EMS and Civil Unrest - Code 3 Conferencecode3conference.com/.../EMS-and-Civil-Unrest.pdf · ∗Low...
Transcript of EMS and Civil Unrest - Code 3 Conferencecode3conference.com/.../EMS-and-Civil-Unrest.pdf · ∗Low...
EMS and Civil Unrest Shannon Watson, CCEMT-P Community Health Supervisor Christian Hospital EMS
Nathan Woltman, MD EMS Fellow Washington University
∗ Describe the preparation needed for civil unrest
∗ Recognize the changes to practice with civil unrest
∗ Acknowledge the focus on provider safety
∗ Understand the emotional wellbeing of your providers
Objectives
∗ Paramedic 10 years
∗ Onslow Co EMS, CHEMS, MIH
Background
∗ August 9th 2014 ∗ 21 days of civil unrest
∗ November 2014 - Grand jury decision ∗ 7 days of civil unrest
∗ 1 year anniversary ∗ 7 days of civil unrest
CHEMS & Civil Unrest
∗ 250 EMS calls dispatched to the hot zone ∗ Trauma, sick cases, maternity
∗ Resources Used ∗ Medications, trauma dressings, vehicles
∗ Staff ∗ 2500 additional hours overtime
CHEMS Total Civil Unrest
∗ Nathan Woltman, MD ∗ EMS Fellow, Washington University in St Louis ∗ Instructor of Emergency Medicine, Johns Hopkins School
of Medicine ∗ Deputy Medical Director, USDOJ (USMS, BATF) ∗ Deputy Medical Director, USDHS (USSS, ICE)
Background
∗ Fire/Medic Fort Collins, CO; Great Falls, MT ∗ Post Certified 2003 ∗ Rocky Mountain Rescue Group ∗ Emergency Physician ∗ Physician-US Army Medical Corps ∗ Law Enforcement Medicine Fellowship ∗ Emergency Medical Services Fellow
Background
City of Baltimore
∗ Largest independent city
in the United States, founded 1729
∗ 622,000 people ∗ 2.7 million person
metropolitan area
Baltimore and Civil Unrest
∗ April 12 2015 ∗ Freddy Gray arrest
∗ April 19 2015 ∗ Freddy Gray dies in
hospital ∗ April 27 2015 ∗ Protests spread across
the city
Baltimore Unrest
Baltimore
∗ Baltimore police command center ∗ Middle of downtown
Baltimore at a confluence of the interstate and several major roads
∗ Homeland Security and
MSP command ∗ Camden yards parking
lots
∗ Why is it important? ∗ Communication on all levels
∗ Challenges we encountered ∗ No communication – fear of unknown ∗ Lack of intel ∗ Reactive
Unified Command
Baltimore
∗ Two methods of EMS response ∗ Baltimore city Fire/EMS
∗ Priority calls in Baltimore city ∗ Calls in hot zone
∗ Tactical Medics ∗ Maryland State Police ∗ Johns Hopkins Center for Law
Enforcement Medicine & USDOJ
Baltimore-Tactical Medics
∗ MSP trains state troopers to work full time as paramedics on helicopter
∗ Federal agencies train federal agents to work part time as medics, mostly for special teams
∗ Physicians trained in tactical medicine attached to federal teams
∗ Tactical medics responded in medically equipped black low profile SUVs rather than ambulances ∗ Could be confused with low
profile law enforcement vehicles
∗ Very little protection for driver/occupants
Baltimore Riots
∗ Riots covered a geographical area comparable to downtown St Louis to Forrest Park
∗ Riots initially isolated to
pockets but then spread across the city, passing through commercial center and a major medical campus
Baltimore - Challenges
∗ Large geographic area ∗ Low situational
awareness ∗ Radio chaos
∗ Vulnerable medic units ∗ Blocked thoroughfares ∗ 600,000 Baltimore
residents needing care
∗ Bystanders effected ∗ Inability to obtain
medications from pharmacies ∗ Diabetics ∗ Coumadin
∗ Breakdown in social services ∗ Shelters, Mental Health,
Dialysis
Changes to Practice
Baltimore Fergusson
∗ Casualty collection
∗ Location of command
∗ Resources
∗ Crew Communications
∗ Initial EMS responses with police escort
∗ PD & EMS restricted to life threats in riot area
∗ Many calls pending for >30 minutes
∗ Physical safety / Fatigue / Mental Health
∗ Hospital Staff Safety
∗ Short scene times
∗ Discontinued services
∗ Two people per vehicle
Crew Safety
∗ EAP &CISM ∗ Mandating vs. Offering
∗ PTSD ∗ Common
∗ Overworking ∗ Crews felt obligated to support their community & coworkers
Fatigue & Mental Health
∗ Have strong relationships with local agencies
∗ Don’t be too proud
∗ Identify additional resources early
Asking for Help
∗ Disaster planning
∗ Treating everyone
∗ Communication with crews
∗ Social Media
∗ Mandating ∗ CISM ∗ EAP ∗ Safety Gear
∗ Sustainability with response
∗ Rebuilding relationships
Lessons Learned