Stanly County Emergency Services – Triage Day

Today was an interesting day I thought worth sharing with you folks from the ether. Just one more glimpse into what goes on in some other people’s lives you might find interesting.I made a Facebook post about it earlier and some of you were interested in the subject, so why not take a few minutes and write it up in a post?

I am a member of an organization called ARES. That’s an acronym for Amateur Radio Emergency Services. Sounds conflicting, right? Which is it? It is a bunch of amateurs or does it have something to do with emergency services? Well, the answer is “yes.” lol

ARES members and Auxcomm members are volunteer HAM radio operators with their own equipment and radio gear who have taken the time on their own to get trained and certified by the FCC in how to work with the incident command system. The training and work tends to revolve around being able to supplement the local emergency services organizations in their area in the event of some sort of natural disaster or other related catastrophe.

This particular exercise was designed around a fake Hurricane scenario in which Hurricane Blue struck land on coastal NC and local emergency services were both overwhelmed and evacuated themselves due to flooding. Our county hospital setup a triage location where the overflow would be brought in and then brought to the hospital for treatment. The idea is that the entire coastal area is completely out of commission so it becomes a mass-casualty situation because our hospital and emergency services infrastructure aren’t designed to accommodate this level of influx. So, what do we do? How does the county respond?

Our Emergency Services Coordinators even setup a mock weather alert to get the radio guys on board.

Over a two or three day period, county emergency services has been gearing up and getting their volunteers ready to go. When the time comes for the system to get put into action a call goes out over the reverse-911 system. It’s basically a phone tree program that autodials all the respective members of various organizations and tells us what we need to know. My call for example came out this morning at 8:00 AM telling me to tune into the local ARES repeater on my radio, call in with my call sign, and await further instructions.

I did as I was told. Once I checked-in with our communications coordinator, I  was instructed, along with the other ARES members, to report to the hospital to work the incident. The county’s incident response plan called for each of us to man certain departments to supplement existing personnel. Local police might also be called to assist, for example to provide additional security since hospital security would be understaffed. Firefighters might be called in to assist with traffic control in the surrounding area. All areas of emergency management can come into play, not just radio operators.

I didn’t get to see too much of what the other departments were doing because us radio guys were jammin. Even with all the fancy gear, I still had three different radios running this morning all morning long to handle the communications needs of my assigned duty.

Speaking of three radios, part of the reason we do these scenarios is to test our responsiveness, our readiness level, and our gear. Today was a good example of things not going right. I’ve got half a dozen programmable radios. Since I’ve programmed them so many times from the computer, it never occurred to me to check the one I carried today to see if it could easily be programmed manually. I intentionally didn’t program anything in advance because I wanted it to be realistic. We’d be on a frequency I wouldn’t necessarily know, but I grabbed a radio I knew was solid and that would last all day even if I used it constantly. Guess what I learned? I found out my UV-82HP doesn’t go into VFO mode… at all. That means I can program it from the computer, but I can’t manually program frequencies. I couldn’t even switch to the frequency we were using for simplex communication. It worked fine on the repeater, so we kept that for backup community communications between us ARES members and the non-ARES ham members in the community that volunteered to help out if needed.

Building density matters.

That was another important lesson of the day. Our digital radio system was deployed inside the hospital’s EOC (emergency operations center). This room is designed to facilitate just this exact scenario. It has computer and phone access for a TON of people just in case an incident command center needs to be setup here. The problem – it’s in a conference room in the middle of the building – with a whole lotta stone, sheetrock, and glass between our radios and the outside sky. Luckily we were able to broadcast and receive, but we definitely felt the difference in the performance. It also helped us prepare to mention to the county coordinators during the hotwash immediately following the drill that it would be REALLY nice if the hospital would procure a 2m/400mhz antenna. We will perform the installation for them free and mount the gear if they’ll make the antenna purchase. So, that’s another step forward in terms of progress made today. We came, we practiced, we learned! Had we been in a real scenario where the incident scene was 5 miles away, we wouldn’t have been able to reach the EOC with radios using today’s communication methods. We’d have had to relay with another operator outside. As it was, our “accident” scene was across the hospital grounds so simplex communications worked fine.

All in all our part of the drill went off without a hitch. We had glitches, sure, but our own internal ARES plans had contingencies built-in, redundancies accounted for, and nothing fell short in any department. We all tend to live by the rule that two is one, and one is none. That basically means that having only one of anything is useless. Having only one way to power your radios, or one line of communication with no backup, is a plan for disaster.

