23 Jan 2009
10 minute read
agk’s Library of Low Resource Medicine
We had a massive storm yesterday, beginning with several inches of snow, continuing through a partial melt, half an inch of ice glaze, then alternating sleet and snow for the better part of twenty-four hours. Electricity was out, taking water and heat with it. Roads were generally impassable, and restricted to emergency personnel only where open. I was the only vehicle I saw on my way in to work (and used the AWD/ABS features of my car frequently – I am so grateful my parents taught me how to skid and recover) and several of my coworkers, including those with giant SUVs, were trapped even much closer to town. All in all, it mimicked many of the conditions my more apocalyptic/oil-transition-minded friends talk about, and as such is a good learning experience for those curious about human behavior in a disaster.
We had several additional loads on our system, not least of which was a staff shortage. We had trouble getting people from their homes to the station, and the supervisor vehicle (a fairly rugged SUV) was running back and forth all morning collecting various staff and medics. We had a full complement by noon, and were able to use the staff from the previous day who had been unable to return home as backup, so that we had nearly twice as many ambulance as usual on the roads. Also, we were able to use auxiliary vehicles, like wheelchair vans, to carry stocks of cots and blankets, but that was later.
There were several immediate problems from the roads closing. First, obviously, was that a certain number of people who did drive went off the road. I don’t think anyone was seriously hurt in our entire service area, mostly because nobody who drove went very quickly. Still, a wreck requires at least an ambulance and a fire truck, which meant that even a small number of lightly damaged vehicles kept us busy throughout the shift.
Also, our trucks went off the road too. My partner and I didn’t, luckily, but at least one of our trucks required a tow, and a fire engine did too. Several times ambulances were caught at the bottom of a hill, and had to depend on volunteers with four-wheelers to carry medics and patients back and forth to the scenes.
Many people on a regular day take themselves, their spouses or kids, or their parents to the emergency room or the doctor’s office, for reasons which don’t require an ambulance but might need some medical attention. When the roads are bad and civilians can’t drive themselves, all of these have to go by squad. So this was also an added demand on our system. Many of the doctors stayed closed, as well, which meant that everyone went to the ER, even for medication refills and headaches.
Also, the cold made people’s illnesses worse, especially respiratory problems, which meant we had more asthma and COPD calls than usual. Plus, there are always background problems- heart attacks, seizures and such- which are always tricky, and though they weren’t any worse because of the weather, couldn’t be ignored. We are set up so that an average day uses 90% of our total resources, and the “average day” calls didn’t stop just because of everything else.
The electricity went out, but its important to note how this happened – laden with ice, trees fell into power lines. When this happened, the broken ends often started fires (“arcing and sparking” as the dispatchers say) in trees, the hook-up points on houses, and on poles and transformers themselves. These all required a fire department response. Because power lines run along roadways, there was often the added hazard of a blocked road, which could mean that the first thing fire crews had to do was cut through an entire tree to get to the part that was on fire.
We were also kept from at least one call by a downed tree. Other trucks had similar problems. With the roads being so narrowly plowed, there were few chances to “go around” any obstacle, and out in the country alternate routes can take literally an extra hour. We just had to wait, lights flashing, for a chainsaw crew to get us moving again.
The lack of electricity caused further problems- people dependent on electrical devices, like oxygen concentrators, had to be moved to relatives’ houses where the power was still on. In previous storms, we’ve ended up leaving compressed oxygen cylinders for people who could tolerate a lower rate of flow (i.e. their breathing problems weren’t as severe – cylinders can supply higher flow rates than can concentrators, but only for limited periods of time, so to conserve supply people who would need more than, say, two liters per minute for more than an hour or two would have to be moved)
Also, many houses’ heat went out with the power, not because they had electric heat but because the gas regulators on their propane or oil furnaces are electrically controlled. To keep warm, many families fired up wood stoves and fireplaces they hadn’t used in a year, or else kerosene heaters and a surprising number (something like a dozen in the county) set themselves or their houses on fire, and many more set off their carbon monoxide detectors. One person (in a nursing home, again more later) was trapped behind a fire, but other than that noone was hurt, a tribute to the fire crews involved.
