Haiti Earthquake EMS response

[VentMedic]

I understand what Vent was trying to say, I think the example is poor.(though she is right, in some states medics are not permitted to give vaccinations) How many paramedics know microbiology epidemiology? Do you have the training to select ab therapy? How about parasitology? Can you trace the vectors of the different species of tape worms? Can you look into a standard microscope found in any high school and identify a protazoa? When you travel to less developed nations or in events when basic sanitation breaks down, this becomes a real issue. It takes no more effort for a physician to render treatment as it does to delegate it.

We've had a few threads in the past on the topic. Unfortunately, public health is too boring to lead to much discussion and some are still trying to decipher the topic of disinfecting their ambulance and stethoscope.

http://www.emtlife.com/showthread.php?t=9484&highlight=vaccinations

http://www.emtlife.com/showthread.php?t=14772&highlight=vaccinations

Unfortunately it is more about the "skill" rather than an understanding of the vaccine, its implications or consequences.

State disaster action plans.
http://www2a.cdc.gov/phlp/H1N1flu.asp

Several states were also still slow in establishing disaster plans after Katrina.

Massachusetts
http://www.mass.gov/legis/bills/senate/186/st02/st02028.htm

 

[18G]

First off, I am generally speaking about the positive effect EMS could have in Haiti when organization is achieved. I have never said that as of this minute all EMS providers load up into a plane and head for Haiti. So I'm not sure where that perception came from.

Physicians hwere I go to school are extensively taught to triage. Additionally from the hospital side, every patient who comes through the door is retriaged paying no attention to the label EMS gave them.

I have no argument that physicians are better suited to triage however, there are not enough physicians to go out into the field and perform this task. They need to be at the field hospitals ready to receive patients.

How many paramedics know microbiology epidemiology? Do you have the training to select ab therapy? How about parasitology? Can you trace the vectors of the different species of tape worms? Can you look into a standard microscope found in any high school and identify a protazoa? When you travel to less developed nations or in events when basic sanitation breaks down, this becomes a real issue. It takes no more effort for a physician to render treatment as it does to delegate it.

To me this is completely irrelevant. You don't need to be a microbiologist to give a vaccination. Do we need to be cardiologists to give cardizem? An endocrinologist to treat diabetic issues?

 

[Veneficus]

We've had a few threads in the past on the topic. Unfortunately, public health is too boring to lead to much discussion and some are still trying to decipher the topic of disinfecting their ambulance and stethoscope.

http://www.emtlife.com/showthread.php?t=9484&highlight=vaccinations

http://www.emtlife.com/showthread.php?t=14772&highlight=vaccinations

Unfortunately it is more about the "skill" rather than an understanding of the vaccine, its implications or consequences.

State disaster action plans.
http://www2a.cdc.gov/phlp/H1N1flu.asp

Several states were also still slow in establishing disaster plans after Katrina.

Massachusetts
http://www.mass.gov/legis/bills/senate/186/st02/st02028.htm

To repeat an important concept since it seems I have not been clear and not directed at Vent:

In a refugee environment, Trauma followed by public health concerns, are the leading causes of mortality.

A disaster is a refugee environment. Right down to the environment being made inhospitable.

In adition to all of the formal education, it takes 7 years of post graduate education to become a trauma surgeon. 6 to be a cardio thoracic surgeon, and 5 to become a cardiologist. Look at the difference between the amount of time spent on cardiology vs. trauma in EMS education.

There is not even a full 4 hours devoted to public health in paramedic education.

If these are the 2 significant medical problems in a disaster, how much help could the average paramedic possibly be?

What would an EMT-B do at all?

I am pro EMS. I even teach. but a spade is a spade, there is simply not enough of the education needed in the average US provider to make a significant difference in a situation like Haiti without considerably more education.

I have not encountered one person I know that works in USAR or disaster planning/response anywhere that thinks the average US EMS worker would be worth the resources they would use. This is an Island. Foreign response teams have to bring their own equipment, food, and water plus enough to help. The deep water port is damaged, not functioning! That is the best way to bring mass amounts of resources. The airport is overwhelmed now. You can't simply call somebody up the street in Texas or California and have them drive stuff down. They need the best of the best down there, not just anyone with some applicable skills.

 

[Veneficus]

To me this is completely irrelevant. You don't need to be a microbiologist to give a vaccination. Do we need to be cardiologists to give cardizem? An endocrinologist to treat diabetic issues?

You need to be able to figure out why the patient is malnurished. You have to know if the antibiotic you have will have any effect at all.

If you are planning to stop vomiting and Diarrhea you need to know what is causing it.

Anyone can stick a needle in somebody you don't need an EMS provider. Which means your resources are better used by teaching the locals how to do these mundane skills.

