The Rapid Assessment and Initial Detection (RAID) and other elements have been identified to support local, state, and federal agencies responding to a WMD. The basis for developing these elements is the four elements of the Incident Command System (Information and Planning, Operations, Logistics, and Finance) and the 12 Emergency Support Functions of the Federal Response Plan. Elements are designed to "plug into" existing task force structures required by the incident commander, the Governor, or the CINC responding in support of the FRP. A potential model response is portrayed in the figure below.
Command
Military command elements are established by the Adjutant General for the National Guard responding as state resources and by the CINC for the area (s) affected for federal military assets. In most cases, the pre-designated DCO coordinates for any federal military assets. A RTF may be deployed to provide command and control during a major federal response. The CINC’s RTF is responsible for the command and control of all responding military elements, less the Joint Special Operations Task Force. It is comprised of command, staff, and technical experts required to support the WMD consequence management response.
Response Elements
Most military elements called to respond to a WMD attack will perform operations supporting the incident commander, state authorities, or federal agencies requiring their help. These elements include:
Rapid Assessment and Initial Detection Element
The point of the military response spear is the National Guard Rapid Assessment and Initial Detection Element. This element is comprised of highly trained experts in a cross-discipline of functional areas that can deploy and assess the situation, advise the local, state and federal response elements, define requirements, and expedite employment of state and federal military support.
Mission: Provide early assessment, initial detection, and technical advice to the incident commander during an incident involving weapons of mass destruction. Facilitate identification of DoD asset requirements.
C2 Cell: Provides overall command and control of the assessment team and conducts hazard modeling.
Recon Cell: Provides early detection, initial sample collection, and NBC reconnaissance.
Medical Support Cell: Provides an initial DoD medical assessment.
Security Cell: Provides initial assessment of security requirements and manages force protection/assessment element security.
Logistics Cell: Determines initial resource requirements and provides supply and maintenance support for the assessment element.
Air Liaison Cell: Coordinates for transportation and/or air movement of assessment element.
Communications Cell: Provides internal communications within the assessment element, coordinates for communications connectivity with civilian responders, and maintains a reach back capability for additional technical expertise.
Units Employed: The RAID Elements assigned to each state/territory represent the first military responders. Regardless of the full-time and traditional member mix, the reconnaissance team will likely be the primary area that technical assistance will be requested. Given the goal of four-hour on-scene, the demands of the RAID Elements will be significant. While not ideal in terms of fully developed response capability, teams from surrounding states or even use of the regional assets may well be necessary if the disaster escalates quickly.
Employment: The RAID Element is organized as an element under the peacetime control of the Adjutant General. Given its rapid response and assessment mission, the RAID Element is designed to assist incident commanders with the initial detection and the nature of the emergency. There is also a wartime RAID Element mission: to provide force protection support within the state during mobilization. As with the other elements of the response module, these elements can also be used as part of a federal (Title 10) response to support the National Military Strategy (NMS) requirements.
The RAIDs have the capability to rapidly deploy to an incident site and provide initial support to the Incident Commander. The element has the capability to conduct reconnaissance, provide medical advice and assistance, perform detection, assessment, and hazard prediction, and can provide technical advice concerning WMD incidents and agents. Equipping the RAIDs requires both military standard and commercial-off-the-shelf components. The equipment list can be found in Annex F.
Information and Planning Element
Mission: Collect, process and disseminate information about WMD emergency to facilitate the overall response activities. The scope of this functional element is to coordinate the overall information activities. Provide an initial assessment of disaster impacts including the identification of boundaries of the affected area and distribution, type and severity of damages, including the status of critical facilities. The information and planning activities are grouped among the following functions:
- Information Processing function to collect and process essential elements of information from the State, and other sources, disseminate it for operations, and provide input for reports, briefings, displays and plans;
- Reports function to consolidate information into reports and other materials to describe and document overall response activities and to keep follow-on support personnel informed of the status of the response operations;
- Displays function to maintain displays of pertinent information and facilitate briefings using maps, charts and status boards other means, such as computer bulletin boards or electronic mail, as available;
- Consolidate information to support the action planning process initiated by ICS.
