# Volunteer during disasters



## MikloHP (Jun 25, 2013)

Does anyone know anything about volunteering out of the state you are licensed in during a natural disaster? What rules apply and what scope can you practice under? Who oversees your practice? Funding for supplies? 

My wife is a Doc and her and I want to creat our own mobile ER to respond to natural disasters. Does anyone have any experience with responding or volunteering?


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## firecoins (Jun 25, 2013)

would you not respond with an established relief organization?


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## rwik123 (Jun 25, 2013)

Join a local Task Force or DMAT.


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## NomadicMedic (Jun 25, 2013)

Get involved with an established relief group. Project Medishare is a good place to start.


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## Av8or007 (Jun 25, 2013)

Volunteer w the red cross or a similar agency. They would probably love to have you and your wife since she's a doc. It would add als capabilities since she may be able to delegate to you in a disaster. 

In summary the mobile er/hospital in a bag is a great idea but just do it w an agency. If the pt needs more than basic mfr skills then your wife could operate under her license as a doc and may be able to delegate to you.


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## MikloHP (Jun 25, 2013)

Our thought is to be there following behind storm chasers so we would be the first responders. That's when people would need us most. We kind of want to be independent of any organizations. We are working on getting funding from FEMA however. We just want to hear from anyone who might know how things work during disaster situations as far as your ability to practice within your scope.


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## NomadicMedic (Jun 25, 2013)

I'm sure others will chime in as to how bad of an idea that actually is.

If you want to be helpful, get involved with an established, recognized emergency response group. Going into a disaster area and "freelancing" is just a recipe for trouble.


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## Achilles (Jun 25, 2013)

MikloHP said:


> Our thought is to be there following behind storm chasers so we would be the first responders. That's when people would need us most. We kind of want to be independent of any organizations. We are working on getting funding from FEMA however. We just want to hear from anyone who might know how things work during disaster situations as far as your ability to practice within your scope.



You need a medical director. You have a doctor and you're like the doctors little finger. Join a CERT team they do disasters all the time.  Other than that, like DEMedic said....


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## Pavehawk (Jun 25, 2013)

States requiring disaster medical assistance use Federal resources or resources from other states through EMAC. Responders who are part of an organized response are able to work to their level of training IAW applicable mutual aid agreements. If you just follow the storm chasers to help out you're not part of the formal response and would have no legal standing.

I seriously doubt that you will find FEMA funding, as FEMA tends not to be a responder per se, but rather a facilitator and money source. All disasters are local and all state and Federal response is based on the needs of the impacted and the items they request.

You would be better off geting involved with an organization that is already plugged in the system, like DMAT, Red Cross, etc then trying to freelance.


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## MikloHP (Jun 26, 2013)

Much obliged to you Pavehawk for providing a useful and constructive response. Certainly the first I've received.


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## RocketMedic (Jun 26, 2013)

Miklo, you should understand that unless you literally roam the nation looking for major disasters, you are at a minimum a day or two away from anything thats not literally your hometown. When Moore was pasted, Oklahoma was literally able to maintain normal operations while locally treating all casualties. Katrina-scale disasters are a different story, but then, look at the ARC. You simply dont have the clout and administrative force needed to make a difference. Locals will look at you and shrug, because at that point, you're just another Ricky Rescue, MD or not.

When we were responding to Moore, we had a neonatal internist or some super-advanced MD show up on our triage point, asking how she could help. I politely told her to go to her job at OU, since her utility on-scene was nil, as all critical patients were already gone and trapped patients would either be minor or dead. 

Your wife may be an MD, and you a Pmed, but freelancing really doesnt work.


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## Chimpie (Jun 26, 2013)

Rocketmedic40 said:


> Miklo, you should understand that unless you literally roam the nation looking for major disasters, you are at a minimum a day or two away from anything thats not literally your hometown. When Moore was pasted, Oklahoma was literally able to maintain normal operations while locally treating all casualties. Katrina-scale disasters are a different story, but then, look at the ARC. You simply dont have the clout and administrative force needed to make a difference. Locals will look at you and shrug, because at that point, you're just another Ricky Rescue, MD or not.
> 
> When we were responding to Moore, we had a neonatal internist or some super-advanced MD show up on our triage point, asking how she could help. I politely told her to go to her job at OU, since her utility on-scene was nil, as all critical patients were already gone and trapped patients would either be minor or dead.
> 
> Your wife may be an MD, and you a Pmed, but freelancing really doesnt work.



