AUTHOR: Angelo Verzoni

Czech hospital shooting highlights occupancy risk, need for preparation

A view from inside a waiting room at University Hospital in Ostrava, Czech Republic, where Tuesday morning a gunman killed six people in the country's deadliest mass shooting since 2015. Image Capture: Aug 2017, Copyright 2017 Google     A shooting in a hospital waiting room in the city of Ostrava, Czech Republic, left six people dead this morning, the New York Times reported. The shooter, a 42-year-old man, killed himself as officers closed in. It was the deadliest shooting in the country since 2015, when a gunman killed eight at a restaurant. The incident highlights the risk of active shooter or other hostile events occurring in hospitals—something emergency management officials have been concerned over for some time. "We're wide open. We don't run you through a metal detector on the way in," Michael Marturano, safety officer for a health care system in Duluth, Minnesota, said of hospitals during a November 2017 interview with NFPA Journal. "Surgery's locked down, the birthing center is locked down, but the other 80 percent of the building is pretty open. You've got sales people coming in, family members coming in, you've got meetings with a lot of community folks, and they need to get in." My interview with Marturano served as the Perspectives article for the January/February issue of NFPA Journal. Our conversation covered the importance of preparing health care facilities for situations involving active shooters, some of the challenges involved with the training, and measures health care workers can take to stay safe in active shooter events. In the nearly three years since our interview, advancements in preparing for active shooter and other hostile events have been made—most notably, NFPA 3000 (PS), Standard for an Active Shooter/Hostile Event Response (ASHER) Program, was released in May 2018. But the risk of such an event occurring in a hospital has pretty much stayed in the same. In June 2017, a disgruntled doctor opened fire with an AR-15 at a hospital in New York City, killing one doctor and wounding six others. In November 2018, three people were killed in a mass shooting at Mercy Hospital in Chicago. Next month, the city of Augusta, Georgia, will embark on a yearlong journey to implement NFPA 3000 throughout its community, and the risk of a shooting occurring in one of the area's three hospitals will be a major consideration for project leaders. You'll be able to read more about this project when the January/February issue of NFPA Journal is published in the coming weeks. While active shooter events in hospitals aren't that common in the US—only seven occurred from 2000 to 2015, according to data from Texas State University's Advanced Law Enforcement Rapid Response Training (ALERRT) Center—they can be a huge headache for hospital emergency planners, said John Montes, the NFPA staff liaison to NFPA 3000. "They have to worry about having an incident on their site, but they are also part of any incident that occurs in the area because they receive the victims," he said. "They are part of that recovery process and response process. It can be very complicated for them to plan."
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Could the US handle a tanker fire like the one in South Korea?

Over the weekend, an explosion and fire aboard the Stolt Groenland, a 25,000-tonne, Cayman Island–flagged oil tanker, left 10 people injured, one of them critically, Reuters recently reported. The blast and subsequent blaze occurred while the ship was docked at the Port of Ulsan in South Korea. The incident is exactly the type of scenario safety officials in the United States worry about. It also serves as a perfect illustration of the danger fires or explosions on large marine vessels pose, especially when those incidents occur when the ship is at or close to port. I explored this topic in detail for the cover story of the September/October 2019 issue of NFPA Journal, "Close Quarters."  "People have this misconception that if a fire or explosion happens on a boat, even in a port, it'll be contained," a Navy fire chief told me for the article. "But that's not necessarily true." The chief's words rang true during the incident in South Korea. The fire on the Stolt Groenland was so large that it spread to another, nearby ship, the 9,000-tonne, South Korean–flagged Bow Dalian. And most of the people who were injured were not even on board either of the ships when the fire broke out—they were workers at the terminal.  While the US has been fortunate to not have experienced a large ship fire or explosion at a port, officials I interviewed for the story pretty much unanimously agreed that if one did occur, many cities' local fire service wouldn't be prepared. "We've started to see ships that are a lot bigger than anything we're used to," a veteran marine firefighter told me. "These vessels are huge, and I don't think any major city, much less a smaller one, is truly prepared." The Agence France-Presse reported that South Korean firefighters "struggled to contain [Saturday's] blaze and prevent it from spreading." Still, all of the 25 people aboard the Stolt Groenland and the 21 aboard the Bow Dalian were rescued—and that represents one of the most difficult aspects of incidents like this, given ships' narrow passageways and limited access points. The cause of the explosion is under investigation, AFP said.

Journal NOW: After Jim Beam fire, read NFPA Journal's 2018 feature on keeping distilleries safe from fire

