Did You Know? There’s More to Dahlgren Decon than Just Peracetic Acid

Part A is 10,000x more effective than Dawn dish soap.  

Peracetic Acid (PAA) is the main oxidizing agent in Dahlgren Decon that chemically neutralizes toxic chemicals and destroys biological agents and pathogens. But there is more chemistry behind the effectiveness of Dahlgren Decon than just PAA. In fact, Part A of Dahlgren Decon, also known as Dahlgren Surface Clean, was specifically formulated by the US Navy to be the most effective decontamination soap available.

A key challenge in decontamination is the removal of oily, viscous, and insoluble materials.  These materials do not mix with water and require a huge volume of water and scrubbing to remove through sheer force.  The traditional solution was to add a surfactant (soap) to the mix, which lowers the surface tension of water and helps the water and the material to mix.  This mixing of soap, water, and contaminant is called an emulsion.

An example of an emulsion is Italian salad dressing.  Just like Italian dressing, an emulsion with oily contamination will only stay blended for a short period of time before the oil, water, and any other contaminant begin to separate out.  This can occur very rapidly and can lead to a small area of contamination being spread out in a thin layer across the entire surface area of a person or object.

The solution to this problem lies in microemulsions like Part A of Dahlgren Decon.  A microemulsion is made using advanced surfactants, which reduce the surface tension of water over 10,000x more than commercial dish or laundry soap.   

Multiple types of surfactants with different properties are used so that the microemulsion can accept both oil and water-based contaminants into the same solution, as well as quickly dissolve and trap volatile liquids and powder solids.  The microemulsion acts like a liquid sponge, absorbing and holding large amounts of contamination.  And most importantly, unlike a standard emulsion, microemulsions are stable and the contamination will stay in solution for an extended period until it can be easily rinsed or wiped away.

The microemulsion surfactant that is Part A of Dahlgren Decon is pH neutral and safe for use on skin.   

It was originally developed for removal of some of the toughest challenges: Chemical and Biological Warfare Agents.  However, it excels at physical removal of a broad range of hazardous materials from a wide variety of surfaces.  Uses include washing off oily contamination such as pesticides or petroleum from spills.

Because it works well on both oil and water-based substances it can be used on both types of OC spray and riot control chemicals.  It will wet, dissolve and remove fentanyl and its analogues while keeping the pH neutral, which is important to avoid aerosolizing or converting the fentanyl into a more dangerous form.  The Part A microemulsion also has use in post-fire decontamination to help remove potentially cancer-causing materials.


Which Communities are the Most Evacuation Challenged?

New data can improve evacuation planning.

In a recent article by Jim McKay on Government Technology’s Emergency Management website, a new study of traffic patterns in 100 communities identified several factors that have a major impact on evacuation constraint risk.

StreetLight Data conducted the study which looked at 30,000 towns in the United States with populations under 40,000.

According to Laura Schewel, the CEO of StreetLight Data, “We decided to analyze small towns because those are the ones where you get the most horror stories and they have the most bottlenecks and the least amount of resources to deal with it.”

The StreetLight Data team developed an index that focused on a few key factors including:

  • How many total routes out of town are there?
  • On a typical day, what percentage of people take a certain route, even if other routes are available?
  • Total population

When multiple routes are available, most people choose a route out of ease of use or force of habit. Emergency managers must evaluate the likelihood of congestion on those favored routes and not assume there will be an equal traffic load on all the available routes.

The states with the most evacuation-challenged communities are:

1.    Florida (20 communities)
2.    California (14)
3.    Arizona (8)
4.    Texas (6)
5.    Washington (6)

The results of the study are available for free to government agencies.

Outside of the factors detailed in the study is the need for multiple patient transport capacity for hospital and nursing home evacuation, or picking up at-risk, homebound individuals. Many of the fatalities associated with large scale disasters that require evacuation occur among the elderly and other at-risk populations.

