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Bound by Duty:
Our Urban Shield Heroes Shine
By: Brendalyn 'Val' Bilotti, CHS-V, R.N., BS, CQM, CHSEMR and Mark Withrow, CHS-V, FABCHS, DABCIP, CMI-I, CTO, BCIH

The dark morning sky begins to lighten as vehicles arrive by 0500 to the Regional Training Center in Dublin, California. Is there a chill in the air, or is it the anticipation of great expectations? With nearly a year of planning, the annual Urban Shield full-scale exercise (FSE) will again become a chapter in our nation's history. Totaling more than 4,000 staff and volunteers including command staff, site captains, law enforcement, fire, EMS, EOD, DMORT, and military branches from the Coast Guard and National Guard, we are ready. So unique in its scope, the two-day exercise becomes a well-oiled machine with a million moving parts, each piece performing a specific role.

Now in its fifth year, Urban Shield has consistently raised the bar and stretched the expectations of each and every person, resource, agency, piece of equipment, and police technology, put it to the test, and then some. Individual observers would find it difficult to appreciate the enormity of this event, or understand the complexity of this multi-layered, intra-related structure. Yet it continues to be a one-of-a-kind, multi-disciplinary, multi-jurisdictional, FSE designed to evaluate the San Francisco Bay Area's response capabilities to large-scale man-made and/or natural disasters.

What is Urban Sheild?

Urban Shield is an assessment tool that tests the Urban Area Security Initiative (UASI) region's integrated systems for prevention, protection, response, and recovery in a high-threat, high-density urban area. It red lines every part of planning, policy, procedure, organization, equipment, and training to see if what's in place is worthy to be called "the standard." It is a 48-hour continuous exercise in which first responders, both national and international, are mobilized and deployed to 36 realistic exercise scenarios hosted by 20 agencies, spanning 700 square miles within Alameda, San Francisco, Santa Clara, and San Mateo counties. The sites selected are based on critical infrastructure concerns as well as tactical, medical, fire, and explosive ordnance response to critical incidents. Due to its unique nature, the national UASI region and international observers included team members from Texas, Massachusetts, Illinois, Colorado, Oregon, and Washington, along with Belgium, Canada, Croatia, Bahrain, Jordan, Singapore, and the State of Israel.

UASI programs such as the Northern California Regional Intelligence Center (NCRIC) and volunteer management have been included in the evaluations to build upon the 2006 chemical, biological, radiological, nuclear, and explosive devices (CBRNE) analysis of regional assets.

Are We Ready?

If we prepare to respond to Tier One threat scenarios, we can increase the success rate of mitigating such threats. It is the commitment to protecting life and property that makes this type of training so crucial and so unlike anything else in the country. Urban Shield is an unparalleled training exercise that allows 4,000 people to gain experience that is as close to real life as it gets. Participants respond to all information and situations as they are presented, in the same manner that they would respond to actual emergency incidents.

According to Police Lieutenant Wayne Hoss, a 2010 participant from the Field Operations Investigative Unit in San Mateo, California, the level of realism was paramount. "Of all the different scenarios thrown at us, I was most proud of our team during the mass casualty incident," he said. "There were 15 role players with authentic-looking injuries. Two years ago, our operators would not have reacted so well under this high-stress event. But, had it been real, we would have saved lives that day! As cops, we are not the best at saying thanks, but you (Urban Shield) guys rock and are our heroes."

Given the scope and level of realism, the FSE presents potential safety hazards to participants. For this reason, an exercise Safety Coordinator has been appointed to identify those hazards and make appropriate recommendations to minimize or eliminate any possibility of injuries. All participating organizations recognize the importance of conducting an exercise of this magnitude in as safe a manner as possible.

All exercise scenarios of Urban Shield are conducted in a "no-fault" learning environment, in which plans, procedures, systems, and processes—not individuals—are evaluated. This allows for an immediate assessment of what skill sets need to be improved upon.

Consider this Piece of the Puzzle

In compliance with the Incident Command System (ICS) structure put forth by the National Response Framework (NRF), the Medical Branch serves a logistics function. Its mission is to keep the participants—our first responders—in the game. In order to achieve this, the two-day event has four tactical field aid stations, four tailgate medical units, and 200 medical staff including physicians, physician assistants, nurse practitioners, RNs, paramedics, EMTs, and first responders from county Search and Rescue (SAR). The staff are drawn from Stanford, California and other area hospitals, the California Disaster Medical Services Association (CDMSA), and the Medical Reserve Corps (MRC).

