Haiti Earthquake EMS response

[ExpatMedic0]

Does anyone know if anyone (I.E. AMR DRT) is sending any employees for disaster response? I would be interested in possibly going if there was an opportunity. I know a major hospital has collapsed and it sounds like we will be sending resources.

 

[MMiz]

I don't ever remember American Medical Response sending personnel for foreign incidents.

 

[reaper]

Miami-Dade Task force is most likely halfway there by now. They normally respond to all international disasters like that.

 

[Jeffrey_169]

I made some calls this morning to see what people interested could do when I found out about it. I haven't heard anything yet, still waiting.

From reports I have seen on T.V. and on Youtube.com it is horrible and almost unreal.

 

[46Young]

Fairfax County FRD USAR leaves Dulles Airport at 1200 hrs today for Haiti. Our OMD is a member of USAR, and always deploys. It's nice to have a physician on hand for medical direction, field amps and such. We have a good number of medics on the team as well.

 

[Jeffrey_169]

I will keep him in my prayers.

 

[enjoynz]

Just a thought - Maybe try the Union Nations or the Government Dept in your State.
They probably can put you in contact with the correct people?
It looks like the US are going to send a co-ordinated rescue team to Haiti.
Other countries are doing likewise.
Good Luck and stay safe, if you do get to go!


Cheers Enjoynz

 

[lightsandsirens5]

I'd check and see if a FD in your area is sending a USAR. I would think that Portland is big enough to have one and they may go. Who knows. Let us know how it goes.

 

[catskills]

Check out the Medical Reserve Corps.

http://www.medicalreservecorps.gov/UnitZipSearch.asp

 

[JPINFV]

I'm going to make an argument that EMS is essentially worthless right now on Haiti. USAR? Yes. EMS? No. Given the damage, any hospitals that are left function are going to be overdrawn completely anyways. What is more important at this point is sanitation and potable water.

 

[Jon]

Matt, Now that AMR has the FEMA DRT contract, it is possible.

I actually should get the rest of my app in to AMR's DRT for giggles.


But I've got to agree with JPINFV and question the purpose of the mission. Although it is also entirely possible that EMS providers will be used in a fixed clinical role, as some of my comrades from Katrina were.

 

[Veneficus]

I'm going to make an argument that EMS is essentially worthless right now on Haiti. USAR? Yes. EMS? No. Given the damage, any hospitals that are left function are going to be overdrawn completely anyways. What is more important at this point is sanitation and potable water.

Outstanding point

 

[reaper]

I disagree. I think that an EMS response is needed there, Now. They have lost almost all hospitals and there is no medical response at all.

EMS in It's normal stage is not going to work. But, EMS workers providing any medical needs they can, is what is going to be needed. Basically work it like a large triage response. Provide what service you can, for the most people.

 

[Veneficus]

This is completely out of the league of most US EMS providers

I think in the ideal EMS world it may be so. But the current idea of “start” triage and rapid transport simply will not work. In what is known as “refugee” conditions the highest causes of death and disability is trauma followed by public health complications. (dysentery, mal nutrition, etc) Most US EMS providers are not educated nor trained for such conditions. (obviously there are those who are) The mindset is totally different. You cannot focus on one patient, you must be constantly aware of your ever dwindling resources. People with what would seem minor injuries during a normal day will likely succumb to infection. There will be walking, talking people who will ultimately receive no help for the benefit of the most.

During all of this it takes education and training that is simply not part of US EMS at large. Look at uniformed health services, there are nursing spots but not paramedic spots. As you pointed out, there are no hospitals to run to. Transfer to definitive care? The level of definitive is normally reduced. Drop off 200 patients in a parking lot with a handful of doctors and nurses? Hardly helpful. Are these same providers going to independently take care of patients for days or weeks on site?

How about logistical support? Where would these providers stay? Who would be responsible for feeding them? How about hygeine?

FEMA? I Wouldn’t hold my breath waiting for them to help with anything except a post incident investigation of what went wrong. Right now one guy who can hammer boards together to make a hut or purify drinking water or set up a soup kitchen is worth 1000 EMS providers there.

The reason we have a small amount of specific teams is so these people can be trained, equipped and supported while deployed. What about vaccinations? How is it a good idea to turn loose a bunch of wackers from the US in a tropical environment during a disaster? Not everyone is a wacker, but how do you screen for them if you just have open enrollment to go now? How do you ensure their home area isn’t negatively affected when you send them overseas? How do you account for and evacuate them when they figure out their family isn't independantly wealthy enogh to do without their income back home? Planning on paying them for their service? Who is responsible for their health and welfare? What if they are hurt or killed? What if they contract a communicable disease? Under who’s medical direction do they work? Most are certainly not educated enough to be let loose on the world without oversight. Who provides the oversight?

