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Life Lines Articles - Disaster First Aid

At a Major Emergency:
Don't Make Things Worse

"Tales From The Street" by Guy H. Haskell PhD, JD, NREMT-P

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Disasters come in all sizes-

It was midnight, and I had just finished my regular eight-hour paramedic shift in Lorain Ohio. I was about halfway through the 20-minute drive home when I heard a distant thud to the south, toward Elyria. When I looked in the direction of the sound, I saw a glow reflecting off the clouds in the distance. I couldn't figure out [what] it was but whatever it was, it wasn't good. The EMS service I worked for covered both the cities of Lorain and Elyria, so I took the next left turn and headed toward the glow.

Within two minutes the [callout] tones started going off in succession. There had been an explosion at the … Chemical Plant, … in the middle of a city of about 50,000 people. … I didn't want to interfere with priority traffic by talking on the radio, since the channels are needed for Incident Command, Fire and Rescue communications. Of course, one of the most important rules to remember as a first responder, and the one most easily forgotten in the excitement of the moment is: Don't make things worse!

As I drove toward the scene I looked for flags or smoke to check the wind direction. I was in luck. I was upwind [the smoke blowing away from me]. When I got into town I could hear from the radio traffic – Fire and Medical Incident Command were up and running. I called dispatch when I heard a lull in radio traffic and was directed to come to the central station.

When I arrived several other off-duty personnel were already there, huddled in dispatch. We were to await there for assignments. More than enough folks were already at the scene of the explosion. After about an hour, we were sent to various schools where shelters were being set up by the American Red Cross. … There were reports of respiratory distress and the fire department had decided to evacuate a sector of the city [that was] downwind of the incident, in danger of exposure to the possibly toxic smoke. My partner and I took a squad and reported to one of the designated schools.

We were dumbstruck by what we found when we arrived. Red Cross volunteers were calmly and efficiently setting things up. They had already designated areas for decontamination, canteen, families and intake. They had set up water coolers, chairs and cots, and they were bringing in food. All of this and the explosion had occurred less than two hours before! Most volunteers were seniors, and they operated in a calm, friendly and professional manner. [We were impressed.] There was much to learn from them.

We were asked to set up a Medical Station to evaluate people who weren't feeling well. [There were] some nonspecific respiratory complaints [problems] but only one patient was transported to the hospital, probably more in emotional than respiratory distress. The chemical released was eventually reported to be a mild respiratory irritant, and the explosion was an accident caused by a worker. He was the only one to die in the blast. By morning, everyone was allowed to return home.

It doesn't matter what the cause of a mass casualty incident is – accident, terrorism or criminal violence. The principles remain the same. First responders must respond quickly. But more importantly, first responders must respond wisely, calmly and efficiently.

The greatest service we can perform at a disorganized scene is to create order out of chaos, calm out of calamity. We must slow down, breathe slowly and deeply, and lower our voices. [Calm facilitates clear thinking.] Tunnel-vision is our worst enemy. We must force ourselves to look around, in all directions and dimensions, and with all our senses. This does not come naturally. To be good in a crisis, we must train ... and when the time comes, we must do as we've trained.

In any large emergency, stay off the phone, especially cell-phones, because these lines are needed by emergency workers. Let them do their job. You can O.M.G. with your friends LATER.

NEVER call 911 for information! That's not what 911 is for. And if there is a major flood, hurricane, tornado, or earthquake - They know it already. Keep a clear head, and do what you can where you are.

There is a detailed, interconnected Disaster Plan in your city, county, and state, like the one described above. Ambulance Paramedics, Police and Fire Departments, and volunteer programs like Red Cross and CERT are each pieces of the plan. You can be a part of it by taking courses like the CERT (Citizen's Emergency Response Training) usually free, fromyour local Fire or Police Department. Consider taking Disaster First Aid and family/community Disaster Response Planning classes locally or online.

When a large-scale disaster happens near you, you are truly a First Responder, because you are already there. Take some time to prepare, and then just do what you can. It will make a difference. It might make all the difference in the world for someone, maybe even someone you love.

To read more articles about Emergency Medical field services by Guy Haskell and others, go to http://www.jems.com

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