CERT Responder Magazine_Vol 1 Issue 3

CERT Responder Magazine is dedicated to providing CERT and first responders with information and tools to assist communities in times of crisis, as well as offering a platform for responders to share their stories.

Letter from CERT Responder Magazine

Thank you for all your support and for subscribing to CERT Responder Magazine

With this third issue, we just want to touch on a few things: We continue to find community volunteer services that fit the criteria of the CERT community, and you will see stories and information from these groups in upcoming issues. You will find that these groups have very similar training and goals as you do, hence the purpose of this magazine: share stories, training, education, and ideas to make us better prepared to serve our communities in time of crisis.

For our success and for unification of the Community Emergency Rescue teams, we need your continued input, both the good and the bad. We want to know what you would like to see in upcoming editions, challenges you are having, and suggestions to help solve challenges of other CERT members.

You are a well-respected part of the first responder community, and play a major roll in what is expected from this community. We welcome your ideas, suggestion, stories and ideas.

Thank you for all you do for your communities and for others.

The CERT Responder Magazine staff.

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Photo courtesy of

LANDINGZONE

MEDICAL HELICOPTERS information for

BY BOB ABRAMS

The information in this story should be used only as a guideline for setting up a landing zone for air medical helicopters. Please work with your local fire service to set up a landing zone class with the air medical service in your area.

I’ve been a Paramedic for many years, including fourteen years in the air medical service, with much of this time devoted to teaching landing zone classes to Fire departments, EMS agencies, Police and CERT teams. I thought this would be a good opportunity to share some of this information with the rest of the CERT community.

When setting up a landing zone for air medical helicopters, always try to find a location that offers open access to the aircraft and is as flat as possible.

As a CERT member, you should first assist the Fire Department in setting up a landing zone when requested. However, there may come a time in a disaster when your team may need to set up on its own. That being said, the following information should be considered:

1) When setting up a landing zone for air medical helicopters, always try to find a location that offers open access to the aircraft and is as flat as possible.

2) Hard services are preferred, but open fields may be considered, as long as they offer a dry landing surface with growth no higher than one’s knees. Anything higher can cause damage to the aircraft and make it difficult for crews to move equipment and patients. Walk the site you have chosen to remove anything that can become a projectile (rocks, bottles, boards, etc.).

3) The landing zone should be 100 feet square and free of powerlines, trees, light standards, water towers, radio towers, or any other obstructions.

4) Keep all personnel 100 feet from the center of LZ (landing zone), and bystanders 200 feet from LZ. Your team should designate personnel at each corner of LZ to ensure safety by keeping everyone from the LZ.

5) Stop all traffic when the aircraft is landing and taking off.

6) At night try to have a LZ kit or lighting to offer the pilot a visual of the LZ. Never shine a light at the aircraft as it could cause visual problems for the pilot. Also, if there are power lines, lay a flashlight against the power poles so the pilot can judge the distance between each of them.

7) In the daytime, it is difficult to see the above-mentioned lights, so it may be advantageous to have someone put on a reflective vest and stand in the middle of the LZ to offer a visual for the pilot. Please move that person from the center of the LZ when the aircraft is making it’s descent.

8) Assist the fire service with landing information for the pilot.

Example: “to the east of the LZ are power lines, west is a water tower, to the south there is a tree line.” In a situation where Fire, Police or EMS are unable to respond, you may need to contact air medical services.

You should know the emergency numbers for these services. If you are setting up the LZ without the above-mentioned professionals, use your cell phone to give directions to the air medical communication specialist, such as the closest cross streets to the LZ and information about obstructions near the LZ. They in turn can relay your information to the pilot.

9) Another very important thing to remember: no matter how good you feel your LZ is, the pilot has the final say about the LZ. He/she must feel comfortable landing the aircraft safely. Don’t be offended if they direct you to set up LZ in another nearby area.

DANGER AROUND THE AIRCRAFT

The reason to set up a safe LZ is not only for the air crew, but also for your team and the public.

When the aircraft is landing, it can produce a very powerful rotor wash (high wind) that can be as powerful as a category 1 hurricane.

Another important consideration is the tail rotor and the main rotor. Both are turning at a very fast rate of speed. The tail rotor is lower, and without proper LZ precautions can cause major injuries or death if approached while turning.

Never approach a running aircraft unless the pilot requests it. Always approach from the front of the aircraft in view of the pilot and the crew.

From the nose of the aircraft to the doors is considered a caution zone. If you are requested to approach the aircraft, follow the crew’s instructions in this area.

From the side doors, back to the rear rotor is considered the danger area of the aircraft and should be avoided. Again, it must be emphasized that everyone is kept away from this area. The best practice is to never approach an aircraft while the blades are moving.

As stated in the beginning of this article, this is only information. You should set up a landing zone class through your Fire, EMS or Police services in conjunction with the local Air Medical Service in your area. Please contact these services for more information. CERT

Focus On

Anthony Brown

Suffolk County CERT President

LONG ISLAND, NEW YORK

Athony Brown, the Suffolk County CERT President, has been a member for 12 years. Suffolk County is the largest county on Long Island, New York measuring 86 miles long and 26 miles wide, with a population of 1,492,583 (as of July 2016). With the close proximity of all that water and dense population, one can only imagine the amount of rescues and emergency services needed. In the beginning, he joined the first all Veteran CERT Unit in the Country, Babylon CERT. A year later, they merged with Suffolk County CERT which is set up a bit differently than most other CERT units. They have a Board of Directors that operates with Suffolk County Fire Rescue and Emergency Services. The Board controls the day to day operations while reporting to Fire Rescue and Emergency Services for deployments, training and support.

