C.e.r.t.

Discussion in 'Health & Medicine' started by notagibbon, Oct 12, 2008.

  1. notagibbon

    notagibbon New Member

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    Has anybody gone through the CERT training? Thinking about giving it a go.
     
  2. kc5fm

    kc5fm Emergency Manager

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    CERT training

    Gone through it. It is WELL worth the effort.

    It's not designed to make you professional anythings. It's designed to help keep you alive and well until the professionals get there. It's also designed to help you help your neighbors.

    For more information, see CERT.

    When you get through the class, join the CERT Email list. Encourage your team leadership to do as well.

    I wish you well.
     

  3. ke4sky

    ke4sky ke4sky

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    CERT Overview

    CERT Overview

    The Process:

    1) Organize Team
    2) Size Up – Recon Scene
    3) Traige – victims
    4) Stabilize victims and remove to Casualty Collection Point

    Use memonic “SAFE” to remember:

    SEARCH – Safely, systematic, buddy system
    ATTACH Tag - Triage first, rescue later
    FIX – Life threatening injury
    EXTRICATE - Remove victims from danger

    Incident Management Purpose - to produce effective results safely!

    1) Do the most good for the most people
    2) Account for rescuers, victims, resources

    ICS Process:

    1) Identify SCOPE
    2) Determine STRATEGY
    3) DEPLOY resources
    4) DOCUMENT actions and results

    Use memonic CALM to remember CERT command structure:

    COMMAND
    ACCOUNTABILITY
    LOGISTICS
    MEDICAL

    Remember the robot from the movie Star Wars - “R2D2”:

    RECON > RANK > DISENTANGLE > DOCTOR

    RECON:
    Maintain situational awareness
    Check surroundings frequently
    Stop, Think, Observe, Plan, Act

    Sizeup - hazard identification, damage assessment
    No wall, no roof, no enter!
    Heavy damage don’t enter to rescue – danger tape
    Moderate Damage – non structural, in/out quickly
    Light damage – Go for it!

    RANK: aka (triage in-place prior to rescue)
    Respirations <30/min, not “panting like a puppy”
    Perfusion blanch test nail bed<2secs
    Mental status – awake, aware, understands simple commands

    DISENTANGLE - Rescue decision based upon Risk to Rescuers!
    Rescue greatest number in the shortest exposure
    Remove injured from immediate danger
    Rescue lightly trapped first
    Work safe, use PPE, Time, Distance, Shielding

    DOCTOR - Traige First – Rescue Later
    Affix TAG before rescue.
    Control bleeding
    Treat for shock

    “RECON” - For Hazards and SEARCH for Victims

    Document hazards and search findings
    SLOW DOWN
    – perform an adequate SIZE-UP
    Before entering walk building perimeter, Mark building using duct tape strips
    placed to left of door as you enter:

    “RECON” - SEARCH METHOD:

    1) As you enter call out: “Search Team, Is Anyone In Here?”
    "Are You Hurt?” “Can you walk to me?”

    If hurt or trapped say “STAY PUT we’ll come to you.”

    2) Physical Search Interior – systematic, top down or bottom up

    3) Stop frequently to LISTEN

    4) Triangulate using flashlight

    5) Mark searched areas, document results

    6) Report by radio to Command, hazards, victims requiring extraction:

    “RANK” - Triage begins with size-up.

    Stop, Look, Listen, and Think. Stop and look and listen. THINK about how you will approach the task at hand. Continue size up as you work.

    Conduct Voice Triage. Call out. "Come to the sound of my voice.” Instruct survivors who are ambulatory to remain at a safe location, and continue with the triage operation.

    Follow a Systematic Route. Start with victims closest to you and work outward in a systematic fashion.

    Conduct Triage Evaluation. Evaluate victims and tag either RED (immediate), YELLOW(delayed), or BLACK (DEAD). Also evaluate any GREEN walking wounded. Everyone gets a tag.

    Treat RED Victims Immediately. Airway management, bleeding control, and/or treatment for shock for RED (immediate) victims.

