Triage: The Balance of Life and Death – Blog Post 8

For the hurt and injured, when it comes to natural or man-made disasters, medical triage puts them in four categories. They are ranked as follows: Minor, Delayed, Immediate, and Morgue. However, as a law enforcement or emergency medical personal, triage becomes a matter of deciding who may live and who may die. How does one decide whose life is more important between the 10 year old, lower class male who has no pulse from shock and or the 50 year old, upper class, father of two, who is suffering a severe heart attack?
Many First Responders like police officers and firefighter are trained in the use of the S.T.A.R.T. method when it comes to mass causality incidents. According to MedicineNet.com, S.T.A.R.T. stands for Simple Triage and Rapid Treatment and was developed in Newport Beach, California. The S.T.A.R.T. method is similar to triage but involves a quicker assessment of the injured subject. If you are talking and mobile, it is possible that you may be placed in the minor category for triage care. It is interesting to note that for the less experienced medical technician, it is hard to ignore subjects who are bleeding and screaming in pain but it is necessary to ensure that the most critically injured be prepped and stabilized for transportation to a hospital. Unlike the S.T.A.R.T. method, advanced triage surrounds the idea of the most critically injured are given priority for medical care and transportation.
In advanced triage, social and class factors do not matter, in caring for the subject. Medical care surrounds the idea that the dead are placed in the Morgue category. However, the people who are about to die are given priority medical care. It is possible that in a Hurricane Katrina or Loma Prieta drugs and medical supplies and care won't be given to those people who have minor injuries. Also in these extreme and severe conditions where medical transportation is rare, people who are given a quick preliminary exam in the S.T.A.R.T. method and placed as "Minor" may or may not see hospital care for hours and even days. It is possible if a subject cannot receive the professional care of a hospital and is in critical condition, professional care may be stopped on them. At that time, this medical judgment call is made by the highest medical professional in the field. It is important for medical personal to put aside their feelings and understand the difference between the living, the dead, and those who are about to die if they do not receive care.
With this idea in mind, medical personal must set aside favoritism, pre- conceived notions, and biases, as these may affect the natural decision making process. When one’s pre – conceived notions affect there judgments, as humans, medical personal tend to fall back on to their training. All emergency medical services have adopted a policy of resorting back to their fundamentals. In this idea, medical personal at the scene of an accident or disaster must follow strict protocol in treating a subject. So one’s race, gender, or sexual orientation does not affect that way they receive treatment. It is hard to ignore a person’s cries for help, but if personal feelings effects one’s actions, they comprise their job and the integrity of their department. This task is easier said than done but is a “necessary evil” in maintaining professionalism and order during critical disasters.
So medical triage can be analyzed many different ways. However, it is up to the individual, whether they be a paramedic or law enforcement officer to make the appropriate judgments when necessary. In simple terms, each individual is tasked with the ability to “play god” and may be called on to make a critical decision of who lives and dies during the duration of their career. Putting aside one’s feelings and ideas is un-human but is necessary to maintain order. For those called on to make the decision of who lives and dies, there is no protocol and standing orders helping them deal with the guilt that someone may not go home to their love ones that day. In the emergency medical field, as a first responder, one stands as the difference in the balance of life and death.


