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Old 02-01-2018, 08:58 PM
ExiledSpartan418 ExiledSpartan418 is offline
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Default Kennesaw CERT



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Hey guys, anyone local in Kennesaw?

If so, has anyone done their CERT?

I am planning on either March or May, depending on schedule, wondering if anyone has any comments or can join the training as well.
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Old 02-01-2018, 09:36 PM
Outpost75 Outpost75 is offline
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CERT is a great program. Before I retired I was a trainer for CERT and ACS/RACES.
Not sure how well formatting will cut & paste, but this is a han dout we used for annual refresher training.

CERT Annual Refresher - Course Overview

CERT process:
1) Organize Your Team
2) Size Up – Recon the Scene
3) Traige – the victims
4) Stabilize victims, remove to Casualty Collection Point

Use the memonic “SAFE” as a reminder to help you remember:
SEARCH – Safely, systematic, buddy system
ATTACH Tag - Triage first, rescue later
FIX – Life threatening injury
EXTRICATE - Remove victims from danger

Incident Management Purpose > To produce effective results safely!
1) Do the most good for the most people
2) Account for rescuers, victims, resources

ICS Process
1) Identify SCOPE
2) Determine STRATEGY
3) DEPLOY resources
4) DOCUMENT actions and results

Use the memonic CALM to remember CERT incident command structure:

COMMAND
ACCOUNTABILITY
LOGISTICS
MEDICAL

Functional “Groups”


Caregivers Staging Officer
Rapid Intervention Team (rescue the rescuers)

Geographical “Divisions”

Teams: Teams: Teams:
Search1 Search2 Search3
Rescue1 Rescue2 Rescue3

As a reminder to help remember the CERT process
remember the robot from the movie Star Wars - “R2D2”:

RECON > RANK > DISENTANGLE > DOCTOR

RECON Maintain situational awareness
Check surroundings frequently
Stop, Think, Observe, Plan, Act

Sizeup - hazard identification, damage assessment
No wall, no roof, no enter!
Heavy damage don’t enter to rescue – danger tape
Moderate Damage – non structural, in/out quickly
Light damage – Go for it!

RANK Traige - "RPM" (triage in-place prior to rescue)

Respirations <30/min, not “panting like a puppy”

Perfusion blanch test nail bed<2secs

Mental status – awake, aware, understands simple commands

DISENTANGLE Rescue decision is based upon Risk to Rescuers!

Rescue the greatest number in the shortest exposure

Remove the injured from immediate danger

Rescue the lightly trapped first

Work safe, use PPE, Time, Distance, Shielding

DOCTOR Traige First – Rescue Later

Affix TAG before rescue. Refer to the traige handout:

Control bleeding

Treat shock

Don’t splint in the field.
Comfort is important. So, if painful “body splint.”

Immediate care for life threatening injuries
Think before acting. Move methodically, but efficiently.

“RECON”
For Hazards and SEARCH for Victims
Document hazards and search findings

1) Pre-plan in your neighborhood, gather facts, www.terrafly.com
Use maps, GIS identify high occupancy structures, flood plains, etc

2) SLOW DOWN – perform an adequate SIZE-UP
.
3) Windshield surveys, immediate post-incident, access area of damage.

4) Maintain situational awareness, check your surroundings frequently.

5) Before entering walk building perimeter, call out, “Is anyone in there?”

6) Mark building using duct tape strips placed to left of door as you enter:

SEARCH METHOD:

1) As you enter call out:

“Search Team, Is Anyone In Here?”

“Are You Hurt?” “Can you walk to me?”

If hurt or trapped say “STAY PUT we’ll come to you.”

2) Physical Search Interior – systematic approach, either top down or bottom up

3) Stop frequently to LISTEN

4) Triangulate with your flashlight

5) Mark searched areas, document results

6) Report to Command.

Radio location of hazards, yellow and red victims to Command:
Refer to corners by their adjacent sides, the “AB Corner” etc.

Rear of Bldg. Is Side “C”

Side Side
“B” “D”

Front of Bldg facing Street Is Side “A”

7) Rescue team moves in to remove victims as your
team completes its building search.

“RANK”

Triage, like other disaster response efforts, begins with size-up. The general procedure for triage in a disaster environment is as follows:

Stop, Look, Listen, and Think. Before you start, stop and size up the situation by looking around you and listening. Above all, THINK about how you will approach the task at hand. Continue to size up the situation as you work.

Conduct Voice Triage. Begin with voice triage, calling out something like, “Emergency Response Team. If you can walk, come to the sound of my voice.” Instruct those survivors who are ambulatory to remain at a designated location, and continue with the triage operation.