I couldn't agree with this post more.

Cities and towns have increased their training and readiness since 2001 (9/11), 2004 (FL Hurricanes) and 2005 (Katrina).  The need for "OMG, we need everyone!" just isn't realistic anymore.

Great example with Moore listed above, but even the Joplin tornado which took out a hospital was handled with a sense of preparedness and readiness.  There were no administrators praying for an out-of-the-area MD to come help save them.  Plans existed and were put into action.

I'm glad RM40 mentioned the Red Cross because I was going to as well.  The Red Cross (ARC) has a Disaster Heath Service function where trained, certified medical providers volunteer in times of emergencies.  During events like Katrina, Joplin, Alabama or even Moore, volunteers are deployed to those areas to help.  And if you're listed as available, can usually be deployed as soon as the next day.

The need for medical care is not only in the immediate minutes after an event, but days to weeks after.  While leading the response in two counties in Alabama in 2011, I had a handful of DHS volunteers who, at the end of the day, were reporting to me the people they had seen.  People who had broken hands, lacerations, all from post storm clean up.  There was no public transportation system and pretty much all of the cars in the damage path were destroyed.  It was until these teams came to their neighborhood did they get the chance to 'be seen' by someone with medical knowledge and equipment.

During downtime, you can volunteer at your local Chapter, helping prepare for these types of events.  This can include training, maintaining equipment, practicing, drilling, volunteer recruitment, not to mention forming partnerships and/or relationships with area agencies.

While I commend your passion about wanting to be there when the event happens, unless it's a doomsday type event, you may be better off working with an established agency or organization.


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## Rayon (Jul 4, 2013)

I have one FEMA deployment under my belt from last year.  My friend Doug (who is a paramedic / RN) and I were deployed to Long Island in support of Hurricane Sandy for 18 days.  We basically lived out of the back of our unit, and were moved around to wherever our Task Force (25 units) were deployed.  Doug was our Strike Team (5 units) Leader.  

As I understand it, a company called American Medical Response (AMR) holds the primary contract with our Federal Government to provide disaster response resources.  In situations where AMR is overwhelmed and cannot directly support the mission, they subcontract out to other companies across the country.  Doug owns a LLC event standby ambulance service, who is approved to directly participate.  The approval process is quite lengthy and not something that can be completed in a short period of time, hence once you get approved its definitely worth hanging on to that foot in the door.  I am not able to give anything other than my direct observations, and since I have only one deployment I would have to defer to Doug for the nuts and bolts of how it all works.  

If you could send me a private message, I could put you in touch with Doug.  I cannot send you a private message because I have to have 5 posts before I can send them, lol so I am not able to do anything but post this on your thread.  

I wish you luck in your future endeavors, and hope that you can find a place to put you and your wife's talents to good use during a disaster.

Happy 4th of July!

R. Yoon
Maryland EMT-B


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## DesertMedic66 (Jul 4, 2013)

Rayon said:


> I have one FEMA deployment under my belt from last year.  My friend Doug (who is a paramedic / RN) and I were deployed to Long Island in support of Hurricane Sandy for 18 days.  We basically lived out of the back of our unit, and were moved around to wherever our Task Force (25 units) were deployed.  Doug was our Strike Team (5 units) Leader.
> 
> As I understand it, a company called American Medical Response (AMR) holds the primary contract with our Federal Government to provide disaster response resources.  In situations where AMR is overwhelmed and cannot directly support the mission, they subcontract out to other companies across the country.  Doug owns a LLC event standby ambulance service, who is approved to directly participate.  The approval process is quite lengthy and not something that can be completed in a short period of time, hence once you get approved its definitely worth hanging on to that foot in the door.  I am not able to give anything other than my direct observations, and since I have only one deployment I would have to defer to Doug for the nuts and bolts of how it all works.
> 
> ...



More than likely I was out there with you guys. 21 days at the Forward Operating Base Floyd-Bennett.


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## DesertMedic66 (Jul 4, 2013)

Everything has pretty much already been stated. There isn't much you can do as a volunteer. Your best option would be to join an organization that does responses (Red cross, SAR Teams, etc). 

If federal help is requested FEMA will start using their resources. AMR (American Medical Response) is the only ambulance company that has a direct contract with FEMA for disaster responses. AMR will sub-contract out to other companies to be able to supply the amount of ambulances and/or personal needed. As already stated there is a lengthy process involving a lot of paperwork to be a sub-contractor for AMR. You have to either be an employee for AMR or for one of the sub-contracted companies in order to be utilized.


