NREMT-Basic

I did use improper SAR terminology, however, I know that CERTs in my area have been used for "non-urban" searching. I think that training to first responder is a great idea. Essentially if CERT members are trained in first aide, CPR and possibly AED, there already there. But if you look at the scheme of the Citizen's Corps, which has "jurisdiction" over CERT teams, medical much higher than bandaides and iodine is the domain of Medical Reserve Corps teams. In looking at the big picture, yes, I think it can be said that at times there is too much overlap of service that might not be necessary. Redundancy is a good thing in disaster response, but only so many layers deep. Which is why, to my knowledge, MERTs and CERTs and DMATs (oh my!) dont engage in the provision of security, etc. In general I think those functions are left to the police (and Volunteers in Police Service..another Citizens Corps group) and the National Guard. Now of course, there are companies like Sovereign Deed, Inc that are private providers of Disaster Relief. For rather hefty fees they will supply food, water, medical, security and even evac capabilities to corporations, etc and I suppose to individuals who can afford what I imagine is a pretty hefty price tag. It would be interesting to hear opinions from others about the privatization of disaster response. Is it going to get in the way? Is it actually helpful? Presumably these groups wont be sapping resources away from municipal, state, federal agencies, but are there problems with them? Ive never had to deal with them as I think they are a fairly new animal the disaster response world but I imagine they will become more common just like Blackwater, Hart Securities, etc. Anybody know anything about these private disaster relief companies and how they work?

Isnt this kind of the pot calling the kettle black? How many EMTs Medics, and Firefighters do we have here who wear more comms power on their belts than a small city's 911 center. Face it..most of us could get by with a pre-paid Nokia but we have our half-caff, no foam, solar-charge alpha-numeric capable, nation building, EKG interpreting personal assistants on our hips. Does your post have phones? If they have a no personal calls on company time policy then we should be able to look at all of the complainants cell phone ins and outs while they are working and there should only be emergency related calls to and from your supervisor. Right? Come on...Its hard to believe this non-sensical conversation is occurring in a forum on EMS. EMS providers alone produce enough EMP pulses to stun a fleet of Boeings out of the sky and we're complaining about teachers who are on their feet 8 hours a day, have to talk to irate parents during "breaks," deal with discipline during their "lunches" and as a professional statistic have a high rate of urinary disorders and disease than any other because they cant even leave the room to go to the rest room. And then its about football coaches, and then its about them getting slapped on the butt. And referring to them by name in public forum and emailing their photos around? What's going on here? Are all of you that are whining at an EMS convention sponsored by Jaegermeister? Anyone who has never made or taken a personal, non-emergency post while working make the next post? And Im catching abuse in chat? Quit whining and go back to work.

Ive received several mailings from the NREMT and I havent been able to see anything but that they have instituted the test as a way to re-register. It doesnt sound temporary at all to me. Now that doesnt mean that they wont change their mind again in 6 months. My concern is that I havent been able to find a 24-hour refresher which the NREMT requires as part of the re-registry qualifications. If anyone knows where one could be had online from a reliable and accredited source, please PM me.

I decided to save the money and have CPR instructions tattooed on my sternum.

We are a state funded medical disaster response team. Though it exists, the chance of us getting shot are significantly less than some of the others we take. Also, type on a tape or tag has never been used as a totally reliable source, but rather as a place to start...a short cut of you will.. As far as "universal type" transfusions, you can only get along so far on those.

The NREMT has instituted a change ( believe as of 2005-6) that you can simply re-take the registry exam rather than meeting each and every CEU requirement.

Hey military types- My disaster team has recently started talking about having us wear blood type tapes sewn on our BDUs. Since we dont have the abundance of velcro that you all do, any suggestions as to wear it might be seen, yet not affect the look of the uniform and also not go overlooked. I have thought of the back of my boonie, back trouser pocket flap and have even thought about stitching it to my boot Any help from you military types would help. thnks.

-----------------:shock:------------

As helpful as that was Spenac, I am forced to cry...NEXT!

