Earthquake reaction

[almog]

Hello,
I'm a paramedic from Magen David Adom in Israel. I will appreciate it if you took a few minutes of your time to help me.
Magen David Adom is assessing it’s method of operation in an earthquake event, in respect to those of other EMS organizations in the world. It will help us if you clued please tell me What will be the response given by your organization in such an event? If you can, please refer mainly to the following subjects:
1. What is the immediate response given by field teams and ambulances?
2. Do you use the “scoop & run” approach or do you open casualty treatment sites? If so, where do you place those sites and what level of medical treatment is given in them?
3. What is the time span during which the teams are expected to deal with the event on their own until assistance at national level has arrived? (red cross, army, etc.)
4. What is your approach toward treating trapped casualties, in the sense of the amount of time being spent on the rescue of one person vs. using this time to help many others who are not trapped?
5. What is you treatment protocol in the case of crash injurie

Thank you very much
Almog

 

[mycrofft]

Good day!

Your questions are very far-reaching and will elicit different answers from different people.

Speaking for the U.S. members, we have a much larger private sector EMS capability than public one in urban areas (where the majority of our people live), we do not have a plan to nationally overtake and direct them in a disaster. It is expected that locally in a disaster cutting off roads and communication it can be at least three days before help arrives. SOme rural areas may face longer lag times; remember we are very widespread and have many environmental zones here.

You might want to google "Emergency Management Institute" for free online classes. Here's their home page:
http://training.fema.gov/emi/

A federally supported grassroots program called Community Emergency Response Team (CERT) has been promoted at many areas throughout the country but their impact is uncertain. Here is a link to the place the program first originated inn 1985:

http://www.cert-la.com/index.shtml

Perhaps some individual EMTLIFE members will respond as well?

 

[almog]

Thank you for your answer . i'm actually hoping for different answers from members in different organizations. We rethinking our MOD. As i see it the best thing is to learn from others. especially from those who have the experiences.

Thanks again.
Almog

 

[almog]

for those how send me privet massage

The forum blocks me from sending you privet answer because i don't have enough messages posted yet.

So I post here.
Thanks for the answers.


I understand that everybody will have to acct on there own at the first 48-72 h. the plane here is to give Ems services in the first 24-48 h till the IDF home front command will be recruited

but isn't there any MOD what should the local EMS do in those 48 h? will they scoop & run or open casualty collecting points till they be able to transport those who need to hospitals / army filed hospitals, will they join local S&R teams for medical support on the ruins, rubble or they don't have the knowledge to do so?


yes i'm working in sported organisation Israeli national EMS but before i can go and send formal letters to formal organization around the globe i need to do some research for a presentation for my Superiors.

Thank you all for your help

 

[AK_SAR]

Most states, cities, and towns in the US will have some sort of emergency management plan in place. These tend to vary from place to place, depending on what is anticipated as the most likely disaster scenario for that area. For example, hurricanes in coastal areas of the SE US, or earthquakes in Pacific coast states. These plans will usually include emergency medical care, and will take into account local situations (for example EMS through fire departments versus private sector services).

These plans are usually available on the internet, and you can probably find many examples using google. For example, I live in Anchorage, Alaska, and our local plan is at: http://www.muni.org/departments/oem/plans/Pages/default.aspx

Be aware however, that many of these plans are probably somewhat optimistic about what resources will actually be available. Also, these plans are often not kept as up to date as they should be. For example, note that for the Anchorage plan it says "The Anchorage All-Hazards Mitigation Plan is currently being updated for 2009/2010", so the linked plan is probably several years out of date.

Hope this helps.

 

[mycrofft]

Seems obvious but it isn't.

Aid returns to a battered region from neighboring unaffected regions. Secure and widespread distribution of assets means that no matter where the disaster strikes, there are neighboring areas with assets to help. It requires proper preplanning to mobilize all these assets. One trouble in the Katrina episode was individuals were entrusted vital jobs, but individuals are prone to be killed or to be too busy to help at that point. For instance, a fleet of busses was held up until the water was rising too far because "the guy with the keys", (probably named Bubba) wasn't there.
Folks here (USA) do not have an inkling of Israel's system. Is there a URL they could look at to learn more?

 

[Akulahawk]

Because of the regionalization of the US, a large national single unified command isn't very workable in the short-term after a disaster. Each region develops a plan that is specific to their situation. Each region knows what their assets are, where they're vulnerable, and to what hazards. They also liaise with neighboring regions about mutual aid.

