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Home > Topics > Mass Casualty Incidents
August 16, 2011
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EMS News in Focus
by Arthur Hsieh

How to be an EMS 'civilian'

By Arthur Hsieh

Editor’s note: The Indiana stage collapse highlighted a huge question for first responders: how do we emergency medical experts react to disasters when we’re in “civilian mode.” The priority, Editorial Advisor Art Hsieh contends, should always be safety.

Disasters often happen in a blink of an eye. For the Indianapolis stage collapse, the disaster happened in front of thousands of spectators and was recorded by an unknown number of cell phone cams.

Based on a variety of news reports, it appears that it took several minutes for professional rescuers to arrive. So, what would you do if you're off duty at a major disaster?

Like me, you would probably feel obligated to rush in and try to help wherever you could. Remember to keep several key points in your head as you assist in "civilian mode":

1) Safety continues to be job #1. It's not clear from the video how much of the staging remained standing after the initial collapse. The scaffolding pieces can weigh many hundreds of pounds each. A strong wind could cause more of the structure to fall.

Off duty, we're also not near a variety of safety equipment that we usually have immediate access to, such as turnout gear, helmets, and gloves. Look for anything that provides you some protection: work gloves, hard hats, flashlights.

Think twice about going into places that are beyond your ability to do so. There will be the urge to affect a heroic rescue. Make sure you have stopped for a minute to weigh out your risks, and the likelihood of a successful outcome, before going in.

2) Coordination will always remain an important backbone in any rescue operation, whether in professional or civilian mode. If you are working with other bystanders, work to establish a quick plan, so that there can be some organization to the chaos. After all, you are trained to do that, aren't you? Take advantage of that training and help lead the unofficial rescuers to be more effective. Establish triage sites, patient collection points, etc.; those with medical training can start initial treatment as patients are removed from the disaster event.

3) Improvisation will overcome adversity. The use of doors as makeshift stretchers is a good one - that's taught in Boy Scout first aid training. Look for clothing, towels, anything absorbent to help control bleeding. Think about basic principles of airway and shock management, and find locations where victims can lay down and still be out of the elements.

Consider when professional help will begin to arrive. Think about turnover reports, and places where staging can occur. You may be able to preidentify areas of the incident that will need to be searched with heavy equipment.

Kudos to the good Samaritans who helped out during this disaster. It's comforting to know that we're still willing to help out when the situation calls for it. As public safety providers, we can provide additional expertise to make the rescue effort even more effective.

About the author

EMS1 Editor in Chief Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. Since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook author, has presented at conferences nationwide, and continues to provide patient care at an EMS service in Northern California. Contact Art at Art.Hsieh@ems1.com.
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