By Joel Lashley, Children's Hospital and Health System, Milwaukee

Want to take another FEMA Incident Command course? Sooner jump out of the moving car on the way to the class? I hear you.

But what if I told you there was a homeland security course you'd actually enjoy? What if it's a hands-on course that could save your life and the lives of those who depend on you?

And what if it won't cost you or your department a dime, because it's a federal program designed for the people who are actually responding? That's right — it's for the ones actually on the ground doing the work, before and after the smoke clears. DHS will even fly you there, house you, feed you and drive you to school in the morning!

The coveted COBRA patch. Only those who dare it can wear it!

The Department of Homeland Security's Center for Domestic Preparedness in Anniston, Ala., has already trained thousands of our nation's first responders for the disastrous possibility of a chemical, biological, radiological, nuclear or explosive (CBRNE) attack. Having attended the week-long Weapons of Mass Destruction/ Technical Emergency Response Training (WMD/TERT) and completed the Chemical Ordnance Biological and Radiological (COBRA) training that's part of it, I could never doubt that DHS is serious about training first responders.

Among the CDP's many assets at the sprawling former Fort McClellan U.S. Army base is the Noble Training Facility, which is centered at Fort McClellan's 100-bed hospital. NTF is responsible for training, research and development geared toward ensuring the survival and effectiveness of healthcare personnel and facilities in the event of a terrorist attack or natural disaster.

The CDP offers courses not just for personnel concerned with preventing and detecting threats, but also for those responsible for disaster mitigation and the maintenance and recovery of post-incident assets. By including EMS, fire, police, public works and hospital personnel, and all the people who actually control and run the country's long-term survival assets, CDP helps give the survivors of a catastrophic attack a chance at long-term survival.

Airline transportation from your local airport to Atlanta is prearranged. CDP buses then pick you up for the 90-minute drive to Anniston, which sits between the beautiful Appalachian hills and Talladega National Forest. If you only had the time, it would be a beautiful place to hike and camp.

Housing is in a comfortable clean barracks, with a private bedroom, and a bathroom shared with one neighbor. The officers club is open to all CDP trainees, but it closes early for a reason I'll get to later. Transportation is provided to and from local attractions, stores and restaurants at no charge.

My own connection with CDP is that the hospital I work for, the Children's Hospital of Wisconsin, is a Level 1 regional trauma center and so would presumably play a major role in the aftermath of any disaster in the area. CHW has made the commitment to send all of the security staff and an equal number of the nursing staff to CDP. CHW security personnel go in groups of three, one from each shift, and so far about 10 of the security staff have gone, which is about one-third of our total staff.

At Anniston

If you attend the WMD/TERT and COBRA course at the CDP, you'll train in realistic environments simulating the aftermath of a CBRNE attack. You'll wear a variety of PPE, including SCBA, PAPR and MOPP gear.  Cops can take a course to learn how to use their patrol rifles and apply their crowd-control procedures while serving in full chemical suits. EMS personnel practice triage and field medicine in realistic environments and PPE. Responders also learn to use chemical and biological detection and decontamination equipment.

COBRA Certified Children's Hospital of Wisconsin emergency and trauma nurses participating in Disaster Drills, at MRMC.

At times it's hard and hot work, dragging heavy training mannequins around and decontaminating them, but once you're finished, you'll have a glimpse of what's expected of you if the real thing ever happens in your community. But hot-zone search and rescue is not all you'll learn at the CDP. Most unsettling for me was a glimpse of the challenges police and healthcare security officers will face if they're ever called on to protect post-incident assets.

According to DHS, the CDP's Chemical, Ordnance, Biological, and Radiological Training Facility (COBRATF) is "the world's only toxic chemical training facility dedicated solely to emergency responders." COBRA, as you might guess, is the part of the course that gets the most attention, so much so that it's even sprouted little cottage industries, as base civilian personnel have taken to selling unofficial COBRA hats and T-shirts to trainees on the side.

According to some of my CDP instructors, the center is the only place in the free world that uses live-agent training. [Ed.: To my knowledge, there's also a facility in Canada that conducts such training.] That's right boys and girls, if you have the right stuff, you too can walk through controlled environments filled with deadly nerve agent, while wearing a gas mask and chemical gear, of course.

Yes, I did it and survived, after which I received my coveted COBRA uniform pin, which I'm told goes for a pretty penny on eBay! And yes, I did see some trainees opt out of the COBRA portion. I also saw someone wearing a "100 COBRA Entries and Survived" patch. I think I'll pass on earning one of those, but I am glad I did it once.

