Archive for category Disaster Response

Announcing the new ACEP High Threat Emergency Casualty Care Task Force

The American College of Emergency Physicians (ACEP) is proud to announce the launching of the new, High Threat Emergency Casualty Care Task Force (HTECCTF). The task force will be under the leadership of Co-Chairs Gina Piazza, DO, FACEP and David Callaway, MD, FACEP with Debra Perina, MD, FACEP, ACEP Board Liaison

Since 2000, there have been over 200 active shooter incidents, resulting in over 1216 victims with over 548 deaths. This tally does not include gang violence, bombings, non- gun related mass assaults or other gun- related violence. In 2011, the multi-disciplinary Committee for Tactical Emergency Casualty Care, was formed to address this emerging threat. In 2014, the first Hartford Consensus document was published that further articulated a critical gap in prehospital preparedness. Later that year, ACEP participated in a multi-specialty working group funded by the Department of Homeland Security and coordinated by the National Association of State EMS Officials (NASEMSO). This working group produced a white paper that identified the lack of high threat prehospital response guidelines as one of the top five critical gaps in domestic EMS preparedness.

In the fall of 2015, The White House issued a call to action to address the challenges of reducing morbidity and mortality from active shooter incidents and terrorist attacks and to expedite the translation of combat lessons learned to the civilian setting.

ACEP is in a position to serve as an effective coordinating body across professional organizations that represent EMS, trauma care, and emergency medical services.

The purpose of this two-year initiative is to create a comprehensive strategy to address trauma care from point of injury through definitive care in high threat emergencies. The Task Force will be involved in building and coordinating external partnerships regarding high threat emergency casualty care.

The goals of the task force include:

  •   Leverage member expertise and leadership to create policies and procedures that reduce morbidity and mortality in high threat emergencies.
  •   Strengthen the national voice in the policy discussions surrounding response to active shooter incidents and active violent incidents.
  •   Serve as a resource for high threat emergency care and work with current ACEP representatives to other professional organizations.
  •   Leverage international networks to create national and international standards for high threat emergency medical care.
  •   Serve as an advisory body on topics of high threat emergency casualty care including but not limited to:
    • Creation of all-hazard response guidelines for high threat care
    • Translation of military emergency medicine and out-of-hospital (EMS) lessons learned to the civilian setting
    • Promote the integrated response to dynamic mass casualty incidents such as rolling disasters, acts of terrorism and active shooter incidents.
    • Support the provision of psychological support to victims of and responders to dynamic mass casualty incidents
    • Promote the integration of non-medical first responders into community preparedness plans

The task force roster has been completed and was chosen from a pool of over 80 extremely qualified individual applicants as well as stakeholder organizations and federal agencies representing a vast knowledge base and expertise applicable to this very important and timely work. The membership includes:

  •   American Academy of Emergency Medicine (AAEM)
  •   American College of Emergency Physicians (ACEP)
  •   American College of Surgeons-Committee on Trauma (ACS-COT)
  •   The Office of the Assistant Secretary for Preparedness and Response (ASPR)
  •   Committee for Tactical Emergency Casualty Care (CTECC)
  •   International Association of Chiefs of Police (IACP)
  •   International Association of Fire Chiefs (IAFC)
  •   Interagency Board (IAB)
  •   National Association of EMS Physicians (NAEMSP)
  •   National Association of State EMS Officials (NASEMSO)
  •   ACEP representatives from the Committees of Disaster Preparedness and Response, Emergency Medical Services and Pediatric Emergency Medicine and the Sections of Event Medicine, EMS Prehospital Care, Tactical Medicine, Disaster Medicine, International, Pediatric Emergency Medicine and Wilderness Medicine.
  •   United States Department of Health and Human Services, Emergency Medical Services for Children (EMS-C)
  •   United States Department of Homeland Security (DHS)

The task force work has begun, including the first face-to-face meeting at ACEP16 in the Mandalay Bay Convention Center in Las Vegas, Nevada on October 18, 2016 from 7:00-9:00 AM, in the South Seas Ballroom A.

For further information the ACEP Staff contacts for the task force are:

Patrick Elmes, EMT/P

EMS and Disaster Preparedness Department
American College of Emergency Physicians
1125 Executive Circle
Irving, Texas 75038-2522
(972) 550-0911 Ext. 3262


Deanna Harper, EMT/I

EMS Coordinator
EMS and Disaster Preparedness Department
American College of Emergency Physicians
1125 Executive Circle
Irving, Texas 75038-2522
(972) 550-0911 Ext. 3313


Resources for EMS Trainers Available Online

EMS4Stroke Logo

Help train your EMS team with these free resources developed by ACEP, the National Stroke Association, and Genentech at

In addition to interactive lessons, an online EMS Toolkit includes these modules:

  • What is stroke? — Understand the impact of stroke and identify stroke symptoms
  • The role of EMS in stroke assessment and care — Examine goals for EMS response times, become familiar with commonly used stroke scales, and study pre-hospital management of stroke
  • Stroke systems of care — Learn about the classes of hospitals that treat stroke, recognize standards for primary and comprehensive stroke centers, and be able to contribute to best practices for stroke according to designated protocols
  • Case studies — Practice proper pre-hospital stroke management with examples

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Stroke Education for EMS Professionals

EMS4Stroke LogoACEP, the National Stroke Association, and Genentech have partnered to develop a FREE stroke education course for EMS professionals.