For more information on how the AmbuBus can give you the multiple patient transport capacity needed for these events, click here.

To read the original article on Government Technology’s Emergency Management website, click here.


Why Are We STILL Calling HazMat Teams for Small Amounts of Fentanyl?

Are We Handling Fentanyl Decon at the Appropriate Level?

Here are a few things no one discusses when we talk about the fentanyl crisis.

Most communities do not have dedicated, full-time HazMat teams. There aren’t six to twelve guys sitting around in full personal protective gear that only respond to HazMat incidents. They are usually firefighters that are also trained as HazMat Techs. They respond to fires and other routine calls.

So, when they get called out for small, street level amounts of fentanyl, they are unavailable if a fire or other incident occurs.

In addition, police, EMTs, and healthcare workers often stop and withdraw if they see anything that MIGHT be fentanyl or another synthetic opioid. They then call the HazMat team and wait for them to respond and handle the detection and decontamination of the substance. That often means they are unable to proceed with treatment or response.

That was fine when encountering fentanyl was a rare occurrence. But now, in much of the country, first responders and receivers are seeing it daily.

To be clear, fentanyl and other synthetic opioids in powder form can easily be aerosolized with deadly consequences.

In a recent incident, eighteen SWAT officers were taken to the hospital after a suspect kicked over a table with fentanyl on it. But most police, EMTs, and healthcare providers know to retreat and call the HazMat team if they encounter anything much larger than a street level quantity of a substance that might be fentanyl.

But the prevalent fear about fentanyl has often meant that HazMat teams are being called out for quantities that could easily be handled by anyone with a little training and the right equipment.

If a small quantity of suspected fentanyl is encountered, the first responder or first receiver has three key concerns that can easily be addressed:

DETECT – Simple, easy to use fentanyl test strips can detect the presence of fentanyl and other synthetic opioids quickly and accurately.

DEFEND – The only protective gear needed to protect against accidental overdose from small amounts of fentanyl are nitrile gloves, a P100 face piece respirator, and safety goggles. They should also have access to Naxalone (Narcan) in case an overdose occurs.

DECON – Much of the substance can be safely removed using a three-part wipe or mitt called FiberTect.   Dahlgren Decon, an easy-to-mix and apply decontamination solution is peracetic acid based and completely neutralizes fentanyl in about five minutes.

First Line Technology, the developers of FiberTect and Dahlgren Decon offer both training and all the equipment needed for first responders and healthcare workers to safely detect and decontaminate small quantities of synthetic opioids like fentanyl.

The First Line Utilization Academy offers a wide range of courses which combine both classroom sessions and hands-on experience. These courses include:

  • Synthetic Opioid Safety – A four-hour course for First Responders, Correctional Workers, Healthcare Workers
  • Tactical DeconTect for Law Enforcement/EMS – A four-hour course on field decontamination of individuals and equipment
  • Dry Decon Training – A four-hour course that covers basic awareness of hazardous material threats, contaminant identification, safety precautions, and operational use of Dry Decon to remove up to 95% of the contaminant using FiberTect wipes.
  • DeconTect Train-the-Trainer – An eight-hour course for First Responders, Medical Professionals, and Correctional Workers to enable them to effectively train others in their organization in Hybrid Decontamination

For more information or to register for courses, click here.

First Line Technology also offers a wide range of easy-to-use kits that bring together everything responders need for the decontamination of Fentanyl and hundreds of other known and emerging threats. For more information, click here.


Six Prison Staffers Hospitalized for Possible Fentanyl Exposure in Connecticut

Incident highlights need for large-area fentanyl neutralization.

In a recent article by Eric Levenson and Mirna Alsharif on CNN, six staff members at the Chesire Correctional Institute were taken to local hospitals for possible exposure to fentanyl.

If fentanyl becomes aerosolized, it can be easily dispersed over an area by air circulated by fans or air conditioners. This can contaminate large surface areas or cause overdoses.

