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Drills Crews on Hazard Responses
'Wish We Got More' Backed by EMTs Leo Deraino, Leena Bindra, Dmitriy Ponomarev, Amanda Schmidt and Lieut. Kevin Darnowski, EMT Lynch last week went through a series of training scenarios designed to acquaint her with the on-the-ground realities of administering medical care while moving through a contaminated area. "It's great - I wish we could get more training like this," said EMT Lynch, wiping sweat off her face as she completed a practice run through the FDNY's subway simulator that had her climbing two flights up and out an emergency hatch onto a mock city street. Approximately 1,500 EMS members have already undergone the intensive, two-day seminar that teaches the fundamentals of surviving in a contaminated zone. The program was set up by Chief of EMS Command John J. Peruggia with a $2.6 million Fire Act grant and $600,000 in matching funds from the city. Lieut. Bill Melaragno, a member of an FDNY hazardous-tactical unit who has extensive military training in decontamination techniques, is responsible for the instruction given to students in the classroom. During the eight-hour session, he expands upon the basic hazardous-material-awareness training that EMTs and Paramedics have already been given by the FDNY. His job is to educate EMS workers about the different types of biological and chemical agents they might encounter at hazardous scenes, and how to identify situations where they may be exposed to such materials. "Who knows how many nuclear reactors there are in the city," Lieutenant Melaragno asked a group of EMTs and Paramedics who started their training last week. "Anyone know? Columbia University has a small reactor. How about chemical plants - anyone know where Pfizer's plant is? And they're not just making Viagra there anymore." The students range from new hires with only a few months on the job to officers and veteran workers like EMT Lynch. While some of the more-experienced EMS workers might feel they already know the basics the class teaches, Lieutenant Melaragno said it's crucial that everyone get a chance to practice updated maneuvers while wearing the new turnout gear recently purchased by the FDNY for EMS members. Defensive Striving "Haz-mat awareness trains people to recognize a hazardous substance and what to do in that
instance," he said. "The haz-mat operations training we're giving them today is how to operate in a 'warm zone,' an area that's been contaminated, from a defensive position." The FDNY has been putting EMS members through the two-day training classes since September. The first day is spent in the classroom with Lieutenant Melaragno; the second day is spent working through various simulated emergencies in the surrounding buildings. In addition to having a life-size replica of four subway cars, complete with train tracks, platforms, real signals, emergency call boxes and escape hatches, there are burned-out cars for confined space rescues, smoke-filled buildings, and a flashover simulator known as the pit. Stretcher Stand-Ins Outside, under the watchful eyes of Capt. Jeffrey Race, the EMS Commanding Officer of Haz-Tac Operations, EMT Lynch and her team race through a rescue in their new turnout gear. Instead of regulation stretchers, they use skeds - lightweight plastic sheets that can be pulled easily by one or two people over a variety of terrains. Patients who have been exposed to radiation or other hazardous materials have to be "wrapped" before they can be moved out of the warm zone. The decision to increase the number of EMS workers who could safely operate in hazardous situations grew out of need, said Chief Peruggia. "We decided that only having a handful of ambulances trained to the operations level wouldn't make sense, since in the event of an emergency many more would likely be needed around the city," he explained.
A Nationwide
Concern New York is not unique in its decision to increase staffing and training of EMS members. A recent gathering in Washington, D.C. of 50 EMS Chiefs from the country's busiest cities found that nationwide, most EMS departments were under-prepared for major disasters that required working in hazardous conditions. The symposium was sponsored by George Washington University's Homeland Security Institute and resulted in the National EMS Preparedness Initiative. Chief Peruggia, who was invited to sit on the board, said the goal is to set national standards for EMS staffing and training. The FDNY is already leading the country in its post-9/11 training efforts, however, and its latest program has gained national attention. Of the department's 220 ambulances, said Captain Race, 35 are haz-tac units that can also respond to regular 911 calls. Haz-tac members are trained to wear self-contained breathing apparatus and can wear the heavy protective suits that are used for direct exposure to hazardous substances. Staffing Make-Up Of the city's 35 haz-tac units, 20 are staffed with Paramedics and 15 with EMTs. Besides the regular operating supervisors, there are two haz-tac trained Lieutenants on duty 24-7 who cover all five boroughs. Five of the haz-tac units were recently given even more training in how to do confined space and collapse rescues. They'll be deployed in the field for a pilot study over the next few weeks. Captain Race said the department was committed to giving its members hands-on experience with the EMS Bureau's new gear and procedures so that when they got into real-life situations, there would be no surprises. That included learning how to administer big doses of antidotes to people exposed to chemical agents - something that EMTs, who do basic life-support work but don't necessarily give injections, would need to practice. 'Need to Inject Fast' "We do this with expired antidotes, but it's real equipment. The antidotes are no good anymore, so it's better than just throwing them away," explained Captain Race. "If you're dealing with a critical patient who needs a massive dose, we want the EMTs to move fast and know how to get this in through clothing, while wearing their gloves and protective gear. We also teach them to bend the needles into the ground when they're done and discard the syringe." The FDNY even brought a Prius, one of the electric- and gas-hybrid cars, to the academy so EMS and FDNY members could practice doing collision rescues in it. The new fueling system changes the way the air bags deploy and how windows and other components work, Captain Race noted. The FDNY has also issued a limited number of voice amplifiers that EMS members can clip over their face masks during training. The masks - air purifying respirators in most cases - make communication difficult. The amplifiers allow voices to be heard, especially over the radio, with muchimproved clarity. Seeking More Chief Peruggia said he was hopeful the FDNY could secure another grant to enable it to deploy amplifiers to all members. For now, there are only a few used for training purposes. The FDNY has also created a back-up of approximately 140 radios in its divisions around the city. In the event that it needs to call in mutual aid, as it did for the August 2003 blackout, the radios will be handed out to incoming companies so they can communicate within the FDNY system. Captain Race and Chief Peruggia said they were pleased with the new gear. The turnout coats, pants, boots and gloves that EMS members were issued can protect them for a limited time in all but the most toxic hazardous environments. But, said Chief Peruggia, the right equipment had to be accompanied by the right training. "We know the capabilities of our gear - it's state of the art," he said. "But at the same time, if you're going to be operating in a certain type of area, you should be trained for it, and that's what this program is about." | ||||||
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