CAP and EMT's

[CadetProgramGuy]

So in the world of NIMS and MINS compliance we need a FR or higher on our ground teams to act as a Type I Team.

CAP however doesn't want FR's or higher to advertise their certifications.

Also as a FR or higher certification, who would you fall under for your medical direction?

Thoughts?

[RiverAux]

So in the world of NIMS and MINS compliance we need a FR or higher on our ground teams to act as a Type I Team

citation?

[isuhawkeye]

Wile the original post is not 100% correct her you go.
http://www.fema.gov/emergency/usr/wilderness_search_team.htm

My question would be, why do you need to mobalize as a type one team. 

If each wing or group could develop some good reliable type III teams my state would benefit

So, is this a NIMS resource typing question, or a thread about medical directors for EMS providers.  Either way we have hashed both issues to death many many times

[CadetProgramGuy]

So, is this a NIMS resource typing question, or a thread about medical directors for EMS providers.  Either way we have hashed both issues to death many many times

We have??

This topis relates to CAP and EMT's on the teams.  Is there a time where we can deliver aid in the field to our targets, or are we opening our selves to lawsuits?

Does Good Sam laws relate to EMT's?

Also I don't understand where I was in-correct.  My statement was about needing EMT's or FR or higher to be type I certified.  Thats what NIMS states in your link as well.  Can you elaborate where I am wrong?

[arajca]

So, is this a NIMS resource typing question, or a thread about medical directors for EMS providers.  Either way we have hashed both issues to death many many times

We have??

This topis relates to CAP and EMT's on the teams.  Is there a time where we can deliver aid in the field to our targets, or are we opening our selves to lawsuits?

That is the major reason there is not a program for HSOs to progress through. Read CAPR 160-1 for more details.

Does Good Sam laws relate to EMT's?

Varies from state to state. Check with your wing HSO or Legal Officer.

Also I don't understand where I was in-correct.  My statement was about needing EMT's or FR or higher to be type I certified.  Thats what NIMS states in your link as well.  Can you elaborate where I am wrong?

A Type I team requires EMT, ACLS, BTLS, not FR. A Type II team requires EMT or Wilderness First Responder. which is a specific skill set not covered in the generic First Responder certification.

As for elaboration,

So in the world of NIMS and MINS compliance we need a FR or higher on our ground teams to act as a Type I Team.

FR doesn't cut it for Type I teams.

[CadetProgramGuy]

So, is this a NIMS resource typing question, or a thread about medical directors for EMS providers.  Either way we have hashed both issues to death many many times

We have??

This topis relates to CAP and EMT's on the teams.  Is there a time where we can deliver aid in the field to our targets, or are we opening our selves to lawsuits?

That is the major reason there is not a program for HSOs to progress through. Read CAPR 160-1 for more details.

Does Good Sam laws relate to EMT's?

Varies from state to state. Check with your wing HSO or Legal Officer.

Also I don't understand where I was in-correct.  My statement was about needing EMT's or FR or higher to be type I certified.  Thats what NIMS states in your link as well.  Can you elaborate where I am wrong?

A Type I team requires EMT, ACLS, BTLS, not FR. A Type II team requires EMT or Wilderness First Responder. which is a specific skill set not covered in the generic First Responder certification.

As for elaboration,

So in the world of NIMS and MINS compliance we need a FR or higher on our ground teams to act as a Type I Team.

FR doesn't cut it for Type I teams.

Thanks for the clarification, I thought I had that covered.  OK On with the discussion.

[DNall]

Right now we're at a roadblock. We aren't supposed to provide care (per CAP because of liability issues. But, many states require you to render aid to the extent of your training/ability; with penalties like license, criminal liability, and certainly civil suit.

So... we're screwed if we do & screwed if we don't.

CAP currently provides incentives (initial & ongoing promotions) to recruit & retain medical professionals (EMTs, Drs, nurses, PAs).

Right now there is little for them to do. There's health & wellness, and limited care at encampments kind of stuff, but that's secondary missions that don't warrant the current incentives versus our other hard working members or the skills they bring to the table.

As I understand it, those incentives are there to build & retain a pool of medical folks, so that when the legal issues are fixed, we'll be able to put it into execution within the force structure.

The way I understand, we'd have a medical director/SOPs on the Air Force side & on call thru AFRCC. We also need doctors/PAs at the Wg/Reg level to oversee qualifications & execution of those SOPs in training.

Sorting out qualifications on a state-by-state basis, making that comply with NIMS typing, and work within a national EMS structure overseen by an active/reserve AF doctor... that's just a little bit of a headache.

My feel for the situation is it'll ultimately require congressional action to fix the problem. The issue is congress doesn't have a plan for that either. The plan needs to be worked out between CAP & AF, then taken to congress for some policy changes to be voted into effect.

