Paramedic Emergency Management - Term Paper Example

 «Paramedic Emergency Management: Victoria bushfires, Australia» Paramedic Emergency Management: Victoria bushfires, Australia Introduction The Victorian bushfires broke out on February 7, 2009, Saturday and it brought forth one of the worse disasters in the history of Australia. More than the hectares of land and vegetation which were ravaged by the fires and more than the millions of animal species perishing in that fire – 173 human lives were forever lost. In the forefront of this disaster was the paramedic emergency management team of Victoria, Australia. Their efforts at managing this disaster will be reviewed in this paper – alongside the disaster management efforts of the disaster management team of Victoria Australia. Disaster management is one of the most crucial elements in any government system. It helps to prevent disasters and minimize their impact on the people and on society in general. Based on this premise, this paper shall first describe the Victorian bushfires and the conditions which contributed to the incident. It shall also critically analyse the disaster management efforts of three emergency responders. From this critical analysis, a personal opinion on how the disaster should have been managed shall also be presented. Description of incident The Victorian bushfires, otherwise known as the Black Saturday bushfires was one of the most devastating fires ever to hit Australia. The conditions attributed to natural and man-made actions all contributed to the devastation that hit Victoria that day. Based on the report by the Victorian Bushfires Royal Commission, Victoria has had a lengthy history of bushfires and the conditions on the 7th of February 2009 were such that they set-up that day to be intense and humid enough for fires to break out all over the region (Victorian Bushfires Royal Commission, 2009). The dry fuels and strong winds resulted to the unpredictable behaviour of the fire and the building up of strong activities which resulted to the lifting of firebrands. The strong winds in the upper atmosphere carried burning bark downwind over great distances – and thereby creating more fires and supporting the phenomenon of fire spotting (Victorian Bushfires Royal Commission, 2009). The firebrands were spread by the strong winds from one area to another. These fires in the Victorian area were of different sizes and effect; the worse of these fires however were rapidly spread after ignition. These fires also crowned forested areas which could not be easily accessed by the fire crews (Victorian Bushfire Royal Commission, 2009). Powerful convection columns were seen above the fires; significant forward spotting was seen as a result of the fuel type, weather conditions, and topography; in the afternoon of Saturday, wind direction changed and further spread the fire (Victorian Bushfire Royal Commission, 2009). Based on the report by the Commonwealth Scientific and Industrial Research Organisation (CSIRO), the high temperature on that Saturday reached over 45 degrees, and the air was also extremely dry on that particular day (CSIRO, 2009). Coupled with the low rainfall in the area, the area was rife with tinder-dry fuel which was so easily ignited and difficult to extinguish. Moreover, a cold front was also making its pass down to the state and churned up strong winds over the region (CSIRO, 2009). All in all, the Black Saturday Bushfires are different major fires occurring across different parts of Victoria. About 78 communities were affected by these fires, including the towns of Marysville, Kinglake West, Narbethong, Flowerdale, and Strathewen. There were about 400 inhabitants injured by these fires. Conditions before the fire were also investigated by authorities and they revealed in their reports that the exceptional heat wave that week leading up to the Victorian fires prompted the authorities to deploy most of their fire fighters into different parts of Victoria; and they were cautioned to stay on the alert for possible fires breaking out (Bureau of Meteorology, 2009). A warning by their Premier even cautioned the state on the possibility of extreme weather conditions with the heat wave and the strong winds which were about to hit them (Moncrief, 2009). All these preparations however were insufficient to contain the intensity and the wide coverage of these fires; hence the events of that day are considered to be one of the worse disasters in Australian history. Hazard The hazard seen in this disaster can first be detailed as natural in the form of the high temperature (heat wave) in the 45 degrees region, the dry air conditions, and the strong winds brought on by the cold front. The lack of rainfall in the region also created dry tinder which was easy to ignite under the right conditions. The dryness and the impact of the heat were also considered partly man-made – based on the phenomenon of global warming. Man’s greenhouse gas emissions trapping heat in the atmosphere instead of releasing it into space. As a result, our air becomes warmer. This warmer temperature results to the extreme weather conditions that we experience, as well as extended seasons of dry weather as seen in Australia just before the fires hit. The lack of rainfall is also said to be partly attributed to the dissipation of rain clouds and the extended dry season and extreme weather conditions experienced in different parts of the world – as seen in droughts in one side of the world and floods in another. Risk