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## frdude1000 (Jul 5, 2013)

Try contacting your local DMAT (disaster medical assistance team) team.  They are federal teams but organized by states.   http://www.phe.gov/Preparedness/responders/ndms/teams/Pages/dmat.aspx


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## TransportJockey (Jul 6, 2013)

DesertEMT66 said:


> Everything has pretty much already been stated. There isn't much you can do as a volunteer. Your best option would be to join an organization that does responses (Red cross, SAR Teams, etc).
> 
> If federal help is requested FEMA will start using their resources. AMR (American Medical Response) is the only ambulance company that has a direct contract with FEMA for disaster responses. AMR will sub-contract out to other companies to be able to supply the amount of ambulances and/or personal needed. As already stated there is a lengthy process involving a lot of paperwork to be a sub-contractor for AMR. You have to either be an employee for AMR or for one of the sub-contracted companies in order to be utilized.



And AMR DRT/ERT deployments are coveted pretty highly cause its a large bit of money for the provider. I can't wait for another deployment lol. I wanna buy more toys


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## DesertMedic66 (Jul 6, 2013)

TransportJockey said:


> And AMR DRT/ERT deployments are coveted pretty highly cause its a large bit of money for the provider. I can't wait for another deployment lol. I wanna buy more toys



Yep. I can't complain about that at all. I was in heaven


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## TransportJockey (Jul 6, 2013)

DesertEMT66 said:


> Yep. I can't complain about that at all. I was in heaven



I've done the Isaac deployment and a personnel shortage deployment to NH. Missed sandy cause I was doing my CCT clinicals lol


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## DesertMedic66 (Jul 6, 2013)

TransportJockey said:


> I've done the Isaac deployment and a personnel shortage deployment to NH. Missed sandy cause I was doing my CCT clinicals lol



Should have been there. Longest EMS deployment in history


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## eonefireemt3 (Jul 13, 2013)

In a disaster situation, the government does not look kindly on freelancing. Any major operation requires coordination of resources to get the mission accomplished. A major disaster area is most likely, going to be secured and they aren't going to allow just anyone in. I applaud your desire to help, but I agree that the only way you're likely to see any action is through a designated agency.


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## Wayfaring Man (Jul 15, 2013)

MikloHP said:


> Our thought is to be there following behind storm chasers so we would be the first responders. That's when people would need us most. We kind of want to be independent of any organizations. We are working on getting funding from FEMA however. We just want to hear from anyone who might know how things work during disaster situations as far as your ability to practice within your scope.



This right here is a NIMS/ICS disaster.  Work with responding agencies under the established incident management plan and protocol for your location, or else you are just more potential casualties, not helping at all.


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## mycrofft (Jul 15, 2013)

MikloHP said:


> Does anyone know anything about volunteering out of the state you are licensed in during a natural disaster? What rules apply and what scope can you practice under? Who oversees your practice? Funding for supplies?
> 
> My wife is a Doc and her and I want to creat our own mobile ER to respond to natural disasters. Does anyone have any experience with responding or volunteering?



Why would you put your head into the bear trap like that? Your wife the "Doc" ("me and her"?) ought to know better. Find your local DMAT or similar organization and get with them. Your spirit is fine, but the concept is so riddled with potential danger to you and any potential patients that you need to re-cast your paradigm.


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## flightless (Jul 21, 2013)

I volunteer with Health Services for the Red Cross  and DAT when there isn't a disaster.  I love it


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## SandpitMedic (Jul 28, 2013)

Please do not freelance. Freelancers become victims at worst and a nuisance at best. Of you want to be a part of the solution join a DMAT or similar task force. Not to mention freelancing is illegal because that is practicing medicine without a license. You need to be under a medical director to practice. 
I am on AMR's FEMA Disaster Response Team; just for background.

Either road you go down, or before whatever team you join you should first get over to the FEMA website and complete all the self study courses for ICS. 
Any team you join that is related to disaster response is going to have those as a pre-req. I believe the current standard is ICS 100, 200, 700, and 800. Intro to Hazmat won't hurt either.