Works Cited
MedicineNet.com
Google Images

In times of natural disasters, how do you help the helpers? Blog Post 7

This video depicts officers of the New Orleans police department looting a Wal Mart days after the 2005 Hurricane Katrina. Looting can happen anywhere during a natural disaster and it is the job of all law enforcement officers to restore order to society but how can order be restored to society when the officer’s well being and that of his love one’s are on the line.
Although, media can be very liberal at painting officers in a bad light, one would have to agree with the reporters in this video. Law enforcement officers stand for law and order and if they are looting two days after the hurricane hit the south east coast, than what would law and order be like in a week, month, or year? These officers should be forced to resign, or be brought up on criminal charges, as this video shames the department and the officers that work for it.
Some may say that survival may behind the fact that police officers are looting because in desperate times, desperate measures must be taken in order to survive. However, law enforcement officers, whether they be local, state, or federal are mainly tasked with upholding the law at all cost. Instead of walking around inside the Wal Mart like they cannot catch a looter, they should be outside the front doors of the Wal Mart providing security. It is up to the drop of disaster relief organizations such as the Red Cross to provide support when people need it the most.
Currently, in the news, it is said that Hurricane Ida is about to follow in the steps of Hurricane Katrina and hit the south east coast line. In this time before the storm, police departments should beef up patrols in high risk neighborhoods. As well, they should make sure that they families and most prized positions are in a safe place to prevent looters and to ensure their personal safety. The actions of the officers were wrong, however, law enforcement officers should be allowed the supplies they need so survival is not an issue when trying to “protect and serve”. It is from learning from the mistakes made at Katrina that other states like California can better prepare for natural disasters.

Dead of a Mass Disaster and Law Enforcement - Blog Post 6

It is commonly said that one can tell how civil a society is by how they handle their deceased. For most western civilizations, death is an enigma because as a society, their ceremonies and customs do not require them to embalm the remains. From this separation, western societies have come to fear death instead of looking at death as a part of life.
According to the World Heath Organization from the California Mass Fatality Management Guide, more than 100,000 people die in natural disasters and millions of others are injured or disabled. With gruesome images of bodies found decomposing many weeks and months later, the initial focus of the media is to paint the government and law enforcement agencies as “not doing anything” or “not doing enough”. In a time of natural disaster for the state of California, when it comes to law enforcement and local government the question should be asked: “How should the dead be laid to rest?”
The 2005 Hurricane Katrina stands as a grime example of how not to handle the dead. When the hurricane hit the south - east coastline, it destroyed many cities. For those who did not flee the cities they either died from drowning in the rising waters or died of starvation, trapped in the attics of their houses. Due to the lack of local law enforcement and government personal, thousands of dead bodies were left out in the open to decay. As noted in a presentation by Robert Gerber, Deputy Chief of Coroners’ mutual aid program, in one instance, a decaying body was found in a busy intersection and marked with a traffic cone as a police officer conducted traffic control. Although law enforcement was under staffed and over worked, this image is both disturbing and paints a negative picture for officers and government officials. With these pictures in their minds, families were outraged that the remains of their “loved ones” weren’t returned to them in a timely and respectful manner.
Learning from the mistakes made at Hurricane Katrina, a procedure is outlined in the California Mass Fatality Management Guide. In this guide a portion of the book outlines what law enforcement and government officials tend to do with the decease. It should be noted in a case of an incident, local governments rely a heavy amount upon by the federal government. Local law enforcement should not have to rely on heavy federal support to act upon an incident.
Once the federal government comes to the assistance of local personnel, the Department and Health and Human Services enacts the National Disaster Medical team’s DMORT team. DMORT stands for Disaster Mortuary Operational Response team. This team consists of private citizens trained in performing autopsies, identification of remains through forensic pathology, dentistry, or anthropology. As well they assist in DNA retrieval, tracking of human remains, and ante-mortem data collection. The Department of Health and Human service’s DMORT team is a good idea but more local law enforcement and government officials should be trained in the capabilities of the DMORT team. Local law enforcement should do the preliminary work before federal assistance is needed.
The California Mass Fatality guide also outlines a family assistance center were families can receive death notifications of their love one, counseling, and receive medical assistance. As well, other federal organizations like the NTSB or the National Transportation Safety Board have outlined what to assist families in a swift recovery of the remains. More emphasis should be placed on local and statement support than federal support in the time of a disaster. Though the California guide is a good outline to a natural disaster, it should be worked to place more disaster support in the hands of local law enforcement and government officials instead of state and federal support.

During a natural disaster, it is by placing more emphasis on local and state functions and instead of federal support that law enforcement can better manage a critical incident. For the state of California to prevent a controversial incident like Hurricane Katrina and the number of dead, it should broaden the focus of local law enforcement to handle more tasks of the federal government. It is by learning how to manage the living that society can better handle the dead.

