The purpose of this handbook is to provide assistance to both new and experienced medical directors as they strive to provide the highest quality of out-of-hospital emergency medical care to their communities and foster excellence within their agencies. The handbook will provide the new medical director with a fundamental orientation to the roles that define the position of the medical director while providing the experienced medical director with a useful reference tool. The handbook will explore the nuances found in the EMS industry-a challenge to describe in generalities due to the tremendous amount of diversity among EMS agencies and systems across the Nation. The handbook does not intend to serve as an operational medical practice document, but seeks to identify and describe the critical elements associated with the position.

Emergency Medical Services (EMS) agencies regardless of service delivery model have sought guidance on how to better integrate their emergency preparedness and response activities into similar processes occurring at the local, regional, State, tribal and Federal levels. The primary purpose of this project is to begin the process of providing that guidance as it relates to mass care incident deployment. The World Bank reported in 2005 that on aggregate, the reported number of natural disasters worldwide has been rapidly increasing, from fewer than 100 in 1975 to more than 400 in 2005. Terrorism, pandemic surge, and natural disasters have had a major impact on the science of planning for and responding to mass care incidents and remain a significant threat to the homeland. From the attacks of September 11th, 2001, the subsequent use of anthrax as a biological weapon, to the more recent surge concerns following the outbreak of H1N1 influenza, EMS have a real and immediate need for integration with the emergency management process, and to coordinate efforts with partners across the spectrum of the response community. The barriers identified from the literature review and interviews with national EMS leadership include: lack of access to emergency preparedness grant funding; underrepresentation on local, regional, and State level planning committees; and lack of systematic mandatory inclusion of all EMS provider types in State, regional, and local emergency plans. In December 2004, New York University's Center for Catastrophe Preparedness and Response held a national roundtable that included experts from major organizations representing the EMS system as a whole. The report from that meeting concluded that: "EMS providers, such as fire departments and hospital-based, commercial, and air ambulance services, ensure that patients receive the medical care they need during a terrorist attack. While EMS personnel, including Emergency Medical Technicians and paramedics, represent roughly one-third of traditional first responders (which also include law enforcement and fire service personnel), the EMS system receives only four percent of first responder funding. If EMS personnel are not prepared for a terrorist attack, their ability to provide medical care and transport to victims of an attack will be compromised. There will be an inadequate medical first response." In 2007, the Institute of Medicine in its landmark report Emergency Medical Services at the Crossroads issued a recommendation that stated: "The Department of Health and Human Services (DHHS), the Department of Homeland Security and the States should elevate emergency and trauma care to a position of parity with other public safety entities in disaster planning and operations." Since the time of these reports Federal progress to address these issues has included the creation of the Office of Health Affairs (OHA) within the Department of Homeland Security (DHS), the creation of the Emergency Care Coordination Center (ECCC) within HHS, and the creation of the Federal Interagency Committee on EMS (FICEMS) Preparedness Committee. In an effort to increase the level of preparedness among EMS agencies, the National Emergency Medical Services Management Association (NEMSMA) approached the DHS and OHA to engage them in a partnership that would provide a greater understanding of the shortfalls in EMS emergency preparedness and provide resources to fill those gaps. The primary objective of this project is to understand model policies and practices across a spectrum of disciplines and provider types that will lead to a better prepared EMS deployment to mass care incidents. This project should serve as a foundation for further development of EMS specific policies and templates that improve EMS readiness to manage the full spectrum of hazards that face their communities.

This report contains research on behaviors and other factors contributing to the rural fire problem; identifies mitigation programs, technologies, and strategies to address those problems; and proposes actions that USFA can take to better implement programs in rural communities. In the Spring of 2004, the U S Fire Administration (USFA) partnered with the National Fire Protection Association (NFPA) in a cooperative agreement project entitled Mitigating the Rural Fire Problem. The purpose of the project was to examine what can be done to reduce the high death rate from fires in rural U S communities. Rural communities, defined by the U S Census Bureau as communities with less than 2,500 population, have a fire death rate twice the national average. The objectives of the project were to a) conduct research on behaviors and other factors contributing to the rural fire problem, b) identify mitigation programs, technologies, and strategies to address those problems, and c) propose actions that USFA Public Education Division can take to better implement programs in rural communities. Research sources included a review of the published literature, some original statistical analysis, and information from national technical experts who have worked with NFPA.