President Brown is obviously an incredible asset to CERT! Over the past twelve years, he has been awarded the Presidential Volunteer Service Gold Medal four times and the Life Time Medal as well. In 2012, he even received an award from the Civil Air Patrol acknowledging his CERT work. President Brown is deservedly proud to mention the honors his teams members have received as well. With over a dozen Life Time Presidential Awards and about sixty other members who have received the Bronze, Silver, and Gold Presidential Volunteer Award, he is proud to have led this Organization for the past almost six years as well as having served in several Board positions in years prior.

WHAT IS THE BEST PART ABOUT BEING A CERT MEMBER?

I am a senior CERT Trainer and I have had the opportunity over the years to watch many raw “recruits” enter the Program and then see them stand in the Gap when the need arises.

WHAT IS THE BEST WORK STORY EVER?

During super Storm Sandy I was in charge of the only Pet-Friendly Shelter that was operating in Suffolk County. We had families coming in on buses at 2 in the morning after being plucked off of their roofs or 2nd floor windows and came to the Shelter literally in the pajamas and often barefoot. My CERT Team provided clothing for these families many times from our personal stores and gave them a safe place to ride out the storm. The grief and shock that these families were suffering was visceral. For a week we had the privilege of being with some of the nicest folks that we have ever encountered during a shelter activation. Families were kept together, we activated the Whiteboards in the classrooms (Shelter was at a Community College) and the kids were thrilled and the parents ecstatic.

WHAT DO YOU CONSIDER YOUR GREATEST ACCOMPLISHMENT?

I was one of ten people on Long Island that received an award and recognition for my work done during Super Storm Sandy. While this is in itself an accomplishment I consider the interaction that I have over the years at many public events when presenting Emergency Awareness and preparedness classes and then having these people come back to me after a storm or event and thank us, the CERT team, for having given of our time in teaching them how to take care of themselves during troubled times.

WHAT DO YOU DO FOR FUN?

I scuba dive and fish. When not doing either I am usually reading.

IF YOU COULD GIVE YOUR FELLOW CERTS ADVICE, WHAT WOULD YOU SHARE?

Even in the worst of times there are people who are relying on our professionalism. Always be positive. Always maintain your training and whenever possible take as many of the courses that are available to us as CERT members.

HOW CAN THE PUBLIC SAY “THANK YOU” AND MAKE YOUR WORK EASIER?

To make my job easier is a simple answer, they should join CERT!

WHO HAS BEEN YOUR GREATEST INFLUENCE?

(EXAMPLE: A PERSON YOU ADMIRE, A HERO, FAMILY MEMBER)

That would be my Dad. He taught me at an early age that if a job is worth doing it is worth doing right and you stay till it’s done. That attitude has remained with me and has stood me in good stead my entire life. CERT

to DRONE or NOT to DRONE

BY LINDA SPALL

Drones are good things, right? These eyes in the sky can take photos, videos, provide aerial views, spot fires, missing people and spy, if needed. They don’t risk the lives of passengers and they are more economical than helicopters and are way less noisy. They can go almost anywhere.

When it comes to emergency services, drones help save lives by helping to access damage from flooding, tornadoes and other disasters, search and rescue, find wildfires and assist with rapid response. Firefighters cansee if flames have been extinguished completely and make sure they have all possible survivors. Drones gather important data regarding wind direction and speed and can collect crucial information during emergency response situations. They are easily transported and can be used almost immediately without having to get a manned aircraft pilot or ready a plane or helicopter. Drones can stay in the air for long periods of time depending upon battery life or if a tethered drone is being utilized and can stand fairly high temperatures and cost less than helicopters. Police can use them to investigate accident and crime scenes, track perpetrators, warn of hidden dangers, location and threats, saving the lives of fellow officers. The Coast Guard can find lost boats and stranded swimmers. Companies can check the damage and extent of oil spills and can map and measure. Drones can see at night by using thermal cameras that help law enforcement and agencies detect objects and people. Drones can go where small planes, helicopters and people can’t when in high-risk environments. We can document, store and use data like never before to help protect our responders, our citizens, our homes and our environment.

Sounds absolutely perfect and amazing! Our lives have changed due to these incredible futuristic inventions. What can go wrong?

Tammy Chatman is the Public Information Officer for Flight For Life in northern Illinois and southeastern Wisconsin. Flight for Life helicopters provide emergent inter-facility and scene

transport of critically ill and injured patients to Level 1 trauma and tertiary care centers. Her take on the usage of drones is both pro and con based on her experience and knowledge.

She even adds to the many wonderful uses of drones for medical purposes, especially in remote areas. She points out that drones are used in Africa flying blood and medical supplies to clinics where there is limited accessibility by traditional means.. Drones are invaluable when delivering small aid packages in earthquakes, floods and other disaster situations. But Tammy is all too familiar with the negative issues as well.

First of all, drones are not picked up on radar. They aren’t always easy to see. In 2016, 2.4 million drones were sold and in 2017, they predict twice as many will be purchased. According to the FAA’s database on drone sightings and near misses, over 100 times a month drones are sighted within 500 feet or less of an aircraft and far above the 400 ft altitude limitation, causing in some cases a near miss.

