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EMSWORLD.com | NOVEMBER 2017 25 grasp on doing things." As the one making the medical decisions for the task force, Abo not only takes care of patients but also his team and their force protection, whether it be FBI agents or the National Guard. He witnesses a broad range of injuries and illnesses on the job, includ- ing heatstroke, dehydration, animal bites, heat rash, hazardous-material exposure, and even fatal electrocutions due to power surges in the water. Abo adds that these are only additions to the list of conditions people already have that require medical attention, such as heart disease, diabetes and pregnancy. EVERYBODY HAS A ROLE In the midst of disaster, Abo had positive experiences with people affected by the storms. "A lot of people are caring for strang- ers as well as showing graciousness. Texans were great hosts," he says. Residents of the Keys have shown his team kindness as well. Despite losing their homes, local firefighters worked with his team every day to provide search and rescue assistance. "I think everybody has a role," Abo says. "We wouldn't be able to do this medically if we didn't have people covering our home areas. Likewise, we're able to get as much accomplished as we are because of the local firefighters walking the streets with us, giving us local intel." Abo says every role, whether or not it's a specialty, is equally important in the col- laborative effort of first responders. "Every- one has their different roles and gets things done, and that's the reason we're able to take care of each other." Doctors and others involved in EMS operations in Puerto Rico, which only expe- rienced tropical storm winds, extended the same care to the U.S. Virgin Islands that were devastated by Hurricane Irma. Edgar Diaz, public information officer for the VA hospital in San Juan, Puerto Rico, discussed current operations to provide aid to the islands affected by Irma. The effort includes the VA's Federal Coordinating Cen- ter (FCC) and a partnership with the National Disaster Management System (NDMS). "This is the very first time our FCC has been activated here in San Juan…and to be able to support our brothers in the Carib- bean," says Diaz. Efren Méndez, Puerto Rico's supervising HELP YOUR NEIGHBORS, HELP YOURSELF After disasters like major hurricanes, citizens can be instrumental in relief efforts, but they require instruction from EMS and other local officials about operating safely. What are the key messages we should emphasize? First, listen to the experts. "Whatever the local officials are advising is the best advice to follow," says Brent Myers, MD, MPH, FAEMS, president of the National Association of EMS Physicians (NAEMSP). "Your local emergency management, EMS, fire, law enforcement and public safety personnel know better what needs to be done than anyone else." The NAEMSP provides educational materials and checklists based on best practices and les- sons learned from previous hurricanes to ensure its members can efficiently plan and take action. For the NAEMSP's most recent position papers on standard and clinical practices in disaster manage- ment, see www.naemsp.org/Pages/Standards-and- Clinical-Practices.aspx. Also tell citizens not to call 9-1-1 unless it is an emergency. Dispatch centers are often overloaded with 9-1-1 calls for incidents that are not absolute emergencies, tying up emergency resources for situations that require immediate aid. Most nonemergent 9-1-1 calls can be avoided since most injuries are prevent- able if people follow basic safety guidelines, Myers says. This includes wearing eye goggles and gloves while removing debris, bathing thoroughly after expo- sure to contaminated floodwaters and being cautious while using power tools. Myers also strongly advises placing generators outdoors or in well-ventilated areas during prolonged power outages in order to avoid carbon monoxide poisoning. Residents must also be mindful of their resting time and be patient waiting for services. "The recovery period is going to last longer than anybody antici- pates," Myers says. "Don't work 14 hours the first day, because you may well be at this for several days clearing your property. Those who are affected have to just wait for those who are going to offer support." Héctor Alonso, MD, chief of emergency medicine at the VA Hospital in San Juan, Puerto Rico, notes the value of citizens preparing before disaster strikes. "It's important that people remain calm and have a personal plan to pre- pare to take shelter at home for three to four days so you don't depend on the government and authorities while they get organized," says Alonso. "Slowly, essential services are being restored, and people should look for instruction by local authorities on where to look for that information." "The most important lesson here," adds Myers, "is that individuals will help their neighbor more than you ever anticipate. A lot of our role is to make sure that that is being done in a safe and appropriate manner." —Valerie Amato