Monday, November 27, 2017

When YOU Are the First Responder

Emergency medical care--having EMTs and paramedics show up at your door when you call 911--is a fairly recent invention.  Prior to 1970 someone (usually untrained) would show up at your door and toss your loved one into the back of an ambulance and haul them to the hospital and maybe they would make it, often they would not.

Around 1970, staffing ambulances with trained medical providers (EMTs and paramedics) started to show greater promise for patient survival rates.  Then came better protocols for when someone called 911 (ie: the dispatcher would get EMS rolling but then offer instructions on how to help the patient until EMS arrived such as giving instructions on how to perform CPR).

Due to the many recent mass murder events including 9/11, the Oklahoma City bombing, and numerous mass shootings, emergency medical care is changing yet again.  In these mass casualty incidents a few problems have been noted.  #1--dispatchers can't give life saving instructions to one caller when they have hundreds and hundreds of calls coming in, #2--patients may have to wait longer for EMS to show up because they are busy helping other wounded people and #3--mass casualty events are taking place in both urban and rural areas.  In urban areas, mass casualty response is pretty good.  All of the responding agencies practice together, plans and protocols for response have been developed, and you are much more likely to survive a mass casualty event today than you were a decade or so ago.  Rural areas are still problematic as there are usually few responders who show up immediately and they usually have to wait for mutual aid from larger cities that are further away.  Patients also usually wait longer to be transported to level one trauma centers (rural hospitals are usually designated a level 4 or 5 trauma center).  Obviously this is not good when it comes to survival rates.

More and more it is being recognized that immediate medical care for victims of trauma and severe injury means that it's more likely the patient will survive.  And by immediate I don't mean when EMS arrives but seconds after the patient drops.  This is where you come in.  The difference between life and death in a trauma injury situation is literally minutes.  If a patient is in cardiac arrest or bleeding out, waiting five minutes means the patient will be dead when EMS shows up.  But, with appropriate bystander care, these lost-cause patients can often survive even the worst wounds.  As an untrained bystander, these are the things you can do now to help out in the event that someone (like in the case of a heart attack at the family Christmas dinner) or many someones (like in the case of a mass shooter at a concert venue) need immediate medical care.

  • Learn CPR.  There are classes for this in almost all towns and it is a simple skill to learn that can save lives.
  • Learn basic first aid.  Again, these are easy skills to learn that can come in handy for the simplest household injury to something bigger.
  • Learn how to use an AED and pay attention when you are out and about so you know where AEDs are located in your community.  Most AEDs will talk you through the steps to use the device and a shock or two can mean the difference between life and death when a patient is in cardiac arrest.
  • Learn how to do the Heimlich Maneuver.  There are dozens of YouTube videos on this topic and preventing someone from chocking to death is a very important skill to have.
  • Stop the Bleed is a relatively new civilian training class in Washington State that is aimed at providing immediate patient care to prevent someone from bleeding out before help arrives.  Learning this skill (and learning how to improvise if necessary) can be a real lifesaver in an emergency situation.
  • Donate blood regularly if you can.  Obviously this isn't an emergency response skill but having blood during a mass casualty event is crucial for blood banks/hospitals in order to save lives.  Usually after a mass casualty incident the community comes out in droves to donate blood but the problem with this is that blood is needed now not in five hours when people can get to the blood center to donate.  Also, blood has a limited shelf life so hundreds of people donating blood after an event doesn't mean enough blood will be available in two weeks if needed.
  • Always carry first aid supplies with you.  This can be as simple as a handful of tampons or feminine hygiene pads (great for stopping bleeding), some condoms (can be used as a tourniquet), aspirin (not NSAIDs or acetaminophen although these belong in a first aid kit too) for when someone is having a heart attack, an EpiPen (these days this item is insanely expensive but can be a lifesaver when someone is having an allergic reaction), plus other basic first aid supplies are better than nothing and can tide you over until emergency help arrives.
  • Communities are always looking for volunteer first responders.  Organizations like fire departments, ambulance companies, and hospitals will often pay for your training course if you agree to volunteer a certain number of field hours after you successfully complete the certification process (as an EMR, EMT, ILS, or paramedic).
  • There are also a number of tactical EMS/first aid courses offered to both certified first responders as well as the general public.  Examples here, here, and here.
  • If nothing else, there are numerous YouTube videos and books you can take advantage of to learn the basics of first responder care to help out others during an emergency.
  • In a Wisdom of the Crowd-esque means of giving and seeking emergency medical help, you can check out the PulsePoint app.

