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Scaramedic

Too Many Emergency Teams?

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Look at the everyday situations. Last winter when we had a blizzard, government shut down. When people called 911 or the police, if it wasn't medical or a life or death situation, they had to wait.

I understand people may be running snowmobiles on your fields, but I am sorry, we can't do anything about it right now.

I understand people may be looting your store after this hurrican, but I am sorry, we can't help you right now.

I understand you may have a large laceration, but I am sorry, if its not bleeding, we can't help you right now.

It is this mentality, that hurts everyone else. We can NOT rely on others. I am not one of these gun carrying extremists. In fact, I don't have a gun yet. But.... Still. It isn't the form of government our fathers imagined. I don't mean our forefathers, I mean our fathers.

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The different resources have different capabilities. The ones that you mentioned all fill a certain niche.

Local/county resources must generally be available instantly. State teams will be up and running in a few hours (USAR, NEHC, ACC). Federal resources (DMAT) will generally not arrive until 72 hours after a major incident occurs/is declared. Others, such as the medical reserve corps, fill healthcare gaps over longer periods, such as when an area's medical infrastructure is so devastated that it takes months to get back up and running.

Each team is trained and equipped to meet these various needs. They plan for utilization of the resources without need for further direction or resupply for the prescribed period of time. When federal resources are inbound, it makes sense for the state resources to have sufficient equipment until they arrive, so they use that 72 hours as a goal. This ensures that response is mobile, scalable, and flexible. Local resources are not carrying cots, state resources carry medications but only certain ones.

NIMS dictates interaction of the various agencies. Communication difficulties always abound, but they all have to have the same understanding of NIMS and their role within it. This ensures that the various agencies interact appropriately and can function independently within the greater disaster system, particularly when communication breakdown occurs.

Here's the spin: we're preparing for terrorist attack that might happen. Al Qaida is out there, planning. This spin gets a lot of attention and a lot of dollars for this kind of preparation.

Here's the reality: natural disasters will continue to occur, frequently, at all different levels of impact, from tornadoes that level towns to tsunamis that level ecosystems. Pandemics will occur as they have throughout history (and the impact is even greater, with a highly mobile and interactive population). This is where our disaster preparation will really pay off. Al Qaida may or may not ever get a nuke into downtown LA, but hurricanes are happening every year.

The disaster preparation we are doing is shifting from preparation for "terrorism" to an "all-hazards" approach, where the disaster resources are scalable and flexible to mitigate an incident of any kind that would overwhelm the healthcare infrastructure.

'zilla

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Zilla, if thoses funds were made available to local communities they would be able to improve the care needed everyday, and thus also be better equiped for the disasters. Make a stipulation that any equipment and personnel paid for with those funds be available to go to disaster areas. You could still even have regional play, oops training days.

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Are you prepared and equipped to handle an avian flu pandemic?

What do you have that a local ambulance service/hospital does not for this purpose?

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What do you have that a local ambulance service/hospital does not for this purpose?

Cans of gasoline and some matches to burn the bodies.

Peace,

Marty

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The different resources have different capabilities. The ones that you mentioned all fill a certain niche.

Local/county resources must generally be available instantly. State teams will be up and running in a few hours (USAR, NEHC, ACC). Federal resources (DMAT) will generally not arrive until 72 hours after a major incident occurs/is declared. Others, such as the medical reserve corps, fill healthcare gaps over longer periods, such as when an area's medical infrastructure is so devastated that it takes months to get back up and running.

Each team is trained and equipped to meet these various needs. They plan for utilization of the resources without need for further direction or resupply for the prescribed period of time. When federal resources are inbound, it makes sense for the state resources to have sufficient equipment until they arrive, so they use that 72 hours as a goal. This ensures that response is mobile, scalable, and flexible. Local resources are not carrying cots, state resources carry medications but only certain ones.

NIMS dictates interaction of the various agencies. Communication difficulties always abound, but they all have to have the same understanding of NIMS and their role within it. This ensures that the various agencies interact appropriately and can function independently within the greater disaster system, particularly when communication breakdown occurs.

