# Disaster Response Training



## dbitt54 (May 24, 2011)

I'm a certified EMT in the state of Nebraska (National reg is current as well).  Also finished my NIMS 100, 200, 700, & 800 training.  I am not with an organization as of now.  With the recent disasters in Japan and Joplin, I keep wanting to do something to go help out.  I feel like I have the training (although I do lack the experience) and the free time to volunteer my services.  I thought about just driving down there since it is only 5 hour drive, however, I know if I go down I'll just either get in the way or get turned away.  So I guess I am wondering, what do I have to do to be able to be called up to help in such disasters?  What certifications do I have to get or what organizations do I have to join to be able to make a difference.  Thanks for any feedback.


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## mycrofft (May 24, 2011)

*Husker du!?  Welcome. Where are you?*

1. Use "Search", there are scads of stuff in our back pages about this.

2.  Heard of Community Emergency Response Teams? (CERT) I suggest you start there, free training, you usually get free stuff, and pretty local.

http://www.easternnebraskacert.com/

http://www.citizencorps.gov/cc/CertIndex.do?reportsForState&cert=&state=NE

http://www.hastingspolice.org/CERT.htm

3. Look into Red Cross as well.

Do not become an unaffiliated volunteer showing up at other people's disasters.


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## bstone (May 24, 2011)

> Do not become an unaffiliated volunteer showing up at other people's disasters.



Absolutely disagree. I did just that and ended up running the largest and busiest tent-based clinic in the MS Gulf Coast after Katrina. In a disaster there is no such thing as "organization". The Red Cross and FEMA were major liabilities after Katrina- they caused way more problems then they solved. People are dead because of their inability to ask for help or admit they are in way over their heads.

Read about the unaffiliated response here:
http://en.wikipedia.org/wiki/New_Waveland_Cafe_and_Clinic


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## feldy (May 24, 2011)

Although organizations like FEMA were a disaster during katrina, times have changed now. The red cross does need volunteers. I am an active volunteer with red cross in new orleans and we need more and more volunteers. Do not let one event (katrina) turn you away from volunteering with such organiztions. 

Do not go unafiliated to disasters as there is no accountability and you could find yourself well in over your head.


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## BEorP (May 24, 2011)

bstone said:


> Absolutely disagree. I did just that and ended up running the largest and busiest tent-based clinic in the MS Gulf Coast after Katrina. In a disaster there is no such thing as "organization". The Red Cross and FEMA were major liabilities after Katrina- they caused way more problems then they solved. People are dead because of their inability to ask for help or admit they are in way over their heads.
> 
> Read about the unaffiliated response here:
> http://en.wikipedia.org/wiki/New_Waveland_Cafe_and_Clinic



We really don't need to have this debate again... it seems like it was just a few weeks ago. Ask anyone who is educated in disaster response and they will tell you not to become an unaffiliated volunteer. You may have had a positive experience in this one anecdotal case, but that does not mean that that should become the general rule.

This would be like a bunch of doctors and scientists (experts in the field) saying that Drug X is not beneficial for Condition Y. But this one time, you as a paramedic gave X for Y and the patient got better. So surely everyone should be giving X for Y and all of those academics must know nothing, right? 

People may have died because of FEMA's problems in the Katrina response, but unaffiliated volunteers also die. Look at all of the unaffiliated volunteers who showed up in New York after 9/11 without PPE and now have serious respiratory problems. Also, who was the only "responder" killed in the Oklahoma City Bombing response?


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## silver (May 24, 2011)

I googled "Nebraska DMAT" 

this was one of the first links. Has some general national links, but you need to put in effort to get local stuff.

http://www.childrensnational.org/EMSC/NationalActivities/DisasterAgencies/Nebraska.aspx

Even talking with some of these people can potentially help you find other smaller opportunities.


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## usafmedic45 (May 25, 2011)

> I thought about just driving down there since it is only 5 hour drive, however, I know if I go down I'll just either get in the way or get turned away.



.....or wind up in jail.  I've had or seen more than a few Rescue Randys tossed into the klink (or at least the back of a squad car) for interfering.  Despite BStone's glowing view of independent responses, not everyone- especially emergency managers and law enforcement- are so eager to have random folks showing up and trying to do their thing.  In fact, his opinion is distinctly the dissenting minority opinion if you ask around.


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## Stingray91 (May 25, 2011)

I wish PA had more known Disaster training locations. All I know is what when I was in CAP they did some SAR missions & disaster relief when it came to Katrina & the such.


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## mycrofft (May 25, 2011)

*Bstone I applaud you, but you are a very special individual in a special case.*

According to the Wikipedia article, you are uniquely experienced and trained, and seemingly there were some exceptional resources coming into play. Also, during the Katrina debacle, FEMA was completely flat-footed and was apparently impeding other agencies from coming in. The New Waveland effort seems to be a primier example of ad hoc organic response to a disaster.

