Treating Trauma

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This week, we consider the many options for treatment in disaster situations. Using the course materials as a guide, consider the treatment option(s) you would deploy in a specific disaster situation, explaining your rationale for the selection(s). Think about the population(s) the treatment would be used with and why this is the most appropriate choice for the population(s) identified.

After reviewing the course materials for the week and the Scenario Module 4, choose to answer questions from either the Health & Social Services section or the Environmental Response/Health & Safety section.  Once you have chosen a section, you must respond to the primary question and at LEAST two other questions in your main post response.  Be sure to clearly identify which questions you are answering in your main post.  At LEAST two of your peer responses must be to someone who chose a different set of questions than you did for your main post.  Any additional peer responses can be to either someone who chose the same question set or a different question set than you did for your main post. 

Health and Social Services

1. What should the mental health community identify as short, intermediate, and long-term priorities at this point?

2. Typical responses to disaster and trauma fall into three broad categories. What are these categories, and how can community planners be better prepared to provide education and training to appropriate response and recovery personnel?

3. How could providing information about Disaster Response Activities and Services assist the victims of Bobsville?

4. What might disaster victims be experiencing related to losses related to (Home, School, Neighborhood, Business, Personal Property, and Pets)?  What actions should PFA providers take when dealing with these types of losses?

5. What are some of the social supports that PFA teams could utilize with evacuees?

6. How can PFA providers help survivors when a family member or close friend has died?

Environmental Response/Health and Safety

7. How can PFA providers stabilize emotionally overwhelmed survivors? Should medications be used in stabilization? Why or why not?

8. What are the different collaborative services that PFA staff can provide to the evacuees?

9. What does the phrase “Helping the Helper” mean?  How should the mental health community prepare themselves for secondary traumatic stress (STS)?

10. How could Psychological First Aid assist with setting up a child-friendly space once the incident is considered safe for this type of action?

Transcript Scenario Module 4

Read through the simulation’s continuing events and watch the following video:

May 2, 2021 8:00 AM

Fire and law enforcement personnel responding to the incident scene are detecting high levels of radiation, and it appears that some sort of nuclear explosion has occurred.
The Incident Commander (IC) has asked for additional mutual aid resources. The IC is requesting the Oklahoma National Guard 63rd Civil Support Team (CST) be deployed immediately along with other neighboring response organizations.

May 3, 2021 8:00 AM

Fire, Law Enforcement, and Oklahoma National Guard personnel have evacuated Bobsville. They have cleared all buildings of non-deceased citizens, and they have marked buildings where there are human remains so that they can be processed and identified. Additionally, the highways where many of the victims were during the initial blast have been closed off, and they are in the process of recovering, processing, and identifying human remains.

All evacuees have been relocated to Disaster Shelters within two hours of Bobsville. Citizens are being advised that they cannot return to Bobsville, creating confusion, panic, and extreme anxiety among some of the citizens. Little information has been shared with the evacuees other than an explosion has occurred that has resulted in many casualties. Some of the shelter evacuees cannot get information about their loved ones and family members. They don’t know if they have been evacuated to another shelter or are among the casualties of the explosion. Some children and individuals with disabilities who have survived the event have been separated from their parents and caretakers, creating much stress and emotional anxiety for them. 

May 4, 2021 2:00 PM

A meeting is held with elected leaders, law enforcement community leaders, etc. The discussion is about high public anxiety over radiation and a diminished understanding of the associated risks and protective actions. There is increased demand for messaging and information even at points distant from the incident. Elevated behavioral health impacts already exist within the impacted population as public fear of radiation results in many concerned, healthy citizens seeking medical assistance.  Though attempted to be mitigated by radiological, behavioral, and medical triage, it has quickly added to the already overwhelmed limited medical facilities. Shelter operations are being impacted by the concerned yet healthy citizens demanding information.

May 5, 2021 3:00 PM

Patient fatalities have exceeded the capacity of the hospital morgue and the county medical examiner’s office. Identification of some of the victims is going to require intensive research and DNA analysis. The State of Oklahoma has asked for assistance from the National Disaster Medical System with Disaster Mortuary Operation Response Teams (DMORT) to assist with identification, evidence collection and decontamination of deceased victims.

Mass Care of citizens, responders and domestic pets is a priority. Some agencies have already begun to arrive at the Reception Care Centers (RCC) and Shelter locations and have established mass care functions. 

Mental health and social workers attempt to provide information to the citizens and develop plans to reach evacuees not located in shelters and RCC locations. They are planning on using the media as a potential avenue of outreach. Their focus will be letting evacuees know that they will be establishing a myriad of governmental and support agencies at multiple locations to assist with mental health support, casework, food, housing, family reunification, finances, etc. 

Senior officials with Fire, Law Enforcement, and the National Guard report signs of stress with their responders related to the inability to save many of the victims they encountered. Some have been working for days with little to no sleep, and the stressors are becoming very noticeable. Bunnyville hospital had to evacuate all its patients and staff to other facilities once it was safe. Those staff members have not been able to return home and have also been displaced from immediate family members while continuing to provide care for their patients.

The National  Guard leadership has decided that the need to start identifying staff that may be exhibiting signs of stress and preparing a safe environment for the staff to begin to receive some psychological first aid. The commander of the National Guard Unit has requested that the Department of Veterans Affairs to provide PFA trained staff and Mobile Vet Centers (MVC) to the impacted area and to the Guard base camp which has been relocated from Bobsville. The commander is looking for the Veterans Affairs teams to provide PFA on an as needed basis for the soldiers that are feeling they need this support. Additionally, the commander has asked the Department of Veterans Affairs to be prepared for some soldiers that will be reluctant to receive support.

Key Issues

  • The Governor has declared a State of Emergency and has given specific mandates that response and recovery activities include supporting the mental health needs of the entire community impacted.
  • First responders are demonstrating stressors.
  • There is a significant number of deceased and family notifications that will need to be made. Some of these notifications will be to children.
  • Hospital staff have been transferred to multiple hospitals outside of Bobsville along with their patients.  They have had limited or no contact with their family members. A significant number of their patients have died.
  • Short-term and long-term housing issues are of great concern for the evacuees.
  • The county medical examiners office has been overwhelmed with deceased, and DMORT teams were requested to support the ongoing processing of departed remains.
  • Disaster County Shelters and RCC locations have begun to receive medical assets, food and evacuation assistance coordinated through the first responders, National Guard, the American Red Cross, state and local public health agencies, and NGO’s.

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