Friday, February 13, 2015

Shadowing CERTs: The Big Test

[Previously on Shadowing CERTs: After seven weeks of training, the students of Fairfax County Community Emergency Response Team (CERT) Classes 85 and 86 prepare to face their greatest challenge -- a full-scale graduation exercise, complete with live victim actors and authentically wrecked buildings. Are they up to the task?]

Disasters don't happen on nice days.

November 15 is a cold, cold Saturday morning at Virginia Task Force One's disaster training center at the former Lorton Reformatory Juvenile Correctional Facility. Nearly 70 Fairfax County CERT students from Classes 85 and 86 (and a few from 88) are in the staging area, getting ready to put to the test the skills and knowledge they've learned in seven weeks of classroom and hands-on training.

CERTs in the staging area get briefed by Incident Commander Brad Smith. All photos (unless noted): Joe Loong

Those seven weeks of CERT training have given these regular people skills to safely assist their neighbors after a major disaster, doing the most good for the most people until help arrives. Skills like how to:
  • Set up a command structure for a disaster response
  • Safely survey a disaster scene
  • Perform light search and rescue operations
  • Extract survivors from moderately damaged buildings
  • Extinguish small fires
  • Rapidly triage, treat, and transport survivors for further care
  • Keep track of rescue efforts and survivors so they can transfer command to arriving Fire & Rescue personnel

The Accountability section uses a sheet taped to the side of a truck to organize teams before deployment.

While the CERTs have been through a few smaller training exercises at the Fire & Rescue Academy, the Lorton exercise is where they must put it all together... in an unfamiliar, authentically wrecked disaster scene, filled with a record-breaking 170 live, vocal victim actors.

Victim actors with wound makeup simulating an amputated hand, impalement by flying glass, and impalement by wood.

Just like the CERTs, the victim actors are volunteers drawn from all walks of life. (We'll take a closer look at them in an upcoming post.) Today, they're portraying survivors of a hurricane-ravaged apartment complex, and have been given wound makeup (called moulage) that simulates injuries ranging from the minor to the severe.


Moulage Lead Susy Ledgerwood applies wound makeup to a young victim actor.

Cold Considerations

Because of the cold, the Moulage Team has to work quickly to apply wounds to the 170 people who need them. The team also has to adjust the types of simulated injuries it gives out, minimizing ones that require exposing bare skin to the cold.


A victim actor shows off her simulated finger amputation.

The cold also means that exercise controllers have to keep a careful eye on the well-being of both rescuers and victim actors, the latter of whom may spend hours in the wrecked buildings waiting for rescue. Participant safety is the number one priority, so victim actors are given blankets and handwarmers, advised to stay off the ground as much as possible, and encouraged to take breaks and hot drinks at warming stations and canteen truck.


A victim actor stays warm while waiting for rescuers.

 

Reality Is Messy

The cold is just one of many factors both rescuers and exercise coordinators have to watch out for.  For years, Lorton has been abandoned, open to the elements, and used for training -- it's a big mess, filled with rubble, broken glass, and sagging ceilings.

Left: Inside a former cell. Right: Off-limits area blocked off by controllers.

It's what makes training at Lorton so realistic (and cool), but it also means that exercise coordinators have to prep the site, blocking off the potential hazard areas to make sure rescuers stay safe while still learning to keep a careful eye on their surroundings.


Geared Up and Ready to Go

Meanwhile, as the victim actors get into position, the CERTs have organized into teams and have gotten their equipment together. And there's a lot of it to bring down to the disaster scene; in addition to the personal gear in their packs and the contents of the CERT trailer, the CERTs have coordinated ahead of time and brought a yard sale's worth of tools, tarps, shelters, stretchers, medical supplies -- all the stuff they need to assist disaster survivors.

CERTs haul their gear down to the disaster scene.
Some of the equipment the CERTs have brought.

CERTs are trained to save lives with the supplies they can find on hand, including duct tape, cardboard, and rags. But being prepared and bringing additional equipment always helps (as long as you're willing to carry it in, around, and out).

Triage, Treatment, and Transport

The exercise officially begins at 10 AM. CERTs arrive on scene, set up a command post, size up the area, and start to deploy search teams. To the watching victim actors, the first few minutes look like a bunch of people standing around and fiddling with tarps and whiteboards. However, getting organized at the beginning is crucial to an effective response, especially before the situation grows in size and complexity.

CERTs set up supplies in the Logistics area. Meanwhile, other CERTs are setting up Medical and the Command Post.

The most visible part of CERT operations is Rescue, where CERTs operating in teams locate survivors and rapidly assess, triage, and treat each victim to stop the three biggest threats to life (severe bleeding, obstructed airways, and shock) -- ideally in under 30 seconds.