Here's the spin: we're preparing for terrorist attack that might happen. Al Qaida is out there, planning. This spin gets a lot of attention and a lot of dollars for this kind of preparation.

Here's the reality: natural disasters will continue to occur, frequently, at all different levels of impact, from tornadoes that level towns to tsunamis that level ecosystems. Pandemics will occur as they have throughout history (and the impact is even greater, with a highly mobile and interactive population). This is where our disaster preparation will really pay off. Al Qaida may or may not ever get a nuke into downtown LA, but hurricanes are happening every year.

The disaster preparation we are doing is shifting from preparation for "terrorism" to an "all-hazards" approach, where the disaster resources are scalable and flexible to mitigate an incident of any kind that would overwhelm the healthcare infrastructure.

'zilla

Doczilla's common sense again for the win! DING DING DING!

Doc you've hit it on the nose. There's an interesing little real time map out there in the ethers of the net which combines the resources of google and various terror and disaster response organizations. It refreshes automatically every 10 minutes and shows everything from suspicious packages and persons and powders, to explosions and overheated nuclear reactors to nasty storms pushing their way into the Solomon Islands. An old lady passes gas in an airport in New Zealand and it makes the map.

The fact is, these things have always happened. In the post 9/11 world however, our radar, literally and figuratively, is collectively more sensitive. We are paying more attention and realizing that these things arent going away but rather happening with more and more frequency. Ill try to find that map, but if I cant link it through, find it for yourself. Then zoom in to just the US. The things you never hear about will scare you. I cant figure out how to link the map in here but its running the corner of my monitor and its scary as hell.

We arent playing off fear here. We're planning, preparing and prepared for reality. Those "warehoused" supplies you envision do exist. But not in the way you envision. They exist under the lock and key and watchful eye of people like IMERT who can begin a deployment four hours post-event.

Nobody was ever supposed to attack the WTC. But they did. Once in 1993 and twice in 2001. They werent supposed to be able to get here, to break our bubble but they did. The Army Corps of Engineers knew that the levies in NOLA and the pumps on the sea wall would fail in a strong C-4 or C-5 hurricane. But they did nothing and the walls failed because that storm was perceived to be impossible. They are not only possible, but a regular occurence.

Im sorry if there are those among you who think that we are draining money and resources away from your volly departments and civil resources, the fact of the matter is that we are not. And if you could see the ledgers, you would know that we fight for scraps just like everyone else.

Someone asked about avian flu and what someone like IMERT could do. Ill go ya one better than telling you myself. Find the best infectious disease specialist you can. You know, that guy at the university who crunches numbers on the nightmare scenario. Ask him to show you a worldwide avian flu epidemic with all the of the known capabilities and assets in place to mitigate it, from patient zero outward. Now start at patient zero, and take IMERT and people like us out of the equation. Patient zero becomes patient 5000 in a matter of a couple of days. 100,000 in weeks. Millions before a month is out. Now put IMERT and those like us back in. See what happens. Have you heard of supportive care? We arent going to save everyone, but we might save your mother, or your children or you. Look at the Asiatic, Hong Kong and Swine flu pandemics. Those who do no learn from history are condemned to repeat it. Only this time, when one too many farmers handles one too many dead chickens, or when the sea rises up to take out an entire coastline, there are 10s of thousands of people standing ready, listening for the sound of their pagers in the middle of the night. Sleeping with one eye open as it were. 10s of thousands of us watching that map I talked about just like I am now. We may not be able to save everyone and yes, there are specialized teams who do nothing but deal with dead bodies. But we just might be the firewall that stands between our own survival and that tsunami thats headed our way. We arent basing anything on what could happen. We are basing everything on what has and will happen.

Just because you dont want to see the monster in the closet doesnt mean he isnt there.

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Doczilla's common sense again for the win! DING DING DING!