So, let’s show you some of what we did.

A Ham’s Go-Box

That’s the front and rear view of one of our member’s personal “Go Box” for communications. It’s a 6U rack enclosure called a Gator Box with all the gear custom mounted and wired into one solution he can pick up, slap the front and back cover on, and walk out the door with in a matter of minutes. It can be powered from a wall outlet, car battery, solar panels, or a variety of power sources as needed.

The front photo shows the ICOM-7100 digital radio, the packet station for transmitting data via radio wave, and the local repeater he’s setup for us to use at the event. There’s probably around $3,000 in that box right there and it probably took him a little over a year to get it working the way he wanted to.

Digital DSTAR and Images over Air

Did you know you can transmit pictures over the air without internet? Did you know you can do it to between two hand-held radios operating hundreds or even thousands of miles apart? That was one of the additions we brought to the mix today. One of our operators was staged at the “scene.” Had this been a nasty industrial accident, or huge multi-vehicular accident, this feature could have been even more helpful. As it was, it just provided an overview of what we could do.

That picture was taken with a cell phone, then transmitted via ham radio as if there were no cell networks active. That radio shown beside my tablet received the picture, translated it back to an image, and fed it over to my tablet – all with no wifi and no mobile service. That’s pretty neat when you think about it. My job was to interface with the triage team staged at the entrance to the emergency room. So I’m there with them telling them what’s going on at the scene and relaying information they need to know about the incoming accident victims. Today of course they had the ambulance radio. But suppose local power was out and a line took out the backup feed to the county’s radio network? Our volunteer off-grid system could completely step in and fill that role if needed. Today we simply worked in parallel. They called in radio calls as usual, but we duplicated the effort with amateur radio for proof of concept. The doctors were amazed that we could take scene photographs of triage scenarios and then pass the data back in near real-time to the emergency staff that could then decide to prioritize victims right there before they were ever loaded into an ambulance. For every patient that eventually came in later on, we already had photos submitted of head lacerations, broken bones, and other injuries so they could prepare a quicker response when the victim arrived. When your hospital is about to be flooded with more victims than it’s designed to accommodate, a ten minute heads-up on the condition of an incoming patient can turn into a visible improvement in response time and level of care available upon arrival.

Maybe the hospital would have decided to send that patient to a waiting area outside the triage area. A broken leg is bad, but they have three pregnant women with abdominal injuries and one patient having a heart attack. The leg can wait a few more minutes.

Putting it into action

EMS is dropping off a “patient” for emergency care. The guys in orange vests are “observers.” They have some role within emergency management and are watching the event unfold and taking notes on what’s going right, what needs improvement, what they might want to address next time, etc.

 

No, we didn’t actually use a pregnant woman for this exercise! These are all volunteers from a hospital in Charlotte, NC that agreed to work the incident with us and be actors/victims.

The triage team has been notified of an impending arrival and is on-standby at the door to the emergency room, ready to receive the next patient.

Moments later, here we are.

What makes it all work?

You’ve seen those towers sticking up in the air that counties use for these kinds of communications, but what actually makes it all work?

Well, this photo below is the repeater shack for our local county. The gear shown on the left is the county’s systems; EMS, Fire, Police, P25 (Viper), etc.  The rack on the right is all our volunteer-owned gear. Yeah, I think we actually have more gear in the building than the county does in terms of infrastructure.

This little radio on the shelf below is pretty neat. For those that aren’t familiar with the concept, it’s called a “packet” radio. And that box it’s connected to on the right? Recognize that? It’s a $29.00 Raspberry Pi micro-computer with a DV-Mega hotspot repeater installed to send the data across the internet.

Well, there you go.. there’s a little insight into what my day was like today. I didn’t get much work done but the ARES work was fun, if exhausting.  Time to read the news and head off to bed. Night y’all.

 


1 thought on “Stanly County Emergency Services – Triage Day

  1. Alamance ARES has a multi-county exercise a couple of years ago that involved a tornado hitting an elementary school during school and needing hospitals in three counties to facilitate emergency services. Coordination between EMS, FEMA, EOC and ARES was a little rough at first but got the kinks worked out pretty fast. We had the same problems with communication inside the hospitals, like they were built to be bomb shelters, poor transmission! Also had programming issues with handhelds. Our repeater works off diesel fuel in the event there is no power but we worked off of several repeaters, mobile units and EOC’s. Was amazing in action. We do “practices” with severe weather events (heavy snows, flooding rains) by calling in weather reports that get forwarded to the NWS too.

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