Preparing Response Teams for Deployment

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Preparing Response Teams for Deployment

• A Presentation for the
• National Disaster Medical System Conference
• April, 2006
• By Jim Acosta, Deputy Team Leader
• Disaster Medical Assistance Team CA-11

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Greetings From SacramentoHome of DMAT
CA-11Andthe Governator
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Hes a Hell of a Guy,

• Unit Commander, 2004-2005
• Now Deputy Unit Commander
• 21 Years in Public Safety
• 1995 Police Officer of the Year

and He Does a Hell of a Job
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Whos Here?

• NDMS teams?
• Military?
• Red Cross?
• HHS/CDC/PHS?
• State/local?
• NGOs
• Everybody else?
• Welcome!

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Objectives Overview

• Why Disaster Response is Different from
  non-Disaster Responses
• Identify Important Elements of Individual
  Preparedness
• Various Approaches to Team Readiness

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Different, and Yet Similar
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Nature of Medical Disaster Response

• Ad-hoc Group
• Deploy to Another Location
• Stressful Conditions
• Need to Perform Well Together
• Accomplish Assigned Mission

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Phases of a Disaster Deployment
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Pre-Deployment

• Ongoing Team Training and Maintenance
• Deployment/Callout Plans and Mechanism
• Keep Your People Interested-Communicate!
• Challenge Your People

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Team Assembly

• One of the Most Difficult Phases
• Skills and Personalities
• Dont Waste the Down Time

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Team Movement

• Convoy Driving with/without Communications
• Use Distinctive Markings
• Pre-select Fallback Assembly Points
• Work Convoy Practice into Drills

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Staging

• A Necessary Evil
• Short-term
• Long-term
• Brief, Focused Training
• Frequent Briefings

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Field Assignment

• Buddy System
• Accountability
• Communications
• Re-supply

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Field Operations

• Old Missions, New Challenges

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Alternate Assignments
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Demobilization

• Complex Process
• Administrative
• Physical
• Mental

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Rotation of Personnel

• Lingering Disaster Strains Resources
• Individual Deployments risk
• Less Institutional Support
• Disaster Fatigue
• Less Employer Support

• Team Leadership Needs to Provide
  Additional Support to These Members

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Rehab

• Body, Mind, Soul
• Ongoing Process
• Post-Deployment
• CISM?

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Objective 1

• Explain Why Disaster Response is Different from
  Typical Pre-hospital Responses.

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Local Infrastructure Overwhelmed

• Collapse of Normal 911 Response System

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Mission is Unpredictable

• May Not Match Pre-Conceived Notions
• May Be Beyond Your Peoples Experience
• May Not Be Fulfilling Enough

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Length of Mission is Variable

• Longer or Shorter Than Expected
• Personal Issues May Intrude from Home

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Objective 2

• Identify Some Important Individual Preparedness
  Requirements.

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Personal Preparation, Training, Equipment

• No Substitute
• No Excuse
• Leadership
• Verify

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Specific Disaster-related Knowledge

• NIMS
• Command Structure-Team and Overhead
• Team Equipment-Tents, Litters, Cache
• How Victims Can Get Assistance

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Technical Competence

• Medical Specialty
• Logistical
• Response Equipment
• Communications

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Interpersonal Skills

• Conflict Resolution
• Self-Reliance
• Personal Initiative
• Customer Service

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Mental Flexibility

• Patience
• Mission Ownership
• Take Care of Each Other
• Know When to Seek Help

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Preconceptions

• Everyone Has Expectations of What They Will Be
  Doing at the Disaster Site
• Reality is Often Very Different
• Conflict Can Cause Problems

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Use PreconceptionsTo Your Advantage

• Group Discussion Prior to Travel
• Visualization
• Leadership Must Set The Example

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Objective 3

• Describe Various Approaches to Team Readiness.

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Team Agility

• The Quality of Moving Quickly With Nimbleness
• Maximize Critical Skills Across Many Members
• Encourage Cross Training and Expertise
• Be Invaluable.

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Personnel Readiness

• Personal Gear
• Position-Specific Competencies
• Austere Environment

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Challenge for Team Leadership

• Harness/Use Good Qualities/Efforts
• Control/Minimize Negative Behaviors/ Interactions
• Mid-level Supervision needs your Guidance to be
  Successful

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Positive/Negative Attributes

• Best Assessed in Advance
• Stress Reveals Underlying Quirks
• Address Individual Problems Before They Become a
  Management or Morale Problem
• In Extreme Cases, SEND THEM HOME

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Humor/Stress Reduction

• Members look to leaders to set the tone
• Blow off some steam!

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Addressing Monotony

• Versatile Game Items-Cards, Inflatable Ball
• Movies/Music for Off-Duty Personnel
• Shopping/ Procurement Trips

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Establish Routines

• Regular Briefings
• Shift/Duty Rotations
• Assign Chores
• Anything to Establish Patterns

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Team Equipment
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Confident Use of Equipment

• BoO Equipment-Tents, Showers, Latrines
• Medical Devices-Ventilator, O2 Manifold, Lifepaks
• Communications-Radios, Satellite Phone, Fax

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Equipment-related Problems

• Not Having the Right Equipment
• Not Knowing How to Use Equipment
• Not Having a Power Source
• Not Knowing How to Get What You Need

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Have Your Experts Make Job Aids

• Simple
• Essential Tasks
• Essential Info
• Not a Substitute for Training

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Fault Tree Analysis

• ID points of catastrophic failure
• Mitigate minor issues (PM, Spares)
• The 1.25 Tees
• Create Failure Drills

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Shuttle Challenger Fault Tree
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Aviation

• Safety-Working Around Aircraft, Winch Lines
• Landing Zones
• Communications with Flight Crews

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Audience Discussion
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A Parting Thought

• But who are ye, in rags and rotten shoes,
• You dirty-bearded, blocking up the way?
• We are the Pilgrims, master
• we shall go always a little further
• it may be beyond that last blue mountain
• barred with snow, Across that angry
• or that glimmering sea
• The Golden Journey to Samarkand, James Elroy
  Flecker