References
- California Mass Fatality Management Guide: A Supplement to the State of California Coroners’ Mutual Aid Plan
- Mass Fatality and Search and Rescue presentation by Robert Gerber
- Photos by Google Images

Police/Fire and Rescue Service & Earthquakes - Blog Post 5

Police/Fire and Rescue Service & Earthquakes - Blog Post 5

On Oct 17, 1989, at approximately 5:04 pm, the San Andres fault buckled creating a 7.0 earthquake that killed 63 people, injured 3,757 people and left some 12,000 people homeless. This earthquake was not only felt in the bay area but was also felt as far south as Santa Cruz and other California coast line cities.
The 1989 Loma Prieta earthquake stood as a wake up call to many Californians in that improvements needed to be made to police and fire/rescue services, better warning systems, and prevention for future earth quakes.
The first observation that could be made was that the police and fire/rescue services were not adequately prepared during that time to handle a mass incident. A perfect example of this in the Loma Prieta earthquake was the collapse of the Interstate 880 overpass in West Oakland. During the earthquake, a mile and half section of the two story overpass collapsed crushing 42 people in their cars. Busy with other calls around the bay area, it took a while for fire and rescue personnel to get to the collapsed overpass. Before rescue personnel arrived, civilian bystanders pitched in too help with what they could. Since than technology such as better computers and radios have allowed police and fire services the ability to respond faster to calls for service. As well, since 1993, FEMA, or Federal Emergency Management Agency recognizes the importance of citizen volunteers. Since than CERT teams or Community Emergency Response teams have been created in over 28 states to respond to earthquake and fire type disasters.
Two other observations that the Loma Prieta earthquake of 1989 pointed out is that early warning systems and building structures needed to be updated. As popular as the media was during that time, the bay area was lacking an instant broadcasting system. Also, the city of San Francisco reflected a lot of damage to the buildings, especially in the Marina district. It should be known that the Marina district experienced the most damage in San Francisco as many of the buildings were built upon the ash and rubble of the 1906 earthquake. In the present, the USGS or US Geological Survey, has made earthquake information more readily available through there website, and media broadcast. Stricter building codes have also been put in place to prevent building from instantly collapsing from the shock waves of the earthquake.



The most important question that one should ask themselves, with improvements in fire and rescue services, warning systems, and future preventions: “Is the Bay Area now safe?” Sadly, all of these precautions have improved the police/ fire and rescue, and fortified buildings but certain areas around the bay are still vulnerable. Most USGS geologists believe that a bigger and more devastating earthquake is destined to strike the bay area between 1990 and 2020. Upon the 20th anniversary of the Loma Prieta earthquake, hopefully, society has learned from their mistakes in order to prepare for another future incident.
References
http://pubs.usgs.gov/fs/1999/fs151-99/
http://pubs.usgs.gov/dds/dds-29/
Pictures from:Google.com

