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Risk vs. Reward and Patient Advocacy

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An OLD shot of Savannah's LifeStar landing for a Hilton Head Island F/R medevac.

The SC-TF1 Director copied an article to our command staff that I found interesting.  It ran in Popular Mechanics titled Unacceptable Risk (I couldn’t find a direct URL for it, so here’s the pdf: HelicopterCrash).

Our organization allows paramedics on scene to request a medical helicopter evacuation with a minimum amount of oversight by the medical control physician.  Being a paramedic myself, I know when to call for a flight and when not to.  I am not about to call for a chopper to take a patient to a hospital for a broken foot, and likewise, I am intelligent enough to be able to assess a patient and opt to fly them to a hospital that has the resources to help my critically injured victim.  I am appalled at some of the case histories where someone was flown out for a routine (very routine) injury and consequently, I know of agencies who simply won’t call for a flight, regardless of the need for it.

How bad of a medic must you be that you can’t tell the difference between a potentially life-threatening injury and one that can be transported by ground to a hospital?  If I’ve got an altered patient with a potential head injury, I know they need to go to a trauma center.  So what if I have to go on an out-of-jurisdiction transport to the trauma center- it’s what we do.

Regardless of whether or not the aeromedical evacuation of a patient is risky and may or may not have tangible benefit, the decision must come to this: What do I need to do for the best interest of the patient? I don’t care if you don’t like the way they look, or they stink, or you are tired.  When you became a medical response professional, you probably took an oath that involved a statement like “Above All, Do No Harm”.  Our jobs involve making sure our patients not only get care, but that it is the right care, it is not care that is provided at a huge cost because we were too lazy to do our jobs, and that the patient’s rights are maintained in their treatment and transport to a medical facility (or not).

Just as I wouldn’t make you take a treatment that could possibly kill you in order to cover my ass, ordering a helovac for a finger amputation isn’t in my first line of thought.  And I know I curse and fuss when I DO call for a chopper and a spot of rain on the pilot’s windshield causes them to scrub the mission, but you know what? I’m a big boy- I’d MUCH rather you err on the side of keeping your crew and my patient safe and I’ll deal with the fallout otherwise.  But to just say, “All patients go by air” or much worse, “No patients go by air” is ridiculous.

Maybe like everything else, we need to stop applying a broad brush to a situation and do our jobs, by appropriately assessing our patient, determining their logical needs based on mechanism of injury, observable findings, and our experience, and make a good call as to what to do with them.  If we ca’t do this much, it’s no wonder we continue to have to convince people we aren’t just “ambulance drivers” but real, live, medical professionals.

Vigilance and Haiti

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South Carolina US&R Task Force at Vigilant Guard

South Carolina US&R Task Force at Vigilant Guard

As is always the case in times like these, fire and emergency service providers stand ready to send whatever relief is necessary to aid the survivors of disasters.   While we continue to keep the residents and visitors to Haiti in our thoughts and prayers, an open letter to the fire and emergency service community from FEMA Deputy Administrator Richard Serino reminds the response community that self-deployment to the disaster areas is not advisable.  For a number of reasons, there needs to be a coordinated response so that well-meaning people and resources don’t ultimately overwhelm what is already bedlam.

While it may seem counterintuitive to some not to send EVERYTHING to the region, I’m reminded of the scenario that presents itself in football when the defensive end is told repeatedly, “Seal the ends and don’t let anyone out” and after being told that twenty times (and having no backs running around the end), he decides to “get involved” and leaves his assigned area, only to be left in the dust by a screen or a reverse.  His job was to protect the flanks from just such a move, and failing that, this weakness was not only recognized by the offense, but exploited.

It is imperative that we take this opportunity to recognize that these disasters also affect our own communities, and this is the time when increased education of your customers is important: what to do if something like this happens here, who will respond, what your capabilities are and how you plan to address your needs in a disaster, and so on.  This is the time when you contact your representatives and reinforce to them that we have emergency operation plans in place and resources, and educate local responders what to do and how to obtain these resources.

Most importantly, someone needs to be watching the outside, anticipating that at any time, events can also happen at home.  In that event, teams selected to move into the Caribbean to aid Haiti may need reinforcement back in their home jurisdictions and we should be ready to help in those situations as well.

Everyone has a part on the team.  Take this unfortunate situation and at least turn it into a “teachable moment”.  If you fail to do this while it is fresh in the minds of the public, I can reassure you, look at past disasters and see how fast those moments faded from view.  We can prevent death and injury often by educating people as to what we do and how to get us when they need us.  But in order to do all of this, we need support, not just during the disasters, but in the times in between.

Keep our fellow US&R teams in your prayers as well as the citizens and other responders in this most distressing of situations and make sure we are ready if anything else goes down on our watch.