Correctional facilities are beginning to see these types of incidents occur frequently within cell blocks or common areas.

To reduce the risk of accidental overdose, personnel at jails and prisons should be trained to identify fentanyl and other synthetic opioids and response teams set up to quickly neutralize the threat before it spreads to larger areas.

First Line Utilization Academy (FLUA) offers customized training for law enforcement and correctional facility personnel. FLUA has a Tactical DeconTect for Law Enforcement Class as well as a Synthetic Opioid Safety Class. Details on each program can be found by downloading the FLUA Course Catalog here.

First Line Technology offers a wide range of decontamination kits that scale from an individual responder size to a large team or area decon kit that utilizes an electrostatic sprayer. Details on the decon kits available can be found here.

See the original CNN article here.


How Bad is the Opioid Crisis in Your State?

overdose response

The current opioid epidemic will kill in one year, a number equal to, or greater than, all the American servicemen killed in the Vietnam War in ten years. 

The National Institute on Drug Abuse (NIDA) recently updated their findings on the crisis. Here are a few key items that underline the severity of the problem: 

  • Every day, more than 130 people in the United States die after overdosing on opioids 
  • The economiimpact is more than $78.5 Billion a year including the costs of healthcare, lost productivity, addiction treatment and criminal justice involvement. 
  • Roughly 21% to 29% of patients prescribed opioids for chronic pain abuse then. 
  • About 80% of the people who use heroin first misused prescription opioids. 
  • The Midwestern region saw opioid deaths increase 70% from July 2016 through September 29. 

The complete list of these statistics by state can be found here.

The Henry J. Kaiser Family Foundation broke out the opioid death statistics by race and ethnicity. Their data shows that the opioid crisis transcends race.  

There is another element to the opioid crisis that is different from most drug-related deaths. With drugs like heroin and methamphetamines, most overdoses were self-inflicted. 

Fentanyl and many of its analogs are easily aerosolized, creating the danger of accidental overdose by innocent bystanders, first responders, and healthcare providers.  

In addition to having Naloxone (Narcan) available to treat overdoses, first responders and first receivers should be trained and equipped to identify opioids and safely and simply neutralize it before an accidental overdose occurs. 

Up to now, most first responders and first receivers have had to ask for a HazMat team to be dispatched if even the smallest amount of Fentanyl is suspected. Traditional decontamination processes are complicated and time-consuming and require extensive training. 

However, a totally new approach to decontamination is making it possible for first responders to safely neutralize the small quantities of Fentanyl and other opioids that they typically encounter 

Called Hybrid Decon, the process involves using specially designed activated carbon wipes that remove up to 95% of the bulk contaminant, then spraying the residual substance with a decontamination solution that chemically neutralizes it in about 5 minutes. 

First Line Technology, the developer of FiberTect wipes and Dahlgren Decon solution recently launched the First Line Utilization Academy (FLUA). FLUA is the only training academy that provides hands-on training with both FiberTect wipes and Dahlgren Decon solution. 

FLUA offers several different courses specifically geared to the needs of law enforcementmedical personnel, correctional officers, firefighters, and HazMat teams. Because the Hybrid Decon process is simpler than traditional decontamination processesFLUA courses are either 4 or 8 hours in length. Among the classes offered are: 



Who Should Attend: First Responders, Correctional Workers, Healthcare

Prerequisites: None

Class Size: Up to 25



Who Should Attend: First Receivers, First Responders, Public Safety, Healthcare

Prerequisites: None

Class Size: Up to 50



Who Should Attend: First Responders, Medical Professionals, Correctional Workers 

Prerequisites: None

Class Size: Up to 25 



Who Should Attend: HazMat Team Leaders and Members

Prerequisites: NFPA HazMat Operator or Equivalent, Member of Operational HazMat Team

Class Size: Up to 25



Who Should Attend: HazMat Team Leaders and Members

Prerequisites: NFPA HazMat Operator or Equivalent, Member of Operational HazMat Team

