Healthcare

The Well-Planned Use of Citizen Volunteers

by Joseph Cahill

The keys to success during any kind of crisis are coordination and resources. Emergency managers are learning again and again that there will be events that will overtake resources. That is particularly true when success is measured, as it should be, by the system’s ability both to respond to the crisis and to maintain normal operations at the same time. One important result of this two-ply requirement is that alternative sources of resources have become an essential part of emergency planning.

To cite but one example: The standard ambulance is ill-suited for off-road areas; consequently, those emergency medical services (EMS) agencies that cannot purchase and maintain a specialized 4x4 vehicle often rely on volunteers to assist with finding, reaching, and transporting – to an improved road and a standard ambulance – people who are seriously ill or have been injured in an accident or, perhaps, a natural disaster such as a hurricane.

In addition, these same “4x4 volunteers” may be pressed into service during a snow storm or other climatic event that renders streets and roads impassable to ambulances. Many cities and towns already use volunteer 4x4 vehicles and drivers not only to drive critical staff to their jobs at hospitals and other emergency/healthcare locations but also to assist EMS personnel in answering emergency calls.

Risk-Based Indoctrination Recommended

Volunteers who are factored into the regular response system typically receive enough indoctrination and training to understand what is expected of them and, a somewhat different category, what is allowed. Whenever possible, it is important, in the planning of training and practice exercises, to include those volunteers who may be involved in a real-life emergency situation.

One of the risks in including ad hoc volunteers – e.g., private citizens who own and drive their own 4x4 vehicles – in a community’s, or agency’s, response plans is that, although well meaning, these public-spirited individuals may have little or no understanding of the emergency plans, operating conventions, and safety procedures not only recommended but usually required. Emergency plans frequently involve complicated processes with many variable and moving parts that require not only initial (and thorough) training but also almost constant practice if they are to be used effectively. In short, it is unrealistic to assume that “occasional” volunteers will remember how the plan works. 

In order for outside volunteer resources to effectively “plug into” an existing plan, therefore, a number of procedural steps have to be taken ahead of time. The first is to ensure that the regular staff itself is thoroughly trained in the plan – to the point that they can carry out their normal duties not only within the plan, when volunteers are not involved, but also when volunteers are present and actively participating.

Friendly Oversight, and the Worst-Case Scenario

It is important to recognize that, when ad hoc volunteers are included in a response plan, new responsibilities emerge for almost all existing staff. Some of them undoubtedly will be asked, for example, to directly supervise and/or partner with the volunteers; and all will have to maintain a friendly oversight so that the principles of safe operations are adhered to and appropriate control of the response scenario is maintained at all times.

The worst-case scenario here is not chasing away and/or discouraging a certain number of the ad hoc volunteers because of too much oversight; it is, rather, causing an increase in casualties – among the responders as well as among the victims – because of too little oversight, a situation that leads to a failure to follow safety precautions, a loss of procedural control, and/or poor coordination of response activities in general.

A final consideration – as with so many other aspects of the homeland-defense picture – is the financial cost involved. More specifically, it must be determined ahead of time precisely who or what agency pays for fuel, or for possible damage to a volunteer’s vehicle, or – a more difficult situation to cope with – damage caused by the same vehicle. All of these issues, and others, can and should be worked out in advance, and covered in a standard release agreement. If left unaddressed, though, they have the potential to cause some major problems.

All levels of government and all political jurisdictions are open to the potential of a disaster that cannot be handled, even when additional resources are provided through local mutual-aid agreements and/or state/federal interventions. The key point to remember, nonetheless, is the same: It is only through the safe integration of all possible resources available that a truly complete emergency preparedness plan can be developed.

Links for later http://www.upton.ma.us/media/EMS/ambulanc_1_R2FI5H_0Z5RDZ-i34K-pR.pdfhttp://www.geocities.com/CapitolHill/Senate/1889/blizzard78.htm

Joseph Cahill has served as a line paramedic for over ten years in The South Bronx and North Philadelphia. He was awarded the distinguished service medal and seven pre-hospital “saves” ribbons from NYC*EMS and FDNY and a unit citation from the Philadelphia Fire Department, and has received both the 100-Year Association’s award for “Outstanding Service to New York City” as well as the World Trade Center Survivor’s Ribbon (two bronze stars).