The risk refers to the objective or subjective probability that something negative will happen. In this case, the risk for the fire occurring at that time is credited to various factors. The risk factors in this case were attributed mostly to the extreme weather conditions seen in the area on that particular day. The risk of someone unintentionally igniting a fire was very high. It would have been easy enough for someone to throw a cigarette butt into a pile of tinder and starting a spark which would have turned into a blaze in a matter of minutes. The risk of someone failing to put out a campfire is also high; and with strong winds, the risk of spreading such fire to other areas was also considerable. The risks seen during the fire were significant. Only three factors are needed to sustain a fire: fuel to burn; heat to cause and maintain the fire; and sufficient oxygen to sustain the fire (Granger, Luxton, & Berechree, 2009, p. 11.2). In this disaster, there was plenty of fuel to burn – taking the form of wood, houses, and vegetation. There was considerable heat in the form of the heat wave across much of Victoria at that time (probably aided by a spark ignited in the area); and there was sufficient oxygen in the air to sustain the fire. The risks were there and only one trigger or spark was needed to ignite the disaster. Impact The immediate impact of the fires included 173 deaths and about 414 burn injuries (Cameron, 2009). In terms of environmental impact, millions of animals were killed by the bushfires and millions also suffered severe burns from the fires (Gelineau, 2009). The catchment dams in the areas were also affected by the fires – with their water supplies shifted to other dams (Ker, 2009). Ash over affected dams has caused these dams to cease operations. Moreover, studies indicate that the smoke from these fires is still trapped over a portion of Antarctica (Australian Broadcasting Corporation, 2009). As far as economic impact is concerned, insurers are estimating the claims on the damage at about $1.5 billion (Nichols, 2009). Looting has also been widespread in these areas and these looters have caused even greater losses among survivors (Herald Sun, 2009). Environmentalists are also keen to point out that the fire emitted greenhouse gases which are now trapped in our atmosphere and further contributing to the global warming phenomenon (CSIRO, 2009). In an unfortunate turn of events, this global warming is likely to contribute to more bushfires in the area. Emergency Response to the Disaster 1. Fire response teams Fire response teams and plans were already set in place even before the February 7 fires. The Delburn fires were already active since January 30 and different people were already attending the emergency relief centres at Mirboo North and Churchill. Registration with the Red Cross for volunteers was also ongoing (Victorian Bushfire Royal Commission, 2009). The Victoria Emergency Management Council advised the Coordinator in Chief regarding the coordination of emergency response and recovery efforts before the fire broke out and the Minister was assured that emergency response teams were already in place for a possible disaster (Victorian Bushfire Royal Commission, 2009). The Department of Human Services also assisted in preparing for the extreme weather temperature that was about to hit them. In assessing the response of the Fire Disaster Management Team, it is clear to see that they were prepared to meet the disaster. They were in fact anticipating it. What they did not expect was the magnitude of the disaster. Many of the fires started in areas which were difficult to access. And this limited access made it impossible for the fire response teams to control and put out fires. As they were coming up with ways to access these roads, the fires were becoming even bigger and wider in coverage—wreaking havoc to more vegetation, forests, and infrastructure. Their air response crews were of limited number to put out simultaneous fires. The fires were spreading faster – more than the ground crews and the air crews could handle. Coupled with strong winds, the conditions for that day could not be contained fast enough to control or even limit its impact. More crews were needed and such crew was not made available in the short time it took for the fires to create much damage. Even as the fire response crews were indeed prepared and anticipating the bushfires, they were not prepared enough to meet the overwhelming challenges of the fire. The disaster could still have been averted or atleast contained. Access to higher areas which may be affected by embers from other fires should have been made possible. Roads could have been cleared for the passage of fire trucks in strategic areas where the fires could have been contained and controlled. Moreover, strategic fire breaks could have been set up earlier – days before the fire in order to reduce the possibility of these fires covering wider tracks. The response to the fires should have been made pro-active, not reactive. In such a way, the fires could have been contained to several counties or to a limited area only. As a fire emergency services commander, I would have implemented land clearance and controlled burning (O’Neill, 2009). Although this proposal would not have been supported by environmentalists and other interest groups, it is an important remedy which can help prevent greater damage on lands which are highly vulnerable to major fires. The overall impact of these controlled burns is much lighter when weighed against the impact of the Victorian bushfires. These fires can also be easily contained in strategic areas only and with the proper equipment and resources available to the fire emergency services (O’Neill, 2009). 