Class Size: Up to 25



Who Should Attend: Anyone


Class Size: Up to 75


For complete course descriptions, cost, and dates, click here


First Line Technology

For the 4th Time, First Line Technology Appears on the Inc. 5000, Ranking No. 4256 With Three-Year Revenue Growth of 72 Percent

Inc. Magazine Unveils Its Annual List of  America’s Fastest-Growing Private Companies—the Inc. 5000

NEW YORK, August 14, 2019 – Inc. magazine today revealed that First Line Technology (FLT) is No. 4256 on its annual Inc. 5000 list, the most prestigious ranking of the nation’s fastest-growing private companies. The list represents a unique look at the most successful companies within the American economy’s most dynamic segment—its independent small businesses. Microsoft, Dell, Domino’s Pizza, Pandora, Timberland, LinkedIn, Yelp, Zillow, and many other well-known names gained their first national exposure as honorees on the Inc. 5000.

“We’re very proud that First Line Technology has been able to achieve a growth rate of 72% over three years in its sixteenth year in business. Our continuing high growth rates can be attributed to our success in taking innovative discoveries from the lab and developing them into life-saving solutions for responders and the military.”
Amit Kapoor, President and CEO, First Line Technology

Not only have the companies on the 2019 Inc. 5000 (which are listed online at, with the top 500 companies featured in the September issue of Inc., available on newsstands August 20) been very competitive within their markets, but the list as a whole shows staggering growth compared with prior lists. The 2019 Inc. 5000 achieved an astounding three-year average growth of 454 percent, and a median rate of 157 percent. The Inc. 5000’s aggregate revenue was $237.7 billion in 2018, accounting for 1,216,308 jobs over the past three years.

Complete results of the Inc. 5000, including company profiles and an interactive database that can be sorted by industry, region, and other criteria, can be found at

“The companies on this year’s Inc. 5000 have followed so many different paths to success,” says Inc. editor in chief James Ledbetter. “There’s no single course you can follow or investment you can take that will guarantee this kind of spectacular growth. But what they have in common is persistence and seizing opportunities.”

The annual Inc. 5000 event honoring the companies on the list will be held October 10 to 12, 2019, at the JW Marriott Desert Ridge Resort and Spa in Phoenix, Arizona. As always, speakers include some of the greatest innovators and business leaders of our generation.

About First Line Technology
First Line Technology has developed a wide range of world-class solutions for first responders and the military. FLT has pioneered an entirely new approach to the decontamination of fentanyl, synthetic opioids, and hundreds of other known and emerging threats. Their Hybrid Decontamination process utilizes FiberTect, a three-part, activated carbon wipe to remove up to 95% of the bulk contaminant. The remaining contaminant is then sprayed with Dahlgren Decon, a peracetic acid -based solution that chemically neutralizes the threat.

FLT developed the AmbuBus Conversion Kit that is used to convert any school or transit bus into a multi-patient transport vehicle in less than two hours with no power tools. There are over 550 AmbuBuses on the road that are used for mass casualty events, hospital and nursing home evacuations, responder rehab, victim sleeping quarters, and hospital surge situations.

With the rise of global temperatures, heat stress is becoming a serious problem. First Line Technology offers both PhaseCore professional grade cooling vests and the Immersion Cooling Equipment (ICE) System, a team-sized arm immersion cooling solution.

First Line Technology was recently featured in a video produced by Fairfax County Economic Development Agency as one of the most innovative companies in Northern Virginia. To see the video visit

For more information on First Line Technology and any of their products or services, visit

Tim Karney, Marketing Manager
First Line Technology
3656 Centerview Drive, Suite 4
Chantilly, Virginia 20151
(703) 955-7510

