Decision Making in Emergency Response

Decision Making in Emergency Response

Emergency Response could be stated quite simply as problem solving.  Emergencies are typically complex problems with dire consequences that must be solved in a very short amount of time to limit damage to people, property and environment.  The FEMA Emergency Management Higher Education Project College Course Instructor Guide states that an emergency is defined as “An unexpected event which places life and/or property in danger and requires an immediate response through the use of routine community resources and procedures”.  This paper will discuss problem solving and the decision making models used by the Federal Emergency Management Agency among others.  Several examples of how those models have been utilized in real life incidents will be offered.  Some analysis of the effects of those decisions will be made.

The Emergency Response Decision Making Model

The Federal Emergency Management Agency (FEMA) utilizes a five step model that works in a cycle in its modeling of proper decision making.  According to FEMA the five steps of the basic model are: 1-Determining the Problem, 2-Listing Alternative Solutions, 3-Choosing one Alternative, 4-Implementing the Solution and 5-Evaluating the Solution.

FEMA Emergency Response Decision Making Model

This basic model can be used for individual or group decision making.  It must be adapted in crisis situations which place more obstacles in the way of the decision making process.  Important aspects of effective decision making are that they contain the three key factors in crisis decision making: Clear values, quality information and an analytical approach.  

A motor vehicle accident is a routine emergency situation faced by emergency responders across the country on a daily basis.  Below is how the decision making process unfolds through this example of a real life incident:

  1. The problem is identified that the driver of a vehicle is pinned by the dash of his vehicle.
  2. The alternative solutions include prying with hand tools, manually cutting parts of the dashboard away from the driver’s legs, removing the seat with simple hand tools, or using hydraulic tools to lift the dash free of the driver’s legs.
  3. The option of using hydraulic tools is chosen because of the speed they offer in releasing the victim.
  4. Commands decision is passed via the IC chain of command to the operating personnel.  Crews use their training and standard operating procedures to extricate the victim.
  5. The patient is constantly monitored to ensure he is getting medical care needed while the extrication occurs.  If his condition changes significantly incident priorities will be re-examined.  The scene is also continually assessed.  If fuel begins to leak from the vehicle the incident priorities will need to be revisited.  Traffic is monitored to ensure the safety of responders operating in harms way.   

Small incidents such as that one tend not to have complications that can come from larger more complex incidents.  The next three examples are indications of how larger incidents bring about more complex issues for decision makers.  The examples will call into play decision making values, quality of information and the importance of decisions made prior to incidents.

How Do Values Come Into Play?

Several high profile incidents have called into question how values can come into play when making decisions in emergency situations.  The Deepwater Horizon incident in the Gulf of Mexico was one.  Another more recent one that I will discuss is the ferry incident in Korea.  In some situations a system lends itself to poor decision making.  Often human error is a cause of an emergency.  In these cases decision making is hampered when the system is set up so that the person that may have caused the emergency is also responsible for the initial actions in mitigating the emergency.  Such is the case in the unfortunate Korean ferry incident.  The Captain, who was responsible for the ferry, was also responsible for a delay in ordering the evacuation of the ship.  In an article written for CNN, Andrew Stephens says students stayed inside “apparently following instructions to stay put – instructions that may be proven by investigators to have led directly to their deaths”.  

Quality information is another important aspect in larger incidents.  In the automobile accident above the situation was so small that the incident command would be directly on scene and see all information first hand.  Larger incidents do not lend themselves to such advantages.  The command must rely on information relayed to him up the chain of command from the on-scene personnel. 

Emergency Response Collage Korea Ferry Oklahoma bombing World Trade Center

The incident at the World Trade Center Towers in New York City is one example of how important all of the information used in decision making can be.  Reports published after the incident indicated that the towers may not have collapsed “if the thermal insulation had not been widely dislodged” by aircraft impact.  The loss of insulation on structural components created what the National Institute of Standards & Technology (NIST) called a progressive collapse. There was no previous data to determine the way a building will withstand plane impact and fire.  Previous large high rise fire data have all been based on the burning of ordinary combustibles, and without the added damage of aircraft impact. 