Command Presents

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Hilton Head Island Fire Station 7

Hilton Head Island Fire Station 7

It’s that time of the year that we hear the word “presents” often enough to make your ears bleed, so I was wondering if my misuse of the word “presents” got your attention. Apparently it did, or you wouldn’t be reading this now.  Or maybe you didn’t notice.   If you didn’t notice, go and look again: when we speak of “command presence”, we speak of the characteristics of the person in charge to lead from a strong, visible, and decisive point of view, not “presents” like a gift.  Having strong leader-like characteristics  as part of your daily personality could be a “present”, if your job is to be a leader.  It also could be very annoying to the people around you.

According to my family and friends, acquaintances, and the Myers-Briggs (and every other psych profile I’ve ever gone through), I exhibit decisive, directive behavior as part of my normal personality.  More often than I care to, my “command presence” comes out when I’m talking with my wife (she doesn’t like it), my kids (they’re not crazy about it either), or my colleagues (they probably think I’m insufferable anyway).  This just goes to show you there is a time and place for everything.  Explaining to your daughter the intricacies of math, for one, is probably not a good time to be strong, visible and decisive.

Likewise, when you are leading firefighters into emergency situations, it is not a time to be easy-going, reserved, and willing to compromise.  There are those out there who are; they are also the ones with crews free-lancing, poor accountability, mixed commands, and poor coordination.  These are also the ones who get people hurt and killed.

While you don’t have to be the second coming of Field Marshal Rommel, you should understand that the fireground or rescue scene is the place where only one person can be in charge.  Coupled with the observation that leadership abhors a vacuum, you can probably understand that if you fail to establish a clear picture of who is in charge, someone else will.  It’s not the act of having a fist fight to decide who that is; the only person who can be in charge is the legally responsible incident commander.  How that decision is made is pertinent to the laws of your jurisdiction, but if you have someone who can’t command, they probably shouldn’t be in that position.

All too often, I see failure in company officers who are “best buds” with their troops on a daily basis, and then can’t understand why there’s so much chaos on their incident scene.  It is simply because those people don’t necessarily see you as the “alpha dog”.  To them, you are just another “member of the pack”.  Other members of the pack don’t call the shots, the alpha dog does.  And like I said, if you aren’t filling that role, someone else is.  That person will also be the one that when things go south, everyone turns toward for the answers.

In this time of giving, give your subordinates a lesson in leadership.  Your leadership should set a positive example, a role model, if you will, for your aspiring officers.  Command and control is important on the emergency scene and failing to work with that does not instill confidence in the abilities of the IC.  It is essential that not only do your charges see you as a leader on the scene, but in the station as well, for if they do not, on the scene is a bad place for them to convince them of that.  Make it a “present” to the people you are responsible for teaching and watching over.  Give them the tools to lead others, and they will hopefully show you that they trust your leadership, and when the time comes, they will walk on that path as well.

The Fixers

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webIMG_1675

How can we help you today?

Are you a fire department or are you an EMS service?  Do you do both?  The knee-jerk reaction I sometimes get was one coined by a previous chief, “We are an EMS agency providing fire service”.  In fact, it sounds so clever that there are a vocal few who like to throw that out there time and time again, like they were the ones who originally came up with the concept (they’re paramedics, so they’re a little biased, I’m sure).

Something I said in a much earlier blog bears repeating:  customer relations are essential for any department operating in this day and age.  There are those who continue to disagree with the use of the word “customer” when referring to those who use our service.  Respectfully, I also continue to insist that just because they don’t walk into your shop and buy something doesn’t mean they don’t have a choice in using your service.  Taxpayers may not be able to change providers, but with enough votes, they can radically change your organization.

The world can change overnight.  If you think the current model of how we provide service is going to last another 200 years, think again.  As our customers become more educated and expect more innovation from government, look for them to insist on ways we can do things better.  We need to continuously and constantly evaluate our direction and possibly even reinvent  our concepts in order to stay out front.  Good customer service revolves around recognizing the needs of our customers and using our skills, abilities and past experience to improve service quality and to provide excellent service.

As has happened over really the last thirty years, our industry has evolved into one that defies definition, one that more and more reflects all-hazard response.  I’m going to go on record to say that I’m even confused as to what to call us anymore.  There’s a famous paragraph in Report From Engine 82 (Dennis Smith) that I’ll paraphrase, because I can’t remember it exactly.

In this city, when you turn on a wall switch, you may or may not get a light.  When you turn a faucet, you may or may not get water.  If you pick up a phone, you may or may not get a dial tone.  But everybody knows that if you pull the handle on that red box, you WILL get a fire truck.