Not entirely true. CERT team chiefs can, as they wish, require that members of their team be trained to at least first responder level. If they do not meet such standards, the onus falls to the chief him/herself, not to the CERT system. But as I said, CERTs are not intended to respond medically. Its actually way down on their priority list. Sometime ago (as related to me by the Deputy Chief) of a CERT in IL, there were a string of tornadoes that came through her area. Leveled parts of several counties. Her members were out as per their agreed protocol with the fire department, shutting off gas to homes to prevent fires and explosions. They were spotted by a local LEO who asked what they were doing. They identified themselves and he asked them to come with him because they had a gas leak, couldnt get the necessary utility response and needed someone with the knowledge to shut down the gas before it ignited. This is the kind of work that CERT members are trained to do and my experience with them says that by and large they arent out there trying to usurp authority or win any medals. They are just trying to assist the communities in which they live and operate. Its a strange conundrum: paid FFs dont like volly FFs. Paid EMS dont like volly/fire EMS. Paid EMS only seems to have something against FFs. FFs have their thing against EMTs and Medics who are not FFs. It seems to me that the problem is not that there are two many groups our there trying to serve in the event of an emergency, its that the ones who already exist cant work and play well together, are jumping each others calls, etc. I am not comparing the team I am on for it to be held up as an exemplar, I learned by lesson about that. But in that team, we have FFs (paid and volly) EMS (paid and volly) nurses, CNAs, dentists, veterniarians engineers, commo guys (who for the record are just plain amazing) and logistics guys who would plant an IMERT deployment on the other side of the sun if you asked them too. Maybe people who arent on one of these kinds of teams should stop looking at whether there are too many of them...they should start looking at how to work with each other. I have yet to be on a scene and hear a FF, or EMT complain about once of these state or community teams, but you can sure as heck get an earful of East Suburban Podunk Fire and West Suburban Podunk Fire. NIMS and ICS may have a long way to go, but they have already gone further toward everyone on the same page, as it were, than any other plan I have seen. There may be a bunch of people literally out there looking at the NIMS/ICS plans together, but at least they are setting up their systems to be compliant because they know its either stand together and work or stand apart and fall apart. I have heard from the members of the USCG and USCG Auxiliary that the "ERT" teams that came to help during Katrina were some of the easiest to work with because for what they may lack in big time equipment or fancy titles, they make up for in working within the NIMS/ICS framework. Im a huge fan of NIMS and ICS. Ive seen it work. And yes, I have also seen it not work...but when it fails, its because the system is being implemented in a spotty fashion or it hasnt run up against a certain issue yet and so does not address it...YET. When I made a comment earlier in this thread about training, I was slapped down for not posting my NIMS/ICS/EMI certificates on the forums. I have them: 100-800 and alot of the little specialty ones along the way. If there is one thing that Katrina and 9/11 showed it was the definitive necessity for working together. If NOLA Fire and Rescue had refused help, things would be even worse than they are now. Mayor Giuliani told people not to come after a certain point, and up to a point, I can see why. Mayor Nagan did not do this. He pleaded for help and he got it. He got it from Illinois and Ohio and Washington State and Maine and Massachusetts and Texas and some responders from as far away as Hawaii and even a couple of foreign countries. Yep, there was a small Japanese contingent there for a time. Starting in February, I will be taking FF training so that I can run EMS with a volly fire department that desperately needs medical folks. I live outside the district, but could throw a rock and hit the fire house. Now also right up the street from me is one of the houses for the FD that serves my city. Ive chose to cross the lines, as it were, to work with this other department because they need the help. The larger city department has what it needs. Lots of aparatus, lots of manpower. 85% of what this smaller village runs are MVC or other medical calls. They dont have the medical responders for it. So I go there. Id like to see the question answered as to why there is do much disension between departments and service and volly and paid. Of course there are various levels of training and expertise. But does that mean that when what a town has the $$$ or charter for is a small volly squad to serve its citizens that they shouldnt do it? I know there have been multiple threads on paid vs volly, urban vs. rural. But Id really like to know why as emergency responders, we cant get our acts together and work and play as a team. There is so much lip service given to the brotherhood of fire and EMS, but if you watch these forums, it would seem to be all talk. After all is said and done, isnt it about the people we help?