The Fire Department of New York (FDNY) is possibly the most respected response agency in the world.  They are certainly one of the most experienced in both large and small events.  No high rise building had collapsed due to fire previously in the U.S.  As an indicator of the doubts that a high rise building would collapse, initially the FDNY command post was located in the lobby of WTC1.  This is further evidenced by the statement that firefighters inside the tower “perceived this as a conventional, large high-rise fire”.  Decisions are made on available information.  In this case unfortunately information simply did not exist at that time.

Another well known incident is a great example of how preparation and decisions made prior to an incident can have a positive effect on response decision making.  When a bomb exploded at the Alfred P. Murrah Federal Building in Oklahoma City in 1995, the city and state responders were well prepared.  The emergency response personnel had recently attended mandatory Incident Command System (later renamed National Incident Management System) NIMS at the National Fire Academy.  As a result they had made some significant enhancements to their response plans.

These included increased mutual aid training, pre-determined response plans, adding a mobile command vehicle, establishing volunteer staff, and adding compatible radio systems.  These changes created a more safe and efficient response.  The added training and equipment aided the command staff in making better and quicker decisions.  The knowledge allowed them to have predetermined procedures which aided in their efficiency.  The Disaster Recovery Center was in full operations only 25 minutes after the bomb.  Despite the magnitude of the incident the response itself was very safe and without major injury. 

Importance of these steps was stressed in the final report.  Emphasis was given to the benefit of meetings between different response agencies which allowed response planners to “know each other better and have a clearer understanding of each other’s abilities and resources”.  

These incidents highlight the fact that while an analytical decision making process is vitally important in emergency response, typical decision making models may not suffice in addressing the issues of what is considered critical decision making that occurs in emergency incidents.  Crisis decision making has factors that make decision making more difficult.   The course material for FEMA 241.b, Problem Solving and Decision Making, list the following: Time constraints that might make consensus building implausible.  Stakes can be high in a crisis, including the lives of victims and responders.  There are uncertain consequences to most alternatives, without set rules to guide the choices, and often those choices do not include what would be considered good choices.  The decision is often between bad and worse.

I would add another factor to the list that adds stress to the decision making process in crisis mode.  During an emergency the status is always changing, and it changes rapidly at times.  This creates the need for key adaptation to the standard decision making model.

The Need For An Analytical Process

These issues stress the need for applying an analytical process with the following keys adaptations or enhancements to the model:  In step one ensure your communications system in place will get you good information.  It must be adequate and accurate.  The second step should only contain credible alternatives.  That should only include those fast and safe enough to be done with available resources.  Choosing an option in step three can be accomplished more quickly if some options are eliminated first.  Be sure to include some failure contingencies.  In the fourth step following the chain of command with all communications being repeated to ensure accuracy is essential.  Some large incidents will call for written action plans.  Finally a key difference in the decision making model adapted for crisis is that assessment, the fifth step in the standard model, is continuous and ongoing in an emergency response.  It occurs simultaneously during the other four steps and will return the cycle to step one as needed when conditions change. 

Modified FEMA Decision Making Model

A hazardous materials incident is an excellent way to indicate the need for an analytical approach to problem solving on the scene of an emergency.  Empirical data is required to make educated decisions.  Research is done using shipping documents, packaging, placarding, labeling, building MSDS, air monitoring and product chemical analysis.  Once all data is acquired and analyzed actions can be planned.  Progressive response stages will occur.  Decontamination will be set up according to the data before mitigation actions can be taken.  Zones are set up.  PPE is determined by the data gathered.  The five step process is definitively followed.  Step one is determining the product/s released.  Step two is research on the product once determined – this will set the elimination zones, determine the level of PPE and decontamination needed, as well as possible evacuation zones.  Step three is to determine what measures are to be taken.  Is the leak to be contained or confined, diverted, diked, or dammed?  Will fires extinguished or allowed to burn to avoid a worse problem with run off?  Step four is also very systematic as responders have baseline vitals taken, are dressed by haz mat trained personnel and tracked individually.  Step five is ongoing as the leaks/spills are monitored and air monitoring around the periphery is ongoing.  Hazardous Materials incident mitigation is quite possible the most analytical of all types of emergencies.