Second of all, hobbyists do not have to register their drone usage and there is no requirement for education or training of the operators. Imagine the coordination that it takes to use a helicopter for a rescue operation for a car accident which demands immediate transport. Local first responders must set up a safe landing site and coordinate the rescue of critical patients in perfect cohesive motion. But an unidentified drone (no matter what the size) is hovering around with the operator hidden somewhere close by but out of sight. Why? Maybe out of curiosity or ignorance or worse, taking photos or video of horrible images (which can be devastating family members of victims). The problem is, the rescue helicopter can’t land or leave

till the airspace is completely cleared, and if no one knows how to find the operator of the drone this can easily cost valuable time and even in extreme situations, patient lives. Even with drones that are registered, whether commercial or public , the owners may be difficult to locate. According to the FAA database on drone sightings/near misses, only 1 out of 10 operators are found. Many drone hobbyists have no idea that a hospital helipad is considered an airport and they must notify the hospital or airport when they are operating within five miles.

Over 100 times a month, drones are sighted within 100 feet or less of aircraft causing near misses.

The ACLU also wants you to realize the dangers. The rise of drones and their usage can violate our privacy and rights as U.S. citizens. The organization is working to urge states and US government to require warrants before using drones to conduct surveillance and searches and to protect privacy issues. (Who wants a drone outside their bedroom window or following them down a street?)

Police departments especially are in a tough position with activist groups. While law enforcement justifiably uses drones to help officers do their jobs with less risk, the drones gather information, track offenders, and relay locations when situations such as stand-offs, chasing perpetrators, hostage situations, bomb threats and shooters occur. Is this an invasion of privacy to those who live nearby, or happen to walk in the background? A drone hovering over one’s house, children, or schools terrorize citizens psychologically. Just ask the villagers in the 8 countries where the US drones have been used. How would you feel to see a 36 ft long, 65 foot wide and 12 foot high Predator drone above your house or children’s school? Of course, one that enormous is highly unlikely. But it doesn’t have to be that big. The Qube is tiny but mighty. It can fit in a trunk or a backpack. Send it up in the air, direct it and get a picture of the surveillance on an I-pad. The Switchblade drone has a little warhead that will blow up in the perpetrator’s face. Little tiny drones can go where people and helicopters can’t, and cannot be detected. Should we worry

about the collected archives of drone data which our government and agencies are recording? Facts are facts, and drones are going to be part of our lives. Lobby groups such as the Association for Unmanned Aerial Systems International are working to make sure that they will have government on their side to expand. We can’t be ignorant about the drone capabilities or the possible impact on our families, children and our civil liberties. Therefore, we need to educate ourselves and help establish guidelines regarding drone usage and set the ground rules while protecting the 4th Amendment of the Constitution.

We welcome the use of drones when it comes to our safety and well-being, and can celebrate the miracles of drones as they enhance our jobs as responders. This article only touches a few of the many valuable uses of drones. For more information, you can go to www.knowbeforeyoufly.org CERT

Level 1 Stroke Center

Secret Service Dogs

The Heroes who Protect the President of the United States

BY MARIA GOODAVAGE Dutton, Penguin Random House

Since ancient times, dogs have helped man track, hunt and keep watch over flocks, family and enemies. Eventually, European cities used canines in the mid-1800’s. Bloodhounds searched for Jack the Ripper in London. Dogs were used in the military as sentries and used in U.S. wars since WWI. Today, K-9 units have the training and skills to detect drugs, explosives and weapons, to rescue or locate drowning victims, to attack and stop on command. It wasn’t till 1975 that the United States Secret Service created its own K-9 team. Maria Goodavage has documented the formation, process, people and dogs that have come to be the previously unsung heroes of the Secret Service K-9 Units.

Surely, writing this book was a daunting task. Names, mention of families, tactics, exact processes and types of training, the kinds of explosives the dogs could detect as well as the various events and venues used for training (such as airports, stadiums, malls) could not be mentioned. Clearance, permission and editing must have been a long process from the start. The result however, is mesmerizing, informative and actually amazing. These trainers, handlers, and dogs have the most important jobs in the security of our nation, protecting the President and Vice-President.

Some dogs walk the fence amid the crowds of tourists, looking for strange behavior or weapons. The dogs are trained to attack and yet stop at the very moment when called off. Some travel with the POTUS to foreign countries to check out meeting rooms, dining rooms and offices and entire floors of

buildings. These dogs are unique, specially trained, and highly valuable.

Goodavage reveals to us the incredible bond between the handler and the dog. A handler takes the dog into his house and family and life. Every day is spent together for years, with dog and man sensing the slightest move and mood, sharing undying affection and mutual dependence. The stories Goodavage tells disprove those who think dogs who are highly trained are abused or simply used as a means to an end. Anyone who has witnessed the pure joy and crazy pleasure of a welltrained dog running an agility course knows how unable a dog is to contain its excitement! Canines are eager to please, not out of fear, but out of love for the work, the fun, the treats and the praise! Learning to sniff narcotics or hidden weapons is almost a game to them, and their handlers are their best friend/ parent. Both guard and love each other equally.

This book is a close look at the decision making, individual abilities and personalities, judgements, sacrifices, health and training, service and relationships of the loyal men, women and dogs that protect our nation’s leaders and home of our country. Maria Goodavage astounded me with her research, sensitive delivery, and the easy read with necessary details in understandable language. She made me smile, gasp, and yes, made me cry. All this in a non-fiction book that was genuinely heartwarming, factual, and captivating.