You don't have to be a cardiologist or endocrinologist to treat these things because you have things like direct and functioning medical oversight, you are taking these patients to the hospital where somebody who does know will help. (I know sometimes they refuse) You have near limitless resources, do you worry about running out of the cardizem or d50? Do you know what drugs you can use to get similar outcome by a different mechanism?

The public health issues I cited have a direct impact on the outcome of a disaster.

I am most interested in learning what exactly you can do to help. I am not interested in excuses for what you cannot.

 

[VentMedic]

I have no argument that physicians are better suited to triage however, there are not enough physicians to go out into the field and perform this task. They need to be at the field hospitals ready to receive patients.

That is a U.S. way of thinking and few here have actually seen a mass mobilization of professionals in times of a disaster. It is very impressive.

Doctors Without Borders have an impressive number of doctors. Cuba already has almost 350 doctors in Haiti and are sending more. If you remember Cuba also offered 200 doctors to the U.S. during Katrina but was snubbed by Bush. Spain and France have sent their doctors. Major university hospitals from around the world are also sending their teams. Doctors at Jackson Memorial Hospital in Miami are considering using a satellite phone system to better assist doctors treating the injured on the Caribbean island. JMH is also where some of the injured are being airlifted to.

 

[Jeffrey_169]

Can anyone tell me why the Sea Bees and Marine Combat Em=ngineers haven't been sent in yet? I have heard nothing about it. Truth is these people are experts at building things overnight. Why not send them in and let them build hospitals? They really are the engineering miracles behind these types of events, and yet I have heard nothing about them.

 

[VentMedic]

Can anyone tell me why the Sea Bees and Marine Combat Em=ngineers haven't been sent in yet? I have heard nothing about it. Truth is these people are experts at building things overnight. Why not send them in and let them build hospitals? They really are the engineering miracles behind these types of events, and yet I have heard nothing about them.

Obama just outlined the Military response:

http://www.fox10tv.com/dpps/military/USS-Bataan-ordered-to-Haiti_3187915

 

[lightsandsirens5]

Can anyone tell me why the Sea Bees and Marine Combat Em=ngineers haven't been sent in yet? I have heard nothing about it. Truth is these people are experts at building things overnight. Why not send them in and let them build hospitals? They really are the engineering miracles behind these types of events, and yet I have heard nothing about them.

USNS Comfort and an aircraft carrier are being sent right now, the Coast Gaurd already has a cutter I beleive and several helo crews working there and the Air Force and Coast Gaurd are airlifting supplies and teams in now. I beleive that several Marine bases were mobilizing as well.

EDIT: Oh ha ha! Yea, look at the link Vent posted.

 

[Cory]

I've always wondered what emergency responders to disasters do about risk of diseases in unsanitary places like Haiti, I guess this is the place to ask. So are you given vaccinations or masks or what?

 

[Jeffrey_169]

obama just outlined the military response:

http://www.fox10tv.com/dpps/military/uss-bataan-ordered-to-haiti_3187915

oorah!!!

 

[Veneficus]

Obama just outlined the Military response:

http://www.fox10tv.com/dpps/military/USS-Bataan-ordered-to-Haiti_3187915

That is a truly inspiring response.

 

[VentMedic]

I've always wondered what emergency responders to disasters do about risk of diseases in unsanitary places like Haiti, I guess this is the place to ask. So are you given vaccinations or masks or what?

To be on a team it is your responsibilty to keep basic vaccinations up to date. That includes: Hep A&B, Varicella, MMR, Polio, Tetanus-diphtheria and influenza as well as having a current TB test.

You should also have your own supply of insect repellant, ear and eye protection, leather gloves as well as gloves to work on patients, protective masks and/or a filtered respirator, appropriate footwear and clothing. The type of team you are deployed with will determine where you will be working and the type of equipment and protection you will need.

9/11 gave the U.S. many valuable lessons with some being learned the hard way. Katrina also was a learning experience for what should have be done and who not to do before, during and after the storm. Of course it also helps to have the right Governor and President during a time of disaster.

For more reading on the topic, the CDC - NIOSH have a good website.
http://www.cdc.gov/niosh/topics/emres/default.html

 

[Double-E]

sooooo....for all this discussion and debate about who has the most knowledge about what the proper response will be...we've yielded no list of agencies where we can volunteer our services?

as an emt i dont think there's much i can do to help but i *can* speak french...that's enough to make me want to at least offer to help and let more qualified people decided whether or not i'll be able to help.

anyone have any idea where to inquire?

 

[Double-E]

from the american red cross site:

We are not accepting volunteers to travel to Haiti. If you would like to volunteer for the American Red Cross, please contact your local chapter.

well...my local chapter says nothing...one down...more to go...

 

[VentMedic]

sooooo....for all this discussion and debate about who has the most knowledge about what the proper response will be...we've yielded no list of agencies where we can volunteer our services?