Follow a Systematic Route. Start with victims closest to you and work outward in a systematic fashion.

Conduct Triage Evaluation. Evaluate victims and tag them RED (immediate), YELLOW(delayed), or BLACK (DEAD). Remember to evaluate the GREEN walking wounded. Everyone gets a tag.

Treat RED Victims Immediately. Initiate airway management, bleeding control, and/or treatment for shock for Category I (immediate) victims.

Document Results. Document triage results for:
- Effective deployment of resources.
- Information on locations of victims
- A quick record of the number of casualties by degree of severity

• Essential info for responders and EMS transport units.

Duct Tape Strip on Victim: Marking Example:
Place tape strip on left shoulder:
Team ID, Victim No. T3-V5
Condition Red

Remember “RPM"

Respirations <30/min
Perfusion blanch test nail bed<2secs
Mental status understands simple commands

Step Procedures
1 Check airway/breathing. At an arm’s distance, shake the victim and shout. If the victim does not respond:
1. o Position the airway.
2. o Look, listen, and feel.
3. o Check breathing rate. Abnormally rapid respiration (above 30 per minute) indicates shock. Treat for shock and tag "I."
4. o If below 30 per minute, then move to Step 2.
5. o If the victim is not breathing after 2 attempts to open airway, then tag "DEAD."
2 1. o Check circulation/bleeding.
2. o Take immediate action to control severe bleeding.
3. o Check circulation using the blanch test for capillary refill.
1. o Press on an area of skin until normal skin color is gone.
4. A. good place to do this is on the palm of the hand or
5. nail beds.
6. Time how long it takes for normal color to return.
7. o Treat for shock if normal color takes longer than 2 seconds to return, and tag "I."
3 Check mental status. Give a simple command, such as "Squeeze my hand." Inability to respond indicates that immediate treatment for shock is necessary. Treat for shock and tag "I."

“DISENTANGLE”

RESCUE Purpose – To create a safe environment for the victim

PROCESS:

1) LIFT OBJECTS – don’t step on, step over or around.

2) USE TOOLS – simple machines

3) BE SAFE – Ensure object free and people clear before moving.
Avoid hang-ups, injuries. Beware of pinch points.

4) TRIAGE - victim before moving.

5) DOCUMENT RESULTS

LIFTS AND CARRIES

Fireman’s carry – Generally no! Only if victim if 80# or less

Solo extraction methods:

Clothes drag
Log roll and Blanket drag
Army Rope / Webbing Drag*

*Roll casualty onto their back, thread rope or webbing under small of back, slide across top of buttocks, loop rope or webbing under, through and around belt at hips, “X” across chest and under armpits. Attach snap link and drag to safety.

Team carry methods:

Log roll and blanket carry – advantage through doorways, around corners or up and down stairs (requires minimum of four people)

Door, table, surf board or other long-wide board 2”x6” or wider – (best with four rescuers) if victim is small can do with two people over a short distance.

“CAT stretcher” - Two folding metal chairs, flat-stacked back-to-back, with legs out, wrap or tie securely together using duct tape, 550# paracord or webbing.

Chair carry VERY problematic – Evac chairs require training.

“DOCTOR”

Death from trauma:

Phase 1 minutes, irrepairable damage to vital organs

Phase 2 hours, crush injuries, rapid bleed-out from internal injuries,

Phase 3 days, systematic organ failure from injury-caused infections

Respiration

Control head, open airway, look, listen feel, not breathing – DEAD

12-20 breaths per minute OK, if “Panting Like a Puppy” - RED

Comfort lowers respiration rate and helps calm victim down
OK for them to sit up if comfortable, don’t “make” them lie down.
Cool burns with water only - Don’t remove clothing, soak to cool

Burns to face critical, swelling impairs breathing
If victim inhaled hot air tag RED

Bleeding injuries and Shock - the “Killers”

Rapid loss of perfusion: - Blanch test nail bed > 2 secs.

Head or spinal cord injury causes blood vessel dilation drops BP
Chest injuries
Major bleeds
Abdominal injuries

Handle GENTLY, elevate feet, keep warm, direct pressure, pressure point
Prevent secondary infection, irrigate only, apply dressing, bandage

Mental Status

Unconscious victim – RED

Semi-Conscious - unaware, can’t follow simple commands - RED

Conscious victim, awake and aware can be cared for and made more comfortable, move to a safe place, protected from weather, wind, rain, and tag Yellow.
SAFETY AWARENESS