The purpose of my poorly remembered paraphrasing of that statement was to illustrate that times have not changed from when the book was published in 1972; just substitute “call 9-1-1″ for “pull the handle on that red box”.  But what we have become has, as we become EMTs and HAZMAT Technicians and Water Rescue Technicians and etc., etc.  I read “Report” cover to cover when it first came out (I was eight- I’m a good reader) and the context of that paragraph has stuck with me forever.  Dennis Smith points out in his story how the fire department was used to handle plumbing issues, to handle overdoses, and to handle pretty much anything up to and including, things that happen to be burning.

So back to customer service; what is our mission?  Why do we exist?  If your answer is, “To protect people from fire” or “To help the sick and injured”, I’d suggest that maybe you should reconsider all of those calls that don’t meet that definition as distracting you from that mission.  If you’re anything like me and the organization I work for, I’d say that not handling those calls is probably counter to the needs of your community.  And what your mission should really be, is defined by those needs.

When someone dials 9-1-1 (or whatever they dial in your community), they do so because they have a problem they can’t handle themselves (or should I say they don’t know how to handle), they don’t have the resources to handle the problem, and they don’t have anywhere to turn for an answer.  Obviously, you are saying, “Well, if my pipes are leaking, why wouldn’t I call the plumber?”  Again, think about the ENTIRE situation.  Maybe they can’t afford a plumber.  Maybe they can’t find a plumber to come out.  Maybe they are totally freaked out by the situation and not thinking clearly.  There are many answers to the question, but the long and short of it is, they trust YOU to help them solve the problem and YOU are the people they call.

So what I’m telling you is that our job REALLY is to respond to a request for help, gather facts about the problem, analyze the options, apply a solution, and ultimately, stabilize the situation.  We may not FIX the problem, but when we leave, things should at least be stable.  We really don’t need doctor-wannabes or adrenaline junkies for our job, what we need are people who can look at any situation and understand the situation, then apply creativity using the resources at hand (either on site or on that BRT you brought) to stabilize their situation.  And further along that line, we’re not asking these individuals to rebuild the house, we’re asking them to stop the forward progress of the damaging element (or disease process or whatever it is) and return some means of order to chaos.  We’re not building a piano here, we’re improvising and hopefully we’ll come out with something that can at least pass for a musical instrument of some sort.

What should our business be called?  What is it that we do?  How can we possibly have meaning in our life if we don’t have a label or title for our life’s ambition?  When I hear of the trash guy being called a “Sanitation Technician”  or a dog-walker a “Pet Care Specialist”, I wonder what title really defines what it is we do.  What it really comes down to is that everyone recognizes the title for your job more than you could ever know.  When someone asks me what I do for a living, I answer, “I’m a Firefighter”.  The knowing look on their faces and the subsequent questions about my job, my worst call, my most stupid call, etc. confirm for me that most everyone understands what our job is really all about.  Now the bigger goal is to get those of us who do it to understand that as well.

Finally, No More Begging

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Hilton Head Training Center FLAG PropFor the past year or so, our department has been building a training facility of our own.  We officially dedicated it on the 29th and christened some of the props with a little demonstration burn to wow the VIPs who came out to celebrate with us.  It’s a nice facility and was designed with more than just training in mind, given our organization’s desire to find multiple uses for things.  The site was designed to also be an effective staging location for after hurricanes, or to be used as a distribution center in the event of the same, and can support our semi-annual HAZMAT roundup.  But to me, one of the best things is no more begging.

For years, we have had to improvise when it came to training.  It’s difficult to motivate someone into working at “drill speed” when they are flowing a handline into the woods and pretending it’s a burning building.  While we have gotten good at being creative, I sometimes felt like my kids, pretending to be a firefighter while spraying a garden hose at an azalea.

To me, there aren’t too many more exciting sounds then the “whoosh” made by LDH coming out of the bed and punctuated with the ding of a coupling hitting the pavement every 100 feet.  Or the sounds of hose being coupled and the background noise of a roaring fire.  And even though we will be using predominantly theatrical smoke in the tower, there’s really no substitute for dragging a charged line through zero-visibility and not having to worry about marking up the walls or carpet of the hotel or timeshare willing to permit us a little realism that day.

Every time one of our more motivated instructors wanted to insert some live action into their training, for the most part, it required an act of Congress.  Not to mention that although you can’t get much better than live fire training in an acquired structure for some good scenarios, between the asbestos mitigation and all the other associated permitting, by the time it was done, one or two days of burning and then cleaning up afterward just doesn’t hold the magic of being able to light off in the burn room and being able to mop up by flowing your streams into the sloped-floor drain designed for just that task.

