Establishing first aid medical control..ideas/experience?

[mycrofft]

Our CERT is furnishing "first aid support" to local events. The CERT is sponsored by the local FD, but their emt and paramedic controller is not involved. Our level II CERT vollies have pased the Calif First Responder class (whatever that is), and a number of them either already were or have gone on to become EMT-B certificates hot to trot.

At an event last year, we had patients being held for a couple hours for "heat exhaustion", someone diagnosed a pregnant lady as having "pre-eclampsia", and another received oxygen. Happily no one was apparently harmed, but the professional responders who took over care for a couple patients were PO'ed at the attitude and possible under or overtreatments; tghe CERT vollies meanwhile pornounced the paamedics "threatened" by teh CERT's work (!!?!h34r.

Anyone have experience setting this sort of deal up? I'm pretty confident, but I always like to hear from the forum.

 

[usafmedic45]

This is why CERTs are generally a bad idea. Basically the problem is that you need to clean house and establish higher standards. Until you remove the weak links, nothing will improve.

 

[mycrofft]

I think CERT is okay but it was not intended for this sort of thing.

Yeah, I am pushing for inclusion under FD medical control, so the whackers can rein it in or take it down the road. Thanks USAF!

 

[DesertMedic66]

My understanding of CERT teams (I have helped a medic teach the medical side of CERT) is that it's just for if a major accident happens. It's not designed for planned community events. That's how the local CERT team is. For any event it will be covered by fire or private ambulance or an event safety company.

 

[usafmedic45]

Honestly, the entire idea of a CERT as a way to augment EMS is laughable at best and utterly ludicrous at worst. If people want to help out, they can just stay the hell away when disaster strikes. A bunch of quasi-trained dofuses running around getting in the way is worse than a simple shortage of manpower because it will amplify the shortage it's meant to fix because you have to assign someone to babysit or get rid of these people. The road to hell or a cluster:censored::censored::censored::censored: of a disaster response is paved with good intentions.

 

[mycrofft]

CERT has mission creep, but it can be manageable.

One of our local CERT's, which has been MANAGED by a FD, has been a real asset to them and the community furnishing hands where there will be no paid hands. Non-actual disaster duties are a way to improve experience/confidence but they have to be managed and supported.

CERT's basic precept is to teach people not to do stuff, how to develop personal preparedness, and THEN to help others in your vicinity in a disaster. In many areas CERT has become an arm of the local FD for special events, assisting in searching for lost kids in safe environments like residential neighborhoods, and even basic logistics such as filling sandbags, and stacking water pallets for wildlands firefighters as LA did in 2005 (year?).
A good CERT should be a channel for vollies. Many are not, and apparently many have gone under, except as a means to conduit FEMA money to local FD's or law enforcement.

Frankly, the concept of CERT (as is the case with all of the rapid responses to 9/11) needs to re-evaluated. Until then, we gotta play safe and try to do some good.

 

[abckidsmom]

Agreeing that they need to be brought under the medical director's wing. Can they do that if they are not an EMS agency? In Virginia, you do prehospital care as part of a licensed EMS agency. Another agency can't just fold you into their agency/medical direction without some organization there.

Our CERTs staff the shelters when they open, made about 5,000 sandwiches during a big wildfire we recently had, and participate heavily in our annual drill at the nuclear power station. They know their place, lol.

Good luck with these guys, sounds like you'll have quite the power struggle if it gets one step uglier than it already is.

ETA: And what a nightmare, precepting these people to determine their competence! Hmmm.

 

[Veneficus]

Honestly, the entire idea of a CERT as a way to augment EMS is laughable at best and utterly ludicrous at worst. If people want to help out, they can just stay the hell away when disaster strikes. A bunch of quasi-trained dofuses running around getting in the way is worse than a simple shortage of manpower because it will amplify the shortage it's meant to fix because you have to assign someone to babysit or get rid of these people. The road to hell or a cluster:censored::censored::censored::censored: of a disaster response is paved with good intentions.

I often agree with USAF in principle, but not on the extreme delivery.

I have to say though, this is spot on.

 

[mycrofft]

Yeah, that description is of bystanders with license.

Our CERT folks have individualy stopped for a couple accidents but nothing outlandish I know of.
CERT can sort of be like twelve year olds in that you want to encourage their interest and enthusiasm, you do not want to crush them when they need correction...but sometimes you can't even "crush them" when necessary.
Since budget cuts, without CERT there will be NO first aid service at local events unless another volunteer group comes forward, like DMAT or MRC. Sort of doing what Boy Scouts used to do before the Seventies. CERT also provides traffic control.