[RiverAux]

Unfortunately, FEMA has conflated the presence of a medical professional of some time with the ability of a team to stay in the field. 

CAP should be capable of having a Type 2 team, except for the medical professional requirement.  Although, it would probably be difficult for any individual squadron to come up with a 28-person ground team with 4 team leaders.  With that one real exception and one challenge we could do it.  Otherwise, having us as a Type 3 team is just fine. 

I don't think our current CAP training would provide us with the man-tracking skills to claim Type 1 status even if we do manage to meet the medical specialist requirements. 

I'm not too terribly worried about these rankings cause the locals aren't really going to pay much attention to them.  Most aren't going to have ANY trained SAR personnel at all in their jurisdiction and will be happy with whatever they can get, while those with a super-high-speed type 1 team probably wouldn't turn away the help of a type 3 team in any case.   

[lordmonar]

While we are talking about NIMS requirments.....we need to be complaint...but who says we have to field a type I team?

We are talking about 52 team members (6 GLS, 6 EMTs, 42 GTMs) and a mission base staff to support them.  (say 2 GBDs, 2LSC, 2CUL, 8 MROs, and maybe 2-4 PSC just to round them out).

Anyone got 68 people sitting around fully qualified ready to deploy as a team?


More then likely we are only looking at type III and IV teams....we still need to get proactive to make the necessary contacts with our local EMS organisations, get the needed MOA in place and do some training to get everyone on the same page.

[isuhawkeye]

I could see groups and wings building type III and IV teams.  an aggressive region ES officer, or national could coordinate the formation and movement of type I and II teams.  You could deploy a type I team on very large scale events like Katrina, etc

[lordmonar]

But that would require organic EMTs...which per CAP policy is not possilbe.

So let's focus on what we can do and do the best that we can.

[isuhawkeye]

very true

[RiverAux]

But that would require organic EMTs...which per CAP policy is not possilbe.

CAPR 160-1

a. Medical care within CAP is limited to emergency care, only (i.e., first aid and stabilization) within the training and qualifications of the person rendering such care, until such time that private professional or authorized military care can be obtained.

CAPR 60-3 1-21

f. First Aid and Emergency Medical Care. CAP is not an emergency medical care or paramedic organization and should not advertise itself as such. CAP will not be the primary provider of medical support on missions or training events though qualified personnel can be used to support such activities. The only type of medical aid that should be administered by CAP personnel or by any other person at CAP's request is reasonable first aid deemed necessary to save a life or prevent human suffering and executed by a person qualified to attempt such medical care within their skill level

Seems to me that a CAP EMT would be able to provide emergency care to the level of their qualifications as part of a CAP ground team. 

[lordmonar]

But that would require organic EMTs...which per CAP policy is not possilbe.

CAPR 160-1

a. Medical care within CAP is limited to emergency care, only (i.e., first aid and stabilization) within the training and qualifications of the person rendering such care, until such time that private professional or authorized military care can be obtained.

CAPR 60-3 1-21

f. First Aid and Emergency Medical Care. CAP is not an emergency medical care or paramedic organization and should not advertise itself as such. CAP will not be the primary provider of medical support on missions or training events though qualified personnel can be used to support such activities. The only type of medical aid that should be administered by CAP personnel or by any other person at CAP's request is reasonable first aid deemed necessary to save a life or prevent human suffering and executed by a person qualified to attempt such medical care within their skill level

Seems to me that a CAP EMT would be able to provide emergency care to the level of their qualifications as part of a CAP ground team. 

It is right ther in para F.  CAP is not a Emergency medical care or paramedic organization........but a type I, II or III ground team IS a paramedic organization....ergo CAP as the rules stand now....cannot ever legally field a Type I, II or III wilderness search and rescure team.

We can sorty  a whole but load of type IV and V  teams and a full cadre of support personell....but it would never get signed into the Staging Area as a type I team because we lack organic EMTs.

[RiverAux]

I think you are misunderstanding what is meant by that phrase.  To me that says we don't sell ourselves as an emergency ambulance service that will come to your house when you have a heart attack or go to motor vehicle accidents. 

It specifically allows for care to be given within the skill level of the person giving it.  It doesn't restrict that skill level in any way.  If they didn't want a CAP member who was an EMT giving an EMT level of care to someone that needed it in order to survive, they could have easily said so by specifically restricting CAP from doing anything beyond the level of basic first aid. 

Having an EMT or first responder on your ground team doesn't somehow magically transform it into some sort of rogue team not sanctioned by CAP. 

Telling the county sheriff that you have an EMT on your team doesn't make you a paramedic organization.  What it means is that if we find the target and they need care to save their life, we have an EMT that could provide that care up to the level of their training if no other medical care is available. 

[DNall]

It specifically allows for care to be given within the skill level of the person giving it.  It doesn't restrict that skill level in any way.  If they didn't want a CAP member who was an EMT giving an EMT level of care to someone that needed it in order to survive, they could have easily said so by specifically restricting CAP from doing anything beyond the level of basic first aid. 