Rescuers record survivor information on a duct tape "dashboard" taped to their legs.

Within those 30 seconds, CERTs will treat major bleeding, and use simple tests to check victims for respiration, perfusion (the flow of blood to extremities), and mental status. The results of those tests will determine if the patient is Green (walking wounded), Yellow (Delayed treatment), Red (Immediate treatment), or Black (dead or expectant).

CERT rescuers assess a victim actor.

Under the stress of the situation, CERTs have to quickly make decisions -- some good, some bad. Survivors are treated. Some are missed on initial passes. Some commands are clear; others are misunderstood. Steps are forgotten. Survivors are mis-tagged. All of this is expected, and part of the learning experience.

Green-tagged survivors who can walk are escorted back to the Medical area. Some of the Yellow-tagged survivors can be given a walking assist, but the more seriously injured will need to be carried out on stretchers, litters, backboards, doors, or whatever means are available. Priority for the six-person lift teams goes to the survivors who are "worst hurt, easiest to get out."




Treating the Wounded

After the survivors are checked into Medical, they're given a head-to-toe assessment and further care. In the beginning, the scene at Medical is relatively calm -- the first survivors to arrive are the Green-tagged walking wounded, with minor injuries.


Green-tagged survivors in the Medical area.

However, as the exercise progresses, more patients arrive, and Medical quickly grows in size and complexity. Patients need to be protected from the elements; dressings and splints need to be inspected and reapplied; and patients must be regularly checked for changes in  condition.


A CERT in Medical assesses a patient.

As rescued survivors keep flowing in, Medical has to be expanded. To keep up, CERTs are transferred from the Rescue and Logistics teams to help with patient care. By the end of the exercise, the Medical area has grown considerably.

The scene in Medical towards the end of the exercise.

Crib Notes

Complicating matters for the Command team, throughout the day CERTs are pulled out of the exercise to participate in a victim extrication skills test, where they must use teamwork, along with wooden levers, blocks, and wedges, to rescue a simulated victim from beneath several hundred pounds of steel beam and rubble.


CERTs use lever to raise the steel beam enough so they can extract the trapped dummy.

Using the skills they've learned in class, teams carefully and gradually lever up the beam, supporting it as they go with a box of crisscrossed blocks (cribbing), so that they can remove the dummy and get back to rescuing live humans.

 

When Help Arrives

A CERT's job doesn't end when the fire department arrives. Once professional first responders get on scene, they'll take command of the rescue operation (and probably also conduct their own searches and patient assessments). CERTs can greatly assist the transition and continuing rescue effort by briefing the incoming Incident Commander on what they've done, who they've rescued, how severe their injuries are, and anything else about the situation that will help the continuing operation.


CERTs share information with Fairfax County Fire & Rescue during the transfer of command.

CERTs will then operate under the new Incident Commander. Depending on the situation and the available resources, CERTs might continue to work in the rescue, or they might be demobilized after the transition is complete.

In this exercise, CERTs worked with responders from Fairfax County Crosspointe Fire Station 41 to practice the transfer of command.


CERTs and firefighters consult one of the status boards tracking patient information.

Wrapping It Up

By mid-afternoon, the transfer of command has been skilfully and successfully completed, and controllers call an end to the exercise. The CERTs, who over the day had rescued a majority of the record-setting 170 victim actors, gathered to debrief and share feedback from evaluators, who noted both successes and areas for improvement. Finally, the now-graduated Fairfax County CERTs received their certificates.

Just like all skills, CERT skills improve with practice, so the CERTs of Class 85 and 86 were encouraged to stay involved with the CERT program and continue to train, learn new skills, and recruit others into the program.

The newly graduated Fairfax County CERTs of Classes 85 & 86.

Congratulations to all the new CERTs!


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Special thanks to all victim actors, CERT staff, Fire & Rescue Department personnel, and especially to Paul Davis Restoration for donating bottled water, and to Firehouse Subs for helping supply food to all exercise participants.

CERT training classes are free to people over 18 who live or work in Fairfax County. Classes are offered several times each year at the Fairfax County Fire & Rescue Academy, as well as other locations throughout the community. Registration is open now for CERT classes starting in March and April 2015 -- click to see class dates and sign up.

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See more photos from the exercise in the album on Facebook and follow the activities of Fairfax County CERT by liking the Fairfax County CERT Facebook page.

Next: In The After-Action, we'll take a look at how the CERTs of Class 85 & 86 gathered intelligence in preparation for the final exercise. We'll also profile some of the volunteer victim actors who participated in the drill.




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

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