In the summer of 2004, the U.S. Fire Administration (USFA) launched its most comprehensive and intensive public fire education campaign for elderly Americans. A FIRE SAFETY CAMPAIGN FOR PEOPLE 50 PLUS provides detailed fire prevention information to assist fire departments and other USFA partners in mitigating the risk of fire fatalities and injuries among the 50 and over population. This report, Fire and the Older Adult, analyzes the fire risk to persons aged 65 and older as a complement to that campaign. The report provides an extensive review of the fire situation for older adults in the United States and evaluates fire risk factors and risks of fire injury and fatality among that population group. On average, more than 1,000 Americans aged 65 years and older die each year in home fires and more than 2,000 are injured. In 2001 alone, 1,250 older adults died as the result of fire incidents. Moreover, the elderly are 2.5 times more likely to die in a residential fire than the rest of the population. With the U.S. Census Bureau predicting that increases in the senior population will continue to outpace increases in the overall population, the elderly fire problem will undoubtedly grow in importance. After offering an overview of the U.S. demographics of the 65 and older population, this report discusses how physical, emotional, social, economic, and residential factors have unique impacts on seniors.

This body of work provides detailed information on the nature of the Shenandoah Retirement Home Fire in Roanoke County, Virginia on December 14, 1989. It will assist policymakers who must decide on allocations of resources between fire and other pressing problems, and within the fire service to improve codes and code enforcement, training, public fire education, building technology, and other related areas.

To develop a clear picture of the specific requirements of the rural arson control system, the IAFC conducted in-depth case studies of these systems in four rural counties. The results from visits to rural arson control programs in seven states are incorporated in this report..

This Orientation Manual provides practical information: both rescue techniques, and preparedness information for the first responder who will encounter people with visible and non-visible disabilities through their work. This publication can assist first responders in advance or make critical emergency decisions. This publication will help first responders to confidently work with the disability community toward the goal of protecting and saving lives and minimizing trauma.

As part of the second needs assessment of the U.S. fire service, a rough comparison was made between needs reported in the first needs assessment survey and resources requested and granted to the same fire departments in 2001-2004 under the Assistance to Firefighters Grant program.

This report continues a series of annual studies by the USFA of on-duty firefighter fatalities in the United States. The USFA is the single public agency source of information for all on-duty firefighter fatalities in the United States each year. The unique and specific objective of this study is to identify all on-duty firefighter fatalities that occurred in the United States and its protectorates in 2001, and to present in summary form the circumstances surrounding each occurrence. The study is intended to help identify approaches that could reduce the number of firefighter deaths in future years. In addition to the 2001 overall findings, this study includes assessments of trends over the past 6 years, as well as special analysis on actions that can immediately impact cardiac health and firefighter safety during emergency operations.

This report continues a series of annual studies by the USFA of on-duty firefighter fatalities in the United States. The USFA is the single public agency source of information for all on-duty firefighter fatalities in the United States each year. The unique and specific objective of this study is to identify all on-duty firefighter fatalities that occurred in the United States and its protectorates in 1996, and to present in summary form the circumstances surrounding each occurrence. The study is intended to help identify approaches that could reduce the number of firefighter deaths in future years. In addition to the 1996 overall findings, this study includes special analyses on violent firefighter deaths, physical fitness and its relation to firefighter deaths, and vehicle accidents.

The specific objective of this study was to identify all of the on-duty firefighter fatalities that occurred in the United States in 1995, and to analyze the circumstances surrounding each occurrence. The study is intended to help identify approaches that could reduce the number of deaths in future years. In addition to the 1995 findings, this study includes a special analysis of the use of personal alert safety devices at fatal structure fires and a special report on several fatalities that occurred during technical rescue operations.

This report delineates the fire risk factors and presents the statistics regarding the fire problem among the elderly in the United States.

This guide outlines the essentials for establishing an arson strike force. It begins with a definition of the concept, presents a brief description of how such a unit might respond to an incident, proceeds through the planning steps for single and multi-jurisdictional strike forces, and outlines key elements in their organization and management.

This body of work provides detailed information on the nature of the fire problem for policymakers who must decide on allocations of resources between fire and other pressing problems, and within the fire service to improve codes and code enforcement, training, public fire education, building technology, and other related areas.