Disaster Worker Injury / Risk Factors

 Tool / equipment hazards, risk of hand, eye, head injuries, electric shock, chemical burns
 Human factors, stress / fatigue
 Structural instability
– Trauma risk, falls, building collapse potential
 Terrain, loose rock, fallen limbs, wet or insecure footing, risk of falls, puncture wounds and lacerations from debris
• Environmental effects: lightning, cold, wet, wind, dust, flying debris, smoke, fumes
• Flooding: Process for water rescue: Reach, Throw, Row and Go
REACH out to victim with hand, pole, ladder,
THROW victim a rope, life vest, picnic cooler, anything that floats
ROW out to reach them from a boat or raft
GO immediately to CALL 911, do not delay.
• Incidental exposures: chemicals, pathogens in flood waters, etc.
If you are contaminated:

 Remove everything, including jewelry
 Cut off clothing normally removed over the head
 Place contaminated clothing in plastic bag, tie closed
 Wash your hands before using them to shower
 Flush entire body with cool water
 Blot dry with absorbent cloth
 Put on clean clothes
 Avoid use of affected areas, to prevent re-exposure
 If professional help arrives, report to responders for thorough decontamination and medical assessment.

Recommended PPE:

• Sturdy footwear
– Ankle support, traction sole
– Safety toes recommended
• Work gloves
• Medical exam gloves and spares
• Safety glasses
• Rain gear and suitable outdoor work clothing
• Reflective vest
• Hard hat
• N95 respirator

Mandatory Information for Personnel using Respirators When Not Required Under the OSHA Standard 29 CFR 1910.134

• Read and heed all manufacturer instructions and warnings regarding fit testing, use limitations, care and maintenance
• Choose a respirator certified for the contaminant of concern, based upon the NIOSH label which tells you what the respirator is designed for and how much it will protect you
• Do not wear your respirator into atmospheres for which it is not designed to protect you. A respirator designed to filter particulates will not protect you against toxic vapors, fumes, smoke or pathogens
• Keep track of YOUR respirator, so that you do not mistakenly use someone else’s.

Infection Control Awareness
Allan J, Morrison, Jr. MD, MSc, FACP, FIDSA, INOVA Health System Epidemiologist, Chair, Infection Control Committee INOVA Fairfax Hospital
Clinical Assistant Professor of Medicine, Georgetown University Hospital
Training for the Fairfax County Office of Risk Management, Used by Permission

• Potentially Infectious Materials
• Disaster conditions which increase risk
• Mechanisms of Transmission
• Categories of Transmissible Organisms
• Disaster Worker Protection
• Guidelines for exposure
– Blood and body fluids

Potentially Infectious Materials
• Body secretions / excretions
– Human: poor sanitation conditions
– Animal: livestock, rodents, vermin, insects
• Decayed carcasses
• Hanta virus from contact with rodent feces
• Putrescible materials
– Spoiled foodstuff, garbage and refuse
• Allergens
– Concentrated fungi, molds

Disaster Conditions
• Stagnant surface water
– Mosquito harborage
• Contaminated flood waters
– Sewage treatment system overflow
– Petroleum, industrial, agricultural, hazmat releases
• Structural instability
– Trauma risk, falls, sharps potential
 Airborne contaminant plumes
– Smoke, dust, toxic gases,
– Radioactive fallout from RDD or NuDet.

Mechanisms of Transmission
• Direct contact (“portal of entry”);
– Non-intact skin
• Penetrating injury (percutaneous)
– Physical injury, causes portal of entry
• Aerosol
• Vector borne

Transmissible Organisms

• Tetanus (most likely in adults who have not received tetanus toxoid booster within 10 years)
• Hepatitis A, B (C much less likely)
• Enteric bacteria (e.g. E. coli, Salmonella)
• Vermin-mediated
– Cats: Toxoplasmosis
– Mice, rats: (urine): Leptospirosis; (feces) Hantavirus
– Tularemia
– Plague (rat flea)
• Toxins (botulinum) decaying, spoiled foodstuffs
• Vector-borne (Lyme, West Nile, Malaria)

Disaster Worker Protection

• Good personal hygiene
– Wash hands, use hand sanitizers, double-glove
• Use DEET containing insect repellants
• Tetanus toxoid booster (every 10 yrs)
• Hepatitis A/B vaccine
• PPE use
– Gloves, hand sanitizers
– N95 respirator in dusty environments
– Correct sizes, fit testing
• Awareness training
• Medical screening (post event)
– If confirmed exposure

Guidelines for exposure to Blood and body fluids

• Immediately notify Command, triage exposed CERT as casualty
• Command contacts the Public Safety Answering Point
• Exposure is not simple contact, but a specific eye, mouth or other mucous membrane, non-intact or piercing contact with blood or potentially infectious material
• Clean exposed area thoroughly with soap and water
• Public Safety – EMS will contact consulting on-duty physician regarding circumstances of the exposure
• If consulting physician agrees exposure has occurred, volunteer will be sent to nearest health care facility to undergo blood sampling and post-exposure prophylaxis…