The course covers the basics of stroke, pre‐hospital assessment, stroke systems of care, and case studies. EMS educators may also download the slides and use them in their EMS education.

Access the course today at

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ACEP’s Lead Ambassador to Japan Gives Update

As most of you know, a triple disaster of the quake, the tsunami and the nuke leak happened in the Northeast of Japan. I would like to make some notes about this, since I grew up in Tokyo and my family and friends are there.

The tsunami made the most damage in the coastal area of the Northeast, including Mtsushima that is one of “the three most beautiful sites in Japan.” In fact we went there two summers ago with great memory. People there are more stoic than other parts of Japan, but very nice. The weather is not as cold as here in Minnesota but still snow on the grounds, probably like Iowa or Illinois.

I know lots of Health Care workers and others volunteered. In a nutshell, very few trauma (those who escaped from the tsunami were fine)  but lots of medical (cold and out of meds for chronic conditions, like insulin, BP meds, Coumadin, etc.) and some psych are the issues. One of my medial school buddies, Dr. Asari, is an expert of Disaster Medicine, and is at Aomori, just north of the main affected area, then got pulled to Fukushima where the nuke plant is. His e-mail with just few paragraph said not too bad with very few rad exposure for himself. We get somewhat conflicting reports from US and Japanese media. I am not sure what to make of.

Thank you for those who sent me thoughts and prayers. My parents are ok (Tokyo is like 2 hours ride with the Bullet train from the heavily affected area). I would also like to share with you some of the organization who support victims of this awful disaster.

  1. American Red Cross (donation goes to Japan Red Cross)
    tel: 1-800-733-2767
    donation page

  2. Japan Society
    donation page
  3. civic-force
    donation page
  4. Japan America Society of Minnesota
    note: Japan Earth Quake Contribution through Nihonjin-kai
    mail to: Caldwell Bunker Burnet
    7741 147th St W
    Apple Valley, MN 55124
    Attention: Yoko Breckenridge
    (I am not sure which charity this goes to but this is local organization)
  5. you can also text to donate, see

Thank you! Feel free to email this to your family and friends who might be interested.

Seikei Hibino, MD, FACEP
Lead Ambassador to Japan, ACEP
University of Minnesota Medical Center, Fairview
Emergency Department

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Latest from Iwaki, Japan

Editor’s Note: An international ACEP member, Dr. Takashi Nagata, has been giving real-time updates to the ACEP Disaster Section about the developing situation in Japan. He agreed to share the information with the emergency medicine community and will try to continue to provide updates when he can.

March 14, 2011 8:35:33 PM CDT

Dear all,

I am fine, and working here in Iwaki, Fukushima. As you know well, the situation is complicated and changing.
It is difficult to present the situation precisely. However, people are very calm now.

Yesterday, I visited two shelters and prescribed medication. There were a lot of old people who lost their medication.
Also, I am supporting the radiation screening point and DECON teams located at the local heath center. About 90 people came here for consultation one day.

I am staying inside now, and watching the situation carefully.
I recognize my weakness and limitation.


Takashi Nagata

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An Update from Iwaki city, Japan

Editor’s Note: An international ACEP member, Dr. Takashi Nagata, has been giving real-time updates to the ACEP Disaster Section about the developing situation in Japan. He agreed to share the information with the emergency medicine community and will try to continue to provide updates when he can.

March 13, 2011 5:48:45 PM CDT

Dear colleagues in American College of Emergency Physicans,

I apologize you for my long absence. In the last 36 hours, I spent time for moving from my home town, Fukuoka, to the affected area.

I am working in Iwaki city, Fukushima prefecture now. Iwaki city is about 30 km away from the nuclear power plant, and so far, the city is not inside the red zone. The population of the city is about 340,000, and the land is 11,231,34 km2. More than 50 people were killed by earthquake or tsunami.

