Calif. truck stocked with everything paramedics need

By Jim Johnson
Monterey County Herald

MONTEREY COUNTY, Calif. — Scenario: A massive earthquake or terrorist attack has just devastated the Central Coast, injuring scores of people and cutting power and water lines.

Monterey County emergency response officials would dispatch an ambulance strike team to the hardest-hit area, five ambulances and crews backed by the county's newest tool, a Disaster Medical Support Unit driven by the strike team leader.

Serving as a kind of mobile incident command and triage unit, the U-Haul truck-size vehicle provides ambulance paramedics with everything they need to treat hundreds of victims and remain in the field for up to three days.

The unit is stocked with basic and advanced life-support equipment, trauma kits, oxygen for up to 50 people, protective gear, diagnostic equipment and other medical supplies, as well as enough bottled water, ready-to-eat meals and generators to support 11 strike team members. It even carries a portable toilet.

Tom Lynch, director of the county's Emergency Medical Services Division, said Monterey County was chosen by the state Emergency Medical Services Authority as one of 25 counties in California to receive the disaster support units. The units cost about $120,000 and are funded through the federal Department of Health and Human Services' emergency preparedness program, which grew out of the Sept. 11 attacks and Hurricane Katrina.

The local unit will be on public display and is available for tours today 11 a.m. to 1 p.m. at the county EMS agency at 19065 Portola Drive in Salinas.

Lynch said the unit has been blended into the county's emergency medical response system and will be an "exceptional, local resource that can rapidly support any medical event or disaster situation in Monterey County or the Bay Area."

Tino Arrelano of the county's EMS agency said the unit would have been useful during the 2006 MotoGP event at Laguna Seca when 11 Westmed ambulances and their paramedics were "overwhelmed" by more than 100 people suffering from dehydration in a two-hour period during a heat wave.

In addition to local incidents, Lynch said, the unit and its ambulance strike team can be requested by any first responder in the state to help with a large-scale, mass-casualty incident. The team is designed to be ready within an hour of a request.

During a disaster, hospitals can be overwhelmed by casualties and paramedics could be forced to treat patients in the field for hours. With the disaster support unit, the ambulance strike team can provide immediate and longer-term pre-hospital care, and can serve as a mobile field hospital, a first aid site, a shelter or a command post.

The unit allows ambulances from the strike team to continue providing emergency care for days without having to leave to re-stock supplies.

One reason the county was awarded the unit was because of its central location and relative proximity to much of Central California.

Lynch said the county EMS agency will provide staffing for the next few weeks until American Medical Response West takes over as the county's interim ambulance provider Sept. 1.

AMR, which has a one-year contract with the county, will provide staffing and maintenance for the unit for the length of the agreement.

Ultimately, the county's long-term ambulance provider will be responsible for staffing and maintaining the unit. The county is creating a new request for proposals for an ambulance provider, and Lynch said the RFP should be released for public review in September.

Lynch said he plans to conduct a series of community meetings at various locations in the county to allow for a full public review of the RFP, which should include a redesign of the local ambulance system.

County officials have said they want a long-term ambulance provider in place before AMR's contract expires.

AMR general manager Doug Petrick said the local emergency unit will be one of six his company operates in various counties, and it expects to operate two more. Petrick said in addition to providing crucial medical and organizational support, the units are invaluable in their capacity for keeping the ambulance strike team members sustained during a critical incident when there often are no other available resources.

"What people often don't understand about disasters is, usually during the first 72 hours, there are no services," Petrick said. "There's no power or water or food or other resources. For our responders, we need to take care of them so they can do their jobs, and so (with the disaster support unit) we make them self-sufficient for those first 72 hours."

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