Friday, September 26, 2008

WAOB

I've been asked by a few people to put on the blog a series of e-mails I wrote to friends.These e-mails were written to people in emergency services to make us laugh at ourselves.They are not meant to be critical of anyone or any goup.If they offend you I hate it because they were not meant to.
I started these at the Arkansas Emergency Management Conference,where my phone was "stolen" and there was quite an adventure in getting a new one. I was frantic to have a phone because hurricane Gustav was coming ashore and we were preparing to shelter evacuees.I called the first one The "Wonderful Adventure of Budd " out of this "WAOB" was born.These were written going down the road or sitting in an ambulance so spelling is not good and grammar sure isn't.Enough of this, here goes:
WAOB : part 3 (I think)
When we last saw Budd he was on his way to confront hurricane Ike,lets rejoin him 8 days into this wonderful adventure:> Budd is now stationed in Lafayette La.at the Hilton Convention center.Here Budd has developed a new form of EMS called lobby EMS.This strenous bbut rewarding field of EMS consist of sitting in the lobby of the Hilton, watching for anything that might require EMS and being prepared to dial 911.Many unscroupulous EMSers would charge Hilton for this,Budd doesn't,Hilton refused to pay.> Along with lobby EMS Budd has also established forward operating base hilton(here after reffered to as FOBH)command.Command is a heavy burden but Budd is willing to bear the load as long as some one else does the work.One of the many problems Budd has faced in fobh is that electric line workers and relief personell try to take his chair.This has neccessiated a change to NIMS there is now in any command structure a position known as chair watcher.This comes from Budds'most often given command "somebody watch my chair"> Budd is extremely proud to note that La hos adopted the Budd method of incident command, that is make sure that no one knows what is going on and create total confusion.Budd has spent years developing this style of command and is sure someday he will be famous for it.A few people might not be familar with this style so lets illustrate.First you take a totaly independant organization named LEMUA that is taffed by Drs and Nurses from acroos the state,that has raised its own funds so that they can be free from gov't red tape,and has thier own field ER put them in a small town that is flooded after a hurricane , where they are happy giving tetnasus shots and treating things like poison oak,snake and spider bites and anything alse that comes along and doing a heck of qa job at it.Now that you have this pictured in your mind the Budd model says send 16 ambulances and crews to HELP THEM.Do not send just any crews send crews that have been in a disaster area and> not allowed to do patient care for 3 days.The best test of the Budd to see if it is working properly is to closely observe the doctors face when you report that you have 16 ambulances and crews there to HELP THEM.If his face shows any 2 of the following signs you have suceeded:fear,anger,fear,disbelief,fear,shock,fear,outrage,fear,rage,fear,or if the doctor begins to exhibit symptomns of the big one you have succeeded.A few people may be strong enough to merely get tight lipped and say "thank you,you can triage"watch this person they are in denial.You must compensate for this by triageing everything as critical.> The next step in the Budd model states move all of your resources away from where you need them.Many people might question this but there is an obvious answer,this way you can call in more rescouces to supply them.However don't fall for the first timers mistake of placing these rescources where they are easy to find.Fuel supply dumps must be placed a minimun of 12 milesaway from the roads,we have found that 12 miles is the optimum figure because any less and it would be too easy any more and the ambulance crews tend to stop at the filling stations they are passing.> > One other benefit of moving your rescources to where they are not needed is transport times, For example if you have patients in arkansas that need to be returned to La,have all of your ambulances come to south La so that they can recieve the assignment to go to Arkansas to get the patient to bring them to La.> One other change to NIMS has been made the common definition of strike team is no longer to be usedif the rescources come from different states they immediately become a task force.> Also always remember that at least one person in every crew should not want to be where they are.> Next edition we will look at how to foster fear and cooperation with other agencies.> until next time always remember park your command center acroos the RR tracks,that is the highest place in town.> > > >

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