Law enforcement/Rescue Services and Pandemics - Blog Post 4

Law enforcement/Rescue Services and Pandemics

History has seen a wide variety of diseases and viral epidemics that have spread throughout the United States and the world. As a civilization, people have learned to adapt and overcome diseases. With the current outbreak of the “H1N1 virus” or “Swine Flu”, some important issues come into question for police and rescue crews of California: If a major pandemic hit California, how could it be stopped? In the case of a pandemic, how should vaccines be distributed? Are California law enforcement and rescue serves prepared for a nation wide pandemic?
To completely understand the previous questions, one must first understand what is a Pandemic? According to California Office of Emergency Services handbook on California Mass Fatality, a “pandemic” is a disease that affects people on a worldwide scale. In a pandemic, society experiences a new flu strain, which affects humans and causes serious illness. As well, this pandemic has the ability to spread among humans very easily. Some current famous pandemics that hit the United States are West Nile Virus and Avian Flu.
With an understanding of the textbook definition of a pandemic, if a major pandemic hit the state of California, how could it be stopped? According to the Office of Emergency services, California is not immune to a global pandemic and that if a pandemic did hit, an estimated 25,000 to 59,000 would die from the virus . This is mainly due to the lack in health care. Although society’s health system does not allow if this, a system like a lottery could be used to distribute the vaccinations to everyone and not just the wealthy. As well, law enforcement should be able to “quarantine” the infected and people who are not sick to keep the disease from spreading. Stricter laws should be imposed so law enforcement could have these capabilities in times of crisis. Since the military is not a force that can handle civil matters, these laws should prevent the government from placing military forces in a law enforcement capacity.
Another important question that is brought to mind is that with the next pandemic: Who should receive the vaccinations? According to the Centers for Disease control pregnant women, household contacts and caregivers and emergency medical personnel are all high on the list for receiving the H1N1 vaccine. However, the priorities for people who receive the vaccination should be re – focused for law enforcement personnel. The main reason why law enforcement and emergency medical/rescue personnel should be given priority over the general population is that they are the ones who can help when it is needed the most. After law enforcement and rescue personnel are vaccinated, vaccines should be distributed by a case upon case basis.
The last question that comes into affect is that is the law enforcement personnel and medical/rescue personnel equipped to handle an outbreak? In the state of California, the Office of Emergency services in the Coroner’s Mutual aid program outlines guidelines of what to do in the planning and consideration part of a pandemic. In the same program, it is projected that 30-50% of “critical employees” due to illness, death, or absenteeism will greatly affect the work of the coroner’s office. With that being said, law enforcement and medical personnel are not ready for a disastrous pandemic. Despite all the training and updates on new diseases, the Office of Emergency services handbook basically says that without outside help from other states or the federal government, work with the deceased and infected will be slow and arduous. With critical workers who do survive, fearing for their lives, most will not report to work. Besides all being said and done, general law enforcement and rescue services are not ready to handle a disastrous pandemic.
What can be learned from present flu pandemics like swine flu is that changes are needed to be made to be prepared for the next real pandemic. Protocols and policies should not only be adjusted to keep order but among society but to also assist law enforcement and rescue workers. It is by understanding the capabilities of law enforcement and rescue personnel in the present that they would know what to do for the future.

References
§ Renteria, Henry. The California Mass Fatality Guide: A Supplement to the State of California Coroners’ Mutual Aid Plan: Governer’s Office of Emergency Services, 2007
Websites also used:
§ http://www.cdc.gov/
§ http://www.flu.gov/

The Siege: A Modern Look at the War on Terror

In 1998, a fictional movie was released, depicting a middle eastern terrorist cell in New York City In The Siege, two FBI agents, after a terrorist bombing that kills innocent men and women, are tasked with tracking down an elusive terrorist that blends into Arab population of New York. The movie, The Siege, brings up many possible scenarios of what could possibly happen if the government experienced terrorist attacks in California and the United States.
Associated with terrorist attacks in Iraq and Afghanistan, suicide bombings are conducted when one detonates explosives attached to themselves killing themselves and anyone around them. In one of the movie’s opening scenes, a terrorist has taken hostage innocent men, women, and children on a bus in down town New York. Sadly, the terrorist succeeds and kills everyone including himself aboard the bus. This type of suicide bombing, was seen in real life, three years after the release of The Siege. According to Encarta.com, on September 11, 2001, the international terrorist group Al Qaeda, hijacked four jet liners, two which crashed into the World Trade Center towers in New York City. This terrorist attack killed more than 3,000 people including the 19 terrorist, making America rethink it’s idea of isolationism. With many densely populated cities in California suicide bombings are possible tactic for terrorist organizations to attract media attention to their cause and strike fear into the hearts of their victims.

As the bombings continue in the movie, the United States Army is sent to New York. However, their counter-terrorist activities clash with that of the FBI. Since it is hard to distinguish “Friend vs. Foe” the Army resorts to the tactic of rounding up all people of middle eastern ethnicity to prevent another terrorist attack. This idea is not just seen in the movies but happened in real life. In World War II, with the bombings of Pearl Harbor by the Japanese, American soldiers rounded up all Japanese Americans and placed them in concentration camps throughout the United States. The general idea behind their incarceration was to prevent another terrorist attack and keep spies away from planning another attack. What the Japanese incarcerations proved is that it is hard to target an enemy that blends into the general population. Without the proper evidence, laws, and laws, finding the enemy could turn into a “witch hunt”.