This is a unique place to do medicine. Take 200 medical professionals, place them in make-shift environments like tents, an aircraft hangar, and/or outside a live-fire weapons range and have them work out of the back of an SUV. Hand them equipment they may not have worked with before, with people they may not know, and tell them to consider the next two days a disaster scenario. Their job is to ensure our law enforcement, fire, and Emergency Medical Services (EMS) professionals are taken care of so they can do their job, stay in the fight, and are able to rescue one more person or secure one more piece of property. These are medical professionals who are conducting real medical evaluations, triage, and treatment. They communicate this information through the Departmental Operations Center (DOC), where continuous monitoring of each participant's bio stats is recorded.

Urban Shield provides a rare opportunity to collect data on a large-scale over a sustained time period on 250 extreme athletes who are our first line of defense against high-risk homeland security threats. Several noteworthy research studies have evaluated performance and rest relationship tolerance, along with tactical medical departmental training and equipment proficiency, which are referenced later in this article.

As Alameda County Sheriff Gregory Ahern comments, "It is critical that we continue to expand regional collaboration and preparedness levels for all first responders. Testing our abilities over a broad spectrum of disciplines and scenarios within the confines of a coordinated training and exercise venue, we will be better prepared to address strategic, operational, technical, and tactical change."

Putting it to the Test

Five overarching goals, designed to strengthen preparedness in order to prevent and respond to threatened or actual domestic terrorist attacks, major disasters, and other emergencies, are the main focus of Urban Shield:

  • • Test overall communication and management capabilities with a focus on City and County Emergency Operation Centers throughout a five county core area;
  • • Integrate critical infrastructure and their on-site private security personnel into a collaborative response framework to test public/private sector response plans and unified response;
  • • Evaluate regional fire, search and rescue, and HAZMAT response with a focus on core competencies;
  • • Evaluate regional Explosive Ordnance Disposal team core competencies and response capabilities; and
  • • Evaluate regional capabilities to effectively identify, integrate, and manage volunteers responding to large-scale disasters.

Of the 36 law enforcement, fire, and EOD scenarios each tactical team must face, one example includes a Mass Casualty EMS Response with Force Protection:

This exercise scenario tests the ability of EMS personnel to provide mass casualty triage and expedient field treatment of multiple casualties while law enforcement tactical teams provide protection, resulting in inter-agency and multi-discipline integration and coordination. Tactical teams are evaluated on their ability to provide effective force protection to responding EMS personnel in an active shooter environment by demonstrating the tactics necessary to isolate and take out the shooter(s). EMS personnel working in this high-stress tactical encounter must effectively administer hemorrhage control with homeostatic agents, tourniquet application, and rapid assessment and treatment techniques.

The most important strength that one can take away from an event this challenging is the expertise of each individual you work with, collaborate with, make mistakes with, learn from, and teach. At the end of the day, it is the numbers you have added to your phone, the respect gained by the actions of incredible people, and leaving with the assurance that we are in good hands.

After Action Report

Forty-eight hours later, at 0500, is there still a chill in the air or is it the feeling of having completed another successful event? The elation you feel deep in your bones comes from doing a good job and knowing that not a single participant was sidelined due to injury. All finished, perhaps a little sore, exhausted, bruised, and blistered, but standing tall, exchanging high fives and pats on the back. The men and women, our dedicated first responders, have shown up in harm's way while everyone else takes cover, and have kept us safe and secure once again. With a near perfect performance record, we will be even better next time.

With the challenge completed, demobilization and a hot wash gives participants the opportunity to shower and remove all the dust, dirt, and sweat that has accumulated over the last two days, take part in a debriefing, grab a hot meal, and enjoy listening to a cadre of respected speakers. The importance of Urban Shield, according to Commander Kevin Hart, Deputy Incident Commander of the Alameda County Sheriff's Office, is "to ensure first responders are as prepared as possible to meet the demands when duty calls." We strive every single day to be ready. It is now time to complete the AAR and begin planning next year's Urban Shield by utilizing all the lessons learned from this year's event and creating new challenges, new opportunities, and building new relationships.

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