Practice Makes Perfect…

May 14, 2007

With any type of emergency services, training for disasters and mass casualties is something that must be done on a regular basis. In the United States, it’s not often that you run into a situation where you have the potential for mass casualties, therefore it’s paramount that agencies constantly train together to ensure a swift and coordinated response when these situations do happen. The recent tornado in Greensburg, Kansas are a grim reminder of the necessity of this type of training. When I worked in Law Enforcement and EMS, we staged mock disaster drills often, using different scenarios each time we trained. These drills did not just include police and ambulance personnel, but instead required coordination of many agencies other agencies, such as fire departments, area hospitals, emergency management crews, American Red Cross, City and County utility crews, road crews, as well as local governments. This training made it much easier to be able to coordinate rescue efforts, respond instantaneously in the event of a disaster, communicate effectively with the various agencies and to be able to react calmly and efficiently, to ensure that the emergency situation was quickly under control. Without these coordinated efforts, a large scale disaster can quickly turn into a three ring circus, which is why it’s important to practice to ensure a more cohesive working unit when these situations do occur.

The situation is no different for the emergency responders in Iraq. They too must be able to be prepared for a situation to arise at any given moment, which might result in mass casualties. Recently the Iraqi Army, medical personnel and Soldiers from the US Army’s 25th Infantry Division held a Mass Casualty Training Exercise just outside the gates of FOB Warrior, near Kirkuk. In addition to providing urgent medical care to actors playing wounded patients on the ground, the responders had to deal with the real-world risks of operating outside the security of the base.

To ensure that their “patients” and the emergency responders were safe, Iraqi and US Military trucks formed a secure perimeter around the site, as Iraqi medical personnel rushed to the wounded who were scattered about, to evaluate or triage their injuries. In this situation, the “wounded” wore moulage or rubber wounds and makeup to simulate injuries and bleeding.

In mass casualty situations, emergency workers are trained to quickly and efficiently evaluate a person’s injuries, to determine which category they should be placed. The deceased, gravely injured and likely to expire, severely injured and in need of immediate care, moderately injured and the minor injured. Triage must be done quickly, serious injuries treated to sustain life and the seriously wounded immediately transported for further medical care. Communication and coordination amoung various agencies is an absolute necessity.

“Coordinating and communicating with all of the elements involved added to the complexity of the exercise,” said 1st Lt. Ranston Harvey, the training exercise coordinator.

“When the alert (of the incident) was made, we had to simultaneously notify FOB Warrior, K-1, the hospital and the supporting services. Everyone had to work together and maintain communication to keep up with what was happening so they could react and coordinate their response.”

Previous Mass Casualty Exercises have been conducted in the past, with the determination made that additional training was needed. If emergency workers aren’t able to respond appropriately in training exercises such as this, then they’re likely not going to respond appropriately in event of the real thing. Working together with other agencies in a team effort is necessary, in order to ensure that response in a real emergency situation, goes smoothly. After this particular training exercise, it was felt that it was demonstrated that their medics and the Iraqi army were ready to react to the real thing.

“We looked at past MASCALs and the (K-1 medical) clinic staff was doing too many jobs,” Harvey said. “So we contacted the K-1 firefighters and security forces to help.”

“Everyone got there quickly, picked up the casualties and got them to where they needed to be treated,” said Sgt. Mohammed Abbas, one of the first responders and a first aid instructor at K-1. “Everyone responded very well.”

Training likely won’t stop though, just because everyone responded well during this exercise. The more that situations like this are planned for and practiced, the better the response is when the skills actually have to be put to use. As the old adage goes, “Practice Makes Perfect.”



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