This document is intended to provide concise practical and technical guidance on arson prosecution. It draws heavily on state arson prosecutors' guides and other literature, and on presentations made at the first in a series of conferences for arson prosecutors at the Federal Law Enforcement Training Center in Clynco, Georgia in November 1985. This document also contains a guide to key literature on arson prosecution. This guide, found in Appendix A, suggests specific readings for prosecutors desiring additional information on the topics discussed in this document. Full citations to materials cited in the text and in the guide to sources by topic may be found in the references at the end of the report.

This report compiles the best practices and common problems of fire protection and criminal justice agencies in identifying, investigating, prosecuting, and preventing arson. Trends, current challenges, and best practices are discussed.

This body of work provides detailed information on the nature of the fire problem for policymakers who must decide on allocations of resources between fire and other pressing problems, and within the fire service to improve codes and code enforcement, training, public fire education, building technology, and other related areas.

The manual is designed as a comprehensive guide that helps fire and emergency service providers understand the concepts that form the foundation of risk management principles and practices, In addition, the manual directs the reader to sources of additional information and operational examples. The manual focuses on the practical application of risk management principles to fire department operations.

This body of work provides detailed information on the nature of the National Guard Plane Crash in Evansville, Indiana for policymakers who must decide on allocations of resources between fire and other pressing problems, and within the fire service to improve codes and code enforcement, training, public fire education, building technology, and other related areas.

This body of work provides detailed information on the nature of the fire problem for policymakers who must decide on allocations of resources between fire and other pressing problems, and within the fire service to improve codes and code enforcement, training, public fire education, building technology, and other related areas.

In 2003, the U.S. Fire Administration (USFA) announced a goal to reduce firefighter fatalities by 25 percent within 5 years and 50 percent within 10 years. It also committed to doing research that would support that goal. The consistently high annual percentage of fatalities related to fire department response and roadway scene operations prompted the USFA to look at several aspects related to these collisions in an effort to improve responder safety. Firefighters who are killed in privately owned vehicles (POVs) during the course of their duties account for the largest percentage of vehicle-related deaths. These are typically volunteer firefighters who are responding to or returning from emergency calls. However, career firefighters are also occasionally killed in POVs while performing their duties. The original edition of this "Traffic Incident Management Systems" (TIMS) report was released in 2008 as part of a cooperative agreement between the UFSA and the International Fire Service Training Association (IFSTA) at Oklahoma State University (OSU). The project was funded by the DOT Federal Highway Administration (FHWA). This latest edition of TIMS was developed in response to the release of the 2009 edition of the DOT/FHWA's Manual on Uniform Traffic Control Devices for Streets and Highways (MUTCD). It becomes evident that injuries and deaths that occur at roadway emergency scenes are a major concern to emergency responders. The purpose of this report is to focus on the causes of firefighter injuries and deaths when working on roadway incidents. This report will focus on the causes of these incidents and provide strategies for mitigating them in the future. The occurrence and severity of these incidents can be reduced through proper roadway incident scene tactics and incident management, information which will be covered in the remaining chapters of this document.

This body of work provides detailed information on the nature of the fire problem for policymakers who must decide on allocations of resources between fire and other pressing problems, and within the fire service to improve codes and code enforcement, training, public fire education, building technology, and other related areas.

The specific objective of this study was to identify all of the on-duty firefighter fatalities that occurred in the United States in 1997, and to analyze the circumstances surrounding each occurrence. The study is intended to help identify approaches that could reduce the number of firefighter deaths in future years. In addition to the 1997 overall findings, this study includes special analyses on collisions involving vehicles operated by firefighters and fatalities that occurred when firefighters working at the scene of an emergency were struck and killed by civilian vehicles.

The purpose of this guide is to provide information for facilities managers and may be useful for those individuals who might need special assistance as to the notification of an emergency situation and/or in the evacuation of a building.

A Fire Safety Campaign for People 50-Plus is a new campaign developed by the United States Fire Administration for our Fire Service partners. In this Campaign Guide you will find: 1) A "how to" introduction to using materials in the Campaign Guides; 2) Campaign fact sheet and flier - in English and Spanish - that can easily be copied and distributed in your community; and 3) Sample media materials, including a news release and live-read radio script, a print public service ad, and tips on how to get the media to use your fire safety materials