Thursday, October 23, 2014

Shadowing CERTs, Class 3: Disaster Medical Operations 1

[Previously, on Shadowing CERTs: The students of Fairfax County CERT Classes 85 and 86 have gotten an Introduction to CERT and instruction in Disaster Management. In their third week, things are about to get a lot more hands on...]

Starting this week, Fairfax County CERT students are expected to arrive wearing their full CERT gear, because class starts with a drill to test what they've learned to date about managing disasters.

When they get to the darkened High Bay, CERTs must quickly size up the scene, set up Command and Accountability functions, send out Logistics teams to gather materials, establish a Medical area, and begin Rescue operations, all by flashlight. (We'll have pictures of a High Bay drill in the Week 4 writeup.)

Throughout the process, instructors coach the students, reminding them to properly tag the building before entering and helping them conduct a top-down or bottom-up search.

In this drill, the victims are plywood "gingerbread" cutouts, as well as a few human instructors who arrive at Medical for treatment. (CERTs will learn patient lifts and classes in a later class.)

Instructor Rich Hall leads class on Disaster Medical Operations. All photos by Joe Loong

After a debrief, CERTs head back to the classroom for lectures and skill drills led by instructor Rich Hall, who leads off by teaching CERTs to identify themselves and ask patients for permission before beginning treatment (noting that consent is implied when dealing with unconscious victims).

CERT responders learn that their primary goal during rescue operations is to rapidly triage, tag, and treat life-threatening injuries, spending no more than 30 seconds per victim. They learn the triage categories of Red (Immediate), Yellow (Delayed), Green (Minor), and Black (Expectant/Dead). And they learn simple methods to evaluate victims, like the RPM test, which checks for Respiration, Perfusion (an indicator of effective circulation), and Mental Status.

Duct tape "desktops" that CERTs use to record the number, triage status, and location of victims.

Students also learn how to use their duct tape and Sharpie markers to make victim tags and a recording desktop that they'll later turn in to Command.

Rich demonstrates the head-tilt, chin-lift method to open an airway.

For CERT rescuers in the field, patient treatment consists of stopping the "three killers" by opening airways, stopping major bleeding (as well as a new addition this year, treating sucking chest wounds), and treating for shock.

They learn just what constitutes major bleeding (it doesn't take a lot of blood to make a big mess), and learn how do use different types of materials ranging from cravats and triangular bandages, to duct tape and torn sheets, to apply a proper (and tight) pressure dressing to stop major bleeding. And they get an introduction on the use of occlusive dressings to treat sucking chest wound, as well as tourniquets (CERTs can get further instruction in both techniques in a separate class offering.)

Class 86 CERTs practice assessing patients and treating them to stop the "three killers" by opening airways, stopping major bleeding, and treating for shock.
During the skill drills, CERTs get a chance to be both rescuers and victims. Drills begin with treatment; then triage and treatment; then triage, treatment, and tagging. Each drill reinforces and then builds on the skills they practiced in the previous drill.

The final hallway drill presents CERTs a large number of casualties, who they must rapidly triage, tag, and treat.

In the evening's final drill, students are faced with a number of victims, either in the High Bay or lined up in a hallway, and must quickly triage, tag, and treat victims, all under the watchful eye of instructors.

CERT rescuers work in teams; one person assesses the victim, and the other prepares the tag and records their information.

In subsequent weeks, the students of CERT Classes 85 and 86 will build on this knowledge, as the drills (and what they're expected to do in them) get more complex.

Joe Loong, volunteer Social Media Specialist for Fairfax County CERT, is an editorial content and community engagement consultant. You can email him at

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