After Anniston

All of the CHW healthcare security staff frequently attend local hazmat courses, but we agree that none can compare to the CDP. We now know for sure that our equipment will work, and that we can do the job if the worst happens.

After returning from CDP, CHW senior security officer Mike Bolmes said, "The instructors were entertaining and educational. They were real experts."

Children's Hospital of Wisconsin Emergency Department and Trauma Department nurses setting up a Portable DECON Unit.

His favorite part was the improvised explosives class, which included a simulated methamphetamine lab, complete with booby traps. As for live-agent training, he said, "The COBRA training was extremely beneficial. It boosted my confidence."

Back when he was a sergeant on the Milwaukee County Sheriff's Office, CHW security services supervisor Mike Endter oversaw police operations on the Milwaukee Regional Medical Center campus. In addition, he has participated in large-scale drills involving police, fire and other emergency response assets at MRMC and elsewhere in Milwaukee County. He has participated in drills involving simulated airplane crashes, railroad disasters and large industrial chemical leaks.

Endter had previously attended FEMA training in Washington, D.C., and has had experience managing operations during a major construction disaster. But even with that background, he had this to say about the CDP and the COBRA course: "It was the first time I actually ever wore, much less trained in, full NBC [nuclear/biological/chemical PPE] before. I've trained in SCBA for fire response but this was totally different…. It was the best, most realistic training I've ever had."

According to CHW senior security officer Sal Scardino, the best parts were "the food (the mess hall fare has a Southern flair and everyone loved it) and talking with first responders from other areas of the country."

What Scardino didn't like was getting up at 0400 for daily blood draws. During much of the training, our blood had to be monitored for chemical exposures. Applicants for training have to complete a prior medical screening before arriving at the center and then submit to basic medical monitoring during the training cycle. <i>That's</i> why the officers club closes early.

Emergency and trauma nurses, too, will be on the front line of disaster mitigation if a CBRNE event happens in their community. Tracy Zierer, RN, an emergency pediatric nurse at Children's, says "Our previous hazmat training was good, but ‘The Center' makes such an impression and provides such realistic training. Rescuing dummies in realistic environments and actually decontaminating and triaging them was definitely more realistic … thorough. It shows you what it will really be like." 

All of us who went through the CDP were trained by instructors with real-life backgrounds in explosive ordnance disposal, chemical warfare, and search and rescue. Tracy highlights the analyses and lectures from experts on the Chechen school incident, the 9/11 attacks, IED attacks in Iraq and other terrorist events.

CHW security services director Mike Thiel and I and other CHW security and nursing staff trained alongside the Georgia Army National Guard's 138th Chemical Company, many of whom had already seen deployments to Iraq and were preparing for another. One of their officers put it to me like this, "If the Army sends us here — and we're chemical soldiers — then you know it's good training. Many of us have been through it more than once. There's a reason we keep coming back."

Thiel intends to continue cycling his officers and supervisors through the training at the CDP. He also requires all CHW healthcare security officers to certify in HICS (the hospital version of the Incident Command System) at the HICS-100 and -200 and NIMS-700 levels, so that any member of the CHW security staff can serve in the incident commander role, until relieved. Who knows who might be on duty when a catastrophe happens, or who might survive to handle it?

Thiel explains the need for this high level of disaster response readiness. "We made the commitment to develop an unparalleled level of expertise in pediatric hospitals. Children's Hospital of Wisconsin and our sister adult hospital, Froedtert Hospital, are the Level 1 trauma centers for southeastern Wisconsin. The Milwaukee regional area and beyond, to Chicago in particular, represent a credible target for modern terrorists and a CBRNE attack."

"I don't understand why everyone isn't sending people to this training opportunity," Thiel says. "It's the best available anywhere, and its free!"

At Children's Hospital of Wisconsin we continue to send our healthcare security, nursing, disaster management and other staff through the CDP. CHW personnel have attended the Hospital Emergency Response Training course, and a few others and I took our ICS-100 and -200 training there. ICS-300 and -400 and other NIMS and ICS courses are also available. The CDP even has non-resident instructors who can be sent to your location for training on some subjects.

At the CDP, Children's Hospital and Health System personnel train alongside firefighters, hazmat teams, law enforcement officers, SWAT teams, bomb squads, and military and EMS personnel from all over the country. We train together because if the worst happens, we'll all be working together, under the worst possible circumstances.

Just ask anyone who has ever survived a disaster. If you go to the CDP, you'll have the opportunity to ask them yourself, because some of them will be your instructors. It doesn't get any more real than that.

About the author
Joel Lashley is a senior security officer/instructor for Children's Hospital and Health System, Milwaukee, and a contributor to Police1, Corrections1 and FireRescue1. Email : joellashley@chw.org