The Value of Character And Principles

I have done some research outside the emergency response arena on decision making as well.  While a great deal has been written on the topic, I feel that one area that deserves further consideration here is the value of character and principles in decision making.  In his book “The Seven Habits of Highly Effective People” Stephen R. Covey states that our decisions are based on how we center our lives. 

Some people are self-centered and will make decisions based on what is best for them.  Some are work-centered and will make decisions based on what is best for their career.  Some are family-centered and will make decisions based on what is best for their families.  The number of different things we can be centered on is unlimited, some can be positive and some can be negative.  Centering on people or situations is not efficient as people and situations change.  Effective decision making comes from a principles centered base. 

Proper principles are positive and do not change.  Principle based decisions will work out to be best for you and what is important to you in the long run.  In my presentation “Decision Making in Crisis Mode for Emergency Response Command Personnel” this point is emphasized several times.  There are two very important aspects of principle based decision making that highlight my presentation.  First is that principles must start at the top.  An organization should have a principles based mission statement that they live up to.  Their objectives and operating procedures should reflect these principles at all times.  This creates a system that has set up the employees to succeed.

Secondly they should hire people based on principles as much as qualifications and skills.  People can learn operations and skills.  It is far more difficult to teach character.  “Put good people into a good system and they will make good decisions.  A person cannot be taught to make good decisions; they can be guided there with values, goals, procedures, equipment and training”.   Good people make good decisions.

  • We build successful responses with efficient decision making
  • What is the first and most important part of building? Foundation. And the foundation of good decision making is character
  • The success of your organization starts with people. People with good character.

Pyramid of Success

In summary a systematic approach to critical decision making in emergency response drives the safe and efficient mitigation of emergency events.  Large and small, natural disasters or man-made situations all require a decision making process that will solve the problems presented by the incident.  An analytical approach that incorporates the five step problem solving and the three key factors of the decision making process will benefit the decision makers.  Making as many key decisions prior to incidents is also important in aiding the decision making process.  This lessens the stress on responders and makes crisis decisions making more manageable.  

Terry Boes

Twenty-two year emergency response veteran. Experienced in firefighting, hazardous materials, emergency response training and emergency response planning. Currently working in Oil & Gas and providing workshops in Emergency Response Planning and Incident Management.

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emergency response

Discussion
  1. Excellent article. When I was taking CPR and Emergency First Aid, we were taught this same method. We were also taught the three C's (Calm, Cool, Collected). I'm a little surprised it was not mentioned in the article because it is an important part of Emergency response and allows you to assess the situation in a more focused manner. Regardless, this is a good article and has a lot of great information.
    Thanks for the article!

    Yeah, keeping a calm and critical mind during emergency situations is as important as taking proper care to aiding a victim in need of help. I have personally seen a lot of people go into mental shock, disbelief, or emotional distress in a emergency situation, and it does prove to easily distract and deter a human from doing what he or she needs to take care of their self and others who have been harmed. Being resilient in proper medical demeanor and minimizing emotional feelings, go far in allowing one's mind to be clear and focused on analyzing what needs to be done and what needn't be pursued.
    kevinkimers
    Excellent article. When I was taking CPR and Emergency First Aid, we were taught this same method. We were also taught the three C's (Calm, Cool, Collected). I'm a little surprised it was not mentioned in the article because it is an important part of Emergency response and allows you to assess the situation in a more focused manner. Regardless, this is a good article and has a lot of great information.