    Document Results for:
    Effective deployment of resources.
    Information on locations of victims
    Record number of casualties by degree of severity

    Remember “RPM"

    Respirations <30/min
    Perfusion blanch test nail bed<2secs
    Mental status understands simple commands

    “DISENTANGLE” - RESCUE Purpose – Create safe environment for victim

    PROCESS:

    1) LIFT OBJECTS – don’t step on, step over or around.

    2) USE TOOLS – simple machines

    3) BE SAFE – Ensure object free and people clear before moving.
    Beware of pinch points.

    4) TRIAGE - victim before moving.

    5) DOCUMENT RESULTS

    LIFTS AND CARRIES

    Fireman’s carry – Only if victim if 80# or less

    Solo extraction methods:

    Clothes drag
    Log roll and Blanket drag
    Army (Rope/Webbing) Drag*

    *Roll casualty onto back, thread rope or webbing under small of back, slide across top of buttocks, loop rope or webbing under, through and around belt at hips, “X” across chest and under armpits. Attach snap link and drag to safety.

    Team carry methods:

    Log roll and blanket carry – advantage through doorways, around corners or up and down stairs (requires minimum four people)

    Door, table, surf board or other long-wide board 2”x6” or wider – (best with four rescuers) if victim small can do with two people over short distance.

    “CAT stretcher” - Two folding metal chairs, flat-stacked back-to-back, legs out, wrap or tie securely with duct tape, 550#cord or webbing.

    Chair carry problematic – Evac chairs require training.

    “DOCTOR”

    Respiration:

    Control head, open airway, look, listen feel, not breathing – DEAD
    12-20 breaths per minute OK, if “Panting Like a Puppy” - RED

    Comfort lowers respiration rate - helps calm victim down
    Let them sit up if comfortable, don’t “make” them lie down.
    Cool burns with water only - Don’t remove clothing, soak to cool

    Burns to face critical, swelling impairs breathing
    If victim inhaled hot air tag RED

    Perfusion: - Blanch test nail bed > 2 secs.

    Head or spinal cord injury causes blood vessel dilation drops BP
    Chest injuries
    Major bleeds
    Abdominal injuries
    Handle GENTLY, elevate feet, keep warm, direct pressure, pressure point
    Prevent secondary infection, irrigate only, apply dressing, bandage

    Mental Status
    Unconscious victim – RED
    Semi-Conscious - unaware, can’t follow simple commands - RED
    Conscious victim, awake and aware can be cared for and made more comfortable, move to a safe place, protected from weather, wind, rain, and tag Yellow.

    SAFETY AWARENESS - Disaster Risk Factors

    Tool / equipment hazards, risk of hand, eye, head injuries, electric shock, chemical burns

    Human factors, stress / fatigue

    Structural instability, terrain - Trauma risk, falls, building collapse potential, loose rock, fallen limbs, wet or insecure footing, falls, puncture wounds or d lacerations from debris

    Environmental effects: lightning, cold, wet, wind-blown dust, debris, smoke, fumes

    Flooding: water rescue:

    REACH out to victim with hand, pole, ladder,
    THROW victim a rope, life vest, picnic cooler, anything that floats
    ROW out to reach them from a boat or raft
    GO to CALL 911, do not delay.

    Incidental exposures: - If contaminated:

    Remove everything, including jewelry
    Cut off clothing normally removed over the head
    Place contaminated clothing in plastic bag, tie closed
    Wash your hands before using them to shower
    Flush entire body with cool water
    Blot dry with absorbent cloth
    Put on clean clothes
    Avoid use of affected areas, to prevent re-exposure
    Report to responders for thorough decontamination and medical assessment.