More about Inc. and the Inc. 5000 

The 2019 Inc. 5000 is ranked according to percentage revenue growth when comparing 2015 and 2018. To qualify, companies must have been founded and generating revenue by March 31, 2015. They had to be U.S.-based, privately held, for profit, and independent—not subsidiaries or divisions of other companies—as of December 31, 2018. (Since then, a number of companies on the list have gone public or been acquired.) The minimum revenue required for 2015 is $100,000; the minimum for 2018 is $2 million. As always, Inc. reserves the right to decline applicants for subjective reasons. Companies on the Inc. 500 are featured in Inc.’s September issue. They represent the top tier of the Inc. 5000, which can be found at

About Inc. Media
Founded in 1979 and acquired in 2005 by Mansueto Ventures, Inc. is the only major brand dedicated exclusively to owners and managers of growing private companies, with the aim to deliver real solutions for today’s innovative company builders. Inc. took home the National Magazine Award for General Excellence in both 2014 and 2012. The total monthly audience reach for the brand has been growing significantly, from 2,000,000 in 2010 to more than 20,000,000 today. For more information, visit

The Inc. 5000 is a list of the fastest-growing private companies in the nation. Started in 1982, this prestigious list has become the hallmark of entrepreneurial success. The Inc. 5000 Conference & Awards Ceremony is an annual event that celebrates the remarkable achievements of these companies. The event also offers informative workshops, celebrated keynote speakers, and evening functions.

For more information on Inc. and the Inc. 5000 Conference, please visit


Four Transport Incubators. 30 Patients in NICU.

How do you evacuate all the infants safely?

A recent fire at Children’s Hospital Los Angeles Main Campus forced the temporary evacuation of about 200 people.

Fortunately, in this instance, no one was injured, and normal operations were soon restored. But the possibility of incidents like this keep many healthcare professionals up at night.

How would your facility handle the evacuation of many neonatal and infant patients with the available transport incubators and ambulances that are usually available? 

How would you decide which patients are transported in the incubators? What do you do with the remaining patients? 

How long would it take to transport thirty infant patients (and their mothers), in the ambulances that would be available? 

Now many regional healthcare coalitions are preparing for these types of situations with two emergency medical transport solutions.

The Baby Pod 20 is a lightweight infant transport device that can be strapped to a seat or stretcher that provides four layers of protection to an infant.  Built with the same materials and engineering as a Formula 1® racing car, it can withstand am accident with 20Gs of force in four directions. It can easily be carried by one person, is significantly less expensive and also requires less storage space than an incubator.

The AmbuBus Conversion Kit can be used to convert any available school or metro bus into a multi-patient transport vehicle that can accommodate between 12 and 24 patients on stretchers. By having one or more buses permanently equipped with the AmbuBus frames, you can safely transport large numbers of patients without depleting the pool of ambulances needed for those that are critically ill.

Together, they are a complete emergency neonatal and infant multiple patient transport solution.

The AmbuBus can also be used in a wide variety of other situations such as mass casualty transport, responder rehab, and victim sleeping quarters. The AmbuBus frames can also be set up free-standing for hospital surge or quarantine situations.

Both the AmbuBus and the Baby Pod 20 are available from First Line Technology.

For more information on the Baby Pod 20, please click here.

For More information on the AmbuBus, please click here.


Will There Be Another Active Shooter Incident in the Next 64 Days?

If we can’t stop mass shootings, we need to respond better.

Active shooter incidents in recent history have shown that communities everywhere must be better prepared to respond to mass casualty events.

Studies indicate that the rate at which public mass shootings occur has tripled since 2011. Between 1982 and 2011, a mass shooting occurred roughly once every 200 days. However, between 2011 and 2014, that rate has accelerated greatly with at least one mass shooting occurring every 64 days in the United States¹.

No community can ever be fully prepared for large scale incidents, but every community should undertake an objective and comprehensive review of their existing mass casualty plans.

These types of incidents can easily overwhelm the essential personnel and resources needed to manage the response. Even with frequent planning, drills, and exercises, first responders and first receivers struggle to adapt when faced with mass numbers of casualties, and limited medical triage, transport, and treatment resources.

