AVWeb

FCC SEEKS PUBLIC comment on new rules for D Block spectrum auction
     The FCC turned to the public in May for suggestions on how to handle the reauction and licensing of the 700 MHz D Block spectrum in a way that best realizes the benefits of a nationwide interoperable broadband network for both public safety and commercial users.

     An auction of the spectrum under previous rules failed earlier this year. Those rules created a 10 MHz license in the D Block, open for bid, to pair with an adjacent 10 MHz dedicated to a public safety broadband license. But because the block didn't meet its $1.3 billion auction reserve price, it will now be reauctioned under new rules.

     The FCC's Second Further Notice of Proposed Rulemaking asked for comments, ideas and recommendations for revising those rules. It also invited input on issues like public safety priority on a shared network and licensing nationally versus regionally. For more, see www.fcc.gov.

NEWS IN BRIEF
     The National EMS Memorial Service has selected Colorado Springs, CO, as its new host city and the permanent location for its Tree of Life memorial … A new program in Baltimore is aimed at diverting 9-1-1 overusers to alternative healthcare and social services resources for their nonemergency needs … A task force of top physicians and government representatives has issued guidelines for who will and won't get medical care in a disaster that outstrips available resources. The very elderly, serious trauma victims, the severely burned and those with advanced dementia are among the groups not to be treated … The National EMS Advisory Council held its first meeting in April, producing a list of priority issues for potential action … Missouri state EMS medical director Bill Jermyn, MD, died of a myocardial infarction in May … The National Academies Press has released Antivirals for Pandemic Influenza: Guidance on Developing a Distribution and Dispensing Program … An ACEP report offers hospitals low-cost solutions to the diversion-causing problem of ED patient boarding … Ongoing feedback is sought on the current draft National EMS Education Standards; see www.nemsed.org/draft_standards/index.cfm …New National Fire Academy self-study courses, including one on ICS in expanding incidents, are available at www.nfaonline.dhs.gov … Establishing 3-1-1 call centers can lead to significant decreases in 9-1-1 call volumes, the International City/County Management Association determined in a survey … Hospital trauma centers in seven major U.S. cities lack capacity to handle patient surge from even a modest terrorist attack, a House committee found … More than 500 EMTs and paramedics in metro Portland, OR, ratified their first-ever contract as Teamsters.