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## TransportJockey (Jul 28, 2013)

SandpitMedic said:


> Please do not freelance. Freelancers become victims at worst and a nuisance at best. Of you want to be a part of the solution join a DMAT or similar task force. Not to mention freelancing is illegal because that is practicing medicine without a license. You need to be under a medical director to practice.
> I am on AMR's FEMA Disaster Response Team; just for background.
> 
> Either road you go down, or before whatever team you join you should first get over to the FEMA website and complete all the self study courses for ICS.
> Any team you join that is related to disaster response is going to have those as a pre-req. I believe the current standard is ICS 100, 200, 700, and 800. Intro to Hazmat won't hurt either.



I'm curious did you get deployed with the Isaac deployment from your operation?


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## SandpitMedic (Jul 28, 2013)

TJ,
No sir


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## TransportJockey (Jul 28, 2013)

SandpitMedic said:


> TJ,
> No sir



Just wondering lol. Me and my supervisor were the only two to deploy from NM operations so we got attached to your boys and girls and the river medical bunch 


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## DesertMedic66 (Jul 28, 2013)

TransportJockey said:


> Just wondering lol. Me and my supervisor were the only two to deploy from NM operations so we got attached to your boys and girls and the river medical bunch
> 
> 
> Sent from my iPhone using Tapatalk 2



Should have gone on Sandy deployment


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## TransportJockey (Jul 28, 2013)

DesertEMT66 said:


> Should have gone on Sandy deployment



If I hadn't been in class I would have lol. They wouldn't let me deploy in the second wave for some reason. But at least the New Hampshire deployment this year was fun 


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## DesertMedic66 (Jul 28, 2013)

TransportJockey said:


> If I hadn't been in class I would have lol. They wouldn't let me deploy in the second wave for some reason. But at least the New Hampshire deployment this year was fun
> 
> 
> Sent from my iPhone using Tapatalk 2



I won't be able to put my name back on the team until 2015.


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## SandpitMedic (Jul 28, 2013)

There should be some deployments this season.


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## TransportJockey (Jul 28, 2013)

Really? Why is that?


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## DesertMedic66 (Jul 28, 2013)

TransportJockey said:


> Really? Why is that?
> 
> 
> Sent from my iPhone using Tapatalk 2



Medic school


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## TransportJockey (Jul 28, 2013)

DesertEMT66 said:


> Medic school



Good reason. Good luck man 


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## TransportJockey (Jul 28, 2013)

SandpitMedic said:


> There should be some deployments this season.



I'm hoping so lol 


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## SandpitMedic (Jul 28, 2013)

TransportJockey said:


> I'm hoping so lol
> 
> 
> Sent from my iPhone using Tapatalk 2



$$$

If its gonna happen, it might as well be on our watch.


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## TransportJockey (Jul 28, 2013)

SandpitMedic said:


> $$$
> 
> If its gonna happen, it might as well be on our watch.



Exactly. I'm just hoping they let me deploy since I just took a promotion to associate supervisor. 


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## SandpitMedic (Jul 28, 2013)

No boss men allowed


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## eonefireemt3 (Sep 2, 2013)

While I agree freelancing can cause difficulties, if something goes down and I am there, I'm still going to render aid that is appropriate to my level of training. Once appropriate manpower is on scene, the operations officer can decide if he/she wants to still utilize me.


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## mycrofft (Sep 2, 2013)

eonefireemt3 said:


> While I agree freelancing can cause difficulties, if something goes down and I am there, I'm still going to render aid that is appropriate to my level of training. Once appropriate manpower is on scene, the operations officer can decide if he/she wants to still utilize me.



Well said. But remember, "take five and stay alive"; don't become one more victim.


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## eonefireemt3 (Sep 2, 2013)

Most certainly. I plan on going home at night.


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## NomadicMedic (Sep 2, 2013)

Well, there's a big difference between something happening while you're there and "inviting yourself to the party". The earthquake in Haiti was a prime example of a Charlie Foxtrot of self deployed "rescuers". The intent was good, and Lord knows they needed the help… The problem is; no infrastructure. There was no place to bunk them. No place to feed them. No fresh water for them. No command and control. It got better shortly after, but the flood of self deployed emergency responders that initially poured into Port-au-Prince was beyond manageable.


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## bellatwain (Sep 18, 2013)

I've been to many places and it's nice to help not just during disasters but also in some activities that can help other.


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## SandpitMedic (Oct 3, 2013)

LOLz- Charlie Foxtrot and "take 5, stay alive"

Clever. I will use those at work and claim it as my own.

Thanks.


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