Public health professionals, emergency managers, emergency medical service directors, police and fire chiefs, are constantly looking to identify “choke points” that could reduce their ability to handle mass casualties.

One of the most frequently cited choke points is the lack of adequate medical transport capacity.

Most ambulances carry one or two patients. With current budget constraints, most EMS units only have enough ambulances and EMTs to respond to daily 911 calls and a small reserve.

When a large-scale incident occurs, even with the support of private ambulance providers, patients may have long wait times before they can be taken to a trauma center.

One solution would be for each community to buy a Medical Ambulance Bus (MAB) that is equipped at an Advanced Life-Saving Level that can handle critically wounded patients.

However, an ALS equipped MAB can cost between $500,000 to $1,000,000. As the pool of available grant dollars has declined, purchasing a MAB is beyond the reach of many communities.

However, there is an affordable alternative.

The AmbuBus Conversion Kit developed by First Line Technology can be used to convert any available school or transit bus into a multi-patient transport vehicle for up to 12 supine patients in about two hours with no power tools.

Many communities acquire an end-of-service school or transit bus as a donation or for a nominal price.

The Basic Life-Saving (BLS) level AmbuBus Kit contains two frames which typically each hold 12 patients leaving an open center aisle. Together with 12 stretchers, pillows, and a purpose-built ramp for loading, an AmbuCarrier wheeled patient transport device, the BLS kit costs approximately $36,000.

First Line Technology offers a full range of accessories including a wheelchair package, portable electric power, multi-patient vital signs monitoring system, and a mass casualty oxygen system to enable the community to expand the capabilities of their AmbuBus.

Most communities permanently install the AmbuBus kit in one or more vehicles for no-notice incidents like active shooters. They then store additional AmbuBus kits for events like hurricanes where there is some advance notice.

There are over 550 AmbuBuses on the road that are used for mass casualty events, hospital and nursing home evacuations, responder rehab, victim sleeping quarters, and hospital surge situations.

For more information on the AmbuBus and its related accessories, please visit 

You can download a free 24-page brochure with details and pricing for the AmbuBus here


¹ Cohen, Amy P.; Azrael, Deborah; Miller, Matthew (October 15, 2014). ”Rate of mass shootings has tripled since 2011, new research from Harvard shows”. Mother Jones. Retrieved December 13, 2017.


Mass Casualties in Paradise

Everyone dreams of a tropical vacation in Hawaii.

But for the passengers and crew of a recent Air Canada flight, an unexpected trip to Honolulu was not on the itinerary. Severe turbulence inflight caused multiple injuries that required the plane to be diverted to Hawaii.

With a significant number of mass casualties onboard the aircraft; federal, state and county agencies from the airport and surrounding areas responded.

Chief Dean Nakano of the Honolulu Emergency Medical Services explained the incident and how his organization was able to use an AmbuBus in its response effort.

“On July 11, 2019 we got a call that an Air Canada plane was on a non-stop flight to Australia when they hit some turbulence and that there were injuries on the plane. They were about one hour past Honolulu when the turbulence occurred. They turned the plane around and flew to Honolulu so the injured could be treated,” said Chief Nakano.

Initially, there were reports of critically injured people on the flight. It was estimated there were 20 individuals in need of medical attention from a total of 269 passengers and 15 crew members onboard the plane.

The Daniel K. Inouye International Airport falls outside the jurisdiction of Honolulu EMS. Incidents there are the primary the responsibility of Hawaii Crash and Rescue and American Medical Response (AMR). “Usually, if an incident occurs there, Honolulu EMS is asked to assist if needed before sending units. However, when we heard there were at least 20 injured and an unknown amount of critically injured people, we started deploying our resources,” Nakano said.

Honolulu EMS responded with a District Chief, three ambulances, along with the AmbuBus. The Chief of Operations also responded to assist with triage and treatment.