Units Employed: Air Force Information Management staffs and Army Information Operations staffs.
Employment: When activated, this functional element will provide information processing support to military response activities. Information may be obtained from a variety of sources to include but not limited to ICS representatives. This functional element will proactively seek information that is a viable to develop an accurate picture of the emergency condition. The collection and processing of critical information is forwarded to the operational element in order to create an overall perspective of the situation. The release of information directly to the public or media remains a Public Affairs function. These elements deploy to an incident site between 8-72 hours after an incident to assist the Incident Commander.
NBC Reconnaissance Element
Mission: Provide NBC Reconnaissance Support to the local Incident Commander.
NBC reconnaissance operations include search, survey, surveillance, and sampling missions.
Search: Reconnaissance undertaken to obtain significant information about the NBC condition of routes, areas, and zones. This information confirms or denies the presence of NBC hazards with detection and identification equipment. Visual observation or the collection of samples in the specified location or region can also provide this information.
Surveys: Missions conducted to collect detailed information of NBC contamination hazards. The survey determines the type of contamination, the degree (extent/intensity), and the boundaries.
Surveillance: The systematic observation of an area to provide early warning.
Sampling: Provides physical evidence of NBC attacks and technical intelligence concerning NBC weapons systems.
Units Employed: Each National Guard and USAR Chemical Company will train a platoon-sized element to perform reconnaissance operations. (The Separate Brigade Chemical Platoons will also train to provide recon support.)
Employment: These elements should be prepared to deploy to an incident site after an incident to assist the incident commander to:
- Confirm or deny contaminated areas.
- Confirm the area is clear of contamination.
Units will operate primarily using standard MTOE and TDA equipment. Additional equipment requirements are attached (Annex F.)
NBC Patient Decontamination Element
Mission: Provide patient decontamination support to the local Incident Commander. Prepare to:
- Perform casualty decontamination near the incident site, prior to evacuation, or;
- Establish decontamination/detection stations at community hospitals.
Decontamination of non-ambulatory casualties is normally performed prior to evacuation. However, in a terrorist incident, many ambulatory casualties will self evacuate, arriving at the hospital still contaminated. Hospitals must have the capability to detect contamination, and decontaminate when necessary.
Casualty decontamination is done by trained non-medical personnel under the supervision of the medical personnel in accordance with procedures outlined in FM 8-10-7.
Units Employed: Each National Guard and USAR Chemical Company, and each Air National Guard and Air Force Reserve Medical Patient Decontamination Team will train platoon-sized elements to perform patient decontamination. (Separate Brigade Chemical Platoons will also train to provide decon support.) This training will be conducted during a weekend drill by the unit squad and platoon level leadership. A train-the-trainer program will be established and a program of instruction will be developed.
Employment: Each decontamination team will consist of twenty non-medical personnel and is capable of decontaminating 12 casualties per hour.
Three teams are required per decontamination site to run 24-hour operations (4 hours on and 8 hours off shifts).
This team requires three to five medical personnel from either the supported hospital/EMS or a medical unit to supervise the process and perform triage and immediate treatment of casualties. Equipment requirements are defined in Annex F.
NBC Medical Response Element
* The Medical Response Elements require further study and analysis. Noted below are the initial concepts for tasking and element employment. The ongoing medical studies must be considered before the DoD response plan is finalized. With many initiatives in various stages of fielding, a more detailed medical response element missions and tasks will be developed further during the first year of the program. The medical response plan requires coordination with our partners, in both the private and public sector.
Mission: Provide medical advice to incident commander and local authorities on protection of first responders and health care personnel in an NBC environment. Provide advice on casualty decontamination procedures, first aid and initial medical treatment. Provide medical threat information and characterize the health risks to civilian and military populations. Provide initial medical advice to include signs, symptoms, and first aid.
Units Employed: NBC Medical elements consist of 6 medical personnel and is capable of providing medical advice to include signs, symptoms, and first aid of NBC agents. Teams consist of: 1 Preventative Medicine Officer, 1 Preventive Medicine NCO, 1 Acute Care Physician, 1 Nurse, 1 Preventive Medicine Science Officer, 1 Practical Nurse, 1 NBC NCO, 1 Nuclear Medical Science Officer, 1 Nuclear Medical Officer, 1 Nuclear Medicine Specialist/Health Physics Specialist.
