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information sharing between public information officers throughout the region is important. An active network between public information officers and communication centers would allow for the rapid dissemination of important information to citizens. For example, officials involved in exercises at Shearon Harris have provided limited information to agencies outside the ten-mile zone. During these exercises, citizens acting on information from the media have called and questioned their local officials who had little information about the exercises. Regional planning is ineffective if there is no agreement among citizens, government, businesses, industry, and non-profits, and ongoing education and training is not provided for all, including the public. This is a transient area with many people moving into and out of the region regularly. Logistically, it is difficult for all agencies across the region to come together for planning and training. In addition to communications issues, there are jurisdictional limits to authorities, which present obstacles during large incidents. For example, a paramedic certified to practice in one county cannot legally practice in another county. Planning should not assume that all off-duty personnel are available to report to work, which should make allowances for some being unavailable. Planning must also address numbers of unsolicited volunteers spontaneously responding to the scene for help. Mass casualty plans need to be regional. A major incident will likely require assistance from other agencies who may not be trained in the same triage methods. This could lead to problems such as inappropriate treatment or transportation of victims. Mass fatality planning should also be regional to ensure consistency in the management and processing of the deceased while maintaining their dignity. Pet sheltering and evacuation must be planned for, as evidenced by Hurricane Floyd. Many people are unwilling to leave home unless they are certain their pets are being cared for. Progress is being made in the development of the state animal response team and local animal response teams. Expanded vulnerability assessments are necessary in the region, with an emphasis on terrorist activity rather than only weather or natural disaster related. A broad new range of targets not previously considered are now becoming painfully apparent. Prudence dictates that all planning assumptions must be tested whenever possible. Decontamination is a major consideration for people on property exposed to hazardous substances. Logistically, it is difficult to decontaminate a large number of people when all other environmental considerations are taken into account. For example, freezing temperatures or extreme heat, geographic location of victims and scope of their exposure, the type of the substance involved, modesty issues, and clean clothes for the victims all complicate efforts. Cross contamination of people and the environment may be a problem, particularly if the incident is near sensitive facilities such as water plants, hospitals, or residential neighborhoods. Little or no medical care can be provided to victims until they are decontaminated. Otherwise, valuable resources like people and equipment will be cross- contaminated and must be removed from service. Ambulances, personnel, and even hospital emergency departments could be rendered unusable. There are very few specific resources for decontamination in the region. Many plans rely on fire departments to conduct large-scale decontamination. However, these departments may be engaged in hazardous materials containment or fire fighting efforts, and so might not be available immediately. Most hospitals have limited decontamination capabilities. UNC, for example, only has one decontamination shower in their emergency department. In mass casualty situations, when the number of victims overwhelm immediate responders, it is not possible to give the same level of care to each patient as in routine situations. In these cases, assorting or prioritization of victims would occur. This is called triage, French for, "to sort." In other words, victims in most need of care receive treatment first. The slide illustrates one sample triage system, which categorizes treatment and transport urgency using color codes. Red tag patients are those who have a good chance of surviving if they are transported to a hospital immediately and provided with definitive care like surgery. Yellow tag surgeries have serious injuries that do not pose an immediate threat to life. These