The AmbuBus deployed by Honolulu EMS was donated by the City and County of Honolulu Transportation Services, which operates the bus services for the county. “When we received it, the bus had 600,000 miles on it. They have great mechanics at the Transportation Services Department because the bus is still running four years later.”

Honolulu EMS purchased two AmbuBus kits to refurbish and equip one bus as a multi-patient transport vehicle. Now it’s capable of supporting 12 supine patients, or 24 seated patients.

Chief Dean Nakano. Honolulu EMS

“The AmbuBus is positioned about an hour away from the airport in rush hour traffic. Unfortunately, we have not been able to have a secure parking location for the AmbuBus closer to town,” said Nakano.

“The AmbuBus was rolling at about six o’clock (that) morning, which is peak rush hour traffic in the area. When it arrived at the airport, triage was set-up and we were able to assess the injured. Luckily, there were no critically injured patients, but we saw we had several walking wounded individuals,” said Nakano. In total there was close to three dozen patients.

There was one federal ambulance and four AMR ambulances at the scene, but their crews were tied up with triage, treatment, and transport duties, according to Nakano.

“Some of the patients were transported by the ambulances on the scene and we escorted seven patients onto the AmbuBus, treating and transporting them to the trauma center,” said the Chief of EMS.

“If the AmbuBus had not been available, transporting the patients would mean using 5 or 6 ambulances making multiple trips. That would tie up one third of the total pool of Oahu’s city ambulances. Taking that many ambulances off their regular duties would put a serious strain on our ability to respond to 911 calls,” Nakano added.

Unlike most EMS departments around the country, Honolulu Emergency Medical Services Division is not part of a Fire Department. The Honolulu Emergency Medical Services division is under the Honolulu Emergency Services Department which also includes the Ocean Safety division.

Honolulu EMS is responsible for providing services for the entire island of Oahu. Oahu county has close to 1 million residents and last year approximately 10 million people visited Hawaii.

The Division had approximately 150 paramedics, which includes unit supervisors, district chiefs, and about 80 emergency medical technicians and 25 emergency medical dispatchers. Honolulu EMS has 21 units (two of which are part-time) so when Air Canada experienced its incident last month, they had 19 units on-duty.

In 2018, Honolulu EMS responded to 95,995 911 calls by ambulance and transported more than 56,600 patients to local emergency rooms. Emergency medical dispatchers answered more than 120,000 911 calls.

Chief Nakano has been with Honolulu EMS since January 4, 1981. He started as an EMT before moving up to a paramedic. He was a unit supervisor for about 12 years and then a District Chief for ten years. He has served as EMS Chief for four years.

Chief Nakano said, “In the four years we have had the AmbuBus, we have used it primarily for training and as standby medical support for large events. For example, we have recently had it deployed during a Bruno Mars concert, the Honolulu Marathon, the Pearl Harbor 75th Commemoration, and the Fourth of July Fireworks show.

We are hoping to have a second bus donated so we will have additional multi-patient transport capacity if we have other large-scale events.”

But of course, they hope to have it but not have to use it.


Click here for more information on the AmbuBus. 


First Line Technology

First Line Technology Recognized for Lab-to-Life-Saving Innovations

Fairfax County Economic Development Agency has produced a video profile of First Line Technology. The video showcases several of the innovative disaster response solutions developed by First Line Technology for use by first responders and the military.  

In the interview, Amit Kapoor, President and CEO of First Line Technology, explains how the company works together with world class scientists and developers in federal and academic labs to identify solutions that have the potential to offer significant advantages to first responders. 

Among the products presented in the video are: 

  • The AmbuBus Conversion Kit which can be used to convert any school or transit bus into a multi-patient transport vehicle in about two hours 
  • Dahlgren Decon and FiberTect wipes which are used together as integrated hybrid decontamination process that can completely neutralize hundreds of known and emerging threats 
  • PhaseCore professional grade personal cooling vests and the Immersion Cooling Equipment (ICE) System for preventing heat stroke 

The Army’s Other Enemy: Heat Stress

The Military Learns to Combat Deadly Heat Stress 

As temperatures riseincreasing numbers of soldiers are put at risk of enduring heat stress that can end their careers or even kill them. 