Employment: After the initial assessment National Guard/Reserve Component NBC medical elements will provide periodic updates to the incident commander and local authorities on protection of first responders and health care personnel in an NBC environment. Elements may elect to use telemedicine reach back capabilities to provide medical advice to local hospitals on appropriate management of care issues. These elements deploy to an incident site between 8-72 hours after an incident to assist the Incident Commander.
Triage Medical Response Element
Mission: Provide triage support to the Incident Commander including the sorting and assignment of treatment priorities to various categories of wounded, and providing immediate emergency care.
Units Employed: Each National Guard, USAR, AFRES, USNR triage team will be trained to perform triage using the Simple Triage and Rapid Treatment (START) system and deploy to an incident site within 72 hours to assist the Incident Commander with a Mass Casualty Incident (MCI).
Employment: Each triage team will consist of 26 personnel and is capable of treating 100 patients per hour.
Trauma Medical Response Element
Mission: Provide expertise in triage, resuscitation, and damage control medicine near the incident site or at a definitive care location. Specific tasks are:
- Perform damage control surgery for up to four patients.
- Augment community hospital systems overwhelmed by NBC casualties.
- Augment hospital/Metropolitan Medical Strike Teams (MMST) after 24 hours to conduct sustainment operations.
- Provide support to local hospitals or MMST triage and immediate treatment of casualties.
- Provides Analgesia and anesthesia for patients under their care.
Units Employed: Each National Guard, USAR, and USNR, AFRES trauma team will be trained in the treatment of chemical, biological and radiological casualties and associated effects from blasts and crush injuries. Teams consist of: 2 General Surgeons, 1 Anesthesiologist, 1 Emergency Medical Physician/Orthopedic Surgeon, 1 Critical Care Nurse, 1 ER Nurse
Employment: These elements deploy to an incident site between 8-72 hours after an incident to assist the Incident Commander.
Preventive Medicine Element
Mission: Provides initial disease and environmental health threat assessments during early or continuing assistance stages of a disaster. Specific tasks are:
- Provide medical threat information and characterize the health risks to civilian and military populations.
- Prepare preventive medicine estimates; conduct rapid hazard sampling, monitoring and analysis.
- Sampling including endemic and epidemic disease indicators.
- Provide initial disease and environmental health threat assessments prior to or in the initial stages of a disaster.
Units Employed: Each National Guard, USAR, and Naval Reserve preventive medicine team will be trained in initial disease and environmental health threat assessments. Teams may require information from the Center for Disease Control and other agencies with endemic disease and environmental effect information to prepare their database for the area. Teams consist of: 1 Preventative Medicine Officer, 1 Industrial Hygienist/Health Physicist, 1 Environmental Science/Engineering, 1 Community Health Nurse, 1 Entomologist, 1 Biologist, 1 Preventive Medicine NCO. This team should attend the HHS/FEMA public health aspects of natural disasters and civil emergencies.
Employment: These elements deploy to an incident site between 8-72 hours after an incident to assist the Incident Commander. Personnel are alerted using pagers and deploy to incident site.
Stress Management Element
Mission: Provides initial stress management for military and civilian responder and incident survivors.
Units Employed: This element is highly trained in stress management and neuropsychiatry. It is capable of providing limited neuropsychiatric triage and stabilization of clinical cases in order to reduce the disabling effects associated with post traumatic stress disorder.
Personnel: Each NBC element will consist of 6 medical personnel and is capable of providing medical advice to include signs, symptoms, and first aid of NBC agents. Teams consist of: 1 Psychiatrist , 1 Clinical Psychologist, 1 Social Work Officer, 1 Psychiatric Nurse, 2 Mental Health NCOs, 1 Chaplain, 1 Occupational Therapy Officer, 1 Occupational Therapy NCO and require training victim assistance, psychological trauma, post traumatic stress disorder, mental health risks associated with relief workers (burn out syndrome) critical events management course.