Its worth noting that water trucks, like FD tankers, are the most dangerous vehicles to drive under good conditions. On icy roads, they are positively heroic.
One nursing home, a rather venerable structure right up the hill from downtown, caught fire when a resident (illegally) smoking in her room set her couch alight. She was eventually extricated without injury, and the fire never spread beyond her room, but for safety’s sake the entire building was evacuated into the cold. This required… a lot of work. I happened to be out of county when this happened, taking a heart patient to Columbus, and due to the poor quality of the interstate was moving so slowly that I missed the whole thing. Nonetheless, the city buses, the Red Cross portable disaster trailer, and our entire fleet were involved, and it is to the credit of everyone that no-one was seriously hurt.
The day belongs to the volunteers, though. Above all, the storm closed businesses, which meant that nobody went to work, and an astonishing number of people decided the best use for their free time was to head down to the volunteer fire department, on ATVs if necessary, to help out. The firehouses were so overstaffed that some had more complete ambulance crews living on station than they had vehicles; contrast this with ordinary days when you may be lucky to get a single first responder. The surplus could be seen all day long, zooming about in the back of four-wheel-drive pickups like Castro’s troops entering Havana, with chainsaws instead of rifles, grinning and waving at shovelers and admirers on porches and sidewalks alongside.
I mentioned we were blocked by a downed tree. A young child had a seizure in an outlying area, and by the time we came to the blockage, one crew of VFDers had gone on to take care of her and left another fellow behind at the tree with a radio to let us know what was happening. No sooner had we reached him than two pickups raced up behind us and a crew of six kids jumepd out and dismantled the tree in, literally, a minute and a half. It was absolutely awesome to watch.
Granted, volunteers don’t pay for their own gas or their gear, but they aren’t paid themselves. They do it for the sense of being useful, the camraderie, and the chance to run up against an impossible situation and kick it squarely in the teeth. In so doing, they probably saved a few lives, and definitely made the residents of the county feel a lot more secure and connected with their townships and their communities.
There were other interesting observations – all the businesses being closed meant that people who are not me (I keep a supply of basic ingredients in my locker) had no food at all for the complete 24-hour shift, and survived on the cookies prepared and donated by the hospital kitchen staff, plus sodas and candy from vending machines. When a gas station opened later in the day, we raced up so my partner could obtain a hot dog.
Also, we didn’t have enough beds at the station for everyone who was stuck there or called in, so I slept (briefly) on the cot in the back of the truck. This is standard disaster-relief procedure though- one crewmember on the cot, one on the bench-seat, as it ensures dry windproofed bedding and discourages theft of medications.
Anyway, this entry is long enough. I’m exhausted and have to go build my house some more.
From: [redacted]
Date: Январь 29, 2009
This sounds very familiar. My dad was the chief of the local volunteer fire department for several years, and Mom was always one of the ladies cooking food, making sandwiches, and generally running around behind the scenes keeping the volunteers fed and moving. The nearest hospital was ten miles away “off the mountain,” while the VFD service area included probably a hundred miles or more of rural mountain roads. The first big temperature-drop night (whether snow, ice, or whatever) they would keep a team at the station, because they knew at least one person would set their house on fire when they lighted up the stove/heater/whatever for the first time that year. They had one smallish truck that was seriously hardcore 4x4 – an old military surplus vehicle that could literally drive over fallen trees. They jack welded a mini-tank & pump assembly to go in it, for both brush fires and winter storms. I first learned how to use a chainsaw to help cut fallen trees.
It’s nice to hear that people are at least still doing that somewhere. In my hometown, so many of the young people moved away to find jobs that the majority of the town is elderly now. There’s barely enough manpower to keep the fire department going for the normal emergencies. I don’t know what they’d do now in a real crisis. Although I suspect it might involve my 5'2" 75-year-old mom wielding a chainsaw.
----------------------------------------------------- from HUCK FINN ON ESTRADIOL © . My friend Anne's old blog, available via http at tagonist.livejournal.com -----------------------------------------------------
agk’s Library of Low Resource Medicine is hosted on sdf