If you come down our way, come by and see it.  We have a lot to be proud of.  And we certainly appreciate the support of the community in helping us get there.  In the end, they are the ones who will benefit the most, though, because as a result of our new acquisition, the training calendar is already filling up with companies who want to practice in a real facility, and not by having to imagine the environment they might be working in.

Hypocrisy

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When a man will condemn others but will not subject himself to the same ethical standards, that, my friends, is a hypocrite.   We talk about people living in glass houses and the logic for their not throwing stones, but we often fail to hold people to their statements that they made to get them to where they are today.

When a man will say that a project is a waste of time, yet take credit for it when the project is being hailed by the media, that, my friends, is a hypocrite.  Likewise, there are “leaders” in this world who like to trumpet their budget cuts and their saving of taxpayer funds, despite being warned that their efforts could prove dangerous, but when things do go badly, they slip free of any blame, and those people are also hypocrites.

When a man will make claims that he has accomplished something spectacular, but won’t permit scrutiny of his claims, is that man a hypocrite?  Shouldn’t we, if we have indeed done an amazing deed, be willing to permit people to look into our claims, to see just what it is that we have done and how we can replicate that “success”?  Hypocrisy is claiming you are all about something, when really you are not; so if you make claims of expertise, shouldn’t you expect critical review of your work?  If it is truly what it is, it will stand up to the examination.

When people go around pretending to be leaders by making claims of their honesty, they should in fact be honest.  If they are about being a good steward of taxpayer funds, they too, should be actually doing just that.  If they think that their cost-cutting efforts are actually beneficial to the community and they prove to be wrong, they should be willing to take that heat.  And when we say we are professionals in what we do, we should permit others to review our works and determine if they hold up to a critical examination of the content.

Change freightens the entrenched and the hypocritical; the entrenched because of their anticipation of loss and the hypocrites, because they will be exposed for what they are when the light of truth shines in.  If you are one who embraces change, it’s probably because you know you don’t have anything to lose.  If you are what you are and you do what you do, and you practiced your art and you learned from the masters, you have nothing to lose and everything to gain from change.

The Case for Credentialing – An Opposing View

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I’m distressed that a comment got sent to my spam filter regarding an earlier post and for that I apologize.  The poster made the comment that he didn’t think I’d print it.  As it is, I would hope by now that readers understand that I welcome opposing views, because it is only by listening to what others have to say that we can grow.  Thus, I’m interested in discussing the issues intelligently and understanding the emerging challenges in the emergency service industry.  So since the comment got sent to the spam folder, I don’t feel that it was shared with you all, and I wanted to insure we had equal opportunity to present our views.  If you have a point to make and it can sway my view, then I encourage it. 

First, an excerpt from a letter Mr. Doug Copp sent to my employer:

In his zeal to please some nefarious people at FEMA I believe he has decided than he will promote himself, at my expense..and your town’s expense. I have had a running battle with FEMA for 20 years because they have used major disasters as an opportunity for military and espionage activities while the ‘victim’ country has been in chaos, from the disaster.

As a person who only cares about saving lives..they hate my guts.
Before 911, I was the most experienced rescuer, in the world; since, 911 I have been sick every minute of every day and after 8 years am still being treated by 7 MD Specialists, for my 911 injuries.

 

This is twisted, perverted and a disgrace that this little man should find it necessary to cause me harm. 
How much do I have to suffer? How much abuse do I need to put up with? If he is so twisted…then he should spend his time mutilating small animals and leave me alone.
 

 

 

Then, his comment, which I retrieved from the spam folder:

This is what I submitted to him as a comment, on his blog site. I do not expect that he will have the courage to post it:

http://www.firehousezen.com/2009/05/29/the-case-for-credentialing/

 “It is disgusting that my name which was so destroyed by a psychotic, twisted pervert,,,aka Thomopson Lang..owner of the Albuquerque Journal ..because I refused to give him an emergency pass,,not because he was wearing women’s clothes..not because of his disgusting behavior but mainly because he was an evil, evil man..and even more so because some wannabee phony pretend rescuers see me as an easy target..get a life..go credential your phony ass.

My 20 years of selfless volunteering saved the lives of more than 200,000 lives..go see the proof at www.amerrescue.org

As far as Mr. Copp’s claims that I have offended him in some way, I hope he continues to read this blog and understand that I’m not about divisiveness but about seeking the truth, and as far as I am concerned (and this is my blog) there is a discussion that should be made about the merits and demerits of credentialing.  We presented some opposing ideas and we will discuss others as well.  But as far as dismissing the idea of credentialing because Mr. Copp feels it goes against him and some of the others out there, well, I’m sorry that he feels this animosity toward me. 
Instead of threatening me with a lawsuit, perhaps he can let us all know just what it is he has in the way of scientific evidence defending his points.  I’m only interested in discussing the facts.  I happen to be opposed to self-deploying groups posing as rescue teams and not showing evidence of having met any recognized consensus standards.

