NBC training/gear for EMS

[rationtin440]

Housil, I did not pose this question in combat lifesaver training or useful books topics because i did not think it was related to either topic. I'm curious what kind of training your ambulance unit has for NBC warfare attacks on civilians (terrorist as the cold war is "over"), Here in the states, to my knowledge, only paramedics can administer atropine, 2-PAM chloride, CANA, or amyl nitrate to victims of a nerve or blood agent incident. I'm also curious as to the equipment/gear that your unit carries specifically for NBC response/decontamination. Anyone else is welcome to contribute what they know of their community/country's resources as well. The reason I'm asking is that there is a growing movement in America to have towns and cities better prepared for another 9/11 which may involve NBC attacks.

[housil]

Not easy to answer...

As a heritag of cold war, we have an own "civil protection department" for any NBC attacks/accidents (like Chernobyl in 1986) or "dirty bombings".

We EMS personal need to go to training each year for a week to different topics. So we had that NBC-attacks-topic too

I can´t tell you all details, but that´s my handout (unreadable on purpose):





The NBC-defens- units have those decon equipment for patients:



for vehikles


for stuff



We, the EMS have also own "quick reaction forces" in case of a mass-casualties-incident.
This are Red Cross own volunteers EMTs with own vehikles. They are the back up for us:



NBC quick reaction unit decon and first aid treatment:

This units have all equipment to treat up to 50 patients each.

We, the regular EMS have some antidotes in our ambulances too as we had to respond to intoxications too. Not by terrorists but by accident at e.g chemical industry etc. So we have all that atropin etc. too
The biggest difference to the US EMS systems is, we respond TOGETHER with an ER Doctor to the scene and give ER treatment at the scene, right in the ambulance. The Doctor either come by car:


(one of our current ER Doctors units "Audi")

or by helicopter (every 100km we have a lifeflight with ER Doc (!) all over Germany)

(our local lighflight and ambluance Mrs. Housil is working on)

So our medical equipment in our ambulances is more than you may know it from US ambulances:

We can walk around the strechter:


Having a respirator


Many kinds of medication

even anesthetics

so we can intubate awake patients if necessary (like last Thursday night, brain injury after car crash):


(ER Doc (red smock saying "Notarzt") connect patient to respirator)


Medic taking care (RR, SpO², heart rate, anesthesia) after Doc did all treatment ("Stay and play")

[rationtin440]

Thanks for reply housil---it may not have been easy to answer but you have a gift of making the answers easy to understand. I realize there are things u cannot discuss and that's cool. I really think that your EMS system is better prepared than ours for this type of situation and the system of having doctors able to meet and ride with patients is a very good idea. I'm thinking (and please correct me if i'm in error) that during the cold war your nation was quick to consider the probability that NBC weapons could be used by either side in the event that the USSR/Warsaw Pact invaded, and your leaders took the threat seriously enough to put a good system in place. Here in the United States, many of our rural/town EMS units have atropine for use in case of exposure to organophospate insecticides from an accident, but not having lived with the real threat of invasion as your country has, the sense of a strong Civil preparedness and EMS training for it has not been taken very seriously. Looks like your nation takes civil preparedness seriously and that is a very good thing.

[rationtin440]

I noticed housil that you have mentioned in other posts that your wife is also an EMT? It is good to see that in your country, there does not seem to be the attitudes against husbands and wives working for the same employer. Here in the states there seems to be a very definate but unexplainable reluctance by many employers, including EMS, to have husbands and wives working for the same company.

[Bypah]

Simple....their EMS system is controlled by the goverment and centralized , I assume meanwhile here in the US is mostly in private corporation hands.

[rationtin440]

I had not considered that Bypah, but may well explain it.

[biscuits brown]

Israel is undertaking a full scale "Home Front Command" exercise this week, with extensive civilian participation. so it may be an idea to watch the Jerusalem Post website for any video clips and pics showing equipment and procedures.
If I see anything interesting I will post.

[housil]

I'm thinking (and please correct me if i'm in error) that during the cold war your nation was quick to consider the probability that NBC weapons could be used by either side in the event that the USSR/Warsaw Pact invaded, and your leaders took the threat seriously enough to put a good system in place.

I´m living just an hour far from former "Iron Curtain", so NBC prepareness was always there. But the "stoneaged" east european nuklear power plants were/are a threat too, even until today. (I´m still having all NBC suits, mask etc at home. You never know...)

Here in the United States, many of our rural/town EMS units have atropine for use in case of exposure to organophospate insecticides from an accident,

Not to get too deep into topic, but atropine alone isn´t the solution!
Mostly the synapses get blocked (acetylcholinesterase inhibitor) by the (organophospate insecticides) agents, so atropine (10ml/100mg ampule) will help to stop your system from driving down everything (RR, heart rate etc). But to get the sysnapses back to working you will need some more medication ("Toxogonin") too! That will reactivate the acetylcholinesterase.

We have 1ml/0,5mg ampules too to deal with circulation (low RR, low heart rate, cardiac arrest, hypersalivation at anesthesia) also.

Here in the states there seems to be a very definate but unexplainable reluctance by many employers

That´s why "Walmart" got lot´s of negativ reputation over here and most (all?) of their stores were overtaken by a different company. They had that too, but by German law the employer can´t forbid you to date a coworker
Except in a bank it´s not allowed to prevent cheating/embezzle with the money.


Me and Mrs. Housil together on duty.

Simple....their EMS system is controlled by the goverment and centralized , I assume meanwhile here in the US is mostly in private corporation hands

Yep. EMS is public service by each State and a "non profit" business. As everybody has a "health insurance" over here, we don´t have to care if the run will get paid or not. It will. If EMS is making more money that all EMS costs a year, we pay it back to the (300) insurances. Privat companies in EMS are almost unknown. Only in (a few) big cities they do some BLS service. So we can be sure there is no cheating with money.
We are also NOT related to any hospital! We bring a patient to the next hospital that a) can treat him and b) the patient want´s to go.
We have one single clearing center for the whole State for all EMS! From that single clearing center, all ambulances, equipment, sellery etc. is paid.

[housil]

Israel is undertaking a full scale "Home Front Command" exercise this week,

All our precautions in bombings are taken over from them as they are well experienced in it...

[biscuits brown]

I understand Olie.

Im surprised that the US doesnt have like a similar "all in one" system. It would seem theres too many layers, like state, fed, FEMA all doing the same stuff? Im sorry if im just plain inaccurate here.

Also the mix of private is funny. It sounds odd to many outside the US.

I think market forces have their place. Its called the shopping mall. Private outfits shouldnt be involved in Home security, home front commands, etc etc. They are not there to give out charity, they are looking for a profit. Thats just wrong in these kind of scenarios. Sorry guys its just a IMHO post.