What practical aspect of care are they going to provide? Inoculations? The Military and Uniformed service is more than capable with tremendous experience in the matter. Bleeding control? So what is the next step in bleeding control if you get the bleeding to stop? What are they going to do then? Sit them in line to see a doctor or get evacuated? Why do you need an EMT for that? What about the emotional aspects? Several here have recently stated they would do everything they could to give a kid a chance. In disaster medicine, old, previously ill, and very young are at the bottom of the resources list. Even if they survive the initial event, someday all this international help is going to dry up. They will not be able to survive on their own afterword.

I could write a book on this matter, but the long and short is that while there are Medics and probably a handful of EMTs that could have a positive impact, that number is small, has not already been prescreened, largely without training, experience, or the raw knowledge to improve the situation, not capable of acting without oversight, and brings far too few contributions while being another mouth to feed, water, and a body to account for. Who is providing the PTSD counciling after they get home? Plan on just giving them disability with "thanks and best of luck?"

 

[Jeffrey_169]

I could not agree more with Reaper. This is what sets us apart from nurses; the ability to work in ALL weahter, in ALL conditions, and the ability to improvise and do what we can with what we have. You do not need walls to have a hospital; you need trained professionals willing to do whatever it takes to get the job done, and who are willing to improvise in the field to provide the best patient care possible. These people are accustomed to having little to nothing; I doubt they are going to less then extremely grateful for us doing the best we can with what is available.

In the words of one of the refuges, "PLease help us...help us anyway you can".

 

[reaper]

I think in the ideal EMS world it may be so. But the current idea of “start” triage and rapid transport simply will not work. In what is known as “refugee” conditions the highest causes of death and disability is trauma followed by public health complications. (dysentery, mal nutrition, etc) Most US EMS providers are not educated nor trained for such conditions. (obviously there are those who are) The mindset is totally different. You cannot focus on one patient, you must be constantly aware of your ever dwindling resources. People with what would seem minor injuries during a normal day will likely succumb to infection. There will be walking, talking people who will ultimately receive no help for the benefit of the most.

During all of this it takes education and training that is simply not part of US EMS at large. Look at uniformed health services, there are nursing spots but not paramedic spots. As you pointed out, there are no hospitals to run to. Transfer to definitive care? The level of definitive is normally reduced. Drop off 200 patients in a parking lot with a handful of doctors and nurses? Hardly helpful. Are these same providers going to independently take care of patients for days or weeks on site?

How about logistical support? Where would these providers stay? Who would be responsible for feeding them? How about hygeine?

FEMA? I Wouldn’t hold my breath waiting for them to help with anything except a post incident investigation of what went wrong. Right now one guy who can hammer boards together to make a hut or purify drinking water or set up a soup kitchen is worth 1000 EMS providers there.

The reason we have a small amount of specific teams is so these people can be trained, equipped and supported while deployed. What about vaccinations? How is it a good idea to turn loose a bunch of wackers from the US in a tropical environment during a disaster? Not everyone is a wacker, but how do you screen for them if you just have open enrollment to go now? How do you ensure their home area isn’t negatively affected when you send them overseas? How do you account for and evacuate them when they figure out their family isn't independantly wealthy enogh to do without their income back home? Planning on paying them for their service? Who is responsible for their health and welfare? What if they are hurt or killed? What if they contract a communicable disease? Under who’s medical direction do they work? Most are certainly not educated enough to be let loose on the world without oversight. Who provides the oversight?

What practical aspect of care are they going to provide? Inoculations? The Military and Uniformed service is more than capable with tremendous experience in the matter. Bleeding control? So what is the next step in bleeding control if you get the bleeding to stop? What are they going to do then? Sit them in line to see a doctor or get evacuated? Why do you need an EMT for that? What about the emotional aspects? Several here have recently stated they would do everything they could to give a kid a chance. In disaster medicine, old, previously ill, and very young are at the bottom of the resources list. Even if they survive the initial event, someday all this international help is going to dry up. They will not be able to survive on their own afterword.

I could write a book on this matter, but the long and short is that while there are Medics and probably a handful of EMTs that could have a positive impact, that number is small, has not already been prescreened, largely without training, experience, or the raw knowledge to improve the situation, not capable of acting without oversight, and brings far too few contributions while being another mouth to feed, water, and a body to account for. Who is providing the PTSD counciling after they get home? Plan on just giving them disability with "thanks and best of luck?"