As of this writing, the book is in hard copy only, however October 31, 2017, it will be available in paperback. CERT

BOOK REVIEW WRITTEN BY LINDA SPALL

Maria Goodavage

why KNOT?

TThe bowline is great for emergencies. It’s considered the “king of all knots”. It’s easy to make, it does not slip or jam, and it can be used in many situations.

USES

THE BOWLINE

here are numerous skills and knowledge sets that can be useful in times of crisis. One skill that is often neglected but has proven to be useful in disaster situations is knot tying. Knowing how to tie some basic knots could be the difference between life and death in an emergency. Rescuers all over the world learn how to tie knots, and this skill can save lives when done properly. What’s more important is that anyone can do it.

In this ongoing series, we will introduce you to some of the most important knots for use in emergency situations.

The bowline is a versatile knot and is used in many scenarios. Here are a few applications:

• Pulling victims out of the water

• Act as lifeline to rescuers and/or victims during a rescue

• Can be used to lower or raise victims

INSTRUCTIONS

1. Take the right end of the rope and curl it over itself to make a small loop.

2. Insert the right end of the rope through the initial loop making a larger loop.

3. Continue around the back of the rope just before the first small loop.

4. After going around the back of the rope, pass the end into the small loop again.

5. Tighten the knot.

1 4 2 3

BY EMILY ROSENBLUM, USN

YOUTH PREPAREDNESS TRAINING More

Necessary for Large-Scale Disasters

Youth emergency preparedness programs are virtually absent from society. Several training curriculums were considered and created, but it wasn’t until after a tornado struck the Missouri town of Caruthersville in 2006 which damaged or destroyed more than 600 homes and a high school, that the TEEN CERT (Community Emergency Response Team) program was created.

The United States remains reasonably unprepared for a large-scale disaster involving youth. Despite important advances in our country’s ability to respond effectively to chemical, biological, or nuclear terrorism, there continues to be inadequate development of youth programs that could be implemented by the local, State, and Federal agencies charged with preparation and outcome management. In recent years, there has been a noticeable increase in awareness of the vulnerability of schools and the challenging logistics involved in protecting youth in educational facilities during unexpected emergency events.

Emergency preparedness programs have evolved over recent years to include not only learning about unintentional emergencies such as natural disasters like tornados, earthquakes or floods, but also deliberate (terrorist) disasters, chemical incidents such as hazardous materials releases . Under the philosophy of planning for anything, emergency response programs must take the approach of creating curriculums for training preparedness and response that integrate intentional and unintentional disasters.

Youth spend most of their waking hours away from their parents in a school environment. Therefore schools play a vital role in assuring that children are cared for and appropriate interventions are delivered after a public health emergency. Many school districts across the homeland have under developed, disorganized, or sometimes non-existent emergency preparedness programs. There continues to be obstacles for many school districts in creating a practical, comprehensive and experienced school-based emergency response training and plans such as evacuations, accommodations for children with special health care needs, and inclusion of after-school programs in emergency response plans.

Popular programs, such as the Mid America Teen Community Emergency Response Team, based in St. Charles

County, teach participants what is most likely to happen immediately following a disastrous event, creating a greater sense of responsibility for being as personally prepared as possible as well as taking steps to prevent or avoid the greatest risks that arise. Most individuals, who step in when trained first responders are not available, may put themselves and others at greater risk because they are unaware of basic safety, life-saving and triage plans; especially how to set up teams that gather information, take action, and communicate effectively. CERT volunteers are helpful in organizing untrained “spontaneous volunteers” for a safer and more effective effort.

Teens, as well as adults, who go through Mid America TEEN CERT training, have a better understanding of the potential threats to their home, school and community and can take the right steps to lessen the effects of these hazards on themselves, their families and neighborhood. “If a disaster happens that overwhelms local response capability, TEEN CERT members can apply the training learned in the classroom and during exercises to give critical support to their family and neighbors in their immediate area until help arrives,” says Mark Rosenblum, Mid America’s director. “When help does arrive, TEEN CERT members can provide useful information to the

responders and support their efforts, as directed, at the disaster site”, Rosenblum concluded. On average in a true disaster, it could take anywhere from 72-96 hours before emergency relief arrives, so TEEN CERT would play a vital role in performing triage and passing on very important information to emergency personnel.

Mid America TEEN CERT trains Boy and Girl Scouts, 4-H, church groups, high schools and other specialty and civic organizations. The program functions entirely without any governmental funding or grants; when volunteer instructors are not purchasing their own training supplies, MATC relies on the generosity of the public, groups and organizations to help provide the much needed instructional materials and supplies. CERT

CERTand SKYWARN

BY CHRIS MAIER, METEOROLOGIST, NATIONAL WEATHER

Community Emergency Response Team (CERT) volunteers have performed an invaluable service in our communities for nearly three decades. As CERT volunteers you take specialized training that allows you to support emergency managers and other first responders during times of crisis. You may also assist with disaster preparedness education efforts or even exercise simulations. CERT is dedicated individuals coming together for the betterment of our communities.

Very similarly, SKYWARN® is a nationwide network of nearly 400,000 trained volunteer weather spotters who provide near real-time reports of extreme weather impacts to officials. SKYWARN weather spotter reports help NWS meteorologists make better life-saving warning decisions, help emergency managers and first responders with situational awareness, and

SKYWARN weather spotter reports help NWS meteorologists make better life-saving warning decisions, help emergency managers and first responders with situational awareness, and help the news media with providing the latest accurate information.

help the news media with providing the latest accurate information. SKYWARN weather spotters receive training and report on many natural hazards - thunderstorms, tornadoes, hail, flooding, heavy snow, ice storms – and the impacts those hazards are causing. SKYWARN volunteers are dedicated individuals coming together for the betterment of our communities. Sound familiar?

