Contra Costa County CERT Program CERT Review

Contra Costa County CERT Program CERT Review

Released: 10 September 2012Released: 10 September 2012

Continuing Education Series

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Community Emergency Response Team

Personal safety is ALWAYS the number one priority Work as a team Wear personal protective equipment…gloves, helmet,

goggles, mask and boots

The CERT goal is to do the

Greatest Good for the Greatest Number

Hope for the best but plan for the worst

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Levels of CERT membership

There are three levels of training in Lamorinda CERT. Level I is a Basic Training level. Level I members

are trained to respond for their families and neighborhoods.

Level II includes Red Cross training. Level II members are available for deployment throughout the local area.

Level III is for medically trained members. This level is available for deployment through Mutual Aid throughout the state.

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CERT Functions During Disasters

First, check on family and home

Then, check on friends and neighbors

Next, assemble in teams and plan your response

Use the buddy system

Check on your neighborhood


CERT Functions During Disasters

CERT Teams should: Conduct light search and rescue Treat injuries Help to relieve survivor stress Extinguishing small fires Locate and turn off utilities, if

necessary and safe Assist first responders as

requested (fire, police, EMS)

Unit Contents

Preparedness Supplies Pets in Disasters FRS Radio ICS & CERT Mobilization Light Search and Rescue Protocols Fire Safety / Utilities Killers, Triage, RPM and Assessment Hypothermia, Hyperthermia Continuing Education Opportunities Drills

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Preparedness Supplies


What Should I Have Under My Bed?


What Supplies And Tools Should I Have On Hand? Look At List


Supply Locations

At home – Food and Water for 14 days and a full supply kit

At work – Food and Water for 3 days, personal protection equipment

In your car – Food and Water for 3 days, small supply kit with PPE

Most people spend 1/3 of their time at work or school, 1/2 of their time at home and the other 4 hours in their car or elsewhere. You need supplies where you are because a disaster can happen at any time.


Food and Water

Choose foods that: You will enjoy Require little cooking or water for prep Require no refrigeration Do not increase thirst (i.e. low salt) Meet the needs of infants, diabetics or others with

special needs

Remember food for your pets, utensils and a manual can opener!


Food and Water

Inspect your food cache every 3 months Use a marking pen to write your food’s expiration date Store in a cool, dark, dry place Store food in airtight or tightly sealed plastic or metal

containers Have some way to cook your food


Food and Water

A person can survive weeks without food but only a few days without water

I’m having a small water crisis here!


Water

Minimum one gallon per person or pet per day for up to 14 days for consumption

Use food grade plastic containers, do not use used milk containers

Observe the expiration date for store-bought water

Replace other stored water every six months

Store in a cool and dark place

Use marking pen to mark expiration date

Be prepared to disinfect additional water


Bug Out Bag

In the military the phrase “bug out” means grab your gear and go – NOW!

Bug Out Bags, also called Go Bags are duffel bags or backpacks that are packed with everything you need to live for a few days.

CERT backpacks are not Bug Out Bags.

CERT backpacks have what you need to search, triage, supply medical help, etc.

BOBs have what you need to survive; food, water, clothes, shelter, warmth, safety, etc.


Disaster Preparedness for Pets


Why Pets Matter

Why Pets Matter 63% of All US Households Own Pets Before Katrina, 25% of Pet Owners Failed

To Evacuate (During Mandatory Evacuation)

Before Katrina, 40% of Pet Owners Left Pets Behind (During Mandatory Evacuation)

Before Katrina, 70% of Those Pet Owners Attempted To Return To Rescue Their Animals

After Katrina, 61% of Pet Owners State They Will Not Evacuate Without Their Pets

Pets Matter, Because People Matter...


Pets in Disasters

"During Hurricane Katrina, tens of thousands of animals became homeless or perished. Many pet owners stayed with their pets and perished," Rep. Chris Shays, 2006

The Pets Evacuation and Transportation Standards (PETS) Act – introduced by Rep. Tom Lantos (D-Calif.) and Rep. Chris Shays (R-Conn.) – requires the inclusion of companion animals in disaster planning at the state and local levels.

