National Planning Sorely Lacking

Q&A with Gary Ludwig, Chair, IAFC EMS Section; Deputy Chief, Memphis Fire Dept.

Coming out of 9/11, what did you see as the greatest needs for EMS in its preparedness for terrorism and major MCIs?

   One of the biggest was just the ability to prepare, train and actually respond. There was very little training that went into handling WMD or terrorist events. You had major agencies that couldn't talk to each other on the radio. And there were resource issues that still challenge us today--a lot of our metropolitan areas struggle to deal with surge capacity. We have to have resources in place to deal with surge.

How would you evaluate how we've dealt with those challenges?

   I'm going to be blunt and say I think we're still unprepared. We have done training, but it's never been an organized effort for what we're trying to accomplish. We've thrown a bunch of resources and money at systems without any real comprehensive national plan; in fact it's up to each community to decide how they're going to spend things like MMRS and UASI money, without regard to how it's going to interface with the regional or national picture. Some communities have used that money to buy stuff based on what their daily need is, as opposed to what fits into the bigger picture. I've even heard of exercise equipment being bought under the premise of terrorism prevention.

   And while we've made some strides, the states aren't close to where they should be in developing national mutual aid plans--strike teams of fire and EMS. If another Hurricane Katrina comes, how will we ramp up resources from other states in an expedient manner and get them to Louisiana? Whatever major event happens, it may stretch people's resources. Some states have done good jobs, but there are others behind the curve. There's not been enough guidance in that direction.

In this tough economy, how can we sustain what we've achieved?

   I don't think we're going to be able to prevent [cuts]. Congress continues to look at what they can cut, and as we continue along without another major attack, I think those monies are going to continue to dry up. Each year we see MMRS zero-funded, and then somehow the money gets put back in. But if we continue down our current path, that money's going to dry up, and we'll slide backward as the material stuff we have bought deteriorates.

Moving forward, what should be our top priorities?

   The biggest is developing a national system that spells out the wheres and hows of deploying patients. If, all of a sudden, we had an earthquake in Memphis with 100,000 casualties, how would we distribute them across our region and nation? Who would control it, and how would it be managed? Where do we fit those patients into the right resources? That's something I see as a real urgent need.

As 9/11 recedes into history, what are the big lessons younger providers should take from it and carry forward?

   One of the biggest issues for me is safety. I think they need to continually train--resource deployment training, incident command training, that sort of training, knowing how to use and protect their resources. We can't become complacent. We lost a significant number of people on 9/11, and we need to know what's happened in the past and learn from it.