CERT Actions Upon Exposure to Blood or Body Fluids

• Identify source patient to enable blood testing
• If consent is not obtained, public safety must be notified immediately to initiate legal actions permitted under Virginia Code to obtain source patient’s blood for testing
• Incident Safety Officer completes Exposure Incident Report in compliance with CDC and VHD guidelines.
• DO NOT DELAY treatment, go directly to the nearest hospital emergency room
• Record all pertinent information regarding the specific exposure and bring it with you to the emergency room.

CERTS CAN protect themselves through:

• C aution
• A lert Awareness
• N otification
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The Following User Says Thank You to Outpost75 For This Useful Post:
Old 02-01-2018, 09:43 PM
ExiledSpartan418 ExiledSpartan418 is offline
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Quote:
Originally Posted by Outpost75 View Post
CERT is a great program. Before I retired I was a trainer for CERT and ACS/RACES.
Not sure how well formatting will cut & paste, but this is a han dout we used for annual refresher training.

CERT Annual Refresher - Course Overview

CERT process:
1) Organize Your Team
2) Size Up – Recon the Scene
3) Traige – the victims
4) Stabilize victims, remove to Casualty Collection Point

Use the memonic “SAFE” as a reminder to help you remember:
SEARCH – Safely, systematic, buddy system
ATTACH Tag - Triage first, rescue later
FIX – Life threatening injury
EXTRICATE - Remove victims from danger

Incident Management Purpose > To produce effective results safely!
1) Do the most good for the most people
2) Account for rescuers, victims, resources

ICS Process
1) Identify SCOPE
2) Determine STRATEGY
3) DEPLOY resources
4) DOCUMENT actions and results

Use the memonic CALM to remember CERT incident command structure:

COMMAND
ACCOUNTABILITY
LOGISTICS
MEDICAL

Functional “Groups”


Caregivers Staging Officer
Rapid Intervention Team (rescue the rescuers)

Geographical “Divisions”

Teams: Teams: Teams:
Search1 Search2 Search3
Rescue1 Rescue2 Rescue3

As a reminder to help remember the CERT process
remember the robot from the movie Star Wars - “R2D2”:

RECON > RANK > DISENTANGLE > DOCTOR

RECON Maintain situational awareness
Check surroundings frequently
Stop, Think, Observe, Plan, Act

Sizeup - hazard identification, damage assessment
No wall, no roof, no enter!
Heavy damage don’t enter to rescue – danger tape
Moderate Damage – non structural, in/out quickly
Light damage – Go for it!

RANK Traige - "RPM" (triage in-place prior to rescue)

Respirations <30/min, not “panting like a puppy”

Perfusion blanch test nail bed<2secs

Mental status – awake, aware, understands simple commands

DISENTANGLE Rescue decision is based upon Risk to Rescuers!

Rescue the greatest number in the shortest exposure

Remove the injured from immediate danger

Rescue the lightly trapped first

Work safe, use PPE, Time, Distance, Shielding

DOCTOR Traige First – Rescue Later

Affix TAG before rescue. Refer to the traige handout:

Control bleeding

Treat shock

Don’t splint in the field.
Comfort is important. So, if painful “body splint.”

Immediate care for life threatening injuries
Think before acting. Move methodically, but efficiently.

“RECON”
For Hazards and SEARCH for Victims
Document hazards and search findings

1) Pre-plan in your neighborhood, gather facts, www.terrafly.com
Use maps, GIS identify high occupancy structures, flood plains, etc

2) SLOW DOWN – perform an adequate SIZE-UP
.
3) Windshield surveys, immediate post-incident, access area of damage.

4) Maintain situational awareness, check your surroundings frequently.

5) Before entering walk building perimeter, call out, “Is anyone in there?”

6) Mark building using duct tape strips placed to left of door as you enter:

SEARCH METHOD:

1) As you enter call out:

“Search Team, Is Anyone In Here?”

“Are You Hurt?” “Can you walk to me?”

If hurt or trapped say “STAY PUT we’ll come to you.”

2) Physical Search Interior – systematic approach, either top down or bottom up

3) Stop frequently to LISTEN

4) Triangulate with your flashlight

5) Mark searched areas, document results

6) Report to Command.

Radio location of hazards, yellow and red victims to Command:
Refer to corners by their adjacent sides, the “AB Corner” etc.