SKYWARN was formerly established by the U.S. Weather Bureau (changed to the NWS in 1970) after the Palm Sunday tornado outbreak April 11-12, 1965 across the Midwest that claimed 271 victims and injured approximately 1,500 people. While SKYWARN was originally established to deal with the tornadoes, in the 50+ years since, training and protocols have been incorporated for other natural hazards. SKY-

SERVICE, SILVER SPRING, MD (WWW.WEATHER.GOV)

The hill

Official SKYWARN weather spotter logo

Amateur radio operators remain an important part of our nation’s response capabilities. Time and time again they can be relied on for communications when primary systems are down.

WARN weather spotters to this day play an invaluable role in “ground-truthing” the impacts of extreme weather. Even with advances such as Doppler radar, weather satellites and advanced surface weather stations, only trained spotters can provide that complete picture of exactly what is taking place. Spotters act as our eyes and ears out in field ultimately providing a better response.

Another intersect between SKYWARN and CERT is that many licensed amateur radio operators (a.k.a. hams) are involved in both. Amateur radio operators remain an important part of our nation’s response capabilities. Time and time again they can be relied on for communications when primary systems are down.

The SKYWARN program is managed by NWS personnel at our 122 Weather Forecast Offices around the U.S. Training is tailored to the hazards that are most prevalent in that region of the country and the reporting protocols can vary. SKYWARN weather spotter training is typically delivered in a classroom or webinar setting. Late winter and spring are when most NWS offices conduct this training. NWS also offers national on-line training modules that are considered supplemental to the required local training. Those modules can serve as a great starting point for understanding more

SOME USEFUL LINKS:

about being a SKYWARN weather spotter. [Reference links are provided below]

Through the years there have been numerous examples of CERT and NWS partnering together at the local level on training and preparedness education. If you have not done so, we encourage you to explore becoming a SKYWARN weather spotter with the NWS office that serves your area. CERT and SKYWARN are a great local partnership. Thankyou for your voluntary service to our communities! CERT

NWS national SKYWARN web page - https://www.weather.gov/skywarn/ Map to locate your local NWS office SKYWARN web page - https://www.weather.gov/skywarn/wfo_links

NWS Weather Spotter’s Field Guide - https://www.weather.gov/media/owlie/SGJune6-11(1).pdf

NWS Sky Watcher Cloud Chart - https://www.weather.gov/media/owlie/skywatchers_chart.pdf

Supplemental national SKYWARN training modules - https://www.meted.ucar.edu/training_course.php?id=23

NWS Norman, OK on-line SKYWARN training videos - https://www.weather.gov/oun/onlinespottertraining

NWS meteorologist Scott Spratt [standing] of the NWS office in Melbourne, Florida conducts SKYWARN weather spotter training at the Osceola County EOC

SAVE A LIFE STOP the Bleeding

BY CHRIS WAHOSKI, CRITICAL ONE EMS

“Uncontrolled bleeding is the number one cause of preventable death from trauma.”

No one should die from uncontrolled bleeding. Due to the increase in active shooter and intentional mass casualty incidents, we need to be pre pared. The goal is to improve mortality and stop the bleed ing when seconds count.

The American College of Surgeons committee agrees that we can pre vent and save lives by using tourniquets. Multiple communities and disciplines are using these devices. If you are a gas station, work, or just the local bakery, are you prepared?

If you are in the military, homeland security, law enforcement, fire, EMS or a local CERT member helping out in a natu ral disaster then you need to be prepared today. Ensure you own safety is the number one priority. Second, the ABC’s of bleeding acronym stands. A- Alert; call 911, B – Bleeding; find the bleed ing injury, C – Compress; hold pres sure on the site of injury by covering the wound or applying a tourniquet if bleeding doesn’t stop. CERT

The only thing more tragic than a death from bleeding... IS A DEATH THAT COULD HAVE BEEN PREVENTED

Critical One Tactical in Saint Peters, Missouri will help you train and be ready to stop the bleeding. Learn what everyone should know after an injury occurs. Critical One Tactical EMS offers a Bleeding Control or B-CON classes. They can also provide you with tourniquets your team will use to save lives. For more information visit at www.c1tactical.com or call the training specialist at 636-387-7150

Lilly.jpg

MASS CASUALTY

EXERCISE

BY LINDA SPALL

Ashooter is on the grounds of the Dale Mabry Campus at Hillsborough Community College in Tampa, Florida. Casualties are everywhere. Within the hour, a second shooter appears at the James A. Haley Veterans Hospital, eleven miles away, resulting again with more casualties. Several mass shootings simultaneously immediately follow at government buildings around the county. Chaos occurs at the scenes of the crimes. Included in the mix is news of a detonated bomb.

Hillsborough County, Florida

Photo

You know what to do. Following proper procedures, organizing priorities, transportation, equipment, triage and safety measures are part of our jobs, however no matter how ingrained in our minds, living through the actual crisis can be overwhelming and more chaotic than we could imagine, especially for the local medical profession with a sudden monumental surge on the health care system.