Last week, a massive fire tore through a Jim Beam warehouse in Kentucky, destroying 45,000 barrels of the company's whiskey. The blaze continued for days as barrels of the flammable liquid were purposefully allowed to burn to avoid further contaminating a nearby river by adding more water to the fire that could then run into the river, according to CNN. Officials say a lightning strike was likely the cause.  Similar scenarios have played out over the years in Kentucky. In 2003, a lightning strike at a Jim Beam warehouse in Bardstown, Kentucky, set the wood-frame structure ablaze and sent 800,000 gallons of flaming bourbon into a nearby retention pond. Seven years prior, a fire broke out at Heaven Hill Distillery, also located in Bardstown, and burning whiskey created what one employee described to the Kentucky Standard newspaper as "a river of fire." And in 2000, a fire at a Wild Turkey distillery in Lawrenceburg, Kentucky, destroyed nearly 1 million gallons of bourbon. I wrote about distillery fires and the resources that exist to protect these facilities from fire for the March/April 2018 edition of NFPA Journal.  While the piece—"Small Scale, High Proof"—largely focuses on the boom the United States has seen in recent years in small, craft distilling operations, the fire safety threats and fire protection concepts detailed in the story apply to any distillery, no matter how large or old. The article, for example, shows that hard liquor, usually 40 percent alcohol by volume (ABV) or higher, can give off enough vapor to ignite in air, at relatively low temperatures. It typically has a flashpoint of 79 degrees Fahrenheit, the article says, compared to pure ethyl alcohol with a flashpoint of 55 degrees F.  Read more at nfpa.org/safedistilling.
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Las Vegas: First responders need to work as a team, can't 'unsee' what they've seen

Photos courtesy of AP/Worldwide At least 59 people are dead and more than 500 are injured after a gunman perched on the 32nd floor of a Las Vegas hotel opened fire on a crowd at an outdoor music festival. The Sunday night shooting is now the deadliest mass shooting the country has ever seen.   Reacting to the news, a SWAT captain and fire chief from two of America's largest cities stressed the importance of police, fire, and other emergency officials working together to plan for and respond to active shooter and other hostile events. The two authorities are part of a proactive group currently working to identify new ways to minimize the carnage that these tragic incidents inflict. Not only are active shooter events becoming more frequent in the United States, but the time it takes for a new shooting to become the deadliest in U.S. history is also shrinking. Forty-one years passed between the 2007 Virginia Tech shooting (32 killed) and the 1966 University of Texas clock tower shooting (16 killed), which previously held the record for the deadliest mass shooting in U.S. history. It was then nine years before the 2016 Pulse nightclub shooting in Orlando (49 killed) topped the Virginia Tech shooting. Sadly, only one year later, yesterday's shooting at the Route 91 Harvest Music Festival claims the record.    “It is the new normal,” said Jack Ewell, a police captain who commands special operations for the Los Angeles County Sheriff's Department. “After each [active shooter event] we scrutinize the incident and try to learn and determine what additional measures we can put in place to try and stop them, and if we can't stop them, to minimize the casualties involved.” Ewell's department serves 10 million people scattered over 4,000 square miles of land and has already sent personnel to Las Vegas to assist with the city's recovery from the incident.    One of the additional measures that could be explored in the wake of the Las Vegas shooting is increasing security measures at hotels, such as searching baggage as guests check in, said Otto Drozd, the chief of Orange County Fire Rescue in Orlando, which responded to the Pulse nightclub shooting along with other local, state, and federal authorities. “If we had instituted something at hotels to check baggage, would it have prevented the Vegas incident?” Drozd asked himself after hearing about the news this morning. It would be a similar change to how security was ramped up at airports following 9/11.   Both Drozd and Ewell are members of the technical committee for NFPA 3000, Standard for Preparedness and Response to Active Shooter and/or Hostile Events. The committee has met twice so far, and the standard is slated to be released sometime late next year or in early 2019. An article on the development of the standard appeared in the July/August 2017 issue of NFPA Journal, along with a podcast on the topic. Additionally, at a meeting at NFPA's Massachusetts headquarters late last month, the Urban Fire Forum endorsed a position paper on preparedness and a unified response to hostile events, which references NFPA 3000.   What's critical is that the standard draws from the knowledge and experiences of every entity involved in responding to active shooter and other hostile events. “It's a cross functional standard which is unique,” said Drozd. “We have the perspective of law enforcement, fire, EMS, and hospitals at the local state, and federal level.” Although each entity takes on a different role during these events—for example, law enforcement initially must be focused on identifying and eliminating the threat, while fire and EMS are entirely focused on aiding victims—it's the interoperability of everybody involved that leads to a successful response. “We have to go at it as one team,” said Ewell. While Ewell's department already uses many of the best practices that will be outlined in NFPA 3000, he underscored the importance of the new standard so that first responders in all jurisdictions can be “working off the same sheet of music,” so to speak.    In Orlando, one key takeaway from the Pulse Nightclub shooting was the need to plan in advance for a designated, safe, and sufficiently sized site to house witnesses, less critically injured victims, and families of those affected. Drozd indicated that his city needed to relocate their staging area three or four times in the days that followed the shooting. Another lesson learned was the importance of quickly establishing a hotline for loved ones to call and inquire about victims. In Orlando, some families waited for days before learning the fate of club-goers. Las Vegas authorities quickly announced a number today for families, friends, and concert-goers to call with questions, concerns, and first-hand perspectives.   Beyond the operational aspects of active shooter and other hostile events that NFPA 3000 will address, it will also aim to shed light on the more lasting impacts these events can have on communities, such as the toll they take on first responders' behavioral health. “Some of the things that first responders see cannot be unseen,” said Drozd. “So while the community's recovery is a long, heartbreaking, and collaborative process, we should not lose sight of the tremendous toll that incidents like these can have on our first responders.”

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