Rear of Bldg. Is Side “C”

Side Side
“B” “D”

Front of Bldg facing Street Is Side “A”

7) Rescue team moves in to remove victims as your
team completes its building search.

“RANK”

Triage, like other disaster response efforts, begins with size-up. The general procedure for triage in a disaster environment is as follows:

Stop, Look, Listen, and Think. Before you start, stop and size up the situation by looking around you and listening. Above all, THINK about how you will approach the task at hand. Continue to size up the situation as you work.

Conduct Voice Triage. Begin with voice triage, calling out something like, “Emergency Response Team. If you can walk, come to the sound of my voice.” Instruct those survivors who are ambulatory to remain at a designated location, and continue with the triage operation.

Follow a Systematic Route. Start with victims closest to you and work outward in a systematic fashion.

Conduct Triage Evaluation. Evaluate victims and tag them RED (immediate), YELLOW(delayed), or BLACK (DEAD). Remember to evaluate the GREEN walking wounded. Everyone gets a tag.

Treat RED Victims Immediately. Initiate airway management, bleeding control, and/or treatment for shock for Category I (immediate) victims.

Document Results. Document triage results for:
- Effective deployment of resources.
- Information on locations of victims
- A quick record of the number of casualties by degree of severity

• Essential info for responders and EMS transport units.

Duct Tape Strip on Victim: Marking Example:
Place tape strip on left shoulder:
Team ID, Victim No. T3-V5
Condition Red

Remember “RPM"

Respirations <30/min
Perfusion blanch test nail bed<2secs
Mental status understands simple commands

Step Procedures
1 Check airway/breathing. At an arm’s distance, shake the victim and shout. If the victim does not respond:
1. o Position the airway.
2. o Look, listen, and feel.
3. o Check breathing rate. Abnormally rapid respiration (above 30 per minute) indicates shock. Treat for shock and tag "I."
4. o If below 30 per minute, then move to Step 2.
5. o If the victim is not breathing after 2 attempts to open airway, then tag "DEAD."
2 1. o Check circulation/bleeding.
2. o Take immediate action to control severe bleeding.
3. o Check circulation using the blanch test for capillary refill.
1. o Press on an area of skin until normal skin color is gone.
4. A. good place to do this is on the palm of the hand or
5. nail beds.
6. Time how long it takes for normal color to return.
7. o Treat for shock if normal color takes longer than 2 seconds to return, and tag "I."
3 Check mental status. Give a simple command, such as "Squeeze my hand." Inability to respond indicates that immediate treatment for shock is necessary. Treat for shock and tag "I."

“DISENTANGLE”

RESCUE Purpose – To create a safe environment for the victim

PROCESS:

1) LIFT OBJECTS – don’t step on, step over or around.

2) USE TOOLS – simple machines

3) BE SAFE – Ensure object free and people clear before moving.
Avoid hang-ups, injuries. Beware of pinch points.

4) TRIAGE - victim before moving.

5) DOCUMENT RESULTS

LIFTS AND CARRIES

Fireman’s carry – Generally no! Only if victim if 80# or less

Solo extraction methods:

Clothes drag
Log roll and Blanket drag
Army Rope / Webbing Drag*

*Roll casualty onto their back, thread rope or webbing under small of back, slide across top of buttocks, loop rope or webbing under, through and around belt at hips, “X” across chest and under armpits. Attach snap link and drag to safety.

Team carry methods:

Log roll and blanket carry – advantage through doorways, around corners or up and down stairs (requires minimum of four people)

Door, table, surf board or other long-wide board 2”x6” or wider – (best with four rescuers) if victim is small can do with two people over a short distance.

“CAT stretcher” - Two folding metal chairs, flat-stacked back-to-back, with legs out, wrap or tie securely together using duct tape, 550# paracord or webbing.

Chair carry VERY problematic – Evac chairs require training.

“DOCTOR”

Death from trauma:

Phase 1 minutes, irrepairable damage to vital organs

Phase 2 hours, crush injuries, rapid bleed-out from internal injuries,

Phase 3 days, systematic organ failure from injury-caused infections

Respiration

Control head, open airway, look, listen feel, not breathing – DEAD

12-20 breaths per minute OK, if “Panting Like a Puppy” - RED

Comfort lowers respiration rate and helps calm victim down
OK for them to sit up if comfortable, don’t “make” them lie down.
Cool burns with water only - Don’t remove clothing, soak to cool

Burns to face critical, swelling impairs breathing
If victim inhaled hot air tag RED

Bleeding injuries and Shock - the “Killers”

Rapid loss of perfusion: - Blanch test nail bed > 2 secs.