One of the last ideas brought up by the movie, The Siege, is how far we are willing to go to find an elusive and clever enemy. Towards the climax of the movie, a possible terrorist is about to be tortured. Denzel Washington’s character, witnessing this action, makes a good point in that “How far is our military and law enforcement willing to go (to catch the terrorist) ?” The rules and laws of our society have been put in place to prevent unreasonable acts, and if people act not within our laws, the blood spilled by our fore father would be for nothing. Essentially, the War on Terrorism, is an impossible war to fight and without politicians supporting it, the United States will fail.
The movie, The Siege, depicts a modern America, where it is near to impossible without impeding on someone’s personal rights to fight the War on Terrorism. Unlike the previous world wars, where the enemy is clear marked and both sides support the traditional rules of warfare, the enemy the United States is fighting in the present, is smart, cunning, and uses different tactics. Instead of resorting to fighting the US soldiers head on, they send suicide bombers and leave improvised explosive devices by road sides. California without the help of the federal government and military is not equipped to deal with another September 11th like attack. California law enforcement and emergency rescue service s can only train in terrorist like scenarios to wait for the next attack. The best way to save California from a terrorist attack is rethink the way, they see the War on Terror.


Works Cited
· "September 11th attack." Encarta.com. Encarta,. Monday. 28 September. 2009. http://encarta.msn.com/encyclopedia_701509060/September_11_Attacks.html
· The Siege Dir. Edward Zwick. Perf. Denzel Washington, Tony Shalhoub. Bedford Falls Production, 1995. Film.
Also used photos/video: “The Siege”

The Importance of Search and Rescue to Law Enforcement Operations - Blog Post 2

With the recent economic down turn, jobs in the law enforcement field are rare and are very competitive. One of the agencies instrumental in helping law enforcement personnel, even in the current rescission is SAR or Search and Rescue. By understanding the activities and duties of Search and Rescue to police work, one is better understand the unit’s importance to the law enforcement field.

To understanding the importance of SAR, one must first understand the actions of a Search and Rescue unit. Associated with any county or national park, a Search and Rescue unit is comprised of paid or volunteer workers. They are tasked with the main responsibility of assisting people in their greatest time of need. Each individual in the unit is trained in areas of Land Navigation, Wilderness Survival, First Aid, and CPR or Cardio Pulmonary Resuscitation. There are also different sub-units in the Search and Rescue unit. There is a Mounted division that searches areas via horseback, a High Mountain rescue unit that rescues trapped hikers or climbers, and a Swift water rescue unit that deals with the lake and river rescues (Sacramento County Sheriffs).

A Search and Rescue Unit’s duties are not just inclined to finding missing people in urban and wilderness environments. In fact, in April of 2009, in Tracy, California, Search and Rescue units were deployed to Search for an 8 - year old missing girl(ABC News). She was later found deceased by a collaborative effort of Search and Rescue individuals and the local authorities. It was in this fine, that Search and Rescue units helped cordoned off the crime scene to await the appropriate law enforcement personnel.

There are other tasks law enforcement related tasks associated with Search and Rescue. One of the main one tasks are evidence searches. In the basic training of a SAR individual, they are taught in how to conduct a basic evidence search and what to do if one comes upon a piece of evidence associated with a crime. Also to aid Search and Rescue units are their dogs. Search and Rescue, not only trains their dogs on how to find live individuals, but to find deceased individuals and evidence specific to a certain crime. Scent dog were also used in the October 1993 Polly Klaas case where she was abducted from her home and later strangled to death (Polly Klaas Foundation).