    Recommended PPE:

    Sturdy footwear – Ankle support, traction sole, safety toe
    Double-Glove = Work gloves worn over med exam gloves
    Safety glasses with side guards
    Rain gear and suitable outdoor work clothing
    Reflective vest
    Hard hat
    N95 respirator

    Infection Control Awareness - Potentially Infectious Materials

    • Body secretions / excretions
    Human: poor sanitation conditions
    Animal: livestock, rodents, vermin, insects

    • Decayed carcasses

    • Hanta virus from contact with rodent feces

    • Putrescible materials - Spoiled foodstuff, garbage and refuse

    • Allergens - Concentrated fungi, molds

    Mechanisms of Transmission

    • Direct contact (“portal of entry”) Non-intact skin

    • Penetrating injury (percutaneous) physical injury, portal of entry

    • Aerosol

    • Vector borne

    Transmissible Organisms

    • Tetanus (no tetanus toxoid booster within 10 years)
    • Hepatitis A, B (C much less likely)
    • Enteric bacteria (e.g. E. coli, Salmonella)
    • Vermin-mediated
    – Cats: Toxoplasmosis
    – Mice, rats: (urine): Leptospirosis; (feces) Hantavirus
    – Tularemia
    – Plague (rat flea)
    • Toxins (botulinum) decaying, spoiled foodstuffs
    • Vector-borne (Lyme, West Nile, Malaria)

    Disaster Worker Protection

    • Good personal hygiene
    Wash hands, hand sanitizers, double-glove
    • DEET containing insect repellants
    • Tetanus toxoid booster (every 10 yrs)
    • Hepatitis A/B vaccine
    • PPE use
    Goggles, Gloves, hand sanitizers
    N95 respirators, disposable single use, correct sizes, fit testing
    • Awareness training
    • Medical screening (post event) if confirmed exposure

    CERT Actions Upon Exposure to Blood or Body Fluids

    • Identify source patient to enable blood testing
    • If consent not obtained, public safety must be notified
    immediately to initiate legal action permitted under Virginia Code
    to obtain source patient’s blood for test
    • Incident Safety Officer completes Exposure Incident Report in
    compliance with CDC guidelines.
    • DO NOT DELAY treatment, go direct to nearest hospital
    emergency room
    • Record all pertinent information regarding specific exposure
    and bring with you to the emergency room.
     
  4. PaulBk

    PaulBk Member

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    Well worth the 24 hour time investment.

    -Paul
     
  5. TechAdmin

    TechAdmin Administrator Staff Member

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    Never even heard it before. Do most LEO organizations require it?
     
  6. digapony

    digapony Member

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    Are there any employment opportunities that may arise out of taking the course?
     
  7. ke4sky

    ke4sky ke4sky

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    CERT isn't a jobs program, it is volunteer service

    That isn't the intent of CERT. It is a volunteer program intended to enable citizens to help themselves and their neighbors during a disaster. The rational is that when SHTF people are going to help anyway. Communities may as well give them useful skills so that they can do so safely without getting killed in the process.

    Many post-disaster deaths are of well-intentioned citizens who try to help. But without proper equipment or training, and they may become victims themselves.

    CERT teaches basic urban search and rescue skills and safety awareness which supplements having plain common sense. We conduct the training in neighborhoods and with community groups, at work sites and in apartment and condominum complexes.
     
  8. oldjeeper

    oldjeeper New Member

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    Cert

    The 4x4 club (www.poineer4wheelers.org ) I belong to is in the process of creating an emergency team that has been asked to assist the regional emergency preparedness office with volunteer help and vehicles that are capable of moving in extreme conditions.

    At present we have 30 members who are signed up. We are studying to take our Technician level ham radio test on the 16th of November. We have vehicle ID (decals) and photo IDs for each member issued through the regional office.

    We hope to all get signed up for a CERT class before the end of the year. If we have team members and their spouses take the class, we should be able to add about 50 CERT trained people to the roster. I have looked through the class curriculum and am excited about what we can learn.

    The process of getting trained and prepared at first seemed to be a monumental task. But we are gradually getting ready. Ham radio capability, Cert training, vehicle readiness and personal readiness are our main focus. This forum will be a very valuable tool for us to use. There is a huge amount of knowledge here and this site will be a wonderful tool to use.

    Thanks,

    Tom Hiser
    Seward, Nebraska