The CERT team commanders I have talked with dont want anything to do with medical. They are there to help turn off gas lines, wake people up in the middle of an evacuation, assist with light, open field search and rescue. The folks are part of the continuum of disaster/emergency response and they are very good at what they do. When the state teams and feds come in, The CERT responders are familiar with the area, have probably walked ever inch of it. They know exactly where things like water towers and aquifers are. Each on of the teams that has been talked about has a specialty that some of the others dont have. With IMERT, I may respond to a city in Illinois that I have been too before, maybe even staid in once visiting a friend, but CERTs most valuable asset is the intimate knowledge of the area. These are neighborhood teams and sub teams. One of them probably owns a grocery store that he can open up and give other teams food and water and bathroom use, one of them sits on the city council, one is a gear head that works in a local electronics store and has a huge amateur radio set up in his basement or back porch. This is what NIMS and ICS are about. How these teams work, as the Department of Homeland Security says, seamlessly and meld together into one unified force. Is it a perfect system? Not yet. But we are working to make it so. The biggest thing we can do is start working these things from the very grass roots up. After all, CERT grew out of Neighborhood Watch. Maybe these teams will never achieve the seamless integration that President Bush and Homeland Security hope for. But in a disaster situation, like any other, many hands make light work. I think we do need to minimize the untrained "show up" volunteers. Buts not what CERT is. Most of the teams I know work very hard and train alot and spend alot of their own money on their own assets which they full well know may be commandeered. They open their homes and places of business to State and Federal EMAs. It may well occur that they could be our first line at some point. I say lets give them what they need so that the first line is a bright line. I dont know when the USA lost its sense of neighborhood and community, but the sooner we get it back, the better off we will be. Know the people on your street, your block. Know who is elderly, shut in, has a chronic medical condition. When we had a recent power outage, we had no CERT, but I put on my rain gear and went door to door. I found a neighbor who was part way through dialysis when her batteries gave out. Her phone wouldnt work because it was battery operated too. Myself and the other person making the rounds got her an ambulance. We carried oxygen tanks and changed them out for the man with COPD down the street. We moved an elderly neighbors car as it started to sink in the mud where he had it parked a few feet too close to the river. These things make differences. There seems to be vocal group out there that says we shouldnt try...thats what the police and ambulances are for. No one denies that. But when your local 911 center is getting 300 calls in 30 minutes and your fire department is running one rescue after another, CERT and groups like them can help. They can direct traffic away from downed lines, bring their chain saws and clear a tree out of an intersection so ambulances and LEOs can get through. I have a big wooden and wire storage unit in my garage that has saws, and shovels and big flashlights and reflective cones and gasoline for generators. And yes, I am starting a CERT team. We arent the green berets out here and we arent trying. We are trying to take some of the pressure of our government by saying "we can help you help us and we can help you help yourselves." Im proud of the goofy bright green vest. Not because it makes me look in anyway official, but because it says one community member helping another...one at a time. In this era of cellular this and satellite that, what happens when those things fail. We go back to basics and folks like CERT are basic, ultra basic. And ask any towns mayor who has a CERT team if he thinks they are a problem. I have done this and they have all told me they are glad for the help and for some extra funding and tools they get because they have a CERT. Individual----->Community----->Local------->State----->Federal------>International We are all part of the thin line. We can all give something and I say we should.

Yes indeed. But why should the myth busters have all the fun. I wonder how much mentos and cola it would take to blow one up? Hmmm. (goes rummaging in jump kit).

Did anyone get to have the fun experiment of exploding the reservoir on an NRB? We took one out in the parking lot, hooked er up, block off outlets and BANG! It set off most of our car alarms. Great fun! If your a student, see if your teacher will let you do it...say pretty please may I? Just once? I bet they let you cause they know its good fun too. Who doesnt like a good explosion?

Bravo Zulu! Twice! You managed to say in a few lines what I hadnt gotten across in pages. Good on ya, stay safe and maybe some day we will work together.

Just tell your partner that having some junk in the trunk seems to be very much in vogue these days...ya know, for the next time a spurned lover asks. Bravo Zulu for the post!

Im really interested here and not trying to pick a fight. These figures you give dont jibe with what the DOD says. The President comes down on the same side as you. A recent DOD estimate places between 85-95% of National Guard units not currently deployed as unfit for service for the reasons I mentioned. I have not served in the military. But I do know that all branches of the service are reporting drastic drop offs in enlistment. The AP recently reported the offering of 6 figure re-up bonuses for special ops personnel citing failure to re-enlist as the necessary reason for this. Im genuinely curious. Who do we listen to?