The above mock-situation occurred on March 30, 2017 as a simulated mass casualty focusing on the health care system’s procedures and their response to treat victims. The event included 45 agencies, 15 hospitals and 511 actors portraying victims. And of course, CERT members were there. In all four different CERTs from within the county participated as coordinators and/or evaluators. The Greater Tampa Area, USF, Sun City and TJK CERT Search and Rescue members participated.

On an annual basis, the Coalition organizes a mass casualty enactment. In order to involve all facets of the system as possible, the scenarios are changed every year.

Ryan Pedigo, Director for Public Health Preparedness for the Florida Department of Health of Hillsborough County explained the intricate, complex planning involved when organizing the event. In 1977, a Hospital Disaster Recovery Committee was formed and began a long journey to becoming a prepared community. This later morphed into a County-wide Healthcare Coalition to include the hospitals, the Department of Health, Emergency Management, long term healthcare facilities and Emergency Medical Services. Together, they address medical systems readiness to respond to incidents and disasters. On an annual basis, the Coalition organizes a mass casualty enactment. In order to involve all facets of the system as possible, the scenarios are changed every year. Last year was a biological attack. This year, the scenario was a coordinated series of mass shootings and involved many non-traditional partner agencies such as the Public Works, Pet Resources, and Community Health Clinics, who used the experience to validate their emergency plans. As always, all local emergency responders such as police, fire, EMTs and the Red Cross were involved as major players as well. This simulation was the largest and most complex the Coalition has ever performed.

The planning begins 9-11 months ahead of the exercise in order to coordinate the event. Hillsborough Community, Everest, Jersey and Keiser Colleges agreed to help provide students to portray victims along with the help of the University of South Florida. The USF CERT team which works with the USF’s College of Public Health, the Disaster and Humanitarian Relief Student Collaborative volunteered to work with the Medical Reserve Corps to evaluate protocols at our 15 participating hospitals. The College of Public Health offers disaster management and humanitarian courses as well as field work and special projects. The curriculum is specific and chosen to give graduates the skills to handle a local or global disaster so all facets are inter-related.

The Hillsborough Community College led coordinating moulaging and transporting all casualties by working with the School Board and Hillsborough Regional Transit authority. The College worked with the Tampa Police Department to hold a “live” drill with an active shooter to test their response process as well as those of the Police. If a major disaster occurred, all health care facilities would be utilized with every bed and medical assistance available.

Phoro Above and Right Courtesy USF CERT

HOW DOES IT WORK?

Each participating location involved in the exercise is informed of the event but not the scenarios nor the extent of their participation. This gives the opportunity for each facility to assign a certain number of rooms, staff and supplies and to handle their “real world” patients but to still act under an unknown emergency.

The actors and volunteers were given casualty cards and moulaged. Trained in their portrayals, they were then planted and taken to area hospitals, even the ones without emergency rooms.

The 15 hospitals in the county received reports of the incidents and immediately responded in emergency management mode. Which patients can they rapidly discharge to make room for the incoming surge of the immediate need victims? Who will knowledgably document the intake and treatment of patients? Communication and coordination with other facilities must be made in order to help doctors decide how to accommodate and maintain all patients until they can move to a different facility. Staff must process how to receive patients in large numbers, triage and track them. Who sets up the criteria for receiving patients and where to put them? Who is in command and control? When dealing with a large number of victims, who checks with the blood banks? Is there enough on hand? What about decontamination?

Right away, Command Centers were implemented at each location. Job positions changed to accommodate emergency mode. Doctors turned into Incident Commanders, overseeing procedures and prioritizing. Administrators helped as transporters, nurses performed triage, desk job positions became Public Information Officers, documenting response times, patient intake, and assisting wherever possible.

Meanwhile, CERT, along with Medical Reserve Corps volunteers and medical students documented the events and evaluated the facilities, staff and handling of events. Carefully recording the times, responses of the various emergency teams as well critiquing various facets of the operation, the evaluators provided all important feedback to the many participants.

These exercises are crucial to our communities’ survival in times of a crisis situation. These all too often incidents of multiple casualties occur across our nation whether by natural or man-made causes. If your community, no matter how big or small, does not have a testing program or yearly reminder perhaps as a Community Emergency Response Team member, you can help make it happen. CERT is an integral cog in the wheel in times of need and each of us can make a difference. CERT

Photo Courtesy Dept. of Health Preparedness Hillsborough Co. FL

Photo Courtesy Dept. of Health Preparedness Hillsborough Co. FL

Phoro Courtesy USF CERT

DO YOUR SMOKE AND CARBON MONOXIDE DETECTORS WORK?

BY LINDA SPALL

In three out of every five homes, a death due to fire occurs in a home without active smoke alarms

My dad’s bedroom

window faced our next door neighbor’s driveway. In the winter, the neighbor would get up and warm his car while he showered, dressed and ate breakfast. My dad became dizzy and weak and had a headache and just wasn’t himself. Sure enough,

He was lucky. We told the neighbor who kindly mended his ways and we bought a carbon monoxide detector. We also had smoke alarms which annoyingly beeped when they were low on batteries and seemed to go off every time I made popcorn. The moral of the story is that smoke alarms and carbon monoxide detectors are necessary and truly do save lives.

Did you know that in three out of every five homes, a death due to fire occurs in a home without active smoke alarms? The National Fire Protection Association (NFPA), says that death in homes without working smoke alarms are twice as high than homes that have functional alarms.