I have nothing to gain from only presenting one point of view here on FHZ.  As I said before and I’ll say a thousand times, I don’t blog on duty and I don’t speak for any of the organizations I work for on this blog, so they have nothing to do with anything on here except to serve as good examples of organizations using best practices.

 

Enjoy and have a nice day.

The Case for Credentialing – Answering Your Comments

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I hate to break free in the middle of this series like this, but there were some comments made that I wanted to discuss.  Since one is on one post and the other is on another post, I felt the need to tie them together and talk really quickly to the issue.

On June 15, Steve said:

Yes, credentials would help but WHO is the final authority on issuing them? WHO sets the standards? How are you going to avoid the age old paid vs volunteer bias in any credentialing agency?

My quick answer: I am against the bias in the career vs. volunteer.  If you can meet the standard, you can meet the standard.  I think there is plenty of room for volunteers, especially in disaster response.  So some career guy is going to tell me my docs can’t be part of the team because they aren’t career guys somewhere?  And I have said in regard to SC-TF1, where I do have some pull, if one person in a one-station volunteer department down the road wants to be part of our team, we need to let him if he meets our criteria (background check, physical agility, etc.)  As Ray Wilkinson, our past Director once said, “I can teach someone to break rocks, what I can’t teach is desire.”  If someone wants to do the job, and goes through the requirements to meet a position, why should I care if he’s a member of FDNY or of Acme Fire Department?  So Steve, I’m with ya, brother.

On June 16, Kevin said:

I live in a state where there is no agency tasked with certifying or credentialing Search and Rescue dogs. I have seen (many times) where someone will buy lights for their POV and load their pet dog into the truck and call themselves a SAR team! If I didn’t know better, I might think all volunteer SAR teams were like this. However, there are a number of excellent non-governmental SAR teams in my state as well. I myself and a member of a volunteer K9 team.

Kevin goes on to say that they have a volunteer K9 SAR team because there isn’t an existing asset and law enforcement has asked for it.  Well, Kevin, as they say in Australia, “good on ya”.  You have identified a need and you have tried to meet that need.  No one else has that asset and it sounds like you have tried to do a good job of using accepted industry standards to meet the need.  THAT is good stuff.

However, I just went to discuss the concept of “those of us who want to do this right, but there are people with authority screwing things up so we can’t get in”, and realized that the post I wrote for that last week never posted as scheduled!  So that is now on the post schedule and I hope it does discuss some of the feelings I personally have in that regard. 

On June 16th, SAR Volunteer also commented:

I totally agree with your points. Please understand this are a handful of small volunteer K9 SAR teams in the state of SC who do NOT self deploy, do NOT work for anyone but the proper state or municipal authorities, train hard, carry their own liability and workmenscomp insurance, align their standards with NIMS Resource Typing, and are working to ensure they meet the proposed credentialing requirements.

And to you too, SAR Vollie, I applaud your efforts.  I think there is a place for the small volunteer K9 teams at the table as well, if they meet a standard.  Let’s take SC-TF1 again for example.  I have said over and over again, if we have people out there who want to do this stuff, let’s get them involved.  But not being a canine guy, I have some difficulty understanding some of the things the canine types are telling me.  So when I get national experts telling me one thing, and some guy with Rover in a pickup truck (or Expedition, as it were) saying his dog can detect live scent, cadavers, lost pets, and get a beer and catch a frisbee, understand that I am skeptical.  And the self-deploying thing is just purely bad in my book, but that’s a whole other issue as well that doesn’t stop with canine SAR teams, and DOES include career guys, departments, and organized teams, etc.  Frankly, if you (SAR Vollie) or anyone else in SC have dogs trained to find LIVE HUMANS in collapsed or damaged buildings, and feel like you can meet a standard, send me an e-mail.  I’d love to hear from you.  But anyone who calls themselves “Urban Search and Rescue” and they are running around doing wilderness searches, well, go back to my box of rocks comment.  Be what you say you are.

Anyway, I hope this illustrates some of the issues considered so far and we’ll get back on track with the next post (which should have published before the last one- go figure).  Please continue with your comments.  I certainly appreciate your perspectives.  Stay safe.

The Case for Credentialing – The Spontaneous Bystander

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First, we have the genuine thing, the spontaneous bystander, who sees a need for action, then does something about it.  Rescue911 commented on the story of the Good Samaritan and how a traveler, with no reason to do so other than to help his fellow man, went out of the way to assist another.  This lends a certain amount of credibility to the discussion that nothing should prohibit people who wish to help others in their time of need.  Now realize, of course, when I am referring to these individuals, I am referring to people who just have a desire to help their neighbors and do the right thing.

