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Thu, 7 Feb 2002 11:42:52 -0500

I'll second that notion.            Ed Ramstrom - Paramedic
                                                UMMEMS

-----Original Message-----
From: Jon Hoerner [mailto:jkh4+@pitt.edu]
Sent: Wednesday, February 06, 2002 10:19 PM
To: trauma-list@trauma.org
Subject: Re: Disaster List?

I've seen information about programs on disaster operations.  However, I'm
wondering if the focus of this training is not where it should be.   From
what I've read/heard, the most successful disaster operations are when
people do what they normally do, eg firefighters fight fires and provide
rescue, paramedic provide medical care at the scene, nurses take care of
patients in hospital/definite treatment area, custodians clean up the mess.
It's just that in a disaster situation, you are expected to do more with
less.

I think any disaster training should concentrate on the leadership skills of
the leaders as well as resource allocation.   Without leaders with these
skills, any disaster situation is destined for failure.  If the leaders have
strong organization/leadership skills, it will carry over and help people do
their jobs more effectively.  Also, having a huge disaster in a 2nd tier
city is going to stretch resources to the absolute maximum.  Increasing the
amount of resouces is most often not cost effective and extremely
improbable.

So, in conclusion, I think EMS field supervisors (not desk people) as well
as ER attending physcians, and high level hospital adminstrators need more
training on how to do more with less. Disaster training for regular personel
or community members I think is more psychological reassurance than
cost-effective disaster preparation.

Any comments?

Jon Hoerner, NREMT-P
Pittsburgh, PA

----- Original Message ----- 
From: DocRickFry@aol.com <mailto:DocRickFry@aol.com>  
To: trauma-list@trauma.org <mailto:trauma-list@trauma.org>  
Sent: Wednesday, February 06, 2002 8:19 PM
Subject: Re: Disaster List?

In a message dated 2/6/2002 7:38:29 PM Eastern Standard Time, pbjorn@emh.org
<mailto:pbjorn@emh.org>  writes:

In summary...and after running my mouth enough for the day...AGREED!

--Thanks.  Appears I wasn't alone after all.  Maybe a bunch of us should get
together and shake things up.  Where does one go to introduce a new
paradigm?

The answer to this is--YOUR OWN HOSPITAL  It won't do you any good to try
anywhere else.  Challenge those in charge of your disaster planning to show
any literature or data indicating a benefit to their way.  There is much
literature out there--my guess is "they" won't know a bit of it.  Then, with
as much diplomacy as possible, keep at them with your logic--keep
challenging their answers and concepts to make it clear they are just making
it up as they go.  Like politics, all disaster management is local--it is
only the local community facilities that will face these disasters--the
state and federal gov't, the agencies and all the bureaucratic wonks will
not be there when IT hits the fan.  Your planning must be done there.  When
a disaster happens--somewhere else or there--make sure you look at the
results and then apply it to your situation.  Look at the results from the
Japanese cult Saran attack in the Tokyo subway, and show your wonks how an
entire hospital was co ERF 

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