Page 109 - JSOM Summer 2020

FIGURE 4 In anticipation of chemical exposures either through lacrimators or more nefarious means, Gainesville Fire Rescue
decontamination strike teams were staged to rapidly decontaminate victims.

weapon, which has become increasingly prevalent worldwide FIGURE 5 Antiquated, ready-to-be decommissioned law
and is difficult to contain. For example, in July 2016, a 19- enforcement vehicles and larger vehicles were placed on the front line
15
ton cargo truck was deliberately driven into crowds of people as barriers against possible vehicular attacks.
celebrating Bastille Day on the Promenade des Anglais in Nice,
France, resulting in the deaths of 86 people and the injury of
458 others. Another vehicular assault occurred on March 22,
16
2017, on Westminster Bridge in London, leaving three people,
including a police officer, dead, and at least 29 hospitalized.
17
Although 10 vehicular attacks took place between 1996 and
2013, the pace has quickened, with > 40 vehicular assaults
since 2014; 20 occurred in 2017 alone. Law enforcement
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prepared for possible vehicular assaults by placing older police
vehicles ready for decommissioning and large vehicles (e.g.,
dump trucks, tractors) as front-line barrier vehicles to restrict
key areas of traffic (Figure 5).

There were also concerns about the ability to respond to si-
multaneous counter-demonstrations at multiple sites within
the city of Gainesville. Plans were made for additional medical
support by fire and EMS agencies. EMS physicians from UF’s
Department of Emergency Medicine EMS Division were em-
bedded at staging areas and offsite to assist in triage, provide entrances were secured with armed police officers for this spe-
medical oversight, and aid in decontamination procedures. cific occasion, with limited visitors allowed that day. Our two
freestanding EDs increased their capacity and were prepared
for an influx of patients. Helicopter EMS was ready to assist
Implementation
in patient transport in the event that a mass casualty incident
With the assistance of the UF president, the UF Department of developed and local hospitals were inundated with patients.
Emergency Medicine and the Department of Surgery surgical
services began to enact and plan for the disaster response, in- Once it was certain that we could not prevent this event from
cluding a multitiered call list in case events escalated beyond taking place, efforts were undertaken to coordinate with other
the staffing capacity put in place for the event. The emergency local law enforcement agencies for support. Although this ef-
19
department (ED) staffing was increased by >50%, and elective fort was challenging, Florida Governor Rick Scott declared a
surgeries were delayed to free up operating room, inpatient, state of emergency 3 days before the event, which was an
20
and ED space. The increased staffing was in addition to the important turning point in preparations. This allowed law en-
tiered activation plan as required by the Homeland Security forcement agencies to pool resources as well as funding from
Exercise and Evaluation Program. The ED continued its base- the state under the Florida Comprehensive Emergency Manage-
line operations; staff continued to see all incoming patients ment Plan to maintain the safety of the university community.
and receive EMS and transfer patients per usual operations. A Ultimately, numerous SWAT teams from the state and federal
portable emergency room tent with basic surgical capabilities levels were represented (Figure 6); even more law enforce-
was deployed directly outside our own physical ED. The ED ment agencies were represented at the patrol level, including

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