Basically, from the beginning, each neighborhood will have to fend for itself. The neighbors will look out for each other. They will try to get messages out to local authorities if there are any serious injuries. The local authorities will attempt to determine what areas need help right now and who can wait. They will send the resources out to those areas that need help the most and where it'll do the most good. The local authorities will initiate the call for help to the next larger entity in the chain. This will cascade upward until the need is met. Due to marshaling time and travel time, it can take 2-3 days before non-local help arrives.

For EMS, in at least one or two counties that I'm familiar with, it's in each ambulance license that each staffed ambulance can be pulled from private service and put into 911 service. Santa Clara County, can pull an additional 10-20 ambulances into 911 service within an hour if needed, and more can be brought in within a few hours.

I don't know how your system works, but it may be a good idea to find a way to temporarily take ambulances from private service and use them in public emergency service. Sometimes, the ability to transport is be best resource available, even more important than the level of service available.

There's a LOT that has to go into planning for large regional events. You shouldn't see what works on small scale and make it bigger... often that doesn't work efficiently. Look at how the army mobilizes in response to larger events. They may start off slow, but soon many many hands can be brought into help.

 

[almog]

Thanks a lot to every one for your answers but i think i didn't explained good what i'm looking for.

We understand all these the MOD of mutual response and mobilize Private EMS is part of the emergency plan for etch era.
but remember that Israel is less then 700 km long and 40 km wide the country is small and severe event will make large damage.
IDF home front command S&R battalions will be mobilized but it will take time up to (24-48 h. )

my major question is what is the initial response of the local EMS/ fire department EMS in the damaged area.
what are the guidelines for them' ,5 minutes after the earthquake stoke.
will they go out only to collect information ?
will they start opening large scale casualty collecting point to TRAGE the people and prevent from over loading Hospitals with those who won't benefit form its treatment in the next 24 h ( will survive any way or wont survive any way )
or they go out evacuate any body thy can.

and again thanks for your help

 

[bigbaldguy]

I think initial "5 minutes after" response in most public EMS services in the US would be to assure safety of team members, then equipment (move assets to safer location if current location is not safe). Communication with higher ups would come next. If no communication is possible we would begin triage and treatment of closest victims moving out from our location always keeping in mind scene safety. Beyond that if we couldn't get in contact with our dispatch we would mostly likely try and coordinate with other agencies and nearest hospital. Theoretically treatment areas would be set up and we would go into a swoop and scoop mode of operation to maximize patient transport and minimize scene time.
If you want to see how not to operate in the minutes and hours after a major disaster Google hurricane Katrina.

To clarify the US does operate on a Triage system. When there are more patients than providers we code patients by priority with those we can most likely save at the highest transport priority, walking wounded on a lower priority and those who will most likely not be saved are not transported.

 

[Handsome Robb]

If I'm reading your question correctly we setup a TRIAGE station as well as a full ICS system similar to the FEMA ICS guidelines utilizing FD, PD, EMS and the Army National Guard Aeromedical unit in town, then transport patients to appropriate facilities per their status.

If the hospitals are compromised/inaccessible a casualty collection point or temporary hospital location will be set up in an appropriate, capable structure. (Think schools, gyms, events center, anywhere that can provide space for multiple casualties.) Critical patients will be flown to hospitals out of the area if we are unable to manage them in our area.

My service has 3 choppers + a reserve chopper + the NG Aeromedical Unit + CALSTAR 6 out of So. Lake Tahoe and Mountain Lifeflight out of Lassen County as well as multiple fixed wing providers in the area as long as they have a runway capable of accommodating them (we have quite a few small airports in the area capable of accommodating these planes besides the International Airport). So we are pretty capable of evacuating critical casualties to a facility capable of managing them.

 

[almog]

OK i think i get the point similar to MDA there is no specific, organized ,clear doctrine. it might be the right why to deal with this kind disaster because its hard predicting the scale and nurture of the event.

So far our MOD for the first hours was fogy. go out there save who as many as you can buy scoop and run and if no choice open casualty collecting point till help will arrive.

The problem is that our EMS service have lots of experiences in suicide bombers in bus's or coffee shops actually we can clear a seen of these kind ( about 60 casualty's )in less then 30 min. but we never had to deal with a big scale nature disaster and we are working on our MOD now .

I relay appreciate your help

 

[mycrofft]

To misquote Klausewitz: the big things are "simple", but their little parts are hard.

http://earthquake.usgs.gov/earthquakes/world/israel/seismicity.php

Once the threat is defined and strategies are settled, tactics are necessary with the accents upon intel, transport, personnel, and support logistics for your relief efforts. Ditto restoring civil services like electricity, water and sewer.

The more civilian personal preparedness you have, theoretically the less need for centralized help.