Correct me if Im wrong, and I frequently am, but I was taught in school that high flow was 12-15 by NRB. I know with the disaster team Im on we now have a thing called a FourTran (spelling) respirator that runs purely off the pressure of the tank so no electricity is needed in a power outage situation. You can set it up for tidal volume, resps per minute and flow. I was sure the medical officer teaching us about it said that it could go as high as 25 LPM. Any medics out there speak to this and if its possible in what cases would 25 be used.

So i was awake alot of last night thinking of what an arse I had been on this subject. Then this morning as work when I went down with chest pains in the parking lot, I really started thinking. Im new to disaster medicine and compared to many on these forums Im new to EMS. It doesnt matter who gets there first, or who has the biggest stockpile of widgets. Its about the lives. I guess there must be a reason why so many groups have adopted some variation of "so others may live." All that matters is that we work together for the same purpose. IMERT or DMAT or whatever isnt any better than anyone else and to those who have said that more money should go into private and municipal agencies through grants, etc...of course youre right. I had my life saved this morning by just such an agency. So I took down the IMERT seal from my signature and all of my fancy sounding intials and am back to just a regular old EMT who happens to work with a state disaster team. It took alot of time for me to realize I was getting ahead of myself and alot of people with alot more experience telling it like it is. Im proud to serve when called. I hope that some day I can be of service to some of you in your states. Until then I say Bravo Zulu! to anyone and everyone who lays it out there every time the tones drop. When I was riding under the L/S today, I felt all of you out there, just plain gettin' 'er done. Pretty amazing. Someday maybe I will have earned my place in that brotherhood. Until them Im just a guy doing the best he can for others. May the good lord bless and keep you all safe as your race to the aide of others. NREMT stands down...indefinately.

I must admit Ive never really understood AMR. Are they sold like franchises and if so how are they union? Can someone talk to me like Im 4 and explain exactly what the deal is with AMR and how they are set up?

The National Drug Stockpile isnt central storage and to my knowledge, EMTs, fire departments, etc have no access to it. The President gets meds first, the congress, then responders and the state and federal level, then "civilians." And your right...its doesnt take EMTs to distribute from the NDS. Its take orders from the President and Congress.

Congrats Shannon on making it through. The weight time has been cut a little with the new CBT. Ill cross my fingers and toes for ya. Keep us posted.

