DMEP course prepares medical professionals for the unexpected

Dr. J. Allen McElroy speaks to students

On Friday, September 7, dozens of medical professionals participated in the (American College of Surgeons) Disaster Management and Emergency Preparedness (DMEP) course; a program aimed at training medical professionals to deal effectively with various kinds of disaster scenarios.

“We don’t get to choose when and where those things happen,” Doctor J. Allen McElroy , Trauma Director at Marietta Memorial Hospital, explained. “The concept of having disaster management committees in your hospitals is absolutely paramount to effective utilization of your resources and saving lives.”

The 8-hour course, directed by Doctor M. Shay O’Mara and the COTS, covers subjects such as triage, planning methods, injury patterns, and incident command terminology for large-scale disasters. Over 100 medical professionals have completed the course since its introduction in June 2017.

Students participate in the DMEP course, under the direction of COTS doctors, O’Mara, Larrimore, and McElroy

“When COTS first offered the DMEP course, I was able to sit in that first class along with most of the other trauma medical directors,” Dr. McElroy said. “I immediately recognized its pertinence to our local hospital planning.”

Dr. McElroy said he also recognized opportunities for improvement, and later decided that he would become a DMEP instructor. In addition to his role as a hospital surgeon, Dr. McElroy also serves as lead medic for the Washington County SWAT Team. Drawing on these experiences, McElroy aims to address the communication barriers that often exist between hospitals and prehospital personnel.  

“If we don’t have the ability to work with each other, we won’t understand what the other institution is trying to accomplish. We won’t understand their language, and we won’t have a common purpose and set of objectives,” Dr. McElroy said.

McElroy explained that the three emergency entities – fire/EMS, law enforcement, and hospital staff – are often “significantly siloed,” with very limited communication occurring between each group.

Fire Captain, Martin Hafey, outlines the contents of an emergency medical kit

“If you have ever read an after-action report on a disaster or MCI (mass-casualty incident) event, one of the biggest areas of weakness is lack of communication and effective coordination,” Doctor Ashley Larrimore, Clinical Assistant Professor at the Ohio State University, said.

“Our course focuses on teaching people across a range of disciplines a common language and approach to disaster management,” she added.

Dr. Larrimore has completed an Emergency Medical Service (EMS) Fellowship at the University of Cincinnati. Like Dr. McElroy, she has practiced medicine both in the field and in the hospital setting. As an instructor, she teaches students the basics of disaster management and guides them through various scenarios.

“It’s important to regularly practice your response to familiarize everyone with their roles, the processes that occur, and to also find where areas of breakdown occur. This allows you to minimize error and maximize safety and ensure the best possible outcome of the event,” Dr. Larrimore said.

Dr. Ashley Larrimore speaks to DMEP students

During the course, students were able to tour a mass-casualty response vehicle, supplied by the City of Grandview Heights Fire Department. The vehicle is equipped to treat 25 victims of blunt or penetrating trauma. It contains a variety of medical supplies, including pediatric kits, backboards, emergency blankets, trauma dressings, and equipment for treating smoke inhalation.

“With this truck we can set up three stations. Each station can take care of fifteen to twenty people,” Fire Captain, Martin Hafey, explained.

Students also had the chance to speak with prehospital providers; and learn more about their procedures for treating disaster victims. Unlike hospital surgeons, fire medics are accustomed to treating patients in extreme environments – and with limited resources.

“Out in the field, incidents happen at any time. 100 degree hot-humid days, middle of blizzards, middle of the night. When it’s dark, you have to use lights from the truck. You can’t necessarily see,” Fire Fighter/Paramedic, James Beckett, explained.,

According to Beckett and Dr. Larrimore, the challenges surrounding disaster scenarios are often very different from doctor’s daily challenges. Mass-casualty incidents demand a shift of thinking.

“In our normal day to day life, we are focusing on providing the greatest good for each individual patient,” Dr. Larrimore explained. “But in disaster situations we must focus on the population as a whole and doing the greatest good for the greatest number of patients.”

Disaster events tend to overwhelm medical resources, causing “logistic challenges” for hospitals. The DMEP training provides medical staff with a framework for navigating these challenges.

“DMEP and disaster management (in general) force us to come together, speak a common language, and then work together to achieve common objectives,” Dr. McElroy said.

“I would love to see those types of principles move beyond just disaster management.”

Dr. McElroy encourages doctors to network with prehospital personnel on a regular basis. He says there are plenty of opportunities to improve that interface.

“If we truly want to be collaborative and symbiotic, then we should be looking for those opportunities to get involved at the prehospital level also. Because what they do is extremely difficult, demands a very high degree of professionalism, and many times is underappreciated by hospitals,” Dr. McElroy explained.
 

For more information about the DMEP course, click here.