DING DING DING! WRONG. Common sense says bad idea to have so many people doing the same thing. Waste of money and resources. Do you know how many government auctions I have gone to and bought basically brand new equipment that has sit just in case in some warehouse? To many to count. Lets not add to government waste, if money is available give to to areas with limited resources to use daily and still be available for disaster response. Oops my bad no common sense allowed.

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DING DING DING! WRONG. Common sense says bad idea to have so many people doing the same thing. Waste of money and resources. Do you know how many government auctions I have gone to and bought basically brand new equipment that has sit just in case in some warehouse? To many to count. Lets not add to government waste, if money is available give to to areas with limited resources to use daily and still be available for disaster response. Oops my bad no common sense allowed.

Ill give ya thte equipment drugs and funding. Will you know how to use them. Can your volly department triage and evac 33,000 people? Youre wasting your breath. We are here and not going away. We are the reality. We are the next step up from street EMS...more accurately 10 steps up. Street EMS has its place and so do we. Soo we give you all these drugs and they sit in a cabinet in your firehouse. Will people know they are there? will they break in to get them in the event of an MCI? Or will you have the training to be able to do methodically, logically and realistically. The fact is your department and most like it dont have the CBRNE response training. We do. Its just fact and not one that I feel I have to defend to you anymore. We're here because the state of Illinois says we are. Take it up with them.

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Basic trying to debate you is like trying to debate my 6 yr old nephew, you only hear what you want to hear. Read Zilla's opinion again, the gist of his opinion is that yes various teams are needed. But, he states that we should be preparing for natural disasters. You and your group seem all jazzed up about one thing....

Can you say with certainty that you are prepared to work an mass casualty event with 33,000 casualties? We have.

Then there is this amazing quote...

Someone asked about avian flu and what someone like IMERT could do. Ill go ya one better than telling you myself. Find the best infectious disease specialist you can. You know, that guy at the university who crunches numbers on the nightmare scenario. Ask him to show you a worldwide avian flu epidemic with all the of the known capabilities and assets in place to mitigate it, from patient zero outward. Now start at patient zero, and take IMERT and people like us out of the equation.

People like us, worldwide epidemic, start from patient zero, blah, blah, blah. Did you even pay attention to what you wrote, if it's a WORLDWIDE EPIDEMIC mitigating patient zero is kind of late in the game. Let's be honest in that case you will be under the control of USAMRIID/U.S. Army and the CDC. Why because they are not weekend volunteers, they are the real thing. They have been planning for this crap before you and I were born.

I am sure that your group is full of capable people who are a lot more humble about their capabilities then you are. Yet wouldn't the public be served better by one larger entity that can handle the scenarios you talk about. I find it amusing that you never mention any other of the response groups by name. IMERT's website does though in regards to the N.O. deployment...

IMERT teams combined with New Mexico DMAT team, U.S. Public Health Service and local providers to staff the hospital 24 hours a day.

...see we need each other. Like I said wouldn't it be easier to just combine IMERT, DMAT, MRC, FEMA, CDC and any other state groups out there. One source for dispatch, one source for protocols, one source for equipment, increased logistical support, and better communications on scene.

Seems like a no brainer to me. One can compare the modern emergency response teams to the Military militias prior to National Defense Act. That act put the militias under control of the U.S. government/U.S. Army under the banner of the National Guard. Why not do the same with ERT's. I am not saying to eliminate anyone just combine them for efficiency.

Peace,

Marty

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...see we need each other. Like I said wouldn't it be easier to just combine IMERT, DMAT, MRC, FEMA, CDC and any other state groups out there. One source for dispatch, one source for protocols, one source for equipment, increased logistical support, and better communications on scene.

FBI, CIA, DHS, ATF, NSA, DEA, USPI, USSS, USTP, USMP, USFRP, Army, Navy, Marines, Air Force, USFA, DOT, DOJ, USPP, USCP, ISP, IMERT, DMAT, MRC, FEMA, CDC, NENA, NREMT, DOE, DSG, COPS, Texas Rangers, and Chuck Norris are ALL going to come kick your ass for even THINKING of such consolidation of services. This is the UNITED STATES! PORK BARREL PROJECTS FOR ALL!

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