Based on the experience of Hurricane Katrina, we decided to do quick survey for the shelters in the city on March 13.
I visited 8 shelters on that day. The range of the people in the shelters is between 200 and 2700, and there is need for emergency medicine support. Many older patients lost their daily medications, and have several complaints.
The situation is not so critical, however, people are fatigued and nervous. At the same time, people understand their situation very well, and try to be calm. There was no panic or riot. The condition of the shelters are well-disciplined and managed. Food, water, and sanitation are provided well, but not sufficiently. On March 14, we will start working for them.

Regarding the situation in the city, water is not available. Electricity, internet, and wire communication are working to some extent. There are still minor to moderate earthquakes in the scene.

Compared with Iwate or Miyagi, where thousands of people are found to be dead, the damage of Fukushima prefecture and Iwaki city is not so serious. However, in addition to the damage caused by earthquake and tsunami, Fukushima is facing with the issue of radiation disaster. This is a complex disaster, and  the decisions are very difficult to make.

I appreciate you for your proposals of the support. So far, it is difficult for us to coordinate the international aid teams now.

Although, the situation is complicated and critical, I think I am very proud of being Japanese and working as an emergency physician in the frontline. I will do my best for my country.

Please keep in touch.


Takashi Nagata from Iwaki-city, Fukushima, Japan

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More Updates from Japan

Editor’s Note: An international ACEP member, Dr. Takashi Nagata, has been giving real-time updates to the ACEP Disaster Section about the developing situation in Japan. He agreed to share the information with the emergency medicine community and will try to continue to provide updates when he can.

March 11, 2011 10:21:03 PM CST

Dear all,

Several DMATs teams can arrive in the Ground Zero, and try to collect the information and establish the command structure in the prefecture government offices.
The number of fatalities raised to more than 1,400 now.

Sendai airport in Miyagi, Hanamaki airport in Iwate, and Ibaragi airport in Ibaragi are not available now. They are destroyed by tsunami.
The tsunami arrived 10 kiliometer from the sea coast in some regions, and many villages/towns located inside are damaged.
Narita and Haneda airport in Tokyo are working.
Kansai, Nagoya and Fukuoka international airport are also intact.

The people live within 10 kilometer from the nuclear power plant named Fukushima 2nd plant are ordered for evacuation, and about 60,000 people are being left.

Korean rescue teams will be deployed soon.

I hope this will be helpful.

March 11, 2011 11:10:22 PM CST

Dear colleagues,

Most of the members might not be familiar with the geographical condition of Japan.
Please refer to this site (

It is day time, and all are working hard for search and rescue activity in addition to medical support.
About 50,000 military teams are sent to the scene, and will work with US forces together.

At least 210,000 are evacuated from the scene.
The two nuclear power plants are not under control, but there is no information about melting down.

March 11, 2011 11:22:06 PM CST

The media mentioned that there is high possibility of melting down in the nuclear power plant now.
This information is not double-checked.

March 11, 2011 11:37:03 PM CST
Dear my friends,

Now I will go to Tokyo to join the disaster response, and will be away from the line for a while.
This is national emergency, and I will do my best for my country as an emergency physician.

Probably I will work at the headquarter office of Japan Medical Association to work for intelligence, planning, and logistics.

I sincerely appreciate you for your warm hearts.

See you soon.
Takashi Nagata from Fukuoka, Japan

March 12, 2011 2:29:10 AM CST

The present situation of nuclear power is critical.
We have another earthquake near the plant, and there was an explosion, and the detail is under investigation.
It is same as Three Miles now, and there is high possibility of Chernobyl disaster in Japan.
There are several plants there, and the worst scenario is consequent reaction of Chernobyl disasters, which we have never experienced before.

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Update from Japan

Editor’s Note: An international ACEP member, Dr. Takashi Nagata, has been giving real-time updates to the ACEP Disaster Section about the developing situation in Japan. He agreed to share the information with the emergency medicine community and will try to continue to provide updates when he can.

Friday, March 11, 2011 6:12 PM CST

Dear colleagues,

It is quite difficult to access from neighboring prefectures to the affected area, because the many national roads and highways are closed or destroyed. And it is still in the end of snow season, and the road conditions are snowy and muddy.

Many colleagues in ACEP are proposing us the international disaster aid, and we sincerely appreciate you all.

However, this is my personal thought, and it is quite difficult to accept disaster relief teams from outside Japan in the next few days.

Some academic institutions, hospitals, and organization will be the counterparts for the foreign disaster relief teams, but so far, I have no contact information. I am staying at the safe place which is located 1000 kilometer away.

If you will come to Japan, I mention that the difficulties in working in Japan is language barrier. I am sorry to say, but most Japanese people are capable to read and speak English, but they are very shy to communicate with the people who speaks English.

Safety is not secured in the affected area. We are very careful about the second attack of earthquake and tsunami and risk of radiation exposure.

On the contrary, security (riot, confusion, violence, etc) will not be an issue for disaster relief work.

