In a disaster, there's no substitute for being able to think on your feet

After six weeks* of instruction on how to help in a disaster, I and my CERT team members would get to test our skills in a simulated disaster.

Last Thursday night, we met at the Healdsburg Fire Department, which had provided the training and was now the scene of the disaster scenarios intended to replicate what would happen if we were to have an earthquake (Healdsburg sits right on top of the Rodgers Creek Fault).

I had attended every session, did my homework each week, and spent last weekend organizing my rescue pack so I could find everything I needed quickly. I numbered every pocket in the pack and made an alphabetical list of what was in each pocket.

Using index cards, I reduced a binder full of instructions on what to do down at each stage of a disaster to a few key points and tucked them in my backpack.

And what were the results of all this preparation? I blew it in one of the three scenarios, triage, when I was asked to lead the rescue team. Without going into detail, I and another rescuer got “electrocuted” because I didn’t assess the safety before we entered a room full of screaming victims. I simply couldn’t think on my feet. It was a disaster.

As a team member in the other two scenarios, extinguishing a car on fire and conducting search and rescue, I did okay.

Here’s a two minute clip of the three scenarios: triage, fire suppression, and search and rescue.

Lessons learned:
1. I’m a better team player than a leader in a disaster.
2. I’m going to participate in simulated disasters that are put on in my area by the Red Cross. This may improve my ability to think on my feet in stressful situations.
3. I’m still better prepared to take care of myself and help others in my neighborhood for having taken the training. I earned my certificate and the embarrassment I felt for blowing it during the triage. I’ll keep the certificate but let go of the embarrassment!

* For more information on our training, check : here, here, here, here, here, and here. I included information that helps people prepare for a disaster and to encourage everyone to take the CERT training.

Community emergency response training to be a good team member

At our last training session before we get to practice what we’ve learned at a simulated disaster scenario next Thursday, we covered CERT organization and disaster psychology.

1. CERT organization = teamwork and working with the professionals at the Healdsburg Fire Department. This is hugely important. We’ll get to practice our skills as team members next Thursday.

2. Disaster psychology: John Bray (photo) of the American Red Cross took us through the psychological symptoms (chart below) that typically occur in rescuers and how to deal with them. We were also given pointers on how to deal with survivors’ trauma. Here's a short video clip of John explaining the emotional phases that survivors go through following a disaster:

The primary reason I signed up for CERT training is so I will be useful, not useless, in a disaster. I admit I don’t think well under pressure, so I spent yesterday organizing my CERT pack and going over what we do when we show up to help in a disaster:

Our simulated disaster next Thursday evening should be exciting. I’ll let you know how it went.

Community Emergency Response Team training - light search and rescue

Our fifth training session involved light search and rescue, building on the previous sessions, which I've described here. My goal has been to share with those who have not taken the training what I’ve learned in the hopes that you will:

1. Find or instigate CERT training in your community;
2. Alert you to a few rudimentary skills that will come in handy if there’s a disaster in your community.

Light search and rescue involves coming up with a safe action plan, locating victims and documenting their location, and learning the procedures and methods required to extricate the victims.

I found the following diagram extremely helpful (click to enlarge).
Upon entering a building, CERT volunteers draw a diagonal mark next to the door. After performing rescue operations and upon exiting the building, another diagonal to make an “X,” then fill in the quadrants as shown. One of the trainees mentioned that using this method of recording which buildings had been searched was helpful in the aftermath of Hurricane Katrina.

If rescue involves extricating a victim from debris that needs to be moved, we learned about leveraging and cribbing. The leveraging is accomplished by wedging a lever under the object that needs to be moved. Any long strong pole will do.

Here’s box cribbing, which is used to hold the debris up while the lever is repositioned (click to enlarge).
And here’s what our leveraging and cribbing practice under the supervision of Bill Albers of the Healdsburg Fire Department.

Responding to an emergency - there's more to it than clearing the airway or stopping bleeding

I’m now more than halfway through my CERT training. My previous posts: here, here, and here.

Our focus last Thursday evening was on “Disaster Medical Operations,” which included head-to-toe assessments. I’ve “borrowed” the following video from the Petaluma Neighborhood Emergency Response Team since my camcorder didn’t record properly:

My team member for head-to-assessment was Laura (photo).
While I played the victim, I noticed that Laura not only splinted my broken elbow but also talked to me soothlingly, reassuring me that everything was going to be okay. When she played victim with a broken leg, I noticed that I would say things like, “Oh, no, your leg bone is sticking out through your skin,” not exactly calming.

The important lesson that I learned during this session is that assisting in a disaster means more than opening an airway, stopping bleeding, or treating for shock. It’s crucial that the words we use show that we are calm and that things are under control. Thank you, Laura!