I do not remember anyone saying that there should be an open enrollment for any EMT or Medic that wanted to go. We are talking organized teams. USAR only goes so far in these situations. The medical response that is there to help the masses is what does the most good.

I have seen this first hand. I have worked many natural disasters in many countries. The medical response provided to these people is what is the difference. You are not there to "save the world". You are there to provide the basic medical needs, that they no longer have available.

This has been done countless times in some of the worst areas of the world. An organized response is priceless to these people at this time. Yes, you have to have providers that can work independently and with few resources. You are not there to provide transport to a hospital or Dr. You are there to provide any medical care that can be done. Even if this means just providing comfort for the end of life.

A blanket statement that EMS is not needed, is ridiculous. Unless you have experienced this first hand, then you have no way of knowing what helps in these situations!

 

[Veneficus]

EMS is not needed.

What is needed is medical providers. As I eluded to, the already organized response is already being deployed.

I do not know your background, but based on your posts here and good personal references, I do not doubt that you could be an asset. Maybe you know a handful of people who can. But I bet my last dollar it wouldn't be in the EMS role. Particularly as it is executed in the US.

I would imagine in your experience it was with the military or already organized expedition. But the heartfelt response of EMS providers is what leads to things like "staging point maveric" as demonstrated in the WTC attack and the risk and worry of "self dispatching."

In the last 2 days I have had several people contact me, some who haven't been EMS providers in years, ask me how they could get involved and telling me how they might be able to contribute.

But passionate as people may be, their involvement will mean little. Those who really want to be involved will start after this disaster for the next one. But i seriously doubt that even 25% of the people who are so passionate about helping today will be follow up after this leaves the news. Just as when the next disaster hits everyone and their brother will want to help at that moment.

I apologize if you think my comments were an attack on you, it was not what I meant, but I did want to point out how complex the issue is and how little the average EMS provider would help.

After all, how much time in EMS education is spent on trauma or public health? A class? A week?

There is always the Advanced Disaster Life Support course. All there is to know in 14.5 hours. Outstanding. (that is after the Basic disaster life support course)

 

[Jeffrey_169]

I see the merits of Veneficus's argument, but I also see the merits of reaper's as well. My experience here in incidents of this size is limited, but I do think in the absence of a better solution something beats nothing.

As for the opinions on FEMA, well they took a hard ht after Katrina, and truth be told the blame here is misplaced. There were hundreds, a thousand by some estimates, of school buses left in the wake of this, and they were destroyed. The mayor of LA said something to the effect of not wanting to demote the poor people of New Orleans by making them ride a bus to some distant and unknown destination. I guess he thought living in filth in the Super Dome was somehow more humane. Besides, the Gov. needed to call FEMA in advance and request their help, which she did not. The federal gov't cannot and will not intervene in the sovereign matters of a state, unless national security is at risk, unless they are asked by said state. I am no fan of FEMA, or any federal agency (they botch everything they set their hand to), but place blame where blame is due. Many people do not know the whole story, and the media didn't make it any better.

IN any event, there are those here who know far more then I about the matters of mass causality and disaster services, so perhaps I too was out of turn. I don't know, I just think something is better then nothing, and too much is better then not enough; right?

 

[MrBrown]

I agree with Veneficus; civillian ambo's have no real use in this sort of situation they may be able to perform some basic field triage and initiate one or two things like IV therapy or bleeding control but thats about it.

What these dudes need is high level infrastructure; surgeons, hospitals, intensive care consultants, stuff like that and I don't see a bunch of ambo's being able to provide that.

As for FEMA, where is that black dude with his shotgun from New Orleans off TV who was trying to shoot down Air Force One?

 

[EMSLaw]

Yes, the usual EMS algorhythm that ends with transport to the ED is not going to work in this situation. But even Doctors Without Borders was saying that all they can do in this situation is first aid care. At least in these initial stages, I suspect that anyone who can make a basic patient assessment and apply a splint and bandage would be able to contribute.

That doesn't mean that everyone should run off, by the way. I'm just saying - while EMTs and Paramedics usually focus on transfer to definitive care, their skills, with some little adaptation, would be applicable to this sort of disaster situation.

I agree, though, that people who want to volunteer for something like this should, instead of rushing off to Haiti, start looking now at what they can do to be ready for the next disaster, that way they actually will be valuable, instead of just in the way.