It was signed into law by President Bush on October 8, 2006


Identify Pet Evacuation Locations

Safe Distance From Home Coordinate with Neighbors Define Tasks Identify Pet Friendly Hotels Identify Boarding Kennels and

Ranches


Evacuation

Evacuate With Your Animals PETS Act: Mandatory Evacuation of Pets with

Human Animals If You Are Not Home:

You may not be home when the evacuation order comes; find out if a trusted neighbor would be willing to take your pets and meet you at a prearranged location.


Secure Your Animals

Your Home May Be Compromised: Create Controlled Environment Have Kennels / Evac-Sacs in a

Safe Place Assign Retrieval Tasks to Family

Members Have Buddy System

• Exchange Keys / Plans With Neighbor / Pet Sitter

Provide Pet Sitter with authorization letter Identify Outdoors Holding Area Obtain Materials to Create Holding Area Identify & Remove Hazards


Keep Your Animals Alive

Store Animal Food (2 weeks) Airtight, Waterproof Containers In Secure Area

Store Extra Water (2 week supply) Not in Direct Sunlight Water That Is Unfit for Human Animals

Is Unfit for ALL Animals Food and Water Bowls Paper Towels, Dish Soap, Disinfectant


Keep Your Animals Healthy

Pet First Aid Kit Medications Ask Vet About His/Her Disaster Plan Blankets Toys and Treats Plastic Poop Bags or Cat Litter and Litter

Trays


Disaster Communications


FRS – Family Radio Service

FRS / GMRS Radios Very low power, 1/2 watt ERP

Very low cost No license required Personal and business use OK Shares FRS channels 1-7 with GMRS Channels 8-14 are FRS only; 14 total for FRS Channels 15-22 are GMRS only (ok to listen) No external antennas allowed Typical 0.5 - 1 mile communication range


SELECTING FRS RADIOSFRS / GMRS with 22 channels

Uses AA alkaline batteries. Not AAA, and not rechargeable batteries unless they can also use AA.

Ignore “mileage” claims. Battery life is more important than transmit power.

Recommended Models

MFG MODEL APPROX. PRICE ($)Motorola EM-1000 R $54.00 PairMidland GXT- 760 VP4 $60.00 Pair

Midland FRS/GMRS Motorola FRS/GMRS


FRS Range

FRS Range limits

“line of sight”


Using the radio

Select a channel – your team leader will tell which to use

Test the radio before you venture out Make sure you can communicate with your team It is not a cell-phone – To talk; hold radio 2”- 3” from mouth, press the

button To listen; let go of the button


Communicating

Listen!

Speak clearly, calmly, carefully

Get the message across without a lot of words

Practice frequently!


Radio Protocols - I

Talking Calling another:

Use agreed-upon identifiers

– “Team 3 this is Team Leader. Over” Wait for response, which should be:

– “Team leader this is Team 3. Over”

– Or just

– “Team 3. Over” Speak in a normal tone of voice, and speak clearly!


Radio Protocols - II

You have made contact: exchange questions and answers in brief, clear language understandable to all who may listen NO “10” codes or “11” codes! NO CB jargon! NO slang or ethnic / gender slurs

Confirm data You are conveying important information to

people you may neither know nor have worked with in the past


Radio Protocols - III

Sample exchange “Team A this is Team Leader”

“Team A – over” “What is your location? – over”

“Corner of Moraga Way and Moraga Road – over” “Check Safeway for damage and injuries – over”

“Will check Safeway for damage and injuries.” “Team A out”


CERT and ICS

CERTTeam Leader

Operations Section

LogisticsSection

PlanningSection

AdministrationSection

Basic CERT ICS


Purpose of On-Scene Management

Maintain physical safety of disaster workers Maintain mental well being of disaster workers Provide clear leadership and organizational structure Improve effectiveness of rescue efforts


Objectives of CERT Organization

Identifies the scope of the incident

• What is the problem?

