Following a major disaster, first responders who provide fire and medical services will not be able to meet the demand for these services. Factors such as number of victims, communication failures and road blockages will prevent people from accessing emergency services they have come to expect at a moment's notice through 911. People will have to rely on each other for help in order to meet their immediate life saving and life sustaining needs.
One also expects that under these kinds of conditions, family members, fellow employees and neighbors will spontaneously try to help each other. This was the case following the Mexico City earthquake where untrained, spontaneous volunteers saved 800 people. However, 100 people lost their lives while attempting to save others. This is a high price to pay and is preventable through training.
If we can predict that emergency services will not meet immediate needs following a major disaster, especially if there is no warning as in an earthquake and people will spontaneously volunteer, what can government do to prepare citizens for this eventuality?
First, present citizens the facts about what to expect following a major disaster in terms of immediate services. Second, give the message about their responsibility for mitigation and preparedness. Third, train them in needed life saving skills with emphasis on decision making skills, rescuer safety and doing the greatest good for the greatest number. Fourth, organize teams so that they are an extension of first responder services offering immediate help to victims until professional services arrive.
The Community Emergency Response Team (CERT) concept was developed and implemented by the Los Angeles City Fire Department (LAFD) in 1985. The Whittier Narrows earthquake in 1987 underscored the area-wide threat of a major disaster in California. Further, it confirmed the need for training civilians to meet their immediate needs. As a result, the LAFD created the Disaster Preparedness Division with the purpose of training citizens and private and government employees.
The training program that LAFD initiated makes good sense and furthers the process of citizens understanding their responsibility in preparing for disaster. It also increases their ability to safely help themselves, their family and their neighbors. The Federal Emergency Management Agency (FEMA) recognizes the importance of preparing citizens. The Emergency Management Institute (EMI) and the National Fire Academy adopted and expanded the CERT materials believing them applicable to all hazards.
The CERT course will benefit any citizen who takes it. This individual will be better prepared to respond to and cope with the aftermath of a disaster. Additionally, if a community wants to supplement its response capability after a disaster, civilians can be recruited and trained as neighborhood, business and government teams that, in essence, will be auxiliary responders. These groups can provide immediate assistance to victims in their area, organize spontaneous volunteers who have not had the training and collect disaster intelligence that will assist professional responders with prioritization and allocation of resources following a disaster. Since 1993 when this training was made available nationally by FEMA, communities in 28 states and Puerto Rico have conducted CERT training.
We recommend a number of steps to start a CERT:
Identify the program goals that CERT will meet and the resources available to conduct the program in your area.
Gain approval from appointed and elected officials to use CERT as a means to prepare citizens to care for themselves during a disaster when services may not be adequate. This is an excellent opportunity for the government to be proactive in working with its constituency.
Identify and recruit potential participants. Naturals for CERT are community groups, business and industry workers and local government workers.
Train CERT instructor cadre.
Conduct CERT sessions.
Conduct refresher training and exercises with CERTs.
The CERT course is delivered in the community by a team of first responders who have the requisite knowledge and skills to instruct the sessions. It is suggested that the instructors complete a CERT Train-the-Trainer (TTT) course conducted by their State Training Office for Emergency Management or the Emergency Management Institute in order to learn the training techniques that are used successfully by the LAFD.
The CERT training for community groups is usually delivered in 2 1/2 hour sessions, one evening a week over a 7 week period. The training consists of the following:
Session I, DISASTER PREPAREDNESS: Addresses hazards to which people are vulnerable in their community. Materials cover actions that participants and their families take before, during and after a disaster. As the session progresses, the instructor begins to explore an expanded response role for civilians in that they should begin to consider themselves disaster workers. Since they will want to help their family members and neighbors, this training can help them operate in a safe and appropriate manner. The CERT concept and organization are discussed as well as applicable laws governing volunteers in that jurisdiction.
Session II, DISASTER FIRE SUPPRESSION: Briefly covers fire chemistry, hazardous materials, fire hazards and fire suppression strategies. However, the thrust of this session is the safe use of fire extinguishers, sizing up the situation, controlling utilities and extinguishing a small fire.
Session III, DISASTER MEDICAL OPERATIONS PART I: Participants practice diagnosing and treating airway obstruction, bleeding and shock by using simple triage and rapid treatment techniques.
Session IV, DISASTER MEDICAL OPERATIONS, PART II: Covers evaluating patients by doing a head to toe assessment, establishing a medical treatment area, performing basic first aid and practicing in a safe and sanitary manner.
Session V, LIGHT SEARCH AND RESCUE OPERATIONS: Participants learn about search and rescue planning, size-up, search techniques, rescue techniques and, most important, rescuer safety.
Session VI, DISASTER PSYCHOLOGY AND TEAM ORGANIZATION: Covers signs and symptoms that might be experienced by the disaster victim and worker. It addresses CERT organization and management principles and the need for documentation.
Session VII, COURSE REVIEW AND DISASTER SIMULATION: Participants review their answers from a take home examination. Finally, they practice the skills that they have learned during the previous six sessions in disaster activity.
During each session participants are required to bring safety equipment (gloves, goggles, mask) and disaster supplies (bandages, flashlight, dressings) which will be used during the session. By doing this for each session, participants are building a disaster response kit of items that they will need during a disaster.
When participants have completed this training, it is important to keep them involved and practiced in their skills. Trainers should offer periodic refresher sessions to reinforce the basic training. CERT teams can sponsor events such as drills, picnics, neighborhood clean up and disaster education fairs which will keep them involved and trained.
CERT members should receive recognition for completing their training. Communities may issue ID cards, vests and helmets to graduates.
First responders need to be educated about the CERT and their value to the community. Using CERT as a component of the response system when there are exercises for potential disasters can reinforce this idea.
FEMA supports CERT by conducting or sponsoring Train-the-Trainer and Program Manager courses for members of the fire, medical and emergency management community. The objectives of the TTT are to prepare attendees to promote this training in their community, conduct TTT's at their location, conduct training sessions for neighborhood, business and industry and government groups and organize teams with which first responders can interface following a major disaster.
CERT is about readiness, people helping people, rescuer safety and doing the greatest good for the greatest number. CERT is a positive and realistic approach to emergency and disaster situations where citizens will be initially on their own and their actions can make a difference. Through training, citizens can manage utilities and put out small fires; treat the three killers by opening airways, controlling bleeding, and treating for shock; provide basic medical aid; search for and rescue victims safely and organize themselves and spontaneous volunteers to be effective.