Thursday, November 7, 2013

New CERTs Respond to Simulated Hurricane in Graduation Exercise

    On November 2, Hurricane Victoria, a Category 3 storm, slams into Virginia, lashing the area with 80+mph winds and adding a foot of rain to already-saturated ground. First responders are swamped with calls to deal with widespread flooding in low-lying areas of northern Virginia and DC. In this large-scale disaster, Fairfax County CERTs are called to help a hard-hit gated community in Lorton. Assigned to assess the situation and assist the population of retirees and their visiting families, they are equipped only with the training and supplies they bring.
This was the scenario faced by over 40 students from classes 73 and 74 of Fairfax County's Community Emergency Response Team (CERT) program, in a final graduation exercise that put their prior seven weeks of classroom and hands-on training to the test.

The goal of the exercise: Use a realistic, high-pressure environment to test CERTs' ability to perform their mission: Do the greatest good for the greatest number of people during a disaster... while keeping themselves safe.

Put to the Test

The CERT students, comprising Fairfax County residents of all ages, occupations, and capabilities, were challenged to respond to a full-scale, simulated disaster scene at the Fairfax County Fire & Rescue Department's training site in Lorton.

Lorton Training Site photo from April, 2013.
Located at the former Lorton Reformatory Juvenile Correctional Facility, the site is a realistic training environment used by professional first responders, including the international urban search and rescue team Virginia Task Force 1.

CERT rescuers assist a victim actor inside one of the Lorton facility buildings.
Placed in and around the wrecked buildings were over 50 volunteer victim actors, wearing moulage -- realistic wound makeup applied earlier that morning -- and given specific symptoms and behaviors with which to test their CERT rescuers' knowledge and training.

Victim actor volunteers sporting moulage (simulated wound makeup) depicting an impalement, embedded glass, and amputated fingers.

CERTs Take Command

From the moment they deployed to the site, CERT students were evaluated on their ability to establish a command structure, survey the scene, search for and triage victims, give lifesaving medical assistance, extricate and transport victims to a medical area for care, and finally, transfer command to Fairfax County Fire & Rescue Department responders.

The first task for the CERT responders was to establish a Command Post in a safe area near the scene. From there, CERTs began to apply the concepts of the Incident Command System (ICS) -- a flexible, scalable, standardized approach for first responders managing incidents of all types and sizes.
CERTs issue orders and manage teams from the Command Post.
In CERT's implementation of ICS, the response effort is led by a single Incident Commander (IC), who is assisted by an Accountability lead who tracks the status of rescuers, resources, and victims -- in this case, using a big piece of cardboard and a black magic marker.

The command structure is centralized, with information flowing to and orders coming from one point, so the Incident Commander can effectively manage the situation, address changing priorities, and prevent the duplication of effort.

Supporting the IC are heads of departments, responsible for Medical and Logistics tasks, as well as the CERTs on the search and rescue teams.

Rescuers in Action

CERT rescuers are trained to perform an initial "size up" of the area, to ensure that it's safe enough to begin rescue operations. Then, CERTs "work the problem" and rapidly search the disaster scene, which may reveal large numbers of victims. To prevent being overwhelmed in a mass casualty situation, each CERT rescuer is trained to assess and triage (categorize) each victim within 30 seconds.

Within those 30 seconds, CERTs will treat major bleeding, and use simple tests to check victims for respiration, perfusion (the flow of blood to extremities), and mental status. 

A CERT rescuer assesses a victim actor with a simulated hand amputation.
CERTs will then tag each victim according to the severity of their injuries: Green (walking wounded), Yellow (Delayed treatment), Red (Immediate treatment), and Black (dead or expectant).

While the checklists are straightforward in the classroom, the processes are complicated in the field by stress and the realistic responses of the victim actors:

After the scene is surveyed, rescue teams report back to Command, which sets priorities and begins sending teams to transport the most serious (Red) patients to Medical for treatment.

CERTs use a flexible stretcher to transport a victim.
CERTs are trained to load and transport victims safely, using a variety of methods, including walking assists, two-person carries, and improvised stretchers.

A CERT rescue team carries a victim actor wrapped in a space blanket.

Treating the Wounded

When the victims arrive at Medical, they are checked in by the Medical team, and directed to the area that corresponds to their triage color code. Patients are given a head-to-toe assessment; dressings and splints are checked; and patients are re-assessed every five minutes.

CERTs in the Medical area work to stabilize a patient.
Using medical supplies that are brought, collected, and improvised by the Logistics team, the goal of CERTs in Medical is to keep patients stable and under care until professional first responders arrive.

Transferring Command

The role of CERT is to provide assistance to victims until professional first responders arrive. In this exercise, EMTs from Fairfax County's Fair Oaks Volunteer Fire & Rescue Department arrived to take command of the disaster response.
CERTs coordinate with EMTs from Fairfax County Fire & Rescue.
During the transfer of command, CERTs briefed responders about the incident, actions taken, and remaining actions. CERTs also gave a tally of the number and types of patients being treated, allowing the EMTs to focus on the care and transport of the highest-priority patients.

Prepared for Disaster

Upon completion of the exercise, the CERTs from classes 73 and 74 met with instructors to receive a debrief and get an assessment of their performance. CERTs were able to see where they performed well, and to find areas where they can improve their skills and tactics. All of the new CERT graduates received a certificate of accomplishment, and were encouraged to continue learning, training, and staying engaged with the Fairfax County CERT program.

CERT training classes are free to residents of Fairfax County over 18. Classes are offered several times each year at the Fairfax County Fire & Rescue Academy, as well as other locations throughout the community. For more information about CERT training, visit the official Fairfax County CERT web site.

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Tomorrow: CERTs in Charge - observations and lessons from some CERTs who participated.

See more photos from the exercise in the album on Facebook and follow the activities of Fairfax County CERT by liking the Fairfax County CERT Facebook page.

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