One of the third duties Search and Rescue has to help law enforcement is their ability to locate dementia and Alzheimer’s patients. In fact, many urban searches have been conducted by walking door – to - door looking for the victim who went missing the day before. In July of 2009, Sacramento County Search and Rescue responded to the call of an elderly man who walked away. Surprisingly, the team found the victim through a quick search of the surrounding area (Sacramento County Sheriff’s).

It is through crime scene preservation, evidence searches, and conducting searches for patients with dementia and Alzheimer’s that Search and Rescue is and will forever be a vital assist to the law enforcement community. Participating in different searches, whether they be for an individual or evidence in a crime, the sacrifices of the Search and Rescue unit are made so “that others may live”.

Works Cited

• Sacramento County Search and Rescue. 2009. Sacramento County Sheriff’s Department. Sept 21. 2009 [http://www.sacsearchandrescue.com/]. + Photo
• Sandra Cantu Found in a Suitcase; Police Closing In on Suspect. April 2009. ABC News. Sept 21. 2009 [http://abcnews.go.com/US/story?id=7275611&page=1].
• Polly’s Story. 2009. Polly Klaas Foundation. Sept 21. 2009[http://www.pollyklaas.org/about/pollys-story.html].

California's Emergency Preparedness - Blog Post 1

California Emergency Preparedness – Blog Post 1

During the 1989 World Series , a massive 7.0 magnitude earthquake hit the bay area. The quake left 63 people dead, 3,757 people injured, and 12,000 people home less. Two years later, a fire broke out in the Oakland Hills leaving 25 people dead and destroying thousands of homes. Presently, in the year 2009, it is said that California is due for another big catastrophe. In this next disaster people will be left without basic municipal services. Medical services will be overwhelmed with the number of calls for assistance and law enforcement will be spread thin across the state. When thinking of natural disasters, preparing for it with training is not enough. In analyzing past incidents, it is fair to conclude that the blame for problems during the disasters does not rely with the relief workers but the people who are managing the relief workers.
2005 Hurricane Katrina stands as a perfect example of how poor management lead to problems with the government. This hurricane left 1,836 people dead, and lefts millions of other people displaced or missing. Two days before the event, President Bush issued a state of emergency for Texas, Florida, and Louisiana, knowing that these states, especially Louisiana could face massive flood problems due to their weak and deteriorating levee system. At this time, it is easy to conclude that the president had far more information than what was known by the public. Orders should have been issued weeks before the hurricane hit to evacuate everyone. In that way, maybe the death tool of 1,836 people could have been avoided.
Another fault that can be placed on management, is that of the enactment of FEMA during the days after the hurricane hit. Despite cries for help by the Louisiana governor, days after Hurricane Katrina hit, President Bush refused to enact the services of FEMA or Federal Emergency Management Agency. Days after the Hurricane hit, Local law enforcement and rescue services were stretched very thin. Most officers instead of manning a patrol car, left the city of Louisiana and abandoning their jobs. Those who stayed work 24 - hour shifts pushing their effectiveness at keeping the peace to their limits. Blame for this part of the disaster lies with local and state agencies. Not only should evacuation order should have been issued prior to the hurricane but drills to manage personnel should have been issued so the local and state hierarchy would not fall apart. In short, stricter laws and orders should have been issued for law enforcement and rescue personnel so chaos would not ensue after the earthquake.
Besides all the physical preparations of emergency drills, preparing a disaster preparedness kit, and updating equipment, law enforcement and rescue crews should development better training programs for leaders and managers. Similar to Louisiana, California has an extensive network of fragile levees bordering densely populated areas. There is nothing worse in a disaster when order falls apart and because of the lack of experienced personnel. Noting only should training be done to prepare for disaster but training should be conducted to manage people in that disaster.


References
• Renteria, Henry. The California Mass Fatality Mangement Guide:
A Supplement to the State of California’s Coroner’s Mutual Aid Plan . CA: Governor’s Office of Emergency Services, September 2007.
• Hurricane Katrina . 2009. US Departments of Health and Human Services. 13 September 2009. [http://www.hhs.gov/disasters/emergency/naturaldisasters/hurricanes/katrina/index.html]