Determines an overall strategy• What can CERT do, and will

they do it?

Deploys resources• Who is going to do what?

Documents actions and results• If you didn’t write it down,

it didn’t happen


Command and Control

Incident Commander… “What to do” CERT team leader

Operations… “How to do it” Manage the teams in the field

Logistics… “How to support it” Manage resources, supplies and equipment

Planning / Intelligence… “What’s going on” Make incident plans,Collect and display information

Administration… “What gets recorded” Collect and compile documentation


Lamorinda CERT Call-Out Policy

CERT members will not self-deploy to an incident. In the event of an earthquake with a magnitude 6.0 or higher all CERT graduates are authorized to deploy in their neighborhoods. They should check in with their neighborhood block captains.

CERT members will wait to be contacted by their local EOC or the CERT Incident Management Team. Under no circumstance will they initiate contact with the EOC, their local Police Department or their Fire Prevention District as CERT Members.

The EOC and the CERT Incident Management Team may use the phone or runners to contact CERTs. Any communication will include the name and position of the official who has approved the communication.

Following an incident CERTs who have a HAM radio license will monitor their local simplex channels. See the web site of the Lamorinda Community Emergency Communications Team (http://www.k6ori.com/) for details.

At the discretion of the EOC or the CERT Incident Management Team a controlled net may be formed for communications with CERT members. The Net Controller will in that case be someone working at the EOC or assigned that role by the CERT Incident Management Team.

CERT HAM operators may be used by the Net Controller to relay messages to individual named CERTs.


CERT Mobilization

CERTS: Take care of themselves, their family, their home and their

neighbors Respond according to your CERT Call-Out Policy,

gathering facts along the way First to arrive is in charge of incident and is CERT Leader

until transfer to another person CERT organization should have effective communications,

a manageable span of control and maintain accountability

The greatest good for the greatest number without placing CERT

members in harms way


CERT Mobilization

CERT IC will develop an organization plan Priorities may change as operation continues;

CERT IC needs to stay on top of these shifting priorities

Communications must be organized, efficient and effective

ICS was developed to assist in the management of major incidents - Use it

Philosophy is always to do the most good for the greatest number of people while maintaining CERT safety


Documentation Responsibilities

CERT Teams provide the Command Staff with ongoing information and documentation on: Damage assessment Team status Ongoing needs

Command Staff documents: Incident status

• Incident locations, Access routes, Identified hazards

• Support locations: Staging Area, Treatment/Triage Areas, Morgue


Light Search and Rescue


Search and Rescue Operations

1. Size-up

Evaluate everything that is going on

2. Search

Locate victims

Document location

3. Rescue

Involve procedures and methods to extricate victims


CERT Size-up

1. Gather Facts

2. Assess Damage

3. Consider Probabilities

4. Assess Your Situation

5. Establish Priorities

6. Make Decisions

7. Develop Plan of Action

8. Take Action

9. Evaluate Progress


Step 1: Gather Facts

Consider the: Time of event and day of week Type of structure and construction type Weather Hazards

Gather facts accurately


Step 2: Assess Damage

360 degree (overview and assessment) Identify entry and egress routes Identify hazards Is it safe to enter ? Potential for occupants

Interview neighbors Voice calls


Step 3: Consider Probabilities

How stable is the situation?

What else could go wrong?

What it all means for the Search and Rescue?

Consider what probably will happen

and what could happen


Step 4: Assess Your Situation

Assess : Whether the situation is safe enough continue The risks that rescuers will face if they continue What resource you will need to conduct the operation

safely What resources are available

Personnel Equipment Tools


Know Your Limitations


Decision To Attempt Rescue

Risk involved to the rescuer

Greatest good for greatest number of people


Safety Considerations

Make rescuer safety your primary concern Use a buddy system Be alert for hazards Use safety equipment Rotate teams

Teamwork = Success


Take Action

Start the Search Mark building before entry Identify alternate exits Stay together & along the walls Start search from top down Right or left handed pattern Continue to call out and listen Move slowly testing the floor Mark each individual unit Complete “X” after leaving


Search Marking System

Draw line on entry

Draw line on exit


Victim Marking System

Make a large “V” (2’ x 2’) with marker or Orange Paint near the known or potential victim. Add team ID and arrow with distance to the victim.