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Update from Emergency Physician in Japan

Editor’s Note: An international ACEP member, Dr. Takashi Nagata, has been giving real-time updates to the ACEP Disaster Section about the developing situation in Japan. He agreed to share the information with the emergency medicine community and will try to continue to provide updates when he can.

Friday, March 11, 2011 4:58 PM CST

Dear all,

Now it is day time. Information is still fragmented.

The damage in the affected area (Miyagi, Iwate, Fukushima, Aoromi, and Ibaragi) is devastating, and we do not know the whole damage.

There is a minor leakage of radiation from the nuclear power and people around the plants are ordered to be evacuated; however, we are concerned about the meltdown. The alert in the system is rising.

At least 1,000 people are dead or missing in Hohoku area, and the number is still rising.

Tokyo seems okay. The railways and subways works in 30-50% of their capability. Haneda international airport and Narita international airport are almost intact, but the several airports in the affected area are closed or destroyed.

Many DMATs have been sent to the scene by the military aircraft.

Japan Medical Association has started the coordination to do medical support to the affected area.

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An Emergency Physician’s Updates From Japan

Editor’s Note: An international ACEP member has been giving real-time updates to the ACEP Disaster Section about the developing situation in Japan. He agreed to share the information with the emergency medicine community and will try to continue to provide updates when he can.

Friday, March 11, 2011 1:13 AM CST

Hello. I am Dr. Takashi Nagata, international ACEP member and a Japanese emergency physician working in the southern part of Japan.

Currently we are suffered from a sudden catastrophic earthquake and tsunami in the northern part of Japan.

The damage is still under investigation; however, it seems serious to see TV news. 

Because I do not have enough information, I am not sure we need international disaster relief work; however, I would like to ask all the members in this mailing list to follow the situation.

Friday, March 11, 2011 3:18 AM CST

Dear all,

We are fine currently.

This earthquake and tsunami in Japan is the most serious in the past.

It mainly hit Tohoku area, the northern part of Japan main land.

In Miyagi prefecture and Iwate prefecture, they had quite serious damage.

There was a catastrophic damage caused by tsunami along Natori river in Miyagi prefecture and Port Kamaishi in Iwate.

In my impression, the damage of tsunami is more devastating than earthquake itself.

Tokyo was also attached; however, the damage seems relatively limited.

In Tokyo, the railway is stopped, and most businessperson (more than 1 million people) will have to stay in Tokyo.

People try to be calm. So far there is no major fire or building collapse.

According to national disaster plan, the medical response teams have started working.

However, the airports (Naneda international airport in Tokyo and Miyagi airport) are closed now.

So, the teams in the neighboring prefectures try to move by motor vehicles.

The teams in the remote areas are being stand-by.

I try to keep sending information.

Thank you for your kindness.

Friday, March 11, 2011 5:11 AM CST

Dear all,

It is night time now.

It is difficult for us to rescue and search for the victims, and we have to wait for the sunrise at least 10 hours.

As far as the media reports, the situation seems stable. Many hospitals are intact in the affected area.

And most people stay in the designated shelters. Food and electric power can be provided.

However, we do not know the whole impact of the earthquake and tsunami.

Military, police, fire, EMS and disaster medical teams have already been deployed to the scene.

There are 11 atomic power plants in the affected area, and so far, all of them are stopped automatically. So far there is no risk of radiation leakage.

Friday, March 11, 2011 7:50 AM CST

We estimate about at least 1,000 fatalities and 2,000 severe injuries in the affected area.

The access from the neighboring prefectures to the affected area is limited. And rescue/search activity does not work well.

Now the media reported that 200-300 drowning were found dead now.

The affected area, Tohoku, is next to Tokyo, and we would like to send teams from Tokyo to the front line; however, the hospitals are busy to work for the overcrowding mild patients in the urban area. So, we cannot afford.

We guess that the situation is like Tsunami in Asia, 2005 or Hurricane Katrina in 2006.

In addition to emergency disaster relief in the acute phase, I think we will need public health approach for the affected area in the long time.

Friday, March 11, 2011 8:52 AM CST

Dear all,

We still have tsunami repeatedly at night, and the most coast lines of Japan become alarm zone now.

The government issued the emergency of nuclear plant in Fukushima prefecture.

The system has already shut down the reactor and then caused problems with its cooling system. So far there are currently no reports of radiation leakage. Military and fire are working hard for it now. These power plants are located about 200 km away from Tokyo.

Now we have several major fires in several places. Rescue activity is quite difficult because of darkness.

In Kobe earthquake in 1995, about 6000 people died, but this occurred in the single prefecture.

This earthquake and tsunami attached multiple areas and regions in Japan.

It is sad to say, but this is the largest disaster we have ever had.

After 6 hours, we will have sunrise.

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