Other unsolicted volunteers, however, piled on from across the country, most if not all needing support, and some needing to be incarcerated. 

I'm hearing that the surrounding areas, and then some, are providing volunteer helpers in Joplin, clearing debris and setting up feeding stations. I do not hear how they are organizing them, but with the level of devastation and the prominence of feeding stations, support may be uncharacteristically easy to provide. Also, ICS is not as screwed up as it was for Katrina under "good old Brownie" (GW Bush's FEMA appointee).

Are there more articles about the New Waveland Café and New Waveland Clinic? There could be a book in that. How about a thread?


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## BEorP (May 25, 2011)

Stingray91 said:


> I wish PA had more known Disaster training locations. All I know is what when I was in CAP they did some SAR missions & disaster relief when it came to Katrina & the such.



PA has Task Force 1 (USAR), but of course this is a professional team.


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## Chimpie (May 25, 2011)

As for someone that just got back from leading the Red Cross response for two counties in Alabama, having people just show causes more problems than those who come as part of an organization.  We will always find faults in a response but that is how we learn from them.

If you want to use your training, head down to your local chapter, take a few classes, register to be part of the DSHR system (Disaster Services Human Resources) and get ready to be deployed. lol  We have some many operations right now it's scary.

The Disaster Health Services function/activity is what you'll be trained under.  They take EMTs, Medics, RNs, etc.  In my area they were sent out with ERVs (Emergency Response Vehicles) with two Mass Care volunteers and two Mental Health Counselors as part of an Emergency Aid Team.  I had both fixed and mobile teams traveling, meeting with residents (Clients), assessing their health, providing first aid and making recommendations for future care.  In one day my three teams made 344 contacts. (still so proud of them)

If you have any questions please feel free to ask.


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## mycrofft (May 25, 2011)

*Solid medical care versus "Rescue Randys"*

As with military operations, once the hooraw is over and casualty pushes are managed, it will be found at any op that the majority of casualties overall are due to accidents, illness. The longer the op, the higher the ratio of accident/illness versus disaster (battle) injury. The deadliest device allegedly used to be the jeep.


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## bstone (May 25, 2011)

mycrofft, you have a good point in that I do have experience running medical clinics previous to being in Mississippi. I ran the CALM Medical Clinic at a large annual summer music festival that occurs in very, very rural places. However that doesn't mean that I went down to the Gulf Coast with all those resources. I went down with none of them and didn't know what I was getting myself into. My friends were serving food as best as they can and I had no idea if I would join a FEMA team, Red Cross crew or what. I ended up finding NO FEMA or Red Cross, the local hospital was knocked unconscious and there was no medical assistance whatsoever for the entire county. I set up a tent to do first aid and people kept coming in asking 'do you have a doctor?' I ended up emailing, calling, pleading and finally found a steady flow of doctors and medicine. It all happened totally randomly and with little forethought of how long I would stay and what I would do when I got there. 

I went with my own food, water and EMS supplies so that I would not be a liability. I slept in the back of my car for 3 months, so I had no issues with a place for sleep.

To read more look at the 'references' section of the Wikipedia article, which has about every single news article written on the topic: http://en.wikipedia.org/wiki/New_Waveland_Cafe_and_Clinic#References

In end of the day I learned this: in large scale disasters no team or group can possibly provide the level of care and support that is necessary. They need to focus on specific areas and ask for help for the other areas they aren't in. FEMA didn't do that, Red Cross didn't do that, Salvation Army didn't do that and they all couldn't admit that they didn't have the resources necessary to do it right.

So, in the end of the day, a group of hippies and evangelical Christians saved the day.


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## BEorP (May 25, 2011)

bstone said:


> In end of the day I learned this: in large scale disasters no team or group can possibly provide the level of care and support that is necessary. They need to focus on specific areas and ask for help for the other areas they aren't in. FEMA didn't do that, Red Cross didn't do that, Salvation Army didn't do that and they all couldn't admit that they didn't have the resources necessary to do it right.



If you went to a large MVC and the paramedics had screwed up managing it, would you conclude that paramedics can _never_ manage an MCI? Obviously you cannot make a judgement like that based on a single case. No matter what your experience was in this single disaster response case, you cannot reasonably draw conclusions about all disasters.


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## bstone (May 25, 2011)

> If you went to a large MVC and the paramedics had screwed up managing it, would you conclude that paramedics can never manage an MCI? Obviously you cannot make a judgement like that based on a single case. No matter what your experience was in this single disaster response case, you cannot reasonably draw conclusions about all disasters.