    The three C's sound simple enough, but are definitely easier said than done. It takes a good deal of effort in a lot of situations, especially those that arise with little or no warning. Even those that are warned of in advance can be devastating and put people into a tailspin.
    Thanks for the article! I am really glad when people share valuable information like this. Information like this is really helpful in times when you need to take action. Once again thanks!
    They taught one basic thing that i still follow and it is "Help if u can lest refrain".Well there are many others but some are essential to process in the next course of action.Good article and thanks to you chris.
    The article's really helpful. For the inexperienced ones, however, it's a tall order to stay calm and avoid panicking during disasters. People tend to lose their wits and end up losing their ability to think straight. Perhaps if they take up disaster response and management courses, they'd be able to overcome their nerves whenever disaster strikes.
    This is a process that our brains go through to solve any problem we face. But like the operating system on our computers, we are generally not even aware of it. In a disaster situation, it is helpful to remember the simple process of problem solving. It may sound obvious, but when you are stressed and panicked, it helps give a clear track for your thoughts.
    The Emergency First Response company has 3 things that are similar to the 3 c's mentioned. With Emergency First Response they say to Stop, Think, Act. This principle means that you should stop and take a look around before you decided to care for someone to make sure there is nothing around that is going to cause harm. Then you are supposed to think about what you are going to do, and then act. I teach FA/CPR classes and it seems like a simple concept for people to grasp.
    kevinkimers
    Excellent article. When I was taking CPR and Emergency First Aid, we were taught this same method. We were also taught the three C's (Calm, Cool, Collected). I'm a little surprised it was not mentioned in the article because it is an important part of Emergency response and allows you to assess the situation in a more focused manner. Regardless, this is a good article and has a lot of great information.


    That's what I learned at CPR class too -the three Cs. You are right, it really is essential to stay calm, it's the only way you are going to be able to think clearly and make the right decisions. It is possible to make a bad situation much worse by losing your cool and I think it would be useful to promote this idea.
    I think it's all very fine in theory to stay calm and centered during emergency situations, the only thing is that not all of us are trained to deal with sudden disasters or emergencies. Many people will panic and possibly do more harm than good. I would say that in some instances it is preferred that people do as little as possible until trained emergency staff is available. Naturally, that can take ages, so the best way to help is to focus on nothing else but the immediate situation at hand.
    Great article for handling stressful and dangerous emergency situations. I will remember the principles and apply them when necessary. Great afbvice.
    The first problem in emergencies is the confusion that results into panic. Our orientation here is to use the term RELAX or KEEP CALM and never mention the word Panic. Those fully trained in rescue operations and emergencies have the presence of mind which is very important particularly when TRIAGE is needed. Triage means the evaluation of the survivors and identifying those that should be saved first.
    That's a good article, thanks. I've actually used the FEMA model with an Education company I was consulting with. They have school across Asia with a number of them located in areas where earthquakes, typhoons, or floods are a real concern. We extended our thinking to other potential disasters such as fires, violent intruders, and social unrest.

    Thankfully we haven't had put to our planning to the test yet, but having an structured way to approach preparation was very helpful.
    Thank you for this article. I have always made it a priority to be prepared for any kind of disaster. I run regular drills with my family members (I am a college student living with my parents and my siblings) but sometimes they get lazy or they don't get the point. They call me paranoid but I know that when a disaster DOES strike, it really is better to be safe than sorry. Thanks again for the useful information. Cheers.
    This article was on point. It touches many subjects as well. You have to remain cool in these situations are things could get even worse. Keeping a calm state of mind could result in life or death.
    The three C´s are definitely important, and one of the ways to prepare for a disaster or emergency situation is just to be aware of the physical changes that are going to happen to your body. For instance, most people are not ready for the adrenaline rush you are going to get, which is followed not long after by fatigue. You need to think realistically about staying calm and reducing that adrenaline surge because the fatigue it causes later might prevent you from doing the most important things as far as survival goes.
    petesede
    The three C´s are definitely important, and one of the ways to prepare for a disaster or emergency situation is just to be aware of the physical changes that are going to happen to your body. For instance, most people are not ready for the adrenaline rush you are going to get, which is followed not long after by fatigue. You need to think realistically about staying calm and reducing that adrenaline surge because the fatigue it causes later might prevent you from doing the most important things as far as survival goes.


    The three C's? I am aware of the ABC of first aid but what is this that you talk about? Pardon my ignorance!
    The three C's are Calm, Cool, and Collected. Don't feel ignorant... not everyone knows about them. It is a set of ways to keep yourself in control that you can control a situation that is occurring. Many learn the methods and do not realize it. Especially when you work in certain fields. Customer service is a good place to learn the three C's strangely enough.
    Holy Moly that was in depth!

    I clicked on it thinking "oh it's probably that same stuff I learned in CPR class."

    I really like how Terry talked about character.

    Seems like a good disaster plan is to surround yourself with people of great character.
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