Hardcore First-Responder Training has Arizona Ready for the Super Bowl

Keith Fehr wants to be ready for anything when the Super Bowl comes to the University of Phoenix Stadium in February. “We trained on structural collapse, on foodborne illness. We practiced a biological agent release, a chemical warfare release, explosions, multi-vehicle accidents,” he said.

As director of emergency management for the Maricopa Integrated Health System, an Arizona system that encompasses an adult trauma center, pediatric trauma, a regional burn center and two behavioral health facilities, Fehr said he has his bases covered. “The big game may never see a chemical weapons attack,” he said, “but you always want to push to the point of failure, to see where you could do better.”

Fehr got his right-to-the-edge training this fall at the Center for Domestic Preparedness (CDP), a FEMA teaching facility where some 14,000 first responders and emergency managers come each year to drill, pairing classroom time with intensely realistic exercises. Walking wounded stagger through a mock downtown. Radiation victims crowd the halls of a full-scale hospital. Hazmat teams deal with actual anthrax and ricin. It’s a hardcore program, with FEMA picking up all participants’ costs.

Elaborate Campus

Founded in June 1998, the CDP has produced about 850,000 graduates. Students come from the ranks of emergency management, EMS, fire service, hazardous materials, health care, law enforcement and others. The center’s 40-plus training courses focus on incident management, mass-casualty response and emergency response to a catastrophic event. The Anniston, Ala., campus includes three major components:

• Advanced Responder Training Complex: A series of buildings spread over five acres, including an apartment complex, dining facilities, a subway, as well as a street tableau with offices, businesses and warehouses. This is where disaster scenarios typically play out. “They could be walking from school, they could be in their apartments or coming out of the subway — just a typical small town USA that suddenly gets hit with a subway explosion, a tornado, an earthquake, a radiological release,” said Bernice Zaidel, assistant director of curriculum development and evaluation at the CDP.
• Noble Training Facility: Formerly a working Army hospital, this 100-bed medical facility is “pretty close to being a functioning hospital,” Zaidel said. “They take over that facility and run it as a hospital, from the administrators to the public information officer to the janitorial staff.”
• Chemical, Ordnance, Biological and Radiological Training Facility is the only training facility in the country where civilian responders train in a toxic-agent environment. Students use nerve agents GB (Sarin) and VX, as well as non-pathogenic strains of anthrax, ricin and radiological materials.

The toxic-agent exercises are among the most challenging. Students undergo medical exams, get their blood work done and shave their beards to fit protective masks. “They are thoroughly trained on how to protect themselves, and the instructors are there to serve as safety facilitators, to make sure everything is in safe mode,” Zaidel said. “The primary risk is the physical exertion during the summer months. The heat and humidity down here can be pretty stifling.”

At the same time, the inherent dangers make toxic training a special challenge for those who oversee the programs. “The real challenge is in making sure that everybody is aware of their job,” Zaidel said. “Everything needs to be coordinated so it runs like clockwork, so everybody has the gear and equipment they need and there is always staff available. It takes a lot of work and commitment to coordinate all that.”

Broad Experience

That work pays off for professionals like Thomas Arnold. As Kentucky’s state training coordinator, Arnold sends 200 to 300 first responders to the CDP each year. They come from the police, fire, emergency management and health-care ranks, and they receive a broad range of experiences.

“There is training that deals with incident command, public information, radiological ops, training for emergency response,” Arnold said. It takes 60 full-time instructors and around 300 subject-matter contractors to cover the wide range of course material, which includes leadership topics such as health-care planning and operations, and response team coordination. Courses may run anywhere from a day to a week.

Arnold praises the breadth of learning experience — from classroom to simulated front line — as well as the diversity of the student cadre. “What’s great about that facility is the fact that they bring in responders from all over the country from different disciplines,” he said. “You can literally be a firefighter from Kentucky training with law enforcement from Minneapolis on one side of you and an EMT from Tennessee on the other side.”

While much of that training may remain the same over time, there is a lot that stays in flux at the CDP, where two full-time researchers and 18 curriculum developers make sure materials keep pace with evolving threats.

Changing Scenarios

Recently, for instance, the CDP teamed with colleagues from the Centers for Disease Control and Prevention (CDC) to work up an Ebola unit. In addition to providing critical information, CDC instructors have been working on site to incorporate the Ebola threat into existing health-care training scenarios.

Much the same thing happened in the wake of the Boston Marathon attacks. That week, CDP instructors cleared all pressure cookers off the shelves at the local Wal-Mart and began making bombs, to show students what they would likely face in similar situations.

More recently, instructors have begun incorporating sophisticated patient-tracking systems to train responders in mass-casualty situations. Using new technology from Global Emergency Resources in Augusta, Ga., emergency responders scan a patient’s bar code using any handheld device, attaching pictures and videos to help chart medical progress. Patient status is readily shared between incident command, public health officers and hospital command centers to create a common operating picture.

Even as program managers labor to keep current on emerging threats, sometimes current events have threatened to overtake the CDP.

Political Detour

In the summer of 2014, officials in Washington, D.C., indicated they might be looking to the CDP as a temporary housing solution to the burgeoning immigration crisis. President Barack Obama’s administration had expressed concern over the mounting number of child immigrants and indicated it would try to provide aid to the children while they awaited deportation decisions.

U.S. Rep. Mike Rogers, R-Ala., wrote to the secretaries of the Homeland Security and Health and Human Services departments, saying he was “deeply concerned” about the proposal. “The CDP is a world-class first responder training facility; however, it was in no way built to house immigration detainees, much less children,” he wrote. “CDP is over 900 miles from the Rio Grande Valley where many of these border crossings occur, and transporting illegal immigrants so far away from the border and their home countries would seem to make this crisis worse.”

FEMA eventually put out a statement saying the CDP would not be considered for the role of temporary immigrant housing.

Despite the occasional blip, the CDP generally stays out of the political limelight — except when its overseers decide to blow up the G8 Summit. It’s what CDP Superintendent Mike King refers to as an “integrated capstone,” a massive multidisciplinary exercise to top off a training period. It’s the kind of thing the center does best.

Prior to the exercise, students form a task force to plan for possible scenarios that might interfere with a high-profile political gathering such as the G8. In the course of their training the instructors weave in planning and intelligence surrounding the upcoming event.

The day starts with an explosion that triggers a mass casualty event, possibly with an unknown substance release. Mock streets are filled with “real” casualties: Up to 100 actors hired from the local community, alongside actual disabled persons in positions of duress. Sophisticated medical dummies realistically simulate the most grievous injuries. Large stuffed animals stand in for pets in peril.

Students are expected to organize the scene, processing casualties, asserting incident command and control within an ad hoc emergency operations center. Students from a law enforcement class investigate, while others seek traces of biological or other toxic materials, and still others work to secure the scene and contain the crowds.

Then the mayor comes in waving his arms, handing all sorts of wrong information to the press.

“We want this to be as hard and as complicated and as complex as a real event can be,” King said. That high degree of complexity is part of what makes the CDP a unique learning environment (along with the live anthrax, of course). This is one of the few places where emergency responders can go to play out a disaster scenario not just on the tabletop, but on the ground.

While that sense of realism is an important part of the learning process, King said, equally important is the presence of so many different players from so many different corners of the emergency responder world.

“When a major incident happens, all the disciplines have to come together to address the situation, so we want to emphasize that by having all the disciplines train together,” he said. “We are looking at large-scale events, and these are things where everyone will be called upon to do things that are not part of their normal discipline track.”

This story was originally published by Emergency Management.