There is a strong different between showing up to an incident that is actively being managed and showing up to one that is not. I arrived to an incident that was entirely unmanaged in an area that help no help whatsoever.


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## BEorP (May 25, 2011)

bstone said:


> There is a strong different between showing up to an incident that is actively being managed and showing up to one that is not. I arrived to an incident that was entirely unmanaged in an area that help no help whatsoever.



My point was simply that you can't make conclusions about _all_ disasters based on your experience in one.


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## bstone (May 26, 2011)

> My point was simply that you can't make conclusions about all disasters based on your experience in one.



To be fair, it was the largest and most horrific disaster in modern US history. I wasn't there for one day or one week, but for three+ months. I ran two clinics that were the only medical resource for thousands upon thousands of people.


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## usafmedic45 (May 26, 2011)

BStone, you're bright guy....stop letting your confirmation bias- and deserved pride in your small role in managing a tiny aspect of a very large problem- get in the way of critically assessing the situation.  You were an exception to the rule.  If something fails 99.99% of the time, the 0.01% that mitigates or breaks even does not override it.  Welcome to being the exception to the rule (a statistical outlier, if you will) in that one particular isolated instance.


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## bstone (May 26, 2011)

> BStone, you're bright guy....stop letting your confirmation bias- and deserved pride in your small role in managing a tiny aspect of a very large problem- get in the way of critically assessing the situation. You were an exception to the rule. If something fails 99.99% of the time, the 0.01% that mitigates or breaks even does not override it. Welcome to being the exception to the rule (a statistical outlier, if you will) in that one particular isolated instance.



The problem is you never know when the situation will required to use an exception to the rule in order to get the job done right and save lives. You know after the fact, but that's too late. 

Please know that I am not suggesting unaffiliated volunteers show up in every situation. I do think it can be very useful to have self-sufficient unaffiliated volunteers self-deploy to an extremely large disaster (such as a Katrina) and then find a place to plug in. If they cannot find a place to plug in then they should go home.


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## mycrofft (May 26, 2011)

*Maybe this is is somewhat like the E.R. debacle at some hospitals*

The overcrowded sub-functioning aspect of intake (ER on a Friday night/ SUV's flocking to a disaster) ought to be accomodated or at least planned for (MUCH bigger ER's with better triage diversion/setting the first SUV's to work setting up a tent city for more SUV's, or charging donations for certain types of SUV's to show up, or such).

The concept of ICS/NIMS needs ongoing reeval and remodeling, hopefully to use organic and neighboring resources better and faster in a situation where an area is devastated. Speed is of the essence, if you preplan for it then it doesn't become "haste".

Maybe send out a call for SUV's with particular talents, as the Florida governor once did for Hurricane Andrew (calling for medical personnel)?

In any event, a prepared and affiliated on-scene volunteer will in most cases be safer and of more help. Working on the perimeter or at home to channel cash or BIG in-kind donatons (like truckloads of bottled water etc) will do as much good as showing up, spraining your ankle, getting tetanus, needing a ride home after staying in a hospital or motel room, etc.)


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## Outworld (Jun 14, 2011)

*Disaster Training*

The topic drifted a bit. My 2 cents, do not show up as an unaffiliated volunteer. Despite the dozens of great success stories about spontaneous volunteers, there are hundreds more that did not go as well. 
Pay your dues. Get some experience. Take some classes. NASAR, ( http://www.nasar.org/ )NDMS, ( http://teams.hhs.gov/conference/ )  WMS, (http://www.wms.org/ )and a dozen other organizations have conferences every year. Join us in Belize for one of our Remote Medical or Rescue courses. (Outworldrescue.com) or take a class with Rescue 3.
Become proficient at improvisation. Become comfortable in crappy environments and develop a sense of humor, self sufficency and the ability to be a team member.  This all comes from experience. 
Every year hundreds of well intentioned medical professionals show up at disasters with the belief that their 'good intentions' count for something, will keep them safe and allow them to make good decisions. There is a reason that the saying about the 'Road to Hell" has been around for a long time. Take some rescue classes, become a good wilderness cook, learn how to route find, pitch a tent, change a tire, run a chain saw, prepare safe drinking water, sleep on the ground, develop 'great' communication skills....the list goes on. THEN, feel free to show up unaffiliated..


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## Dr.NREMT-B (Jul 27, 2011)

*Adls/bdls*

You might look into getting your Advanced Disaster Life Support certification.  They are getting ready to hold some courses in Nebraska this next month.

You can check out their website!


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## JeffDHMC (Aug 2, 2011)

Out of curiosity; where does an unaffiliated fellow come up with the supplies (or the tent) to set up a tent to treat that many people? Seems like you might need a lot of stuff to treat these people in an area with no care. I'm not flamim', just wondering.

Jeff


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