 Quarantelli discusses the social aspects of the emergent response of spontaneous bystanders in Katrina, but also in the Guadalajara gasoline spill and fire.  There is also discussion on the subject by Kirschenbaum that the current philosophy of governmental and NGO response to disasters effectively dilutes the response of neighbors and has resulted in an over-reliance on these agencies to provide assistance.  After all, man has been besieged by disasters since time immemorial and it’s not like they had FEMA to come to the rescue back in biblical times.

There’s something very beautiful (albeit, chaotic) in the spontaneous response of the altruistcally motivated.  But call me skeptical, I see a lot of response from people who claim that altruism is their motive, but I’m not seeing that generosity of spirit coming out when they’re busy operating video cameras to sell tape to the media or taking souvenirs, rather than manning a sand-bag line.  More about THAT kind of person later.

There are indeed a few challenges with this kind of emergent response, problems that if resolved, would go a long way toward goodwill with the community in general (it seems like everyone’s got some kind of beef with FEMA in every disaster, despite their extraordinary efforts to educate people that they need to be more self-sufficient and less reliant on the government), and provide resources to the jurisdictionally responsible agencies that seem to be strapped for bodies when the big one rolls around to their neighborhood.

The main problem faced by those of us in the disaster community when it comes to spontaneous response, is the fact that as the designated adult supervision at these events, we have a responsibility to insure not only mitigation (or depending on the complexity and scope, control) of the incident, but the safety of those who were not necessarily part of the problem before, but now are. 

Let’s step down a wee bit and look at it from the perspective of the first-due engine arriving at the scene of a water rescue.  Let’s even go further to relieve the complication of the situation, and let’s say this is a static water body and it’s just one person involved.  Now I understand that the vast majority of those of you reading the are responders, so bear with me as I educate those who are not.

If, as the officer of the first arriving fire apparatus on scene, we have a single person in need of assistance in a pond (or lagoon as we call them here on Hilton Head Island), it’s really just a cut-and-dried approach to the situation.  Providing we have the resources (water rescue equipment, trained and prepared personnel), it’s a matter of assessing the scene, determining the problem, solving and planning a solution, and putting the solution into action.

Our problem, however, is that more often than not, it isn’t that easy.  In a lot of cases, when we roll up, there are people in the water trying to make a rescue.  In a lot of cases, one or two of these people are now ALSO in distress.  There are bystanders who are interfering with the operation because they don’t understand that standing for a second and looking over the scene for additional hazards is necessary so that we ourselves don’t also become part of the problem (“WHY AREN’T YOU DOING SOMETHING?!!!”).  There are those who parked their vehicle in our way so they could get a better look.  These days there are people video taping so they can sell it to the media or even better, catch you doing something wrong.  Without beating this horse too much, suffice it to say that there are a whole lot of other things going on here.

Now how, you might ask, does this apply to me as a spontaneous responder?  Well, the video taping and the access issues aside (you are a Good Samaritan, after all), let’s go to that first issue: those of you in the water.  Think for a moment, while you are in front of your computer, why this person got into trouble to begin with.  It might very well mean that they can’t swim.  It might be, however, that there is another danger you don’t see.  Thus the need for experienced and equipped responders who can provide an effective rescue.  There is an oft-quoted saying in the confined space rescue community, that 50% of the victims in confined space emergencies are the first responders.  These are often well-intentioned, but less-than-educated or undisciplined responders who failed to take into account the dangers associated with space entry themselves.

My whole reason for saying this is that while most of us in the response community can certainly appreciate the bystander response to an emergency, there are cases upon cases in every aspect of disaster and technical rescue response where the spontaneous bystander response in and of itself became an additional rescue mission for us on our arrival.

So, how can the person who doesn’t have a desire to be part of an organized response help?  Take CPR and first aid courses.  Attend a seminar on what to do in a disaster.  Know that there are other ways to help (“throw, tow, row” come to mind BEFORE “go”).  Put your name on a volunteer reserve list or call your local jurisdiction and ask if there is some way to help if needed.  But more importantly than anything, when you are inclined to go and help, if the legally authorized incident commander (or their designee) gives you an assignment, no matter how mundane, it is what they DO need done for the management of the incident.  You may not understand or appreciate the IC’s request, but in our eyes, there may very well be a method of allowing you to contribute at your level of expertise and to permit your contributions without adding to the complexity of the situation (when something goes wrong and you aren’t equipped or prepared).

