Disasters and Individual Readiness

January happens to be one of the "on-call" months for my DMAT. About a week before each on-call month, I go through my 72 hour pack and my main gear bag, making sure that anything I "borrowed" from it was put back in, any foods that need to be replaced are, and that everything is in good shape. I potentially have to live out of my 72 hour bag. It has food, my medical gear, first aid kit, change of clothes, stuff to keep me busy, some survival gear, etc. And my gear bag is replacement clothing, sleeping bag, sleeping pad, pillow, spare bag (Things expand while on deployment! I swear!), MREs, and more.

I had begun this process, then got hurt. On December 31, I called my unit commander to advise him I would not be deployable for 6 weeks. I think that hurt worse than the injury. I joined DMAT to provide medical care during disasters. I made the decision to join the team right after 9/11 (I had heard about them during my EMT recert class), and I've been with them ever since. I've deployed since in 2004, and 2008, with wildland fire medical and CalMAT thrown in in-between. Even when the orthopedist told me the news, I had not immediately thought it would take me out of deployment availabiltiy, but that realization hit a few moments later.

This week, as hopefully all of you are aware, a 7.0 earthquake hit in Haiti, a few miles from Port-Au-Prince. Casualty estimates are 50,000 to possibly 500,000. That's just the dead. Injured? Try 4 or 5 times that. Illness, infection, rescue/recovery/rebuilding injuries will increase that. And the hospitals and clinics are destroyed. This is a first for DMATs. We have historically worked US missions, although some teams have gone to US territories, such as Guam, and American Samoa. Teams landed in Port-Au-Prince today, along with DMORT (Disaster Mortuary Response Team), IMSuRT (International Medical Surgical Response Team), and more. My team is on standby, although not first out the door for this mission. The medical response for this mission will be prolonged. The magnitude of this disaster is almost surreal. 3 million people are homeless. Malaria, Dengue, HIV/AIDS, Hepatitis B, and TB are endemic in Haiti.

I was asked last night "how broken I was", by one of my teammates. A few want me to deploy with the team, but I can't. Part of my readiness is assessing my capability. I am an EMT. Yes, I am also the Electronic Medical Record expert on the team, but I am first and foremost an EMT. I can't do that work right now. And I need to let my elbow heal, so that I can continue to be a responder, for the team, for my company, and for my employer. This is my livelihood at stake right now. Back in July, I had to make the same decision when I had my knee worked on. Each of us has a responsibility to ensure that we are capable of performing our work. And to assess ourselves and determine that we are not putting our team or partners at risk due to illness or injury. I don't want to do something that will make my arm worse, and potentially send me to the O.R., when I can potentially avoid it by allowing my arm to heal. And I don't want to risk the safety of my team.

Besides, there will always be more deployments. And I suspect multiple deployments to Haiti.

For My Paramedic Friends Who Have Passed On

The medic stood and faced God.

Which must always come to pass.

He hoped his uniform was clean,

He'd gotten dressed kind of fast.

"Step forward now, paramedic.

How shall I deal with you?

Have you always turned the other cheek?

To my church have you been true?"

The medic squared his shoulders and said,

"No Lord I guess I ain't,

cause those of us who wade in blood,

can't always be a saint.

I've had to work most Sundays,

and at times my talk was tough.

And at times I've been violent,

cause the streets are awful rough.

But I never took a penny

that wasn't mine to keep...

although I worked a lot of overtime,

when the bills got far too steep.

And I never passed a cry for help,

though at times I shook with fear.

And sometimes, God forgive me,

I wept unmanly tears.

I know I don't deserve a place

among the people here.

They never wanted me around,

except to calm their fears.

If you have a place for me, Lord,

It needn't be so grand.

I never expected or had too much,

But if you don't I understand."

There was silence all around the throne,

where saints had often trod.

As there medic waited quietly

for the judgment of his God.

"Step forward now, paramedic.

You've borne your burdens well.

Walk peacefully on heavens streets.

You've done your time in hell."

I have posted this to honor those paramedic and EMT friends of mine who have passed away, including my original mentor, Jesse Abrams, and most recently, Ozro Henderson, Team Commander of DMAT TX-4, who passed away yesterday:

Please say a prayer for his family, friends, and for his team.

Note: I did not write this. I would love to know who the author is, to give this incredible person appropriate credit. If you know, please email me.

Proud To Serve

For those who want to see my team (I am almost dead center in the middle row):

I am very proud to serve with DMAT CA-11, NDMS, and my country.