2. Pre-hospital emergency care response The State Health Emergency Response Plan was also set in place even before February 7, 2009. Based on the possible risks which prevailed at that time, Ambulance Victoria was activated at 8:00 am on the 7th of February 2009. Consequently, the Ambulance Emergency Operations Centre plan and deployed its resources and placed other agencies on standby (Cameron, et.al., 2009). The Alfred was also mobilized to accept major burn patients. Initial reports of burns on 100 patients were confirmed for treatment. Others had non-survivable injuries. The Alfred was staffed with three consultant ER physicians, 2 advanced trainees, 2 medical officers, and one intern. Eight nurses on duty at that time had training in critical care (Cameron, et.al., 2009). It was obvious that their medical team alone was insufficient in meeting the demands of the victims. The prehospital care was also insufficient to meet the needs of the burn patients. Although the emergency response teams were ready to deploy, the number and the intensity of the needs of the victims were too overwhelming for the Emergency Response teams to meet. Moreover, the injuries sustained by the victims were better handled under critical care. The critical care offered by Alfred and other hospitals were not sufficient to ensure adequate help for the victims. The prehospital response teams were not sufficiently equipped with the training and skills to cope with the significant injuries suffered by the victims. In this regard, there is a need to improve the skills of the paramedics in dealing with severely injured patients. Their concern during emergency care is to prevent further injuries, to protect the patients from infection, and to quickly transport them to the nearest treatment facility. Such measures help ensure that the injuries of the victims are not made worse by the paramedics. Adequate training for the paramedics and pre-hospital responders should be provided in order to improve the speedy recovery and the survival of the patients. The on-site hospital control team was set-up near the Victorian Hospital Emergency Centre making possible the rapid flow of information and the speedy implementation of decisions outside the hospitals (Cameron, et.al., 2009). The team also included two plastic surgeons with specialties in burns; burns liaison nurse, and a burns care coordinator. Social workers and public relations staff were also available in the Centre (Cameron, et.al, 2009). It is also important to note that despite the shortcomings in skills and training among the pre-hospital staff, the on-site staff was quick to make adjustments in their response to patient needs. This efficiency could be seen in the fact that all patients with burns of 20% TBSA who would have normally been admitted to the Alfred were not admitted yet. Priority admissions to the Alfred were set aside first for the benefit of those with 30% (or higher) TBSA burns (Cameron, et.al., 2009). When resources were limited, the emergency medical teams applied the rules of triage and prioritized those with severe injuries first. In so doing, the medical teams were able to prevent the worsening of injuries among those who were severely injured. Consequently, they were able to reduce the severity of the impact of the fire on the general population. As an ambulance commander, I would also have ordered the paramedics to carry out pre-emptive evacuations of people who are in the most danger of being endangered by fires or who may be difficult to reach and rescue during fire outbreaks (VFBV, 2009). Pre-emptive evacuations help prevent and minimize human casualties and injuries. It also helps reduce damage to property because people can secure their belongings as early as possible while anticipating the dangers of the fires. As an ambulance commander, I would also have ordered the more seriously burnt patients to be brought immediately to the treatment centres and ordered the mildly burned to be transported at a later time. 3. Government response (Council Relief and Recovery Centres) Council relief and recovery centres provided facilities for refuge and for services and material needs of the people. The government agencies were in close contact and coordination with each other and with the volunteers in order to ensure that sufficient supplies (food, shelter, clothing, water, and medical attention) were available to the people taking refuge in these centres (Victorian Bushfire Royal Commission, 2009). Relief and refuge areas were set-up at different points around affected areas in Victoria. The government tried its best to communicate and coordinate with agencies like the Red Cross, the United Nations-WHO, and the Department of Human Services in order to help bring in food and medical supplies for the people in the centres. These agencies also assisted the survivors in making contact with their loved ones and to locate some of their loved ones in other parts of Victoria (Victorian Bushfire Royal Commission, 2009). The coordination among these agencies is considered to be dynamic and effective. At the time of the disaster, supplies seemed to be difficult to access. However, as aid workers were able to get through these areas, improved access to supplies was made possible. The