Indian Health Service Staffers Train For Mass Casualty Response

Owen Le Beau stood in the hospital parking lot watching as members of his Hospital Emergency Response team tried to cut away the clothing from a man who was injured in a terrorist bombing and may have been exposed to sarin gas, a powerful nerve agent. It’s not an easy task: personal protective suit hood limited their vision and the rubber gloves made something as simple as using a pair of scissors difficult.

Le Beau, the Chinle (Ariz.) Service Unit Emergency Manager, was one of 35 Indian Health Service (IHS) employees who traveled from their homes in New Mexico and Arizona to train on hospital emergency response skills at the Center for Domestic Preparedness (CDP), marking the first time IHS employees have trained as a group at the CDP.

The IHS staffers took the Hospital Emergency Response Training for Mass Casualty Incidents. The three-day course is open to members of the healthcare community. During the course, the students learned about the relationships between the Hospital Incident Command System and the Incident Command System. Most importantly, they received guidance on the development and design of a Hospital Emergency Response Team (HERT). The HERT team is responsible for decontaminating patients before the patients enter the hospital.

The students learned to select and wear the proper level of personal protective equipment and how to decontaminate survivors and staff during a mass casualty incident response.

The Indian Health Service, an agency within the Department of Health and Human Services, is responsible for providing federal health services to Americans Indians and Alaska Natives. The 35 staff members who attended CDP training the week of April 6 work in various Navajo Area Indian Health Service (NAIHS) facilities on and near the Navajo Nation in the Southwestern United States. NAIHS is responsible for delivering health services primarily to the Navajo Nation and San Juan Southern Paiute Tribe.

The staff members ranged from doctors and nurses to an emergency manager and a housekeeping aide supervisor, but they all shared the common goal of wanting to be better prepared to serve their communities. “I wanted this training because, according to our hazard vulnerability assessment, our number one threat is mass casualties in the Chinle Service Unit area,” LeBeau said. He further explained that some of the hazards could come from ordinary, everyday occurrences, for example the derailing of a hazardous materials railcar on the east-west rail line that runs through Gallup, NM or if one of the many tractor trailer trucks that cut through the Navajo Nation wrecked and spilled fuel or hazardous cargo.

“I considered us to be capable in our decontamination skills, but now I’m seeing a lot of areas in which we can make changes,” Le Beau stated.

The Navajo Nation is the largest land-based Indian tribe in the United States. They have the largest reservation, which encompasses more than 25,000 square miles in northeast Arizona, northwest New Mexico, and southern Utah with three satellite locations in central New Mexico.

NAIHS provides comprehensive health care through inpatient, outpatient, contract, and community health programs that are centered around four hospitals, eight health centers and other community based, smaller health clinics. Additionally, Tribal health organizations and private providers offer health care services. The total user population served by Federal and Tribal Service Units in the Navajo Area is over 246,000.

Serving a rural area, many of the patients may travel 100 miles roundtrip to receive care. Some do not have electricity or running water in their homes. And, most of the elderly patients speak only Navajo and live according to traditional Navajo cultural practices, Le Beau explained. Fortunately, NAIHS personnel from other facilities signed up for the training as well, including Anson Damon III, an occupational health and safety officer at the Gallup Indian Medical Center in Gallup, NM.

“I wanted to get experience with the personal protective equipment and the Incident Command System,” Damon said. “The hands-on presentation gives you an opportunity to expand your skills. Working here with FEMA is a really great experience.”

Damon has worked in emergency management and safety for about 10 years, first heard about the CDP while working in the private sector. He’s only been onboard at the Gallup center for about four months now, he said.

The CDP training directly related to Le Beau’s and Damon’s roles as emergency managers. But, the training was just as important for housekeeping aide supervisor, Teaira Francis, who explained that decontaminating incoming patients and helping the healthcare staff during a mass casualty incident is part of her job as a Housekeeping Aid supervisor at the Chinle Service Unit.

Francis, said she was familiar with aspects of CDP’s training when she arrived. She had just completed her second hazardous materials training course in the past two years. In addition, she has taken most of the Incident Command System courses.

“I love this training! The staff is very experienced,” said Francis, who was looking forward to her last day of training when she and the other students would don personal protective equipment, set up a hospital decontamination station, and decontaminate mannequins that replicated the hazardous-material contaminated patients.

“That is the closest to reality that we get in training. The instructors will be evaluating everybody: the nurses, the emergency management staff, and housekeeping,” Francis explained. “I don’t think anyone from Housekeeping – throughout the Navajo Area – has ever taken this training before.”

Le Beau coordinated with the CDP’s West Region Tribal Training Coordinator, David Hall. Working together, Hall was able to reserve every seat in the class for the IHS staffers.

“It was a wonderful opportunity to host 35 members of the Indian Health Service for this training,” Hall said. “Their mission to provide medical and public health services to members of federally recognized Tribes and Alaska Natives is critical to ensure their continued preparedness. They are a great group, who learned a lot and have a desire to return for continued training.”

The CDP offers more than 40 courses covering 10 different disciplines of emergency response. All CDP courses are fully funded for state, local, and tribal responders. This includes travel, lodging and meals. CDP training is also open to emergency responders working for the Federal government and in private industry on a fee-for-service basis. Contact the CDP by calling 866-213-9553 or clicking http://cdp.dhs.gov. You can also connect with the CDP on Facebook, Twitter and LinkedIn.