At the end of our session, a young fireman, Jason Boaz, came into the room. (photo).
We started talking and I learned that his sister, Dr. Cynthia Boaz, a professor at the State University of New York at Brockport, was writing articles about the current turmoil in Burma and other subjects. Jason handed me an article his sister had just sent him, Some Thoughts About the True Miracle in The Andes, now published at CommonDreams.org.

As I read the article that evening, I thought, “How timely!” It was about a plane crash in the Andes 35 years ago last Saturday and how Nando Parrado, was able to save 15 other survivors against incredible odds. How did he do it? He brought his spirit to the task of saving lives by walking out for help in street clothes at elevations as high as 17,000 feet in subzero weather for 11 days.

At one point, Nando thought death was inevitable, but he chose to keep walking. Dr. Boaz ends her article with, “Although he didn’t know it at the time, in choosing to continue walking, Nando not only saved his own life and those of 15 other men, but he pulled all of us one step further down the road of human evolution.”

I expect to be in Nando’s shoes, but I know that reading about his courage in the face of such incredible odds adds to my determination not to limit my response in an emergency to a mechanical approach based on a checklist but to bring my courage to the task as well. Thank you, Jason and Cynthia!

RPM - The acronym to remember in triage

This week our CERT training involved our ability to respond in a disaster to the three “killers,” airway obstruction, bleeding, and shock.

If a disaster hits, the first thing we volunteer emergency responders are being trained to do is to utilize "triage," a system of sorting patients according to need when resources are insufficient for all to be treated. The goal in triage is to quickly assess all the victims to determine who needs immediate care, who can wait, and who is beyond help. We need to spend less than a minute per victim.

Here’s what we practiced:
A. Tilting heads back to unblock the airway.
B. Controlling bleeding, by applying direct pressure, elevating the limb and applying pressure to the brachial or femoral artery. Here's the group practicing:

C. Learning the symptoms of shock, and when they are present, elevating the victim’s feet and keeping him/her warm.

To assist us in determining whether or not a victim is suffering from shock, we learned the acronym “RPM” and were given the handy card below to clip onto our CERT backpacks. The “P” is for “perfusion,” which measures capillary refill. We used the “blanch test,” which involves pinching the nail bed or the palm of the hand, and if it takes longer than 2 seconds to refill, that victim gets an “I” on his/her forehead.

In addition to receiving emergency training, we are being encouraged to gather up what we will need to be self-sufficient for at least 72 hours in the event of a serious disaster. In my first CERT post, I included a diagram of a garbage can filled with emergency supplies.

If it feels daunting to begin the process of preparing for a disaster, I highly recommend you use this 16 week list, courtesy of the Healdsburg Lumber Company and endorsed by the Red Cross. Each week is broken out into what to do, what to buy, and useful information.

PASSing it on: CERT teams practice suppressing fires

On September 20th, I attended my first Community Emergency Response Team (CERT) training, which I posted about here. My goal is to PASS on what I learn each week by posting about it.

Last Thursday the second session focused on fire safety. This was as exciting and fun as it looks:

This is what we practiced: (Click on it to enlarge)
We also learned about this sign means:
I’ve seen them on buildings and never really bothered to find out what the colors and numbers mean. This sign is known as the National Fire Protection Association 704 Diamond:

1. The red quadrant describes the material’s flammability
2. The blue quadrant indicates health hazard
3. The yellow quadrant indicates reactivity.
4. The number in each of the colored quadrants indicates the degree of risk associated with the material. The higher the number, the higher the risk.
5. The white quadrant will include a symbol, such as the W with a line through it, which means that the material should never be mixed with water.

As emergency response team members, our task is to alert professional firefighters about what the diamond says and evacuate persons who are downwind to an uphill and upwind location.

(CERT logo from CERT website, PASS and 402 Diamond - National Fire Protection Association)

Community Emergency Response Team training - I want to be CERTain that I can help in a disaster

Last week I started training so I can be a part of a Community Emergency Response Team (CERT) in my community. One night a week for seven weeks I’ll be going to the Healdsburg Fire Department to learn fire safety, disaster medical operations, and light search and rescue operations.

When I complete the course, I plan to go visit all of my neighbors to let them know that I and others in the neighborhood are trained to help and to find out if they have any special needs, i.e., a disability that might require special attention.

We’re in earthquake country here in northern California, with the Rodgers Creek fault running right through our town. In 1906, the earthquake on the San Andreas fault affected not only San Francisco (watch a simulation of the earthquake) but also our county.

It doesn’t really matter what disaster a community may face. We need to be prepared to take care of ourselves and our neighbors for a minimum of three to five days (think Hurricane Katrina).

The best place to start is at home. Here’s a sample emergency preparedness kit, using a trash can as a container (click on it to enlarge):
CERTs are starting up all over the US. Check here for more information.

(CERT logo from CERT website, emergency preparedness kit courtesy of Healdsburg Fire Department)