Earthquake Care : Plan Would Train Doctors for Disasters

Hoping to close gaps in Orange County’s disaster planning, county officials Thursday unveiled a program that would train a cadre of doctors to provide emergency care after an earthquake.

The plan is unprecedented, said Dr. Bruce E. Haynes, director of California’s Emergency Medical Services Authority.

“This is a very important program for the state of California,” Haynes said at a press conference at the Orange County Fire Department headquarters in Orange. “It’s a new approach which can save lives.”

The plan would create “a lifesaving army . . . a SWAT team to develop medical care” after an earthquake, Orange County Supervisor Gaddi H. Vasquez said.

Haynes and other experts in emergency medicine predicted that in the next 20 to 30 years, the county will have a major temblor that, without such emergency training, will kill at least 20,000 people outright and seriously injure another 80,000.

However, once the new disaster plan is set in motion, doctors should be able to save up to 10,000 critically injured people, estimated Dr. Robert Bade, medical director for the county’s Emergency Medical Services department.

Under the plan, 40 emergency-medicine doctors would take part in a 2-day seminar next fall, studying triage procedures and reviewing methods for handling “crush” injuries.

Until now, hospitals have had their own disaster plans, but there has been no local effort to mobilize physicians outside a hospital, Bade said.

“The vast majority of physicians are totally ignorant of what the (disaster preparedness) plan is or how it works, even if they participate in a local effort, such as preparing a hospital disaster plan,” a draft report on the plan said.

Along with training to remedy that deficiency, doctors would be armed with a backpack full of medical supplies that they could carry in the trunk of their cars.

With that equipment, Bade and other emergency-medicine experts said, county

doctors should be able to roll out a clean tarpaulin over the earthquake debris, then get to work splinting broken limbs, giving intravenous solutions, anesthetizing those with multiple injuries and keeping earthquake victims alive long enough to get to a hospital.

In addition, the plan calls for stashing a four-box, portable disaster kit full of syringes, gauze bandages, antibiotics and other medical supplies at 100 fire stations around the county.

“There’s no way to overemphasize the importance of equipment,” Bade said. “A physician without equipment is a hand holder in an emergency. With equipment, he’s able to operate.”

Vasquez said he would be asking fellow supervisors to adopt the plan within the next few weeks.

After that, Bade said, he and other emergency physicians will try to raise about $1 million in private contributions and government grants to buy medical supplies and pay for training.

Bade and other doctors estimated that each backpack of supplies would cost $5,000; a four-cooler kit of medical supplies would cost $7,000.

Eventually, Bade said, all 80 of the county’s emergency physicians would be trained as “Disaster Medical Directors.” After that, similar training would be offered to anesthesiologists, trauma surgeons and nurses.

Working with county fire officials and a $12,000 grant from county supervisors, doctors from the Society of Orange County Emergency Physicians developed the plan over the last 3 years. Their 80 members are expected to be the first county doctors to receive training in disaster response.

Also in July, UC Irvine’s College of Medicine will offer a new residency program in emergency medicine. The first six residents in that program will also receive the new training course in disaster preparedness, said Dr. Kym Salness, director of emergency medical service at UCI Medical Center in Orange.