This all being said, in times of disaster, people do want to help and the response community has to be proactive enough to have a mechanism for channeling the energy of these responders.  The big issue in my eyes is to make sure people know in advance what they can do, create programs to educate lay responders, and tap them when you can to promote interest.  Furthermore, it is a good practice to identify a place they can report to and get information on them, credential them to the extent possible, and assign them according to their quickly-identified expertise.

I will tie this into the argument about credentialing later, but this is the first discussion regarding the “interested parties” against the argument for credentialing, so be on the lookout for the next post.  Thanks and feel free to comment or help illustrate your view on the subject.

The Case For Credentialing – The Argument

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SC-TF1 in Chalmette, September 2005

SC-TF1 in Chalmette, September 2005

As discussed in the last post, there are those who are against credentialing, for their own reasons.  Because I have had plenty of discussions about the subject, I think I have the discussions channeled into four groups (and if you have a different argument, let me know, because I don’t want to miss anything on the subject).  I plan to talk about each of these in a little more depth, but I wanted to at least put the parameters of the argument out there.

First, we have the genuine thing, the spontaneous bystander, who sees a need for action, then does something about it.  The discussion I have heard so far from this camp is that there should be nothing that would stand in the way of people who just have a desire to help their neighbors and do the right thing.  Quarantelli discusses the social aspects of emergent response from spontaneous bystanders in Katrina, but also in the Guadalajara gasoline spill and fire.  Plain ol’ people like every other neighbor you ever had saved lives, and were not agents of the government, had no training, and only did so in the effort to help others.  There’s something very beautiful in that, but call me skeptical, I see a lot of response from people who claim that is their motive, but I’m not seeing that altruism coming out when they’re out operating the video camera or taking souvenirs, rather than manning a sand-bag line.  More about THAT kind of person later.

We also have the disaffected group/person I call the “outsider”.  Having been one on a few occasions, I can certainly empathize with their cause, but I don’t necessarily sympathize with their way of handling things all the time.  Often, these are people who have a lot of training, or maybe come from somewhere where they had a lot of training and experience, and the place they are now in life won’t make room to allow them in.  There are dozens of reasons we will discuss, but there are also some issues regarding the credentialing side of things that would STRENGTHEN their position if they were in fact, truly qualified but being marginalized.

Then there are those who are currently the jurisdictional responder but are afraid the light of truth will expose that their organization/agency is not following industry standards, or that they are not ready, or are failing in any number of reasons.  These people really don’t have much sympathy from me in regard to their argument against credentialing.  However, there might be some discussion that merits a look.  I’ll reserve my judgement for now.

And finally, there are the thrill and glory seekers.  They might be there for the attention, they might be there for the notch in their gun, or they may be there to profit by defrauding the response community.  So as of now, this is where I stand and these are the arguments I want to discuss at first.  There are in some, compelling ideas.  There are in the others, no possible way you’ll be able to get me to support their theory.  But we’ll talk about them and I’d love to get your thoughts on the subject.  See you in a few.

The Case for Credentialing

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Side of an OFFICIAL SC-TF1 vehicle in Louisiana during Katrina.

Side of an OFFICIAL SC-TF1 vehicle in Louisiana during Katrina.

I’m about to launch into a multi-part blog to discuss the merits of credentialing.  Right now I am aware of some opposing arguments to the requirement that disaster response personnel have credentials, particularly when it comes to those who routinely offer their services after a disaster but are not necessarily part of a response entity.

At this time I am dealing with the multiple phone calls for information on a group calling themselves “Urban Search and Rescue“, located right here in my own community.  From what I have been able to tell, they were featured on a local television interview the other day and managed to get a request for assistance out there, but failed to provide a working telephone number, as well as having bad links on their webpage.  When people found they could not reach this entity, I’m guessing they “googled” the terms “Hilton Head Island Urban Search Rescue” and believe it or not, that gets a few hits for me and my phone number.

When I say there’s some confusion, you bet.  When I tell the bewildered caller that, yes, I’m the Deputy Director of the South Carolina Urban Search and Rescue program and the Vice-Chairman of the State Urban Search and Rescue Alliance, but I have no idea who ”USARK9″ is or what their credentials are, you can imagine the rest of the conversation.  After all, they have seen their official looking vehicles, I have heard they walk around town in official looking uniforms, and apparently, according to their website and some discussion from the media, they’re doing a good job of self-deploying all up and down the coast, but I don’t know who they are.  I must be an idiot.

But this isn’t a discussion about them; this is a discussion about how when we don’t know who you are or how you got here, it makes it a little problematic when we are trying to put you to work, or eventually, trying to feed and shelter you (because invariably, these “assets” don’t come with the support they need), a la Hurricanes Andrew, Floyd, Katrina, et al, the World Trade Center, and any number of disasters that happen on a fairly regular basis.  It is a problem when we can’t account for you, it is a problem when you can’t work within a command structure, and it is a problem when we think you have one capability and it turns out that you do not.  It is also a problem when uninvited guests show up and get hurt, then want compensation.

