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Workplace Violence Prevention News

Workplace Violence Prevention - Medical Emergency Response Teams

Friday, January 25, 2013

What Does Your Company Need?



Does your company have an employee Emergency Response Team (ERT), an employee Medical Emergency Response Team (MERT), or even dedicated Search & Rescue (SAR) personnel in case of an emergency? What does your company need and what are the differences?
Most companies know that they need an Emergency Action Plan (EAP) according to 29 CFR Part 1910.38 – “Emergency Action Plans”. And as part of your company’s EAP you must include, in part, the following procedures:

  • How to report a fire or other emergency
  • Emergency evacuation, including type of evacuation and exit route assignments
  • How employees who must remain to operate or shut-down critical plant operations
  • evacuate
  • How to account for all employees after evacuation
  • How to perform rescue or medical duties

Now, your EAPs become more complicated if you have hazardous materials on site when 29 CFR Part 1910.120 – “Hazardous Waste Operations and Emergency Response” is invoked. And should you have chemicals listed in Part 1910.119 “Process Safety Management,” at or above the specified threshold quantities on site, the requirements of Part 1910.119(f) – “Operating Procedures” will also apply. Specifically, paragraph (f)(1)(i)(D) – “Emergency shutdown including the conditions under which emergency shutdown is required, and the assignment of shutdown responsibility to qualified operators to ensure that emergency shutdown is executed in a safe and timely manner.”

It is inherent in the emergency shutdown of operations involving hazardous materials (HAZMAT) that non-essential employees may need to be evacuated to protect them from potential exposures. However, there are many more common emergency scenarios in and around your office, facility or campus that could result in employee evacuations such as:

  • Fire and Smoke
  • Vehicle Accident/Fire
  • Earthquake
  • Power Outage
  • Elevator Failure
  • Medical Response
  • Odor Response
  • Communications Outage
  • Explosion
  • Severe weather
  • Active Shooter
  • Civil Unrest

Response Team Structure

In order to effectively comply with these emergency plan regulations, companies will require some form of volunteer employee response team. The optimum employee response team structure for managing evacuations, small fires and medical emergencies, depends upon several response team factors including:

  •  Office configuration (i.e., one floor vs. multiple floors)
  •  Building configuration (i.e., single vs. multistory)
  •  Campus configuration (i.e., multiple buildings - close vs. distant proximity)
  •  Proximity to Emergency Medical Services (EMS) (i.e., rural vs. urban, or onsite)
  •  Number of employees
  •  Employee interest in volunteering
  •  Geography and topography
  •  Industry standards (based upon historical incidents)
  •  Training budgets
  •  Corporate liability philosophy

At the simplest level, you may have the equivalent of “hall monitors” who are designated employees responsible for ensuring that employees in their area are safely and expeditiously evacuated in case of an emergency. These monitors are responsible for accounting for all employees after an evacuation. Such “monitors” could also provide shelter-in-place coordination when events demand. Monitors have the least amount of emergency training. Next, you may have dedicated SAR teams that are responsible for locating any missing employees after an emergency. Such teams generally have additional training related to rescue methodologies and unique skills related to rescue tools, such as axes, pry bars, ropes, radios, etc. A higher level team would be an Emergency Response Team. ERTs are generally trained in a variety of skills including CPR, triage, Basic First Aid (BFA), search and rescue, damage assessment, minor fire suppression, securing utilities, crowd control and Incident Command System (ICS) functions and communications. Given the nature of your business, they may additionally require HAZMAT awareness or other specialty training.

A Medical Emergency Response Team (MERT) is a term used for the highest level of emergency medical care training for corporate and industry personnel. A MERT is tasked with being first on scene for medical emergencies within a facility or company and providing basic medical care until professional first responders arrive. MERT members can take anywhere from 8 to 48 hours of medical training depending upon the intended scope of their practice. Companies do not have to provide volunteer employee staffing for all emergency team levels from hall monitors to MERTs. Depending upon the response team factors noted above, you may decide to only have a MERT, whose members function as both and ERT and MERT. Or, you
may only have ERT employees. Your optimum response team structure will be based upon the factors listed above as well as historical accident and local emergency data.

Training Options

ERT - An excellent baseline curriculum for ERTs would be FEMA’s Community Emergency Response Team (CERT) program which is currently set at 24 hours. This base curriculum includes the following topics:

  •  Disaster Preparedness
  •  Fire Safety
  •  Disaster Medical Operations – Part 1
  •  Disaster Medical Operations – Part 2
  •  Light Search & Rescue
  •  CERT Organization
  •  Disaster Psychology
  •  Terrorism Awareness
  •  Final Skills Evaluation

The disaster medical operations classes include basics such as personal protective equipment, controlling bleeding, treating basic injuries, splinting fractures and sprains, and triage. However, this baseline content can be expanded over time with routine upgrade training specific to your
business and response team factors noted herein. Such upgrade training might include crowd control (during evacuations), managing spontaneous volunteers, internal and external communications, interfacing with professional first responders and HAZMAT awareness.

SAR Team – It is extremely important that these teams receive specific training relative to where they can safely search and which types of rescues they are capable of performing. All too often, inexperienced rescuers rush in and wind up needing to be rescued themselves! The Light SAR training provided in the CERT program is a good initiation to SAR activities; however, more site specific training would be required to ensure their safety in your workplace. These teams need to understand basic structural integrity issues related to the types of building construction they may search. Knowing the differences between wood construction, brick and mortar, concrete tilt-up, and a steel and concrete building is critical to determining the safety of the structure during or after a destructive event such as a fire, earthquake or severe wind event.

MERT – There are various medical training options for MERTs depending upon the level of support intended by the company and budget constraints. To be clear, all medical training for MERTs is considered “basic life support.” As such, the level of instruction provided in such training can vary significantly from 8 hours to 48 hours. The 48 hour training course results in a Medical First Responder designation which is just below an Emergency Medical Technician (EMT). It is possible to establish your MERT with some minimum medical training and, as they develop, expand their training to include more complex medical assessments and treatments. On-going Training and Exercises – Once trained and qualified, your response teams will
require regular training in order to maintain the myriad of skills they now possess. For medical teams especially, regular monthly training is critical to keep victim assessment and treatment skills sharp. Annual emergency exercises will also help to maintain employee response skills and
identify program weaknesses, which should result in procedural changes and additional employee training. Failure to provide continuing training for these select employees provides a disservice to them and weakens you Emergency Action Plan, opening the company up to regulatory penalties.


The optimum emergency response team structure will be based upon the many factors listed herein as well as historical accidents and local emergencies at your office or facility locations. The use of well-trained volunteer employees with clearly defined responsibilities can
significantly improve the safety of all your employees and protection of your capital assets. And, finally, it is important to stress that any company emergency response employees clearly understand their limitations both physically, emotionally and from a training standpoint so as not
to exceed their scope of practice.

About the Author

Jim Serre has over 30 years of engineering, process safety management consulting and corporate training experience. He has over 7 years of Cal EMA qualified Search & Rescue experience and has provided Emergency Training to thousands of citizens in neighborhoods, businesses and faith-based groups. He is a certified instructor for FEMA’s Community Emergency Response Team training; a Disaster Services instructor for the American Red Cross; and an ASHI qualified CPR/First Aid instructor. Additionally, his knowledge of survival and preparedness skills make him uniquely qualified to design emergency kits that can save your life. For more emergency preparedness information and training capabilities see his website at www.getreadygear.com.

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