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usar/medical/notes from 26 June 03 USAR Medic Workshop

USAR Specialist Skills Working Group

Notes from Workshop to Scope the Development of a USAR Medical Capability for NZ

26 June 2003, Auckland

1. In Attendance

Frank Angelini St John, Central (TF1) Howard Wills St John, Central (TF1) Frank Haggerty St John, Christchurch (TF2) Ross Knauer Christchurch Hospital (TF2) Roy Breeze NZFS Auckland (TF3) Carey Dobbs St John, Northern (TF3) Tony Smith St John, Northern (TF3) Charmaine Tate Auckland Hospital (TF3) John Takerei Auckland SERT Phil Thacker Auckland SERT Stephen Henderson Auckland SERT Lynda Angus USAR Steering Committee (Chair) Jim Dance USAR Steering Committee Dave Brunsdon USAR Specialist Skills Working Group Convenor

2. Workshop Objectives The objective of the workshop was to identify a framework for developing a sustainable medical capability for USAR in New Zealand to cover the three Task Force teams and Regional Response teams. The development of this framework is being undertaken in the context of the USAR Specialist Skills development programme, and is a specific outcome of the overall 2003/04 USAR Project Plan. 3. Scope of USAR Medical Response Function 3.1 The following USAR Medical response functions were agreed upon, expressed as

priority principles:

• Team wellness (Health & Safety)

• Limited veterinary nursing for search dogs

• Initial patient care

Key supporting principles are:

• USAR Medics are not intended to be used as a free-standing medical resource i.e. their focus is operating within the collapse site. This is consistent with the context of USAR teams as a second tier response i.e. principal medical responders should already be present within the incident cordon.

• As well as treating physical injuries, a key role of Team Medics is to address psychological aspects (e.g. initial symptoms of Critical Incident Stress).


The importance of communicating the limited scope of the Medic role to the Emergency Services and other potential Incident Controllers was highlighted (e.g. simple summary statements).

3.2 The scope of pre-deployment USAR Medic involvement covers:

• Maintaining team medical records (including annual personal checks). • Gathering and analysing baseline medical data (required from a Health and

Safety perspective), noting the need to maintain strict confidentiality of these records within the team.

The focus of all USAR Medics must be on planning and maintenance of the team, and not just on the infrequent deployments.

3.3 The scope of this initial discussion focuses on providing direct support to Task Force teams. Once the scope of the USAR Medic function is clarified at this level, variations relevant to the support of Regional Response teams will be developed.

4. Medical Team Components

• Following the international model, the Task Force Medical Team should comprise USAR doctors (as managers and advisors) and paramedics.

• While the international model of two team doctors and four paramedics per Task

Force is seen as a desirable objective, a National Medical Support Team starting with the initial two doctors currently involved in USAR was endorsed as a workable initial solution.

• Similarly, while four paramedics per Task Force is seen as desirable (and already

achieved for TF3), it was agreed that two local paramedics per team is considered sufficient as a minimum for maintaining a direct relationship with a team and currency of records, etc.

• A key knowledge element of the team doctors is their experience in pre-hospital

care and contacts with other medical specialists.

• It was agreed that less experienced paramedics should be encouraged to become involved in USAR regionally (either as a regional resource or directly with a Response team) or both practical support and succession planning reasons.

5. Training

The three elements of qualification and training required are (i) Emergency Medical Care, (ii) USAR Medic and (iii) USAR Response training.

(i) Emergency Medical Care

Advanced paramedic was agreed as the target minimum requirement given the level of experience and decision-making ability required, along with currency of clinical/pre-hospital experience.


(ii) USAR Medic

Specific training in medical skills required to support USAR activities (FEMA have a four day course to generate this qualification, noting the greater emphasis on terrorist aspects following September 11 2001)

(iii) USAR Response Training USAR Cat 2 Technician status agreed as being required for a Task Force Paramedic, given the likelihood of their being required to operate in the confined space of a collapsed situation.

A NZ-oriented USAR Medic course needs to be developed (customised) from the FEMA base.

6. Organisational Structures

It was agreed that a USAR Medical Advisory Group be established. The initial focus of this group is to produce a Position Paper on the NZ USAR Medic function and proposed operating basis (ordinary or non-deployment situations as well as deployment mode), including training standards and associated requirements. It was agreed that the group should comprise Drs Tony Smith and Charmaine Tate, one paramedic from each of the Task Forces, Roy Breeze and Dave Brunsdon. The people present at this workshop will comprise a wider corresponding group for feedback, etc.

7. Next Steps

• All to forward any relevant information, papers etc to Dave Brunsdon for exchange.

• Task Forces to advise Dave Brunsdon of their paramedic nomination to the

USAR Medical Advisory Group. • USAR Medic Advisory Group to meet in August to develop the Position Paper,

covering:

- Functional role of the USAR medical team,

- Recommended national and local organisational structures,

- Scope of training package(s) required,

- Outline of medical cache to be held by each Task Force,

- Proposed work programme and budget,

- Recommended material to update the USAR website.

• Information on the scope and function of the USAR medical capability (once

agreed upon) is to be exchanged with the regional Emergency Care Co-ordinating Teams and Army and other Primary Health Care Providers.

Note: All recommendations and communications on USAR medical matters are to be

considered and approved by the USAR Steering Committee.