Employment: These elements deploy to an incident site between 18 and 48 hours after an incident to assist the Incident Commander.
Security/Law Enforcement Element
Mission: The National Guard provides support for the Incident Commander IAW state and local emergency response plans to assist in maintaining order, ensuring public safety and providing assistance to the law enforcement officials. Specific tasks and capabilities include:
Access Control: The potential for mass panic following a WMD incident will overwhelm the ability of hospitals to function effectively without additional personnel to control access to the facilities. National Guard troops could be called upon to augment law enforcement and hospital security personnel to maintain efficient access control in the hospitals. Because arriving victims may be contaminated, the personnel assigned this function require both awareness level knowledge and training in performing security operations in personal protective equipment (PPE). The units assigned this responsibility need ready access to PPE which allows for rapid mobilization from a local armory to an incident site.
Site Security: Once the limits of the contaminated area are established, a cordon will need to be established to prevent people from entering the area. Because this mission will be performed outside the hot zone and National Guard units regularly perform this type of mission in other disaster situations, no additional training beyond basic awareness will be required.
Civil Disturbances: The potential for lawlessness and disorder will exist following any WMD incident. Units designated with on-street civil disturbance missions need to have awareness level training on WMD incidents.
Quarantine: The National Guard could be called on to assist in the implementation of a quarantine if public health officials determine that a biological attack using a communicable disease agent occurs.
Evacuation: National Guard units will be required to assist in any evacuation ordered by the local officials. Military Police and other types of units may be called upon to assist in managing the flow of traffic during an evacuation. Because this mission will be performed outside the hot zone and National Guard units regularly perform this type of mission in other disaster situations, no additional training beyond basic awareness will be required.
Mass Care Elements
Mission: Provide support to the incident commander in providing shelter, feeding, emergency first aid, and bulk distribution of emergency relief supplies. Specific tasks and capabilities include:
Shelter: The provision of emergency shelter for disaster victims includes the use of pre-identified shelter sites in existing structures; creation of temporary facilities such as tent cities, or the temporary construction of shelters; and use of similar facilities outside the disaster-affected area, should evacuation be necessary. Military installations and facilities such as the armories and reserve centers can be used. The military can also be tasked to provide tentage, cots, etc. in the event of an incident.
Feeding: The provision for feeding disaster victims and emergency workers through a combination of fixed sites, mobile feeding units, and bulk food distribution. Such operations will be based on sound nutritional standards and will include provisions for meeting dietary requirements of disaster victims with special dietary needs. Mobile kitchens and MRE’s may be requested from the military to support mass feeding operations.
Emergency First Aid: Emergency first aid services will be provided to disaster victims and workers at mass care facilities and at designated sites within the disaster area. This emergency first aid service will be supplemental to emergency health and medical services established to meet the needs of disaster victims.
Bulk Distribution of Emergency Relief Items: Sites will be established within the affected area for distribution of emergency relief items. The bulk distribution of these relief items will be determined by the requirement to meet urgent needs of disaster victims for essential items. Military units can be tasked to man these operations.
Mortuary Affairs Element
Mission: Provide mortuary support to include identification, processing, storage, and disposition of remains following a mass casualty WMD incident. Specific tasks and capabilities include: assist in providing victim identification and mortuary services, temporary morgue facilities; victim identification utilizing latent fingerprint, forensic dental, and/or forensic pathology/anthropology methods; and processing, preparation, and disposition of remains.
Communications Element
Mission: This function is to assure the provision of telecommunications support to the response forces following a WMD emergency. This functional element coordinates actions to assure the provision of required telecommunications support. This functional element will coordinate the establishment of required temporary telecommunications. Support includes Government-furnished telecommunications, commercially leased communications, and telecommunications.
Units Employed: Tactical Army, Navy, and Air Force communications units may provide communications elements to link key command and control and deployed assets. Each NBC command element will consist of an information specialist.
Employment: These elements deploy to an incident site between 8-72 hours after an incident to assist the incident commander. Personnel are alerted using pagers and deploy to incident site. This functional element serves as a basis for planning and use of military telecommunications assets and resources in a WMD emergency.