The Centers for Disease Control and Prevention (CDC) shows that over 400 Americans actually die from carbon monoxide poisoning every year. That’s not including those cases caused by fires in the home nor the number of victims in the emergency room or hospitalized.

Most likely, when these incidents occur, the detec tors are out of batteries or disconnected.

LESSON NO. 1: MAKE SURE THEY ARE WORKING

(Hint- test them on the first of every month)

LESSON NO. 2: CHANGE YOUR BATTERIES

Change Smoke detector batteries at least once a year. Carbon Monoxide batteries should be changed every 6 months. (Recommendation: Here in the Mid-West, we are on Daylight Savings. Twice a year when we Change your clock – Change your batteries). At the same time, vacuum the inside of the detectors to get rid of any dust or dirt which can interfere with the effectiveness.

LESSON NO. 3: INSTALL ON EVERY FLOOR OF YOUR HOME

That includes attics and basements Put smoke alarms in each bedroom and outside of each bedroom area. Put carbon monoxide detectors on every floor but don’t put one in an attached garage. Carbon monoxide detectors need to be at least 5 feet away from appliances and 20 feet away from any fuel-burning source and should be out of direct sunlight. . Avoid areas with high humidity like your shower or dishwasher or blow ing fans or air vents.

LESSON NO.

4:

MOST SMOKE ALARMS HAVE A LIFE SPAN BETWEEN EIGHT AND TEN YEARS, and again, replace the batteries every year. Recom mendation is to change carbon monoxide detectors every five years. .

At my daughter’s house, when I open the oven to take out some thing, the smoke alarm goes off.

If your cooking is like mine, you can avoid this by installing heat detectors which are designed to respond to a fire, but not smoke. Since we are in the 21st century, you can have your home monitored and send/receive automatic notifications to first responders with a home security system. You can now monitor the presence of smoke, fire or carbon monoxide and the fire and/or police departments are notified. Be Smart and make sure you and your loved ones are safe.

Over 400 Americans actually die from carbon monoxide poisoning every year.

The Power of

WOMEN AS FIRST RESPONDERS

BY LINDA SPALL

Today, most teams of EMTs are composed of 50% men and women and we now have a plethora of female police officers, firefighters, medical and emergency staff across the United States. The common beliefs are that women reign when it comes to conveying empathy, are better listeners, are more sensitive to a woman’s needs and form a more trusting relationship with women victims.

Members of ALERT meet with Cynthia Guiani-Sayadi (standing).

Photo: Faizza Tanggol/World

Our preferences regarding which sex will treat us in an emergency will be based on many variables. Our age, culture, living situations, religious beliefs, upbringing, and personal history all will play a part in our prejudices but no matter the situation, our society is very lucky to live in a century where men and women are partners in emergency response.

Due to the high number of women-headed households among the displaced and the lack of jobs, women and girls often are forced into unacceptable wage labor such as prostitution and sexual exploitation

Sadly, when it comes to being a victim however, women seem to have disproportionate disadvantages. When caught in disasters, the females find themselves with the additional stresses. Many times they are the caretakers of dependent children, run a single-parent household, have a current pregnancy, experience sudden displacement, psychological trauma and social and economic distress. Women with illnesses, substance abuse issues, the aged or already have low-income issues can be even more vulnerable in natural disasters or emergencies. Imagine the disruption of relocation to a shelter, the lack of time or ability to assess the danger or damage of the situation and the worry and panic of the loss of loved ones while being responsible for feeding your children or grandchildren.

The after effects of disasters in poor areas in countries are

equally threatening. Due to the high number of women-headed households among the displaced and the lack of jobs, women and girls often are forced into unacceptable wage labor such as prostitution and sexual exploitation. In some areas of our world, discrimination against women, girls and the aged is apparent when resources are distributed. Safety issues are a constant fear as some are prey to sexual abuse or child abuse.

This is 2017 and there are answers. From the above information, we as CERT responders can do miracles. We can organize, train, educate and assist. We can be pro-active. The operative word is “Community”. We can educate and take responsibility for our next door neighbors or block or neighborhood. As CERT members, we can make a difference.

Following, check out how one Emergency Response Team group makes a difference in their community.

ALERT provides cardiopulmonary resuscitation to a female patient.

Photo: Faizza Tanggol/World Food Programme

THE World Food Programme, the leading humanitarian organization fighting hunger worldwide, gives food assistance in emergencies and works with communities to help improve nutrition and build resilience. An article written by Faizza Tanggol gives insight to problems and their particular cure. https://www. wfp.org/stories/philippines-all-women-emergency-response-team

According to the article, Cynthia Guiani-Sayadi, the former city administrator of Cotabato, Philippines, created an all-women response team after she was wounded in a car bomb in 2013. 56 others were injured and seven were killed. Seventy percent of Cotabato City are Muslims.

“One thing that I saw during that in -

About 70% of the population in Cotabato City is composed of Muslims. Cotabato City already has an all-male rescue team called City Emergency Response Team, but with the formation of the all-female response team, the city government aims to provide a genderand culturally-sensitive lens to their disaster risk reduction initiatives.—Cynthia Guiani-Sayadi

cident was that we really need women to help women. In Islamic custom, we do not allow men to touch us unless he is our husband or our father,” explains Cynthia. “So when I was brought to the hospital, while looking at the other

victims, I thought, “I have to create a team for purposes of disasters like this or even other disasters.”

The team was called ALERT (All Ladies Emergency Response Team).

CERT Teams are composed of leaders

The women apply first aid to a bombing “victim” during their rescue demonstration..