Thursday, November 23, 2017

Happy Turkey Day and More

It's been a busy month so hopefully things will get back to normal in a bit and blogging will become a bit more regular.

  • First, Happy Thanksgiving to you and yours. I hope you consumed a goodly amount of turkey and the fixins and have avoided the crazy Black Friday shopping mobs (or not, if that's your thing).
  • And a belated Happy Veterans Day.  I can't believe I forgot to blog on that important day.
  • Here's hoping you #OptOutside tomorrow (Friday).  I have a group trail run scheduled for zero dark thirty tomorrow morning which should be fun.  This is much more enjoyable (IMHO) than battling the hoards of shoppers fighting over consumer crap.
  • On another note, if you haven't heard about the battle for net neutrality, you should know what it is and what you can do to help the cause.
  • On another, completely unrelated note, there's a little town in Eastern Washington that I used to drive through fairly often.  They are perhaps best known for their annual census update sign (old sign but I couldn't find a more recent picture) and a bit further down the road, they were known for Boggan's Oasis which sadly burned to the ground a few nights ago.  If you are feeling generous, it would be nice to see them reach their GoFundMe goal.
  • On a more useful note, consider doing these end-of-the-year financial preps before the new year arrives.
  • I found this interesting take on air travel over at USA Today.
  • And the analytical part of my brain thoroughly enjoys this column over at Refinery 99.
That's all for the update today.  Happy holidays and onward!

Sunday, November 19, 2017

Lessons From a Long-Term Power Outage in Puerto Rico

Last week someone living in Puerto Rico offered the world (well, Reddit) some insight on what it is like to live in an are where the power has been out for nearly two months.  It is a fascinating read which you can find here.  Some of the highlights:

  • headlamps with lots of spare batteries are a good thing.
  • generators are great...for a while...until fuel gets scarce.  Consider getting a solar-powered generator.
  • it goes without saying that a major power outage--with bad infrastructure to begin with--on an island far from the mainland makes things infinitely worse.
  • politics gets in the way of things being done quickly and correctly.
  • there is kind of a cell network up now. Note that if calls can't go through, texts often can.
  • eventually things like stores and offices may get power first but that leaves many many neighborhoods still in the dark.  And it really is dark at night.  Candles are in high demand.
  • laundry is being done in buckets, "washboards have become a hot commodity".
  • the writer of this piece as well as many people in Puerto Rico who have been interviewed on TV have pointed out that most people were not prepared for this sort of disaster (many didn't have food or supplies put aside for even a few days!).
  • cold baths/showers are the norm.
  • home invasions are a big concern and looters have been stealing generators.
  • on the other hand, people who try to protect their generator by running it in the house can kill themselves and their entire family due to carbon monoxide poisoning.
  • improperly wiring generators into your household electrical system can also be dangerous.
  • if you have an ample supply of wood, a wood stove is a very good investment.
  • hoarding of food and water deliveries is a thing (as it is in other disasters as well).
  • basic preparedness things are important: have cash on hand and savings in the bank, stockpile food, water, and fuel.  A gas camp stove is a good thing to have as well.
  • the first few weeks you may not be able to access your money in the bank so have plenty of cash stored (safely) at home.
  • canned food is the food of choice due to not having refrigeration.  Sterno fuel is also good to have on hand.
  • some people still can go to work everyday, many others have lost their jobs (due to businesses closing).
  • having guns for protection is a good idea.
  • there was a long thread about the best kind of hard alcohol and spirits to have on hand.  Not a bad idea IMHO.
  • garbage service also gets put on hold so imagine the piles of trash stacking up.
  • at first people were helpful and pulling together, after a month of so with no improvement people started to get not so nice.
  • deaths from diseases (public health related) as well as suicide are spiking.
  • standing in long lines for food, water, and fuel (as well as getting there which could be hours from home) has been a challenge.
  • people need non-electrical things to do to pass the time (play an instrument, read, etc).
  • price gouging is a thing as well, especially right after the disaster hit.
All of these things should give you a heads-up on things to plan and prepare for before a disaster hits your area.

Friday, November 3, 2017

Lessons from This Week in Survival News

Some survival lessons from this week's news feed...