In a recent NBC News report by David Hasemyer of Inside Climate News, the U.S. Army is putting significant effort into understanding the causes of heat stress and treating soldiers that experience its effects. 

The video showcases how Fort Benning Georgia’s Emergency Room is developing new treatments for heat stress, as well as teaming with researchers to identify potential cases on an individual level before a serious health problem occurs. 

Research and treatment of heat stress is necessary, but an essential factor may be overlooked. 

Preventing heat stress is better than treating heat stress.

Recently, several Army bases, both in the United States and overseas are deploying a simple but highly effective heat stress prevention modality. Portable, durable basins of cold water such as the ICE System manufactured by First Line Technology are prepositioned along the route of march or at remote ranges where training occurs during hot weather. 

During training or operational cycles, soldiers immerse their forearms into the cold water and walk in place to circulate their blood. Their cooled blood flows throughout their bodies dropping their core temperature about 1.8F in 3 to 10 minutes. 

The ICE System can accommodate up to six individuals at a time. If a serious case of heat stress occurs, the ICE System can be used to fully immerse an individual up to six feet in height and the basin can hold up to 800 pounds. 

For more information on the ICE System, please visit 

To see the original article visit, 


Mass Casualty Wildfires Could Overwhelm Hospitals and Medical Transport

As reported by Adam Rogers for Wired, the devastating California Camp Fire in 2018 was a wake-up call to emergency managers and public health professionals.

The fire killed at least 85 people and destroyed the local Feather River Hospital. That reduced the available medical treatment facilities needed to treat patients and requiring the evacuation of existing patients.

The article states, “That moment made real a problem that specialists had been warning about for years. “There were four beds immediately available in the entirety of Northern California for a burn patient. Everyone else was going to have to wing it,” says Tina Palmieri, director of the Firefighters Burn Center at UC Davis, which would receive 10 burn victims from the Camp Fire alone.”

The threat of major wildfires has been increasing with both climactic conditions and the encroachment of human beings into areas that were once wilderness.

Regional coalitions of emergency managers, healthcare providers, and EMS services in wildfire prone areas are looking for ways to build flexibility and resiliency into systems that are resource constrained.

One potential solution for both the medical transport and patient surge capacity issues is to stock and deploy temporary medical transport capacity and patient sleeping quarters using systems like the AmbuBus Conversion Kit developed by First Line Technology.

In a wildfire scenario, the AmbuBus can be an invaluable resource in four critical areas of response:

Multi-Patient Transport

The AmbuBus Conversion Kit provides two structural steel frames that can typically accommodate 12 patients on stretchers or backboards. The kits can be installed permanently or temporarily into any available school or metro bus in less than two hours by two people with no power tools.

Most communities that utilize the AmbuBus install at least one permanently so that it can be rapidly deployed to evacuate hospitals, nursing homes, or at-risk homebound patients from the disaster area.

They also stock additional AmbuBus kits that can be temporarily installed for additional transport capacity when the danger of a wildfire is imminent.

Hospital Surge Capacity

The AmbuBus kit can be set-up free-standing in a hospital corridor or cafeteria. Less critical patients can be accommodated here which will free up hospital beds for seriously burned or ill patients.

Victim Sleeping Quarters

Major wildfires can destroy hundreds of homes. Additional AmbuBus kits can be installed in schools or tents as temporary sleeping quarters for victims until more permanent accommodations can be found.

Responder Rehab

When not needed for patient transport, an AmbuBus-equipped vehicle can be dispatched to the fire staging area providing a place to rest and rehab or on-scene sleeping quarters.

For more information on the AmbuBus Conversion Kit, click here.

To read the original Wired article, “Hospitals Aren’t Ready for a Mass Casualty Wildfire”, click here.