Head or spinal cord injury causes blood vessel dilation drops BP
Chest injuries
Major bleeds
Abdominal injuries

Handle GENTLY, elevate feet, keep warm, direct pressure, pressure point
Prevent secondary infection, irrigate only, apply dressing, bandage

Mental Status

Unconscious victim – RED

Semi-Conscious - unaware, can’t follow simple commands - RED

Conscious victim, awake and aware can be cared for and made more comfortable, move to a safe place, protected from weather, wind, rain, and tag Yellow.
SAFETY AWARENESS

Disaster Worker Injury / Risk Factors

 Tool / equipment hazards, risk of hand, eye, head injuries, electric shock, chemical burns
 Human factors, stress / fatigue
 Structural instability
– Trauma risk, falls, building collapse potential
 Terrain, loose rock, fallen limbs, wet or insecure footing, risk of falls, puncture wounds and lacerations from debris
• Environmental effects: lightning, cold, wet, wind, dust, flying debris, smoke, fumes
• Flooding: Process for water rescue: Reach, Throw, Row and Go
REACH out to victim with hand, pole, ladder,
THROW victim a rope, life vest, picnic cooler, anything that floats
ROW out to reach them from a boat or raft
GO immediately to CALL 911, do not delay.
• Incidental exposures: chemicals, pathogens in flood waters, etc.
If you are contaminated:

 Remove everything, including jewelry
 Cut off clothing normally removed over the head
 Place contaminated clothing in plastic bag, tie closed
 Wash your hands before using them to shower
 Flush entire body with cool water
 Blot dry with absorbent cloth
 Put on clean clothes
 Avoid use of affected areas, to prevent re-exposure
 If professional help arrives, report to responders for thorough decontamination and medical assessment.

Recommended PPE:

• Sturdy footwear
– Ankle support, traction sole
– Safety toes recommended
• Work gloves
• Medical exam gloves and spares
• Safety glasses
• Rain gear and suitable outdoor work clothing
• Reflective vest
• Hard hat
• N95 respirator

Mandatory Information for Personnel using Respirators When Not Required Under the OSHA Standard 29 CFR 1910.134

• Read and heed all manufacturer instructions and warnings regarding fit testing, use limitations, care and maintenance
• Choose a respirator certified for the contaminant of concern, based upon the NIOSH label which tells you what the respirator is designed for and how much it will protect you
• Do not wear your respirator into atmospheres for which it is not designed to protect you. A respirator designed to filter particulates will not protect you against toxic vapors, fumes, smoke or pathogens
• Keep track of YOUR respirator, so that you do not mistakenly use someone else’s.

Infection Control Awareness
Allan J, Morrison, Jr. MD, MSc, FACP, FIDSA, INOVA Health System Epidemiologist, Chair, Infection Control Committee INOVA Fairfax Hospital
Clinical Assistant Professor of Medicine, Georgetown University Hospital
Training for the Fairfax County Office of Risk Management, Used by Permission

• Potentially Infectious Materials
• Disaster conditions which increase risk
• Mechanisms of Transmission
• Categories of Transmissible Organisms
• Disaster Worker Protection
• Guidelines for exposure
– Blood and body fluids

Potentially Infectious Materials
• Body secretions / excretions
– Human: poor sanitation conditions
– Animal: livestock, rodents, vermin, insects
• Decayed carcasses
• Hanta virus from contact with rodent feces
• Putrescible materials
– Spoiled foodstuff, garbage and refuse
• Allergens
– Concentrated fungi, molds

Disaster Conditions
• Stagnant surface water
– Mosquito harborage
• Contaminated flood waters
– Sewage treatment system overflow
– Petroleum, industrial, agricultural, hazmat releases
• Structural instability
– Trauma risk, falls, sharps potential
 Airborne contaminant plumes
– Smoke, dust, toxic gases,
– Radioactive fallout from RDD or NuDet.

Mechanisms of Transmission
• Direct contact (“portal of entry”);
– Non-intact skin
• Penetrating injury (percutaneous)
– Physical injury, causes portal of entry
• Aerosol
• Vector borne

Transmissible Organisms

• Tetanus (most likely in adults who have not received tetanus toxoid booster within 10 years)
• Hepatitis A, B (C much less likely)
• Enteric bacteria (e.g. E. coli, Salmonella)
• Vermin-mediated
– Cats: Toxoplasmosis
– Mice, rats: (urine): Leptospirosis; (feces) Hantavirus
– Tularemia
– Plague (rat flea)
• Toxins (botulinum) decaying, spoiled foodstuffs
• Vector-borne (Lyme, West Nile, Malaria)