Photo:

Faizza Tanggol/World Food Programme

and compassionate strong individuals who can make monumental impacts. You can do it as a team or as an individual with your team backup. Think of “the power of one”. How can you make a difference?

By mobilizing women in potential emergency situations, we can study the impacts of disaster on women in different stages of their lives and plan ahead on how we can protect, shelter, nurture and help our citizens. By integrating women in decision making, processing and planning and let them be seen as partners, they can participate as primary distributors of emergency rations, be part of the decision-making process of shelter and camps, work with relief agencies by sharing the particular needs of your neighbors and community, which can increase awareness and make changes and improvements AHEAD of time. Changes can be made such as giving attention to the men and women

with dependent children, offering legal protection and physical assistance.

We need to thinking outside the box, preparing ahead with ready programs ready to assist, educate and involve all our neighbors, especially, the aged, the foreign born, the children, or special needs groups by informing citizens ahead of any potential disaster. Family block parties are great ways to make sure everyone has handouts with information regarding safety and disaster preparedness. CERT members have great opportunities to assist in their own neighborhood. Talk to your social groups. Let them know who you are and what you do!

Not everyone knows about CERT. Imagine the power and changes to be made if they did! CERT

Helping Community Responders with Special Needs Pediatrics

BY PATRICIA CASEY

Scenario: You are at the Fall Festival working a CERT booth and across the path, a young child drops to the ground, you rush over only to find out from the older sister that the child is a special needs child and must be handled with care. 911 has been called. You feel perhaps out of your league. Some children have sensory or neurological issues can’t hear, or receive treatments that may be harmful or have any number of challenging concerns.

Paramedic Patricia Casey from SSM Health Cardinal Glennon Children’s Hospital in St. Louis has been involved in EMS for over 20 years and knows pre-hospital emergency treatments. Through her experiences, she witnessed many changes in the field and shared some valuable, insightful thoughts regarding the challenges of treating pediatric patients in an emergency situation. She has graciously shared information with us regarding a program currently being held at Cardinal Glennon called STARS that can help comfort both patient and responders.

STARS is an acronym for Special needs Tracking and Awareness Response System. STARS assists in creating detailed emergency care plans for children with special health care needs. The STARS care plan houses valuable information such as medical history, known effective treatments for anticipated emergencies, caution notes or procedures to be avoided, allergies and normal baseline neuro-

logical findings. STARS aims to improve emergency care for children with complex medical needs and the program often times spreads beyond a two page care plan. Special trainings are held for local first responders with the child present when possible; this gives first responders a chance to interact with the child when an emergency isn’t taking place.

Natural Disaster planning becomes an important aspect for STARS plans too, especially for those children who are technology dependent; for example, many STARS patients rely on home ventilators, suction machines or home dialysis to survive. Prolonged power outage becomes a threat to the lives of technology depend-

ent children if not planned for. Planning safe access and egress for children who live in areas that are prone to flooding or flight plans for patients who live in rural area with little access to advanced care are other examples of how STARS plans are put into action.

This innovative life-saving program includes the following features:

• Responders have access to information PRIOR to an emergency taking place and have knowledge of the high-risk children in their response areas.

• Included in the care plan are details of the child’s medical history, baseline vital signs, common emergencies, treatments that may be harmful, and baseline neurological status.

• Once the children are identified, a representative from the department visits the child and his or her family either at their home or the children often times come up to the firehouse, EMS department building, or community hospital.

• The STARS form is completed with the involvement of both parties. The initial visit is a time for the emergency care providers to visualize and document how the child is at his or her baseline.

• The families can also be educated on

STARS assists in creating detailed emergency care plans for children with special health care needs.

how the 911 system works and if the child has anxieties about the ambulance or community emergency department, he or she can hopefully become less fearful by touring it and touching equipment.

• The child is then assigned a “STARS #” that coincides with their emergency STARS form. The STARS form is kept accessible on all ambulances and also at the community hospital.

• In the event of an emergency, the family is instructed to relay their personal STARS # to the 911 dispatcher so that the dispatcher can alert the responding crew they are responding to that particular “STAR child”.

Agencies are encouraged to follow up on the children throughout the year and to even involve them in public relations events in order to develop an even greater sense of comfort. The EMS outreach team at SSM Health Cardinal Glennon offers free, ongoing specialized training to the departments to help keep them up-to-date on the latest standards in special needs pediatric emergency care.

For example, during a tracheostomy emergency, the dispatcher notified the responding ambulance crew their patient was STARS #10. With the notification of a residence being that of a STARS patient, first responders knew exactly which house they were going to and the info needed, including the first names of the parents, and the issues involved. Parents even knew the responders since they had participated in many trainings with department. Responders from both the fire department and ambulance district had received aggressive training on tracheostomy emergencies from SSM Cardinal Glennon staff and paramedics also visited the child’s home to witness routine trach changes to increase comfort and competency.

The STARS system has worked successfully in cases of respiratory compromise, seizures and general illness. Without STARS, if a regular caregiver was not present during an emergency or a family member was unable to accurately describe a child’s baseline due to stress, EMS would have no accurate way to assess a child with special health care needs due to not having a baseline to start from.

Hopefully, this incredible program will be used on a broad scale in many local communities. CERT

Do you have a program such as STARS in your community? Let us know what you think! We’d love to hear from you! Patricia.casey@ssmhealth. com EMS Liaison / STARS Coordinator

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