Back Home

I just got home from deployment yesterday. We first went to Atlanta, staging in anticipation of Ike landing in Miami. Then it changed course, crossing over Cuba as a strong Cat 4 storm, into the Caribbean Ocean, and then back over Cuba one more time before setting its sights on the Galveston, TX region very early Saturday, September 13th. There is A LOT of damage in Texas and Southwestern Louisiana. Not just Galveston, but Beaumont, Palestine, and other cities also. Houston also sustained major damage from hurricane Ike. In fact, the tallest building in Texas had most of its windows on one side completely blown out, most likely due to a pressure gradient caused when Ike pushed on the other side of the building.

We ended up at the George R. Brown Convention Center in Houston on Saturday, after Ike made landfall, providing care to the special needs population that arrived, primarily by ambulance and bus. It was a wonderfully fulfilling and successful mission for us.

The armada of ambulances, staged and ready to transport patients to local hospitals, and for long distance transport to San Antonio.

Never Forget

It was seven years ago today that this nation was attacked by terrorists. It changed many of our lives in ways we are still discovering. We traded some of our openness and freedoms for what we hope is enhanced security against further attacks; TSA screening everything we own when we board a plane, "LiveScan" fingerprinting and increased background checks for simple things such as employment, RealID coming up, and more.

It was on September 11, 2001, after the attacks, that I made the decision to join DMAT CA-11. I had tried to join the military years and years ago, but they wouldn't take me, since I was missing a kidney. I have always felt a strong need to give back to my country. I remember filling out the application that day, and have been a member of this team since then. Interestingly enough, my application sailed through in record time (Karma?).

Today I sit in a hotel in Dallas, waiting with my team and many others for Hurricane Ike to make landfall. Whether we move before it moves in, or afterward, is up to the folk well above my level. Some teams are out there evacuating patients, others like us, are waiting for our missions, which will eventually occur.

Please take time today to honor those who died as a result of these horrid acts. And take special time for those who died trying to save so many... the firefighters, EMTs, and police. They truly died serving their country on that day. If you don't already volunteer, consider it. It doesn't need to be DMAT... local non-profits are always looking for volunteers.

Training and Stress

While Hurricane Ike decides what to do, we are here training. It seems like busywork, and to some extent it is, but there are aspects to deployments that need reinforcement. Even to those of us that are deployment "veterans" (i.e. those who have been on a 2 week mission in austere settings before), you can't learn enough of some subjects. For the new folk, it may be their first introduction to a subject while out in the field. So, if you hear me referring to training, realize it is for a very good reason!

Stress can be a big problem on deployments. So, we are given downtime for obvious reasons. It lets us "let our guard down", stand down, cool down, whatever you want to call it. Sharing a room can be a stressor for some people who are more accustomed to having a hotel room by themselves. Eventually, living in a tent, a gym, or other location can (and will) add to stress. I am writing this entry during a 1-hour period of downtime.

So, just to let everyone know, I am doing fine. Kicking back in my room right now! Another training at 3:00pm... (Eastern time, that is)

Hurry up and wait

Well, we made it to Atlanta yesterday. Red-eye flights are fun... NOT! I can't sleep on planes. I've tried, nothing helps, even diphenhydramine only makes me drowsy. Every noise or vibration keeps me awake (Yes, I have tried earplugs). So, we made it to our hotel, got checked in (Checking in 35 people takes a bit of time!), and got to our room. Switched rooms, when there was a plumbing issue (Toilet leaking). Got dinner, and got to bed. Some of my teammates went out for a little while to wind down... I didn't need that. My bed is so friggin comfortable, I was out in moments! I am going to thoroughly enjoy this time here, since I believe in the "No good deed goes unpunished" principle. Chances are, once Hurricane Ike hits, we will be sleeping on cots in or on our sleeping bags (Been there before!).

More to come later!

Deployed to Atlanta

Well, my team (DMAT CA-11) has been deployed. We will be on our way to Atlanta to pre-stage for the expected landfall of Hurricane Ike. We are leaving at (get this) 12:25 AM on a flight to Houston, then on to Atlanta.

Finishing packing my gear... hope I don't miss packing something important. I use lists, but all of us manage to forget something!

Activated

Tonight, I got activation orders, effective 11:00 am tomorrow. Will let you know when/where/etc as I know.

Holding pattern

I am still waiting to see if I am deployed. In the meantime, life goes on...

Hurricane Gustav

... is making landfall as I write this entry. I am currently anticipating being deployed in the near future (24-48 hours) to the region. Depends on the amount of damage, the needs of the evacuees, and what NDMS decides to do. For those of you who are curious, there are teams that have been "pre-deployed", and are staged (waiting) in safe locations in nearby states. Others are already handling special needs populations that were evacuated to Dallas and other areas.

I just heard on the news (NBC) that the storm surge is topping one of the levees. Not good, folk. There is also a barge and a boat on the loose in one of the canals. They can actually damage the levees.