You seem to have it all nailed down. I mean youve seen pictures of half a dozen or so team members, and most of the ones in the picture you are mentioning are nurses, commo, logistics, etc. I think other than the nurses, there is one medical specialist in that photo, but I could be wrong. Youve missed what I said from the beginning so to try to civilize the tone, I will try again. Im not saying we are going to take anything away from anyone. If nothing else, we have far greater resources by shear volume than the CFD. We show up about 4 hours post event and fill the gap between overwhelmed local responders and the arrival of the feds. And DMATS dont go overseas, so the Iranian earthquake is out. DMATs are federally funded and operated by their individual state. Hence their designations as DMAT-MA-1 (Disaster Medical Assistance Team- Massachusetts-Task Force 1. The team to which I belong shows up at the request of the Governor of Illinois or with the signing of a EMAC (emergency medical assistance compact). We are there to help local and other state teams, including the NG. Yes, we do have the right to commandeer local resources...maybe thats right, maybe its not. Take it up with governor Blegoiavich. Im sure he would listen to someone from outside the state who doesnt know a thing about how these teams operate. He has been behind us since he took office. As have the Presidents who have awarded members of the team special Presidential Citations. Youre a medic. We show up in your town. If you are part of a command team, our command team will meet yours in the TOC and say "what can we do to help you" and you, if you were overall IC would tell us. Then we would start talking to our logistics and commo boys and set up a command center of our own complete with things like satellite phones, weather radar, direct lines to Illinois or other state governors and Washington. If there ever was a true example of "We're from the government and we are here to help" its teams like IMERT and the various DMATs, etc. Im sorry that you and folks like you have a problem with it. Im sorry you think we are glorified EMTs. Thats not even close to the reality of the situation. Before I joined up, IMERT deployed three seperate teams to the Gulf Coast, which you know if you saw our site. We also deploy to events where there are large groups of people in huge public venues. We have the assets of the NG and ANG at our disposal per orders of the Governor. We're not coming in to take anything away from anyone. The closet we get to ambulances that I know of are John Deere gators modified with roll cages and med beds. We are there to help you. But those field hospitals of which you speak so nastily can mean the difference between life and death. They can be heated and air conditioned, as can our trailers, which when emptied of gear and vehicles can be used as further command posts and team quarters. Are you really that threatened? I must admit I dont get it. Did you ever check our that map I recommended. The kinds of events it shows are the kinds of things we respond to or go on standby for. We have more than 1000 members throughout the state any number of whom are on call at any given time and ready to deploy and those whose comittments require that they serve on a general medical or sort of a second wave team. I know I came out guns blazing and that that could be an embarrassment to the team and for that I am sorry. But for the life of me I can understand why, living in Oregon or Massachusetts or Florida (which by the way has one of the country's best DMATs) you would not want high tech, high volume help which can provide you with personnel and material you may not have. If your responders homes are destroyed, we can house you. If you run out of something, we likely have it. The shear quantities of assets alone that we can bring to bear should be a comfort and not a source of rivalry. IMERT, DMATs, Disaster Mortuary Teams...all here to help the people of their respective states when asked. Its just that simple. Your governor says "we need more boots on the ground"and we can send you EMS, logistics, communications, nursing, HAZMAT, WMD specialists, dentists and even veterinarians. As part of theOffice of Homeland Security/ Illinois Terrorism Task Force, in the unthinkable event that something like 9/11 happens to you, or something even worse, how will your agencies respond if 2/3 of their responders are dead or critical. We provide medical for the ITTF and USAR teams. When we work along side you, your going to be safe because we are provided with security teams from the National Guard MP batallions. Our medical director is head of Emergency Medicine and Trauma at a level 1 in Chicago. Our team commander and deputy commander are both CCP and flight medics. So at first I gave a bad impression and made it sound like we would swoop in and save you from yourselves. That isnt the case at all and if thats what it sounded like I apologize. We are mutual aide on a huge scale. Everyone associated with the team is the best at what they do and in their chosen discipline. Thats why they are there. My field happens to be disaster/terror medicine. I will be training at Hadassa Hospitals Terror Medicine Center on a fellowship next summer. EMS and Disaster/Terror med are different fields. We are trained and continually train to deal with MCIs on massive, massive scales. If being proud and honored to serve with the first team of its kind in the country and one that is acknowledged by those in the disaser/terror med field to be among the very best is wrong, them Im wrong. Illinois falls down in a lot of places in EMS. But IMERT isnt one of those weak points. We were first set up to work in IL alone. Then Katrina happened and we were called into out of state service. This is now part of our protocol. Im sorry that intimidates of angers you. Do you have this reaction to the National Guard and FEMA showing up. Would you rather do it all by yourselves no matter what it is. All i want to be is the best I can be at what I do and I spend hours each day working toward that goal. Someday the seams will disappear. But until they do, history shows this is the best practice way to do things

Gee....I would have thought you would have sprung for the color ink to print those. I guess you couldnt cause of all the money we take from you.

And for someone who has demonstrated he doesnt know what the hell he is talking about, you sure do alot of it. Theres probably a reason you have the worst pretender of a wannabe actor ever as your avatar. And I doff my hat to you in the hot air spewing department. You sir, are indeed, an expert in that regard. Rave on, brave lunatic...rave on. NREMT stands down.

Its called the National Drug Stockpile. Ever heard of it. Can you see past your locality enough to know that caches of equipment, drugs and other supplies are kept all over the US. Do you have the key? People like IMERT and others do. I dont know where the caches are because Im not supposed to. I only have to know how to use what they give me. What you dont realize is what these teams actually do. Say its a Biological event: 1. Evaluate 2. Decontaminate 3. START triage 4. Field treat. 5. Evacuate. 6. Repeat ad infinitum. And for those of you that think NIMS is a joke, Id like to know how much youve trained in it. Im guessing not very far or you have never used it in an actual event. Im signing off now on this. You can argue till you run out of air. Dont worry. We have that too when the two cylinders you carry crap out.