  • Two women were rescued presumably from five months adrift at sea.  While the details are being debated, I'll point out that the fact that they had a year's worth of food stored and water filters is a good lesson in preparedness.
  • The Weinstein scandal is toppling his and other careers like dominoes.  The lesson here is to teach your kids--both girls and boys--how to avoid as well as defend themselves against sexual assault.
  • Global warming is a thing.  Whether you believe it is just cyclical weather change or a man-made deal, our planet is warming.  If you intend to be alive for the next 30 to 60 years, plan accordingly (ie: you might not want to live on beach-front property in Florida).
  • Sears and Kmart are closing more stores.  This probably doesn't come as a surprise to anyone but it is a reminder to not put all of your financial eggs in one basket.  No matter where you work, always keep an eye on the state of your company AND be prepared to change jobs at a moment's notice should your company suddenly go out of business.
  • There was another terrorism-related attack in New York City a couple of days ago as well as a random shooter at a Colorado Walmart the following day.  While it is not something most people are used to, these days people need to keep their head on a swivel when they are in public places.  People shouldn't have to worry about their personal safety every time they leave their home but the sad reality is that random violence can happen anywhere, anytime so always keep your wits about you and pay attention to your surroundings.
  • The President's Twitter account was recently deleted temporarily.  Not a bad thing IMHO but the overarching points about social media are many--you can't rely on social media to not be slanted/biased/misleading; you can't rely on social media to be available when you need it; social media companies are private companies so freedom of speech doesn't apply when using these services; social media, while quite useful, also has a number of negative effects on your brain (not a good thing).  The lesson here is to have alternate communication methods, reign in your social media use to something manageable, and don't believe everything you read online.

Thursday, October 12, 2017

Las Vegas Shooting Conspiracy?

I usually think conspiracy theorists are a couple bottles short of a six pack.  In the case of the recent mass shooting in Las Vegas, however, the wacky conspiracy theorist are making more sense than the official press releases provided by the local police and FBI.

Weird, never-to-be-resolved crime is not an uncommon thing in Las Vegas.  There was the case of the Mayor's son, a judge, who was found beaten in a public restroom, in a case that wasn't reported until a couple of weeks after it happened and never resolved.  There was the county commissioner's weird drama with his girlfriend which ended with a suicide attempt and that was the end of that.  Then there was the Tammy Myers shooting which started out as a random road rage incident and turned out to be people who knew each other which ended with one dead and more questions than answers.  In these and other cases, details are released that make absolutely no sense.

With the confusing and conflicting details released about the Vegas mass shooting, about the only thing people are sure about is that a lot of innocent people were killed and injured at the Harvest Music Festival on October 1.  Other than that, the who, what, when, where, why, and how questions all remain unanswered in any sort of definitive way. 

On the one hand, people generally like to believe what the authorities who are investigating such an event determine through their investigative process.  On the other hand, you can't put it past the government to plant a false flag or conduct some other illegal operation and try to cover it up.

Which brings us to the case of the Las Vegas mass shooter that makes absolutely no sense, at least as far as the who (some rich old white guy), what (mass shooting? false flag? gun running set up gone wrong?), when (the timeline keeps changing after the powers that be realize each incarnation of the timeline makes less and less sense), where (32nd floor of the Mandalay Bay? was there a second shooter?), how (how did some very normal guy plan and execute the largest mass shooting in US history?), and why (why???  no answer to that one even after 12 days of investigating).

I'm more inclined to agree with this guy's analysis of the situation that anything I have heard from law enforcement to date.  Some other theories can be found hereAnd here.

Tuesday, October 10, 2017

You Need to Be Ready to GO

It's been a busy week (month? months?) of disasters.  There were hurricanes (not one but three), there was the mass shooting in Las Vegas, now there are wildfires that have killed 15 and displaced thousands.  What do all of these incidents have in common?  You need to be ready to go at a moment's notice.

Victims of the hurricanes had some warning that their area would probably be devastated and many were warned to evacuate.  Victims of the Vegas shooting had moments (in the concert venue) to minutes (in the rooms closest to the shooter) to leave the area immediately.  Victims of the wildfires that are currently raging in California had minutes to hours to gather what they could and evacuate.  Can you imagine what you would do if you had maybe 10 minutes to grab what you could of your life and leave, probably never being able to return to get the stuff you left behind?

At minimum you need a few things (wallet, ID, phone, cash and credit cards) to see you safely away from your current disaster situation.  From those few things you can set up somewhere else, regroup, and start your life over again somewhere else.