NDMS Training Summit

Just got back from the NDMS Training Summit. If I hear from anyone at my work that I was "on vacation", I think I will remind them that I need a vacation from my "vacation". It wasn't by any means a vacation. This was work, pure and simple. Granted, it is work in Nashville, TN at the Gaylord Opryland (Right next to the Grand Ole Opry), but it was still work...

Day 1 - Travel to Nashville (Got up at 3:30AM to finish packing... left the house at 4:15. Went to work briefly to pick up my USB drive that I forgot, and turn in my parking pass from the day before. First flight at 6:00am. Got to the airport around 5:00am. Next flight was in Denver, CO. Got into Nashville around 2:00. Got to my hotel around 3:00. Checked in, then got over to the training summit to pick up my badge and switch some classes around.


Day 2 - Core Disaster Life Support class (4 hours). Then Electronic Medical Record training for the 3rd time (Longer story here). Butt is getting sore from sitting in hotel conference center chairs.


Day 3 - Basic Disaster Life Support class (8 hours). My butt is starting to get seriously numb.




Day 4 - Advanced Disaster Life Support class, day 1 (8 hours). Now, my legs are getting antsy too! I am drinking iced tea like it is going out of style. And my bathroom breaks have increased due to the iced tea! :-)

Day 5 - Advanced Disaster Life Support class, day 2 (8 hours). THIS IS THE FUN DAY! We had a mass casualty incident (MCI) training. Scenario was a bomb going off at a concert. And a second device went off. We found a third device on a patient. We also had training on patient simulators (These are like manikins, but they respond to what we do. Technically, you could kill them by doing something wrong, or if their injuries are too severe, they could "die". Their eyes blink, they have pupillary responses, they breathe, they have a heart rate and pulses. Its actually kind of eerie. You can push meds and they react. Really cool! Also Personal Protective Equipment (PPE) refresher (For some, it was a brand new experience suiting up). Last class was learning how to use Mark-1 kits (Atropine/Pralidoxime (PAM-2) combo), and how to give smallpox vaccine. All in all, this day made the rear-end trauma of the previous 4 days worth it.

Day 6 - Final general session at the training summit. Very informative presentation by the military on trauma care. Then, it was travel back to Sacramento. Flight left at 6:11pm CST. Next flight from Denver at 9:45. Got back in Sacramento at 11:15pm. After waiting for luggage and my ride, got home around 1:30am today. Crashed until 10:30am.

Now, you may ask, "Why would I take all of these classes?" Because I happen to be one of a group of people who see the writing on the wall. These trainings are an "All Hazards" medical training for mass casualty events. Basically, it puts all healthcare providers on the same page for dealing with MCIs. I see it coming as mandated training for healthcare personnel. And I want to teach it.

So, my next step is to take the instructor training.

Of course, I had "downtime", I went to the Grand Ole Opry and saw Carrie Underwood, Randy Travis, and Vince Gil all in the same night. I went to dinner one night with my team, DMAT CA-11, with our sister team CA-6 (All of us do this each year at the conference), and with some friends from other teams on another night. And yeah, I enjoyed a few drinks at night. But trust me, with what I learned, it was no vacation.

Honoring Our Veterans

Please take time today to honor those who serve, and who have served, to defend our country. Regardless of your political beliefs, they deserve our respect for their willingness to lay down their lives defending us.

I thought I would share a picture of my grandfather, Willard Dorsett, taken during World War II, that I found. I wish I had a picture of my other grandfather, Alfred Meyers, that I could show you. Both served in World War II with distinction. I am so proud of their service.













I have also added a picture of myself with two of my brothers, Josh and Daniel. They are both serving currently. Josh is in the Army reserves, and Daniel is active in the Air Force. Daniel is on the left, Josh on the right. Why am I in uniform? I am in a DMAT, part of the National Disaster Medical System. But I am not the focus of today, they are. This is just the only picture I have of them in uniform.

Firestorms

As I write this, I am preparing for possible deployment to Southern CA. I have already been contacted, and am awaiting a call saying I am going. Our mission: Provide medical care to the firefighters. There may also be other missions, as a hospital and skilled nursing facilities are also being evacuated with the other 250,000 people evac'd, but that is the primary one.

The firestorms in Southern CA provide sharp memories to a lot of us of 2003, when San Diego, Los Angeles, and San Bernadino counties had major firestorms. Our DMAT was on a deployment exercise with other CA teams, when our exercise became a "realtime" emergency. We got caught in fireborne winds that damaged equipment, and reminded us what nature can do. Team members deployed from the exercise to the fires.

The picture is a satellite image of the fires. The smoke is seen trailing off over the ocean.

Anyhow, I am tired and rambling and need to get a few hours sleep. Please pray for those affected by the fires, and for those fighting them.

(UPDATE: I was deployed at 11:45PM. I am reporting this morning, and will be gone for 3-5 days (possibly longer). So, as a result, I probably won't be updating here until I return.)