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Disaster Medical Specialist

by Alexandre Migala MD

Paramedics who join a US&R team should undergo additional training in Disaster Medicine that exposes them to a variety of situations and scenarios intended to challenge their creativity and flexibility while introducing a number of skills not in the typical paramedic’s repertoire. Alumni of the training recall their experiences, with a mixture of frustration, excitement and good humor — “The Wedge” or “The Tunnel”.

The TEEX US&R Disaster Medical Specialist course involves a curriculum re-emphasizing the core medical skills of paramedics while expanding those skills applicable to mass casualty situations involving collapsed structures and austere environments. The course introduces equipment available in the US&R cache by highly experienced instructors and physicians who provide the most current research and data mated with their expertise.

Fundamental skills such as patient assessment and examination are expanded to include assessing with limited exposure, as access to only an extremity or part of the body may be available. Monitoring patients requires flexibility and adaptability as the senses and equipment available are limited or hindered by the environment - high intensity noise, dust and smoke, space and equipment limitations. Trainees are exposed to small tunnels, collapsed structures, limiting movement, confined spaces, noise, water and simulated smoke that strains the imagination and forces the use of all their senses and equipment to evaluation and treat the patient. “Med Specs” are taught to hone their skills and be confident in those skills so they can render care anywhere and anytime, while enforcing the “team” approach in conjunction and in cooperation with the rescue and search specialists.

Trainees are challenged in their airway management skills by subjecting them to “The Wedge”, “The Tunnel”, and “The Box” that require various approaches and limited access to patients, and emphasize adaptability and various skills that may be required. Airway techniques include digital intubation, variations of direct laryngoscopic intubations, the lighted stylet, the surgical techniques, and camera-assisted intubations. Vascular access skills that are emphasized include exchanging over-wire techniques, central venous access and intra-osseous access using the EZ-IO.

The FEMA US&R Medical Working Group continues to investigate equipment and protocols that have been developed by the civilian community and the military through experience in Iraq and Afghanistan, including hemostatic dressings, tourniquets, and the possible use of ultrasound, for possible implementation among US&R Teams.

The Disaster Medical Specialist course is scheduled for December 14 – 18, 2009.

To view the Program of Instruction for this course, click here.

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