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CERT Part 3: Disaster medical – after a quick assessment ‘MacGyver’ it

By Sue Botos

Westshore

You could tell we were going to get down to the nitty-gritty during this third CERT basic training class. After presenter Jean Maxwell, a Lakewood Hospital R.N., introduced herself, CERT coordinator Tricia Granfors asked, “Is anyone bothered by the sight of blood?”

A few hands tentatively rose, but not mine. Really, I think I’m OK with it. As long as it’s not mine.

Which means, according to today’s topic “Disaster Medical,” some of us could be out there assessing the injured and performing some quick first aid, while others would do more of the record keeping and coordinating of staging areas in the event of an emergency.

“It’s not for some people, and that’s fine,” said Maxwell, referring to the fact that during a disaster there is plenty to do for everyone, both on the scene and behind.

“Our goal is to provide the greatest good for the greatest number of people by using triage,” Maxwell said. She was referring to the system of sorting victims according to treatment need, from immediate attention, those tagged red or yellow to those slightly injured (green), or those beyond help.

Probably the biggest myth buster, at least for me, was that emergency responders should not spring into action with CPR. On the scene, initial evaluation of each victim needs to be done ASAP, according to Maxwell, who added that the “three killers” – airway obstruction, excessive bleeding and shock – need to be treated first. “CPR is wonderful, but it should not be used at this time. Once you begin CPR, you can’t stop,” she noted, adding that this would then tie up someone who may be needed elsewhere.

Most important, Maxwell said, was “voice triage,” calling out to victims and listening for response. This, she said, will identify those who could possibly identify their injuries for responders. She added that one should also request permission to treat an individual. “You need to respect cultural differences, but a lot of that goes out the window in a disaster,” she stated.

Maxwell went over the procedure for opening an airway by gently tipping back a victim’s head. She also reviewed the various points where pressure can be applied to stop bleeding, and how to recognize shock.

“We cannot focus our attempts on rescuing the worst one in the pile. This is especially difficult,” Maxwell frankly stated. She stressed that triage was a quick assessment, followed by treatment.

It is important to note, said Maxwell, that CERT members always work in teams and never have to make difficult decisions on their own.

We then practiced what we learned, dividing into two groups, which took turns as the “victims” and “rescuers.” Peggy Dage won an award for catching the first group of rescuers omitting “verbal triage,” while Nancy Brown was recognized for her portrayal of an injured non-English-speaking woman.

Energizer’s Tim Brown returned to present post-triage care, covering a plethora of information on how to treat everything from burns and fractures to nasal injuries, to heat- and cold-related conditions.

Brown said that the initial evaluation of a victim involves attention to PMS – pulse, movement and sensation. He also stressed the importance of maintaining personal hygiene, even under makeshift conditions, especially when it comes to unidentified fluids. “If it’s warm and wet and not yours, don’t touch it,” he stated.

“Sometimes you have to’ MacGyver’ it,” Brown noted, telling us that anything handy, including pieces of debris or even another limb, can be used for splinting.

Our bandaging exercise let classmates get to know each other a bit better. My partner, Brandon Vallee, was making up this unit, having already taken CERT training earlier, just missing out on helping during Hurricane Sandy. (No wonder his bandaging was so good.) As fellow Rocky Riverite Kamal Haddad splinted Greg Atwell’s arm, he told of how he had worked for the Red Cross, visiting 12 different counties to assess emergency situations before first responders arrived.

Brown also countered a few old wives’ tales when it comes to burns, which are now categorized by skin layers affected rather than first, second or third degree. We learned it’s not OK to apply butter, ointments or ice.

This burn care information may come in handy for next week’s Fire Safety unit. …

 

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