Disaster Worker Protection

• Good personal hygiene
– Wash hands, use hand sanitizers, double-glove
• Use DEET containing insect repellants
• Tetanus toxoid booster (every 10 yrs)
• Hepatitis A/B vaccine
• PPE use
– Gloves, hand sanitizers
– N95 respirator in dusty environments
– Correct sizes, fit testing
• Awareness training
• Medical screening (post event)
– If confirmed exposure

Guidelines for exposure to Blood and body fluids

• Immediately notify Command, triage exposed CERT as casualty
• Command contacts the Public Safety Answering Point
• Exposure is not simple contact, but a specific eye, mouth or other mucous membrane, non-intact or piercing contact with blood or potentially infectious material
• Clean exposed area thoroughly with soap and water
• Public Safety – EMS will contact consulting on-duty physician regarding circumstances of the exposure
• If consulting physician agrees exposure has occurred, volunteer will be sent to nearest health care facility to undergo blood sampling and post-exposure prophylaxis…


CERT Actions Upon Exposure to Blood or Body Fluids

• Identify source patient to enable blood testing
• If consent is not obtained, public safety must be notified immediately to initiate legal actions permitted under Virginia Code to obtain source patient’s blood for testing
• Incident Safety Officer completes Exposure Incident Report in compliance with CDC and VHD guidelines.
• DO NOT DELAY treatment, go directly to the nearest hospital emergency room
• Record all pertinent information regarding the specific exposure and bring it with you to the emergency room.

CERTS CAN protect themselves through:

• C aution
• A lert Awareness
• N otification
Thanks for that Outpost. That is alot in 24 hours. I am very into learning new skills and ideas, this would cover alot. I will go over your list and see what I can prepare for ahead of time.
Thanks!
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Old 02-01-2018, 10:02 PM
Outpost75 Outpost75 is offline
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Fire Academy instructor cadre took several posted CERT gear lists from a EM listserv, merged them into one, sorted the items into categories, and consolidated their contents into one list for planning purposes for teams being deployed in mutual aid scenarios of up to seven days.

Attention must be given to the weight of necessary items that you MUST carry to safely complete your mission, your physical condition, and your need for mobility.

A concept widely used by search and rescue groups is a total gear package consisting of three LEVELS:

Level I:

Clothing you are wearing and pocket contents including minimum survival items such as a pocket knife, lighter or matches, eyeglasses, small “task light” flashlight, pint water bottle, cell phone and pager if you use one for alerting. Suggested weight of Level I gear should not exceed 2 pounds.

Level II:

Consists of personal equipment to support a solo foot assignment in the field for a 12-hour operational period: Personal protective equipment, comfort and safety items include small personal first aid kit, rain gear, hat, snacks, water, portable 2-way radio, headlamp on hardhat, extra batteries, 1 liter water bottle (bottles 2 in hot weather), snacks and personal medications for a day, sunglasses, multi-tool or pocket knife, map and compass or personal GPS. Suggested weight of Level II gear should not exceed 8-10 pounds.

Level III:

Consists of your technical rescue gear, extra expendable supplies and life support items to supplement the first two levels. An internal-frame pack of 1500-2000 cubic inches, is a good choice. A 25-30 pound pack is the maximum which a 35 to 50 year-old male in “good” physical condition, with no medical problems, should carry all day. New team members should undergo medical evaluation including a stress test, and when necessary follow up with a structured physical conditioning program conducted under medical supervision.

For out of state Mutual Aid deployments a 72-annex is added to the usual 24-hour CERT/SAR pack. A rubbermaid storage box kept in your vehicle is a re-supply point for your walking kit. In it you should have:

2 full changes of clothes, including socks and underwear
Personal hygiene items - soap, shampoo, towel, razors, deodorant, toothpaste, dental floss
Food for 5 days - 10 Heater Meals, MREs or LRP-CW military rations as a minimum
Water – Minimum 5 gallon container and filter recommended
Sleeping bag, or 2 wool blankets weighing minimum 4 pounds each
Cold weather clothing – insulated coveralls, or trousers, extra socks, anorak, parka
Rain suit or poncho
Stock of spare batteries for GPS, 2-way ham or MURS radio and flashlights

Pick and choose the essential equipment for your assignment from the following category lists.