Engineering Element
Mission: Public Works and Engineering support includes technical advice and evaluations, engineering services, construction management and inspection, emergency contracting, emergency repair of wastewater and solid waste failities, and real estate support for the stated purposes. The United States Army Corps of Engineers is the lead for this Emergency Support Function.
Specific tasks include:
Emergency clearance of debris for reconnaissance of the damage areas and passage of emergency personnel and equipment for lifesaving, life protecting, health and safety purposes during the initial response phase,
Temporary construction of emergency access routes which include damaged streets, roads, bridges, ports, waterways, airfields, and any other facilities necessary for passage of rescue personnel,
Emergency restoration of critical public services and facilities including supply of adequate amounts of potable water, temporary restoration of water supply systems, and the provision of water for fire fighting,
Emergency demolition or stabilization of damaged structures and facilities designated by State or local government as immediate hazards to the public health and safety, or as necessary to facilitate the accomplishment of life saving operations (undertake temporary protective measures to abate immediate hazards to the public for health and safety reasons until demolition is accomplished),
Technical assistance and damage assessment, including structural inspection of structures.
Units Employed: ARNG & USAR Engineer units and ANG/AFRES Civil Engineering units could be tasked.
Transportation Elements
Mission: Provide support for the incident commander (through the SCO or FCO/DCO) IAW state and local emergency response plans and the Federal Response Plan to satisfy the requirements of Federal agencies, State and local governmental entities, and voluntary organizations requiring transportation capacity (service, equipment, facilities, and systems) to perform their assigned WMD response missions.
Units Employed:
Air (Fixed): The Air Force (including ANG and AFRES) will be tasked to transport both civil and military response assets and elements to the site of an incident. Pilots and aircrews require awareness training.
Air assets may be tasked under the National Disaster Medical System to provide transport of patients (post-decontamination) to medical facilities around the nation. Pilots and aircrews require only an awareness level of training.
Air (Rotary): Military rotary wing assets will be critical to the operations of the other military response elements and in support of the local Incident Commander. Potential missions include:
Transport of the RAID: In order to meet a four-hour response window, many of the RAID’s will be stationed at or near air units. Rapid activation of pilots and crews will be necessary. The RAID air liaison cell needs to coordinate with the supporting aviation element to ensure that adequate cargo capacity is available. The pilots and crews will require an awareness level of training.
Air Ambulance: The potential for mass casualties in a WMD incident will quickly overwhelm the hospital capacity in a local community. The use of aeromedical ambulance companies to transport patients to more distant treatment facilities can help to alleviate this problem. This transport capability is post decontamination and outside the hot zone. (Helicopters should not be used within a chemically contaminated area because their rotors tend to spread agents/contamination.) Pilots and crews will therefore only require an awareness level of training.
Survey/Reconnaissance: Helicopters may be used to conduct an aerial reconnaissance of a radiologically contaminated area to determine the spread/level of contamination. Pilots need to receive training in the conduct of this type of operation.
Ground: Military vehicles such as military busses, HMMWV’s, trucks, etc. can be operated in support of ESF#1 if not otherwise required to carry out the unit’s emergency mission. Potential assets include transportation units that can be activated to provide additional transportation support. Only an awareness level of training will be required for those vehicles operating outside the hot zone. The assigned drivers of vehicles operating within the hot zone (such as ambulances) will require training on vehicle operations while wearing protective clothing.
USCG National Strike Force
The Coast Guard's National Strike Force's capabilities and responsibilities are available for responding beyond port areas. The Strike Teams are regularly deployed throughout the US on behalf of both USCG and EPA On-Scene Coordinators (OSCs). Further, the Strike Teams are key tactical response units for the EPA to call upon when responding under the Federal Response Plan Emergency Support Function #10. The potential exists that the Coast Guard OSCs could very well be the first Federal presence in a WMD scenario. Coast Guard OSCs have a pre-established response organization in coastal areas (including rivers and Great Lakes) with state and local responders as well as fire and police. USCG OSCs have experience coordinating support services (NOAA Scientific Support Coordinators, CDC, etc.) and other government agencies with response capabilities into a cohesive unified command.