Actually, the reg says level of training, but the current legal policy says nothing beyond basic first aid for life saving purposes only regardless of training, and they're serious about that.

But that would require organic EMTs...which per CAP policy is not possilbe.

So let's focus on what we can do and do the best that we can.

Granted we should be forming up as Type III/IV teams right now, but CAP doesn't even have a plan right now. I can train my people, but I can't certify them & even if I could I couldn't deploy them cause CAP has a whole lot of HUA syndrome going on.

I'm not too terribly worried about these rankings cause the locals aren't really going to pay much attention to them.  Most aren't going to have ANY trained SAR personnel at all in their jurisdiction and will be happy with whatever they can get, while those with a super-high-speed type 1 team probably wouldn't turn away the help of a type 3 team in any case. 

You're completely missing the point. The guy below is not...

I could see groups and wings building type III and IV teams.  an aggressive region ES officer, or national could coordinate the formation and movement of type I and II teams.  You could deploy a type I team on very large scale events like Katrina, etc

[DNall]

My vision for a type I team would be 4-man GT w/ EMT x 4-6 teams. One RV or trailer based mobile command center w/ full up comms, sat internet, generators, etc; manned by on-scene commander (IC3 or OSC), IT, MROx4. And 1 organic aircraft w/ SDIS capability (upgrade the transmit capability).

So, think back to the MS setup after Katrina. Centralized Air Ops & ICP up north a bit, with three FOBs up in the damage zone.

Same kind of deal, functioning airfield up closer to the impact area with ICP & central air ops - after Ike over here that would have been Ellington Field (versus we operated out of IWS, which is further from the action & away from all the other players).

That mobile command center deploys up into the area, co-located with field customers. For example, I'd have put those next to county EOCs for the hardest hit areas. Just roll up & set up, and that should be as soon as winds are low enough to move the assets, not days later.

At this point I can liaise with that county EOC. I can put their comms back on the air via P25 highbird. I can give them near real-time imagery on my laptop in my command trailer. I can put my GTs into their area with supplies. They can take damage pics, hand out supplies, and help people that need it - and lots do at this point. I got air to support those those GTs not getting into areas they can't deal with.

That all make sense? That's type-I. I got lots & lots of experienced people around here that are more than qualified to do that kind of work, and have done it for CAP in the past. Every bit of that is well within our existing capability. It'd take some work to scale it up around the country, but it's not beyond us at all. That's what we want/need to be doing. That's why we're in CAP.

What I got after this hurricane crashed thru my neck of the woods though was wait a week, then toss some food for a couple days, then run some ELTs that were obviously not distress anymore, while an air mission flew around taking lots of pictures but nothing I'd call emergency related.

[flyerthom]

While we are talking about NIMS requirments.....we need to be complaint...but who says we have to field a type I team?

We are talking about 52 team members (6 GLS, 6 EMTs, 42 GTMs) and a mission base staff to support them.  (say 2 GBDs, 2LSC, 2CUL, 8 MROs, and maybe 2-4 PSC just to round them out).

Anyone got 68 people sitting around fully qualified ready to deploy as a team?


More then likely we are only looking at type III and IV teams....we still need to get proactive to make the necessary contacts with our local EMS organisations, get the needed MOA in place and do some training to get everyone on the same page.

Two unexplored options are DMAT and local MRC's. Our area has both and few contacts have been made.

[Eclipse]

This is another easy one.

Don't worry about EMT's or medical professionals operating officially or with anymore sanction than exists today anytime soon.

Its not going to happen.

Period.

NIMS is not a prescription, it is a national, flexible, framework for standardization.

CAP is a special beast with special rules, functions, obligations, and limitations, we are not your neighborhood SAR team, we're "other", and as such, we'll continue to work as we have, NIMS or not.

NIMS does not change an organization's mission, capabilities, or limitations, its simply a way to categorize and standardize resources as they are sent.  NIMS does not change PD into FD, or non-medical responders into Squad 51.

What is likely going to happen is that we will simply type individuals based on how our training fits into the framework, and not categorize what we call a Ground Team today into the SARTech nomenclature.

This idea that NIMS is going to force CAP, or any other agency, to radically change their core mission or capabilities is silly, and blatantly agenda driven by the (understandably) frustrated medical professionals who are handcuffed during CAP operations.

CAP is not a first-responder agency, is not tasked or capable today of providing anything more than basic, community-level first aid, most for team safety, and that's fine with the majority of members.

[RiverAux]

Actually, the reg says level of training, but the current legal policy says nothing beyond basic first aid for life saving purposes only regardless of training, and they're serious about that.

No "policy" supercedes our regulations (or ICLs) so if such a policy exists (please provide citation) it is irrelevant.