Bags and Containers

Multi-pocket gear vest for everyday carry personal items you carry - Level I

Waist Pack to carry water bottles, health and medical items - Level II

Internal frame rucksack for rescue equipment, food, water, shelter and multi-purpose gear - Level III

Rubbermaid Brute container in vehicle for supplemental storage - 72 hour annex

CERT / SAR Job Aids

Flagging tape
Masking tape
Sharpie fine tipped markers (2)
Wide felt tipped marker
Lumber crayon or grease pencil
Carpenters pencil
Fisher Space Pen
Rite In The Rain CERT notebook
CERT FORMS Book
CERT Field Operations Guide

Health and Medical

CPR masks
N95 masks, minimum 1 per day, recommend pack box of 12
Triage tape or tags
Decontamination gel or hand sanitizer (12oz.)
Antibiotic ointment
Baby wipes or moist towelettes (100)
Alcohol prep pads (100)
Tweezers
SAM splints (4)
Tongue depressors (20)
Petrolatum
Insect repellent with sunscreen SPF30
Sterile needle
Oral thermometer
Sterile #10 blades (2)
Spenco second skin
Knuckle bandages (12)
Band Aids (100)
Butterflly strips (50)
Tincture of benzoin (1/2oz.)
Betadyne (4oz.)
Waterjel (4oz.)
Quick Clot ACS 25g (4)
Military wound compresses (4)
CAT tourniquets (2)
1” Medical tape (100 ft.)
2” Medical tape (50 ft.)
4” ACE Wraps (4)
4” Kerlix rolls (8)
4x4 Dressings (20)
5x9 Dressings (12)
10x8 Dressings (4)
cravats, triangle bandages (12)
Safety pins (24)
Pint irrigation wash bottles (2)
EMT scissors
5” straight jaw Kelly forceps
Aspirin 325 mg (100) not for children under age 12
Acetaminophen 500mg (100)
Ibuprofen 200 mg (100)
Syrup of ipecac
Activated charcoal
Antacid tablets

Signals and Safety

VS-17 Panels (2)
Railroad flares, traffic cones or triangle reflectors (6)
5 lb. 2A-10BC dry chemical extinguisher (2)
Fox 40 or ACR Whistle
Signal mirror
Glow sticks (10)
DANGER tape

Communications

AM/FM broadcast pocket radio
Portable NOAA Weather radio
GMRS/FRS radio
MURS or Marine Band VHF
Cell phone with mobile charger
Ham 2m or dual band 2m/70cm radio

Tools and sharps

Pocket Utility Knife, Swiss Army, Boy Scout or Mil-K-818
Multi-tool, Leatherman or Gerber
Sturdy fixed blade, aviator’s survival, K-Bar or equivalent
Adjustable Crescent wrench
Non sparking multi-use rescue tool
Folding saw
Shovel or folding U-Dig-it
Hatchet or Axe
Bottle jack
High lift jack

Rope, Cordage and Connectors

Duct tape, multiple sues
Paracord (50 ft.) for tag lines
Rope (50 ft.), static load
Nylon webbing, for slings and hoists
Bungee cords (8)
Gear bands cut from bicycle inner tube
Cable ties (100)
Snap links (4)
Tow strap

Clothing and Shelter

Casualty blankets (4)
Wind/rain suit or poncho
Wool or fleece warming layer
Extra dry wool socks (4)
Gloves, cold weather
Watch cap or balaclava

PPE

ICE Card with emergency medical and contact info
Safety glasses with side guards
Sun glasses
Gloves, nitrile, box of 24 pr.
Gloves, rescue/mechanic’s, 2 pr.
N95 masks box of 12
Boots, ankle support, traction sole, safety toe
Vest, ANSI reflective Type II
Hard Hat (CERT) ANSI Z89.1-1997, Type I, Class E & G

Fire & Light
SparkLite kit
Waterproof matches
Princeton Tec LED headlamp on helmet
Surefire G2 hand held flashlight in med bag
Microlight II on gear vest zipper pull personal illuminator/beacon

Navigation

GPS with mobile 12V power cable
Orienteering map compass on dummy cord
24,000 scale USGS Topo of assigned search sector
Official State DOT road map
Local street map

Food and Water

Survival water filter
Micro-pur tablets
Pint irrigation bottle in first aid kit
2 quart canteens drinking water on person
four gallon spare water containers or 5-gallon water can in vehicle
Snacks 24 hours: hard candy, trail mix, jerky, peanut butter, crackers, raisins
Ten MREs

Multi-Purpose and Misc.

5 gal. plastic bucket and lid to store this stuff in, field latrine
Extra batteries, two complete change outs for all devices
Emergency cash, enough for hot meal and a tank of gas home
Extra reading glasses if you need them
Toilet paper
Disinfectant
Paper towels
Folding litter or stretcher
9x12 tarpaulin or Plastic sheeting
Garbage bags and twist ties
Ziplock bags, quart and gallon sizes
Canteen cup or mess tin
Spoon or spork
Paper plates & plastic utensils
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