While I always have those few things with me--in my pockets or in a very unfashionable fanny pack--I prefer to have enough things with me in my EDC bag so that I feel pretty much prepared for anything.  Even better is having a Bug Out Bag at the ready to grab and go at a moment's notice.  Obviously a BOB would not be a very practical item to have at a concert.  An EDC bag would be better (minus any firearms or other items that would be flagged by a security scan at a concert venue) for the 'flee and never return' scenario.  During the wildfire evacuations, it looked like people were filling their vehicles with everything but the kitchen sink, which leads me to the conclusion that they hadn't previously given much thought to what they would take if they needed to evacuate with very little notice.

So here are some things to consider today:

  • You go out for your morning run but when you come back home you see that SWAT has your neighborhood barricaded and no one will be allowed to go back to their homes until the scene has cleared which could be hours from now.  What do you do?  Where do you go?  Do you have the stuff with you to take care of yourself until you can return home?  What about your family?
  • You go to a big community event, expecting to be there for the day, and are caught in the chaos of what could be a terrorism-related event/mass shooter/etc.  Once you are safe, what do you do?  How do you get back home?  Can you get back home or are all roads to your neighborhood on lock down?  Where else can you go?  How would you get there?  If you are separated from family members, how do you find them?
  • You are on vacation at a beautiful resort and there is disaster heading your way--maybe a hurricane, an earthquake, a terrorism-related event.  What do you do?  How do you respond?  How do you escape?  How do you get back home?  How do you connect with family members that you are separated from?  Will you have enough food, water, and shelter to take care of yourself until help can arrive?  Will help arrive?  If so, who, how, and how long until they get there?
  • You are at home and have seen the smoke over the hills and know that there are wildfires in your area but they have been heading away from you.  Until now.  Now the fires are heading your way and you receive a reverse 911 call telling you a mandatory evacuation order is now in affect for your area.  You need to leave your home immediately and there is good reason to believe it will be a pile of cinders when you return.  What do you do?  What about the kids, pets, and cattle?  Do you have a (several) evacuation routes you can take to get to safety?  What do you put in your vehicle if you only have five minutes to gather the most important things?  What are the most important things to take?  Where will you go?
Obviously in the midst of a disaster situation, chaos will be the order of the day.  But planning, practicing, and being well equipped can mean the difference between a total freak out that doesn't accomplish anything and an orderly (as orderly as possible), efficient, and effective evacuation to a safer location for you and your family.

Tuesday, October 3, 2017

50 Things About the Las Vegas Mass Shooting

In a perhaps rambling, no particular order post...

