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DISASTER RESPONSE Mobile hospital deployment in Long Beach, NY. Photos by Henry Cortacans the storm than the storm itself. "Be careful what you eat," he advises. "A number of our EMS responders got ill, particularly the out-of-state ones, because they were eating donated food. While the intentions of the general public were good, we had no way of knowing if that food was properly stored, or contaminated. It's best to stick with MREs, or food supplied from trusted sources. And also public health and hygiene are important to prevent outbreaks such as norovirus. There was a small norovirus outbreak that sickened a handful of responders. "We also had a surge after the storm 40 MARCH 2013 | EMSWORLD.com hit of carbon monoxide illnesses and fatalities because people were incorrectly using generators," Cortacans says. "One thing I thought was really good, the EMS Task Force equips our members with personal CO detectors and they carry them all the time because we typically just respond to disasters. But a good lesson would be for EMS agencies to routinely carry these CO detectors. Some of our members, who were not deployed on an assignment with us but were working with their local jurisdiction, had it on them and would come into residences where these things were alerting them to high levels of CO. Especially during a disaster, EMS crews should all be outfitted with personal CO detectors, especially working in areas with prolonged utility disruptions." Other lessons noted by Cortacans, Bascom, Clancy and Caruso were: • To activate EMAC early, so out-ofstate assistance can be on hand at the start of a disaster to assist with surge capacity and in areas where local EMS services are unable to respond, as well as with incident management. • According to Clancy, it wasn't just important to establish all the key leadership positions early on, but for leaders to be present in the field, not just the EOC. "We had staff at our command center, our state EOC and we had key state officials in the field, not only at various sites where a lot of the activity was happening, but also when EMAC resources came in to make sure there was a coordinated effort with local resources," she says. • Medical ambulance buses are an incredible force multiplier, and one of the most effective uses of EMS funding for mass casualty response. • Plan, train and exercise. Cortacans notes New Jersey probably has two dozen incident-type specific emergency operating plans, of which 90% have been implemented because state EMS officials value their effectiveness. • Use social media to communicate with employees and the public when traditional means of communication are interrupted. • Besides electricity, have a back-up plan for other utilities that require power, such as water. If the water company is out of power, arrangements will need to be made for portable toilets and potable water for hygiene and drinking. The most important lesson? "Take care of yourself," says Caruso. "We all know we shouldn't put ourselves at risk, but in times of disaster it might be easy to overlook the most basic signs that it's time to have a healthy snack, take a break, sleep, stay hydrated, etc. We must delineate very clear operational periods and enforce them."