Make a circle around the “V” when a potential victim has been confirmed to be alive. If more than one confirmed live victim, mark total number under the “V”.



Make a horizonal line through the “V” when a potential victim has been confirmed to be dead. If a combination of live and deceased victims are found, make two “V”s.



When all victims have been removed, make an “X” over the symbol.


Building Marking System

Buildings are marked by Structural Engineers only!

CERT OK

NO CERT

NO CERT


Search Methodology

An effective search methodology:

Is systematic and thorough Avoids unnecessary duplication

of effort Provides for documentation of

search results


Search Methods

1. Call out to victims

2. Stop frequently to listen

3. Use systematic search pattern

4. Mark searched areas to document what you found

5. Report what you found


While Searching

Always know the closest way out Search under & around debris Check elevators

Always be alert for aftershocks, Always be alert for aftershocks,

fires, and the smell of gasfires, and the smell of gas


Conducting Rescue Operations

Maintain rescuer safety Create a safe rescue environment

Move debris and objects out of the way Use tools not your backs to move objects

Triage and stabilize victims in lightly and moderately damaged buildings

If necessary, evacuate victims quickly but safely


Extrication Method

Depends upon: General stability of immediate environment Number of rescuers available Tools and equipment available Strength and ability of rescuers Condition of victim


Removing Victims

Types of victim removal include: Self-removal or assist Lifts and drags

Allow victims to extricate themselves

when possible


Fire Safety / Utility Control


Basic Fire Chemistry

Fire safety, at its most basic, is based upon the principle of keeping fuel sources and ignition sources separate


The Fire Triangle

Three things must be present at the same time to produce fire:

1. Enough Oxygen to sustain combustion

2. Enough Heat to reach ignition temperature

3. Some Fuel or combustible material

Together, they produce the chemical reaction that is fire.

Take away any of these things and the fire will be extinguished.


CERT Fire Safety

Before you fight the fire, answer these questions: Can my buddy and I fight the fire safely? Do we have the right equipment? Are there other hazards? Is the building structurally damaged? Can we escape?


How to Use A Fire Extinguisher

PPull

AAim

SSqueeze

SSweep



PPASSASS Pull the safety pin This will allow you to discharge the extinguisher



PPAASSSS AAim at the base of the fire



PAPASSSS SSqueeze the top handle This depresses a button that releases the

pressurized extinguishing agent



PASPASSS SSweep from side-to-side until the fire is

completely out



Before attacking fires, have pins pulled on extinguishers Test the extinguisher before approaching any fire to

make sure it works Size-up fire before attacking it. Be upwind! Commands for fire attack: Ready - ready; Going in - going in; Backing out - backing out



Start using the extinguisher from a safe distance away, about 8 feet and then slowly move forward

Keep about 6 feet between you and the fire



Once the fire is out, keep an eye on the area in case it re-ignites

Don’t turn your back on the fire


Hazardous Materials

Can be corrosive, explosive and deadly!


Hazardous Materials

If you see this building placard, Stop!! Do not enter, take information and report it!


Hazardous Materials

Example of a vehicle placard


Hazardous Materials

Be upwind and uphill from spills and smoke Use “Rule of Thumb”


Utilities

Locate and label gas, electricity and water shutoffs


Utilities

Keep a gas shutoff wrench or crescent wrench near, but not on the gas shut-off valve

or 12” minimum


Utilities

Turn off gas if: you smell it, hear it leaking, there is major damage and the meter wheels are spinning

DON’T turn it back on

Call PG&E after the incident

DON’T attempt to extinguish fire on or near the meter

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Utilities

Treat all wires as live electrical lines.