  1. The first inking of a problem was a couple of Twitter posts and a Reddit post about a shooting.  Since there are shootings everyday here--usually gang or domestic-related--I didn't think it was a big deal.
  2. Pretty quickly there was a deluge of posts; people then realized that something big was happening.
  3. The Broadcastify and Scanner Radio apps went from 500 listening to 50,000 listening in minutes.
  4. The scanner apps gave the most up-to-date info on what was happening.
  5. You know that bad stuff was happening just by listening to the radio traffic from first responders.  In most cases their voices are "normal" but that night their voices were serious as a heart attack.
  6. Eventually the radio apps went down due to an overload of listeners.
  7. It took minutes for social media to go from zero to a hundred with posts about the event.  Facebook, Twitter, and Reddit were where I was getting my information.
  8. There were A LOT of false reports.  After the initial reports of a shooting at the Mandalay Bay, reports of active shooters in several other casinos were reported on the scanner and on social media.  All of the other shooting reports were proven false.  Crowd hysteria?  Maybe.  Someone said that a girl running in flip flop made a loud popping sound so people thought the sounds they heard were gun shots.
  9. The TV news media didn't break into programming for maybe 30 minutes after initial reports of the shooting hit social media.
  10. No emergency alerts about the incident were sent either via cell alert or emergency TV alert.
  11. People who were on scene responded with heroism and ingenious actions.  Barricade fences were used as make-shift stretchers, several civilian cars were used to transport patients to local hospitals, first responders in the crowd began treating and triaging patients at the scene.
  12. This sort of incident is why it's a good idea to have some medical training and carry some basic medical supplies.
  13. This sort of incident is also a good reminder that any time you are in a public place, it is a good idea to know where all of the exits are, where escape routes are, and where places for cover and concealment are.
  14. One problem with social media is that people were giving incorrect information (wrong number of shooters, wrong location of shooters, wrong information on where to go, etc).  It's also a risk that social media rumors can start a witch hunt for people who don't even have anything to do with the incident (remember the Atlanta bombing?).
  15. Another problem with social media is that people were posting reports and pictures about what law enforcement was doing--a bad idea as the bad guy can be monitoring social media and you don't want to give away tactical positions of the officers.
  16. People were posting on social media that they were going to the scene to help.  This is not what the police wanted--they needed to clear and contain the scene--so the police needed to request that people not come to help.
  17. Of course some people went anyway but couldn't get far as all of the roads around the scene were immediately locked down.
  18. One guy became 'internet famous' for a moment because he said he was going home to get a gun so he could hunt for the assailant.  Note that unless there is no law enforcement on scene and you have a clear shot of the assailant and can stop a mass shooting, roaming about with a gun will lead law enforcement to mistake you for the shooter and kill you.
  19. Patients were taken to any hospital people could find (note to future rescuers, serious patients need to go to a Level 1 trauma center, not an urgent care).
  20. That being said, patient surge through the hospital system was pretty well organized.  As was triage by hospital staff.
  21. And the hospital, according to interviews, were practicing what is considered battlefield medicine--do surgery to stop the bleeding, put that patient aside, do the same with the next patient. etc.  When all patients were stable then patients were taken back into surgery to finish fixing the problem.
  22. A GoFundMe was set up by city officials and it has raised an incredible $4.2 million dollars so far.
  23. Reuniting families of the dead and injured (nearly 600 in total) was a huge job.  There are still three people in the hospital who are unidentified as of now.
  24. A number for family members was set up to help reunite people, unfortunately this line soon went down.  It took a bit of time to get another contact number set up.
  25. Many people were calling all of the hospitals and coroner's office looking for family members, this overloads the system and takes staff away from more important jobs which is why it was important for all people looking for loved ones to go to one source (the phone number set up for their calls).
  26. The city quickly set up a shelter for victims and their family members.  
  27. They also set up a family reunification center at the large convention center on the Strip (this center started out at the police headquarters but it was quickly overrun with the family members of all 600 victims so it needed to be moved to a larger facility).
  28. Arrangements needed to be made for people to retrieve their stuff that was left at the concert venue as well as from their hotel rooms on closed off floors.  Also to get back to their vehicles left at the concert venue.  This took days, not hours.
  29. So much stuff was donated to hospitals, blood banks, the convention center...all by locals and tourists alike.  Logistics was an issue.
  30. Many victims who ended up in the hospitals needed donations of clothing and shoes as theirs were too bloody to put back on.
  31. Eventually blood banks were so overwhelmed with donations that they needed to schedule people in order to keep the lines under control.
  32. The conspiracy theorists are having a field day of course.
  33. From the first report of shots fired to breaching the door of the shooter it took nine minutes.  That's a remarkably fast response.
  34. Machine guns and full-auto firearms are legal in Nevada.
  35. The FBI was requesting that anyone with video, photo, or other evidence submit it to their office as it could help with their investigation.
  36. The FBI also offered victims services for people impacted by the shooting.
  37. The news broadcasts about the incident were 24/7 relentless.
  38. Community memorials and vigils immediately popped up everywhere; there have been several over the last couple of days.
  39. The hotels (and several other local businesses including airlines) really stepped up and offered free food, lodging, transportation, etc for victims and their families.
  40. Counseling and bereavement services were also coordinated quickly for victims, their families, and first responders.
  41. Social media was also being widely used for people to post photos and descriptions of missing/unidentified loved ones.
  42. Notifications to all family members took a bit of time as you can imagine.
  43. The Metro police were pretty good about using both social media and regular press conferences to keep the public up-to-date about what was happening.
  44. All of the responders (law enforcement, hospital staff, EMS, etc) worked A LOT of hours, non stop for days after the incident.
  45. The outpouring of support--financially, emotionally, materially--from people all over the world was truly amazing.
  46. Local and state politicians were very much supportive and on-message together throughout the entire event and aftermath.
  47. Judging by some of the survivors being profiled on the news, survivor's guilt and PTSD are starting to kick in.  It is important after such an even to seek out appropriate mental health care.
  48. For first responders, there is an entire website dedicated to their mental health after traumatic events.
  49. The processing of the scene, investigation, and the completion of a final report will take weeks, even months.  Roads around the scene opened 48 hours after the shooting happened, the entire floor of the hotel where the shooter positioned himself is still blocked off, and I'm surprised that so many reporters at the police press conference were asking questions that would be in a final report--it's only been two days people.
  50. This entire situation is going to be used for future training for cities around the country for a long time to come.
Our prayers go out to all who were impacted by this event.