June 23, 2018
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All hands on deck: How Maine can prepare for disasters

By Paul Averill Liebow, Special to the BDN

Over the past year or two we have seen a number of incredible disasters unfold — because of immediate roving press coverage and instantaneous satellite uplinks.

I sat in tears and awe all day watching Boston’s Hurricane Katrina scale total disaster response. Police, fire, emergency medical services and federal agencies thundered down from the clouds and up out of the ground. Within minutes some of the world’s greatest hospitals were ready for and receiving anyone limping, dragged or carried in.

This was especially comforting to me, having participated in the infancy of disaster planning back in the 1970s for Eastern Maine Medical Center, Maine Emergency Medical Services and the Maine Emergency Management Agency. Every drill brought new ideas, perfection always our unachievable goal. New options were debated respectfully, in exquisite detail, and relentlessly. Consensus solutions were written into “the plan.” I have one now.

Within minutes of the Boston Marathon bombings, the scene commander was alerted, team commanders huddled, and a total commitment disaster response plan flashed out. But within seconds bystanders clicked on instinctively, saving lives that would otherwise have been lost in the first five minutes.

While some fled the first flash-bang, the man in the cowboy hat held onto a man’s artery in his shattered thigh to stop the bleeding. Off-duty EMS, doctors and nurses stabilized fractures and cervical spines with “unqualified” strangers. A man ripped off his shredded, smoking shirt to make a tourniquet.

A woman looking for her daughter to finish felt her hair singed off as she was knocked to the ground. She looked over to a young girl her daughter’s age, her leg mangled beyond repair, immediately feeling “an umbilical cord forming between us.” She crawled over to help, momentarily putting her own daughter’s safety on hold. Later she said nothing to anyone, hoping to avoid press sensationalism, but a week later was found and helped with her new leg on national TV. All three will be at the marathon next spring.

Others opened airways, stabilized necks or just held and comforted the dying. Then they all gently moved patients toward waiting ambulances. Perfectly, by the book, with overwhelming force, love, presence of mind and scene safety. I had my recurrent vision of the FDNY running up, while everyone else ran down.

It then occurred to me that we are woefully unprepared for the first minutes, hours, even days almost everywhere else a major disaster will happen — so graphically illustrated in Moore, Okla., after May’s tornadoes, and at the fertilizer plant holocaust in rural West, Texas.

We need a system that enables all trained professionals nearby to seamlessly meld with local first responders anywhere, anytime, in any weather. Volunteers vetted by the Federal Emergency Management Agency would have GPS localization pagers in their cars. A computer program would determine the maximum number of people of any specialty needed and predict how many would be near any area pinpointed, how soon they could be on scene, and give them perfect directions.

If the scene has already been set up, volunteers would report to flagged specialty staging areas, just as they would to any health care facility duty station in their own home EMS region, per their local hospital system’s integrated disaster plan, and await orders. If they are immediate bystanders, they would jump in until local official uniformed responders on duty swarm. Then they would become another set of steady hands, with clear heads, experience, knowledge, mutual respect and guts.

They would arrive with initial response personal safety and stabilization gear. But any walk-on, even the chief trauma surgeon from The Brigham would be just another pair of hands until asked by local first responders for their input, which would take about a nanosecond for any of the first responders I’ve had the privilege of working with here in Maine. Scene access for the hysterical or unscrupulous would be controlled. Police would use their good judgment for all volunteers.

Off-duty or retired police could put a flashing blue light on their roof, a gold badge on their chest, and block every intersection within miles, in a few minutes or even seconds if needed, and only for a few minutes.

This analogy applies to all other groups that might unpredictably be needed. An instantaneous multi-specialty team of strangers forms. Lives are saved. “All hands on deck!” was revered in maritime history. This plan is the embodiment of the real spirit of America, not our present selfish greedy politics, that the world can and will emulate!

Paul Averill Liebow, of Bucksport, served as an emergency department attending physician at Eastern Maine Medical Center for 30 years. He was regional EMS director for 20 of those and won the Governor’s Award for outstanding service.

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