Yeah thanks for insulting those of us who have worked many disasters as both paid and volunteer.

There's a reason why lists aren't posted. This is not something one can or should volunteer for on the spur of the moment. If you have not already been part of an agency that regularly trains for a disaster, it is unlikely that you would be appropriate for this type of situation regardless of what language you speak. You will also often have to make a commitment of 2 weeks which should be approved by your employer when you join since you will be leaving your employer on a very short notice. You may also be expected to pick up some of the cost yourself for your own supplies. For some volunteer organizations, you pick up all of the cost which can be several thousand dollars from your own pocket. Be very careful and research thoroughly before you jump into any situations.

However, if you are serious about volunteering and actually want to put forth the effort to train for a disaster, apply to your state's' DMAT chapter. This is also the safest way to volunteer since you will be afforded the benefits of being a Federal Employee.

http://www.hhs.gov/aspr/opeo/ndms/teams/dmat.html

Of course you could become employed at a FD or EMS agency that has an elaborate disaster team and work you way onto it.

In summary, with all the disasters we have had in this country and others, if you really wanted to be part of a team that responds, you would have already started doing your research and preparation. As with anything, even disaster preparedness for your own family, don't wait until a disaster happens.

 

[VentMedic]

For those of you who might want to volunteer to be part of a future disaster response, here is what HHS/DMAT is doing now.

http://www.hhs.gov/news/press/2010pres/01/20100114b.html

HHS Deploying U.S. Medical Personnel to Haiti

The U.S. Department of Health and Human Services (HHS) has activated the National Disaster Medical System and the U.S. Public Health Service Commissioned Corps. More than 250 personnel are in the process of deploying to Haiti and over 12,000 personnel could possibly assist in the coming days.

The medical teams include doctors, nurses, paramedics, emergency medical technicians, emergency medical and surgical physicians, and other medical personnel from Georgia, California, New Jersey, Massachusetts, and Florida. An International Medical Surgical Response Team will provide care for severely injured patients and five Disaster Medical Assistance Teams will provide basic medical care. These personnel will be accompanied by 22,000 pounds of medical equipment and supplies.

 

[techinthemic]

Hi guys I have been reading this thread with some interest. I am an EMT in the uk, soon to taking my para degree. Is there anyway I can join the international effort? Things here seem to be very segmented and heavily government controlled with only a select rescue team based within the fire service being deployed. (Ambulance staff here work for their local National Health Service ambulance trust, not the county Fire and rescue service.) I would be eager to join an organisation who are prepared and familiar with taking international ambulance staff and placing them in a position where we can be of most use. I understand and expect tests and references will need to be taken and checked before any further training can begin, but this disaster has prompted me not to let my own countries' reservedness stop me from doing more. I hope you can suggest an appropriate organisation - I'm sure you must have one, thanks.

 

[Jeffrey_169]

Hi guys I have been reading this thread with some interest. I am an EMT in the uk, soon to taking my para degree. Is there anyway I can join the international effort? Things here seem to be very segmented and heavily government controlled with only a select rescue team based within the fire service being deployed. (Ambulance staff here work for their local National Health Service ambulance trust, not the county Fire and rescue service.) I would be eager to join an organization who are prepared and familiar with taking international ambulance staff and placing them in a position where we can be of most use. I understand and expect tests and references will need to be taken and checked before any further training can begin, but this disaster has prompted me not to let my own countries' reservedness stop me from doing more. I hope you can suggest an appropriate organization - I'm sure you must have one, thanks.

You might try the International Red Cross. If they cannot help you, they should be able to recommend one. I doubt they will need you immediately, but they might be able to refer you to someone who can help. There is a great deal of special training involved, and so while your intentions are valiant, it would be doubtful they could use you right away. With the proper training, they will surely be able to use you in the future.

I am no expert on this issue, however I believe this is a good place to start.

 

[Aidey]

Not to change the subject, but has anyone been watching the new coverage with Dr. Gupta on CNN?

He keeps going on about how horrible the situation is, and how they have been reduced to using cardboard for splints until the doctors can look at people and they are hanging IV bags from trees.

Now, call me crazy, but am I the only one who thinks he is making it sound worse than it is? I'm not saying it isn't bad, but he's making it sound like cardboard splints and IVs from trees are signs of the apocalypse.

I've personally done both (wildland fire...lots of trees, no IV poles). We've also used those folding cardboard mass casualty backboards during MCI drills and we use the cardboard splints on my ambulance now. It sounds like they are MacGyvering what they need out of what they have and doing pretty well. Or at least doing better than the news is making it sound like.

I know they probably aren't using the pre-fab cardboard splints, but those seem like they would be a more than acceptable method of splinting during a MCI. Am I wrong in thinking this?

 

[Veneficus]

a TV personality make something sound more than it is, I thought that's what they were paid for?