Medical


Medical

The goal of CERT medical training is to be able to assess and treat victims of a Mass Casualty Incident where the number of victims overwhelms the number of responders and where advanced medical help is not immediately available.

The goal of standard first aid training is to treat a single victim and then, if necessary, hand them off to an advanced medical care provider.


Life-Threatening Conditions

The “Killers”: Airway obstruction

Excessive bleeding

Shock

Life-threatening conditions must receive

immediate treatment!


Shock

Result of ineffective circulation of blood Remaining in shock will lead to death of:

CellsTissuesEntire organs


Shock - Signs

Weak, restless or irritable

Rapid and weak pulse

Rapid shallow breathing

Pale, cool, moist skin

Blue lips or fingernails

Nausea and vomiting

Dizzy, drowsy or unconscious

Very low blood pressure

Treat anyone unconscious for SHOCK


Shock - Treatment

Control major bleeding

Place in Recovery Position

Maintain body temperature

Loosen restrictive clothing

Recovery Position


Triage

During triage, victims are evaluated and prioritized according to the urgency of treatment needed

Spending a lot of time trying to save one life may prevent a number of other patients from receiving the treatment they need

TRIAGE – French term meaning “to sort ”


Triage Operations

Size Up … What’s happening? Check the scene Stop, look, listen and think

Assess your situation … What could happen? Conduct voice triage

Develop a plan of action … What will we do? Start where you stand Follow a systematic route Evaluate each victim and tag them Transfer “Immediates” to medical group immediately!

Document Triage results

“Immediates”…airway, bleeding, recovery position

Help, Document and Report


S.T.A.R.T. Categories

MINORMINOR IMMEDIATEIMMEDIATE DELAYEDDELAYED DECEASEDDECEASED


“ “ MINOR ”MINOR ”

Walking wounded

Do not require immediate care

“Screamers” Use as helpers to care for others


“ “ IMMEDIATE ”IMMEDIATE ”

Life Threatening Injury

Victim needs immediate care

Fails R – P – M check

Adult >30 respirations per minute

Child outside 15-45 respirations/m

Breathing normal, no radial pulse

Capillary refill > 2 seconds

Mental check


“ “ DELAYED ”DELAYED ”

Serious Non Life Threatening Injury

Did not walk out of scene R-P-M within in acceptable limitsMay have broken bonesMay be extrication problemMay have chest pain, etc.


“ “ DECEASED DECEASED ””

New term: MORGUEConsidered Non-SalvageableObviously deadPulselessNon-breathers who fail to breathe after

airway has been clearedMortal injuries


Patient Assessment…RPM

Respirations

Perfusion

Mental Status

Three things to check…

Anyone who is unconscious is an “Immediate” by definition!

Anyone who can walk and is not “Red” is “Green” by definition.


RPM…Respirations

No breathing Position airway, if still not breathing try it again If still no breathing tag as DECEASED and move on

to next person

Out of range for breaths per minute Tag as IMMEDIATE and move on to next person

Within range for breaths per minute Go to the next step… Perfusion

Range…Adults under 30 breaths a minute Children to 12 years: 15-45 breaths/min


More than 2 seconds Tag as IMMEDIATE and move on to next

person

Less than 2 seconds Go to next step… Mental Status

RPM…Perfusion…Blanch Test

Goal…perfusion in under 2 seconds


Can not follow directions Tag as IMMEDIATE and move on to next person

Can follow directions Tag as DELAYED and move on to next person

RPM…Mental Status

Can victim follow simple directions?


Head-to-Toe Assessment

Get permission to conduct assessment Conduct on all victims, even those who

seem to be alright Children are assessed Toe-to-Head Everyone gets a tag Verbal assessment Hands-on assessment

look, listen and feel for anything unusual

Victim has the right to refuse treatment


Head to Toe Assessment

1. Head2. Neck3. Shoulders4. Chest5. Arms6. Abdomen7. Pelvis8. Legs9. Back

Anyone with an injury to the head,neck, trunk or upper legs are “Immediates”

Let them know what you are doing. Communicate!