coordination and the provisions for supplies could have been improved by providing these areas beforehand with the necessary supplies to shelter and offer refuge to as many people as possible. This would have anticipated the problem of limited supplies even before it happened and ensured that relief efforts at the time of the disaster would be directed to other un-anticipated needs. Aggressive information dissemination should have been carried out by the concerned government authorities – warning the people of the possibility of the fires breaking out and for them to make preparations to evacuate as soon as possible. The information dissemination by the authorities should have also covered warnings and reminders for people not to throw cigarette butts or other flammable materials in areas which are dry and which might catch fire. Industries which work and handle flammable and spark-emitting tools should also be cautioned on the handling of sparks and flammable materials. Conclusion The Black Saturday bushfires resulted to one of the most disastrous events in Australian history. It was brought on by natural events, and spurred on by man-made actions. The hazards and risks present right before the fires were enough to spark the first light which started the fires. Although the authorities were anticipating the bushfires, its actual impact on the people and on their resources was not expected. In the end, the disaster management teams were ill-equipped to control and manage the fires. The medical teams were able to cope adequately, but in the end, they could not manage it well enough to save more lives and to minimize the impact of the fires. There is room for improvement seen by the authorities after the fires were finally stopped, and these were hard lessons to learn. In order to avert future fires from causing greater damage, these preparations and precautions must be laid out and implemented strictly and on a wider scale. Works Cited About Black Saturday (2009) Country Fire Authority. Retrieved 27 September 2010 from CFA 2009 Country Fire Authority http://www.cfa.vic.gov.au/about/history/about_black_saturday.htm Bushfire aftermath: smoke trapped over Antarctica. (2009) Australian Broadcasting Corporation. Retrieved 27 September 2010 from http://www.abc.net.au/news/stories/2009/05/28/2583676.htm Cameron, P. (2009) Black Saturday: the immediate impact of the February 2009 bushfires in Victoria, Australia. Australian Post Online. Retrieved 27 September 2010 from http://www.apo.org.au/research/black-saturday-immediate-impact-february-2009-bushfires-victoria-australia Cameron, P., Mitra, B., Fitzgerald, M., Scheinkestel, C., Stripp, A., & Batey, C. (2009) Black Saturday: the immediate impact of the February 2009 bushfires in Victoria, Australia. Medical Journal of Australia, volume 191(1), pp. 11-16 Emergency and Incident Management (2009). Victorian Bushfire Royal Commission. Retrieved 27 September 2010 from http://royalcommission.vic.gov.au/finaldocuments/volume-2/PF/VBRC_Vol2_Chapter02_PF.pdf Final Report Summary (2009) Victorian Bushfires Royal Commission http://www.royalcommission.vic.gov.au/finaldocuments/summary/PF/VBRC_Summary_PF.pdf Fireground Response (2009) Victorian Bushfire Royal Commission. Retrieved 27 September 2010 from http://royalcommission.vic.gov.au/finaldocuments/volume-2/PF/VBRC_Vol2_Chapter03_PF.pdf Gelineau, K. (2009) Millions of animals dead in Australia fires. Associated Press. Retrieved 27 September 2010 from http://www.google.com/hostednews/ap/article/ALeqM5hn9MswZT1UDQOM4JFexha4JktfeQD969HIS80 Granger, K., Luxton, D., & Berechree, M. (2009) Chapter 11: Bushfire Risks. Geoscience Australia. Retrieved 27 September 2010 from http://www.ga.gov.au/image_cache/GA4214.pdf Health Lessons from Black Saturday (2009) Medical News Today. Retrieved 27 September 2010 from http://www.medicalnewstoday.com/articles/156465.php Ker, P. (2009) Dash to save Melbourne's drinking water. The Age. Retrieved 27 September 2010 from http://www.theage.com.au/national/dash-to-save-melbournes-drinking-water-20090217-89wm.html Looters move in to rob the dead at Heathcote Junction (2009) Herald Sun (News Limited). Retrieved 11 February 2010 from http://www.news.com.au/heraldsun/story/0,21985,25037815-661,00.html (dead link) Moncrief, M. (2009) Worst day in history: Brumby warns of fire danger. Fairfax Media. Melbourne: The Age. Retrieved 27 September 2010 from http://www.theage.com.au/national/worst-day-in-history-brumby-warns-of-fire-danger-20090206-7zf1.html Nichols, Nick (2009) Insurance bills set to rocket. GoldCoast.com. Retrieved 27 September 2010 from http://www.goldcoast.com.au/article/2009/02/10/47451_gold-coast-news.html O’Neill, B. (2009) The Victorian Bushfires. Ludwig von Mises Institute. Retrieved 27 September 2010 from http://mises.org/daily/3343 Relief and Recovery (2009) Victorian Bushfire Royal Commission. Retrieved 27 September 2010 from http://royalcommission.vic.gov.au/finaldocuments/volume-2/PF/VBRC_Vol2_Chapter08_PF.pdf The exceptional January–February 2009 heatwave in south-eastern Australia. (2009) Bureau of Meteorology. National Climate Centre. Retrieved 27 September 2010 from http://www.bom.gov.au/climate/current/statements/scs17d.pdf Q&A: Victorian bushfires (2009) CSIRO. Retrieved 27 September 2010 from http://www.csiro.au/resources/Victorian-Bushfires-QA.html#1 Victorian Bushfires Royal Commission (2009) Volunteer Fire Brigades Victoria. Retrieved 27 September 2010 from http://www.vfbv.com.au/royalCommission.php Read More