The "stay away" principle is a good one, CERT's (at least here) are taught NOT to go freelancing or appear as SUV's at emergencies, but follow the precept, which is start with your oewn safety, then the immediate surroundings, then start teaming up.

 

[mycrofft]

I'm listening, thanks so far.

(smileys not working B) Oh okay there

 

[Veneficus]

In 2 different states I was employed to provide first aid, a local PCP acted as medical control.

 

[usafmedic45]

No offense, MyCrofft, but it seems like your entire area has a major coordination issue with using teams as they were intended to be used.

 

[nonameheroes]

I think it would be better just to contract to a private BLS company or get the local FD involved rather than get CERT involved. While CERT looks good on paper, they really arent designed to do anything more than help triage an MCI in my opinion. They pretty much arent anything more than a glorified FR without the actual National and State training. And sadly when I think of CERT, all I can think of is that episode of Family Guy when Peter gets CPR trained and uses it at a car crash on 2 live patients

 

[usafmedic45]

Pretty much. "But there will be no first aid!" is an invalid argument. There's apparently low quality first aid now so the public isn't benefiting either way.

 

[zmedic]

First off, it's worth looking into what the laws of your state and county are regarding emergency response. It's possible that what you are doing at the first aid tent comes under the state office of EMS, and there will be specific rules regarding what you can do, medical control etc.

Secondly, if there aren't such rules, and you have limited equipment, you might be fine under a good sam law. But that is only if you are basically holding the patient's hand and controlling bleeding while waiting for EMS. How are you giving oxygen? Who perscribed it? Once you start doing things like blood pressure, oxygen, backboarding you are moving away from what you can get away with without med control.

I think it would be worth your group sitting down with the local fire department and saying "since you aren't staffing these events we would like to. How can we do that in such a way that won't cause friction and be helpful?"

 

[mycrofft]

I'm not explaining local situation very well.

1. CERT was conceived to help teach laypersons what not to do in a disaster, to get them to prepare, and indoctrinate them to team up in a disaster and help those around them until the porper authorities are there. Since this is extremely rare, and even in actual disasters like the Katrina hurricane CERT is not activated nor does it always self-activate as it is supposed to do, CERT gets used to provide non-disaster services like acting as a volunteer auxilliary to paid FD's and law enforcement in such events as fairs, lost kids, putting on big exercises, etc. The first aid training has been expanded beyond the CERT disaster-oriented stuff. In or particular case, the CERT program is totally under the local FD.

2.Due to local budget cuts, the FD, who has in the past provided first aid (and beyond) standby at events, will no longer be able to. (In the actual event, we will see if they don't scrape up somthing). So the CERT is basically working under a Good Samaritan basis with FD sponsorship allowing them to present as an organization at these events. (CERT actually started getting gigs covering local football games as a fundraiser, but this was protested by the other teams...go figure).

3. I think we will get a cadre of licensed (RN, Paramedic) and professional (local FD medical coordinator) people, examine successful local protocols, develop a set, then open it up for discussion. If individuals can't abide, then they will be used for other functions, like traffic control, staffing the recruitm,ent booth or even helping hand out fire and home safety lit.

I'm still listening.

 

[cruiseforever]

Why would you put someone that cannot be trained or refuses to go by the rules in the recruitment area? People that you want to join would be put off by this type of person.

 

[mycrofft]

Apologize for delay

Actually, they are very charming and energetic and make a good front person. What might bother me is their recruiting like-souls to join.

As a total organization, I'm trying to get them to veer more to public education ("Neighborhood Emergency Training", or NET), and maybe sup[plenmt the firefighters teaching kids fire safety at events, since the FD can't pay their firefighters to go do that anymore.

 

[mycrofft]

Tomorrow night showdown.

COmmittee heads meet, then general membership.

 

[mycrofft]

Ready-aim-fire ("pop").

After being told I would be on the committee to draw up protocols, and prepping here and elsewhere, a non-medical fire chief produced another county's protocols, and then singlehandedly said our people could administer oxygen. NOw they want me to look the "finished product" over for "anything that's missing". Sure, I said I would, but my "uncomfort" level just went through the ceiling. I'll stick to teaching from now on.