Symptoms

Change in consciousness

Inability to move one or more body parts

Severe pain or pressure in the head, neck or back

Tingling or numbness in extremities

Difficulty breathing or seeing

Heavy bleeding, bruising or deformity of the head or spine

Blood or fluid in the nose or ears

Bruising behind the ears “Raccoon” eyes (bruising

around the eyes) “Uneven” pupils Seizures Nausea or vomiting Victim found under collapsed

building materials or heavy debris

Signs of a closed-head, neck or spinal injury

Minimize movement of head, neck and spine


Treating Burns

Remove victim from burning source Cool the burned area, no more than 1/9 of the

body at a time Cover to reduce infection Elevate burned extremity higher than heart

No ice, antiseptics, ointments, butter, etc…

Use extra caution with severely burnedinfants, young children and elderly


Wound Care

Control bleeding Prevent secondary infection

Objective of wound care:

Treatment of wounds:

Clean wounds – don’t scrub Apply dressing to wound Apply bandage to hold

dressing in place

No tourniquets!


Rules of Dressing

In the absence of active bleeding, remove dressing and flush, check wound at least every 4-6 hours, redress as necessary

If there is active bleeding, redress over existing dressing and maintain pressure and elevation


Guidelines for Splinting

Support the injured area Splint injury in the position that you find it Don’t try to realign bones Immobilize above and below the injury Check for color, warmth, and sensation

below the injury site

All fracture & suspected fractures require splinting


Nasal Bleeding

Causes: blunt force, skull fracture, non-trauma related conditions

Blood loss can lead to shock

Victims may become nauseated and vomit if they swallow blood

Treating Nasal Bleeding

Pinch the nostrils together, lean forward

Put pressure on the upper lip just under the nose


Symptoms of Hypothermia

Primary signs and symptoms: A body temperature of 95o Fahrenheit (35o Celsius) or

less

Redness or blueness of the skin

Numbness accompanied by shivering

Later stages of Hypothermia: Slurred speech

Unpredictable behavior

Listlessness and confusion

Shivering stops at a temperature of about 92o


Treating Hypothermia

Remove wet clothing Do not immerse in hot water Wrap victim in a blanket or sleeping bag and cover

head and neck Protect victim from weather Provide warm fluids to conscious victims

no alcohol or caffeine Place unconscious victim in recovery position Watch the victim for changes in status

Even mild degrees of hypothermia can have serious consequences


Symptoms of Hyperthermia

Heat ExhaustionHeavy sweating

Paleness

Muscle cramps

Tiredness and weakness

Dizziness or Headache

Nausea or vomiting

Fainting

Heat Stroke is the most severe form of hyperthermia and is a life-threatening emergency!

Heat StrokeRed, hot, dry skin (no sweating)

Body Temperature over 103˚F

Rapid, strong pulse

Dizziness

Nausea

Confusion

Unconsciousness


Treating Hyperthermia

Get victim to a cool place/air conditioned if you can Cool victim as rapidly as possible

Immerse in cool water/shower/garden hoseIn low humidity, wrap in wet sheet and fan the

victim vigorously Monitor body temperature until it drops to 101- 102˚F Give victim fluids to drink unless nauseated (no

caffeine or alcohol) Transport Immediately!


Continuing Education Opportunities

CERT Refresher Course and Drills Advanced Specialty training

Medical Specialty Team CoCoCART – County Animal Response Team Traffic Control Specialty Team Advanced FRS (Family Radio Service) HAM Radio

Red Cross First Aid, CPR training Red Cross Dog and Cat First Aid / CPR training Red Cross Disaster Services training FEMA IS online classes CERT Instructor training

Unit Summary

Need for Preparedness Pets in Disasters FRS Radio ICS & CERT Mobilization LSAR Protocols Fire Extinguishers Killers, Triage, RPM and Assessment Hypothermia, Hyperthermia Continuing Education Opportunities

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Exercises

Head to Toe Exam

Head Tilt / Chin Lift

Bleeding Control

Splinting / Slings

Triage Exercise RPM

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