The blog will discuss my perception of the problem, opposing viewpoints as they have been made know to me, considerations and existing knowledge, and hopefully incite some discussion.  As you may or may not realize, I have a pretty open mind.  So don’t be surprised that I agree that there is a need for spontaneous bystander rescue (although it makes me a little uneasy) and I agree that there are genuinely altruistic people and agencies out there who desire to help and have problems fitting into the picture. 

Anyway, as usual, I have a lot going on, but I’ll lay out the discussion further and ask you to chime in if you have something you’d like to say, and I’d expect to add the next blog in a day or so.  Rome wasn’t built in one blog, after all.

In Memoriam – SC-TF1 Search Canine "Dixie"

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dixieI recieved a report about the passing of one of our search canines, Dixie, today from Dan McManus, the SC-TF1 Director:

“It is with great sadness I report to you that Dixie, one of the State US&R Team’s four service dogs, died December 31st, 2008, due to an intestinal failure. Sadly, our 8 year old canine passed away in her kennel at the home of canine handler Duane Brock on New Years Eve, Dixie will be missed by every member on this team.

Dixie was a Labrador who has had quite an amazing life serving her country as a search and rescue canine. She started training when she was a puppy as a human scent detection canine. This type of training is used for when victims are trapped in debris and are not visible to the human eye.

 Her career started by serving almost two years with the FEMA Tennessee Urban Search and Rescue Task Force One (TN-TF1)  until she was recruited to South Carolina’s US&R Task Force (SC-TF1) in June of 2005. Shortly after joining the South Carolina Urban Search and Rescue Team, Dixie was deployed to St. Bernard Parish with the Task Force for the rescue efforts of Hurricane Katrina. Recently Dixie and our other three canines were flown to and from Columbia to Beaufort in a National Guard Chinook Helicopter to participate in the largest disaster response exercise of its kind. According to our pilots it was the first time in their long military careers have they transported Search and Rescue K9′s anywhere.

Our handlers are volunteers who take on a great amount of personal and family time in order to staff our team with specialized canines such as Dixie. During the years, any handler will tell you even though they are not your average house pet and are to be used as a highly specialized tool, they become a large part of your life and it’s hard to lose them so suddenly. Please keep Canine Handler Duane Brock and his family in your thoughts and prayers.

Although Dixie was the oldest of our canines, her drive and motivation to work as a member on SC-TF1 was undeniable. Her dedication to this organization will be deeply missed by all of us and because of this, we will find a location in our new building to remember her service by.”

Lots of Work Ahead in 2009

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One of my biggest concerns in 2008 has been the dwindling funds available for urban search and rescue programs around the nation. When things cut loose out there, these are the resources that everyone wants, but given the state of funding for these programs and the state of the economy, they may also be the first programs to see the axe.

When a few of us got together and developed the State Urban Search and Rescue Alliance in the middle of 2005, we had no idea that there was as much interest in putting together regional and state assets as there was. We found that virtually every state (and even some of our Caribbean neighbors and compatriots) were in the process of developing these programs, but people weren’t talking the same language (NIMS typing and credentialing was in its infancy), were “reinventing the wheel” in so many facets of their work, and most of all, weren’t communicating that they had things to share or that they had needs that could be filled by others.
The nation’s emergency service providers should learn a lesson from all of this: we can work together by reaching out to others, and find commonalities that can bring us together rather than to continue to stay in our “silos” and perpetuate the turf-guarding that keps us from solving our serious issues. In this day and age of stripped budgets, if we can show that we are willing to lay down our egos for the common good, we might have a bigger stick to wield when it comes to chasing the vultures away from our already scarce funding allocations.

Happy Thanksgiving

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Last post today, I promise (I only have a few more I’m moving over then things will stabilize). I want to give thanks for my wife and children and my family and friends; for the many opportunities we have been given and for allowing us to be good stewards of those responsibilities; and especially the continued courage, strength, wisdom and patience required to lead firefighters and rescue personnel not just on emergency scenes, but daily, where it really counts. My wife says all the time, “Of those who have much, much is expected.” I believe it and hope to always live up to it.

Picture by Deputy Chief Ed Boring, Hilton Head Island Fire & Rescue

Entering IntoThe Blogosphere

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I’ll keep it short but sweet; I’ve been blogging for a few others and figured maybe I need to blog for myself. This will be a site for discussion of much of the emergency service leadership issues that revolve especially around special operations, since that is where my interests lie. So if you have some ideas, let them fly. In the meanwhile, I’m out here.