OKLAHOMA DISASTER RELIEF

Oklahoma Disaster Relief Medical Reserve Corps
Orientation/
Training Manual
INTRODUCTION
5. OPERATION

Oklahoma Disaster Relief Medical Reserve Corps

Orientation/

Training Manual

September 22, 2010

INTRODUCTION

The Oklahoma Disaster Relief Medical Reserve Corps is organized as a division of the Disaster Relief Ministry of the Baptist General Convention of Oklahoma. It exists to assist in relief and recovery of persons affected by crises in medical care brought about by natural or man-made events. In past crises of natural disaster such as earthquakes, tsunamis, floods, etc. there has been considerable effort expended in providing clean water, food, temporary housing and immediate recovery of some structures for housing, education, and worship. In a few locations we have been able to send some medically trained persons to help in immediate relief of injuries and disease in areas of great need following such disasters as well. Initially, these efforts were not well organized or coordinated. Following the earthquake and tsunami in 2004 and the hurricanes in Florida and the Caribbean coastline in 2005, the ODRMRC was organized and is in further development to provide a better organized and efficient response to such disasters.

Following the attacks on the twin towers in New York in 1991, the Citizens Corps was established to help the entire population of the United States to be better able to respond to any subsequent disastrous events. Part of that is the Medical Reserve Corps which is designed to allow medically trained persons to provide voluntary aid in needy areas within the country. Because of licensure and other legal restraints, the ODRMRC is obligated to work within the Oklahoma Medical Reserve Corps to avoid the hazards that prevent us working independently within our country. Accordingly, we have entered all the members of ODRMRC into the OKMRC and any deployment will be under their umbrella for deployment, supervision, and legal protection. However, we will be completely independent of the OKMRC when we are deployed outside the USA. Accordingly, our deployment will be coordinated and assigned by the NAMB under the Disaster Relief organization. The Disaster Relief Ministry of the BGCO will be in direct supervision of any team deployed by ODRMRC. For any questions regarding the policies or operation beyond this manual, see the basic Disaster Relief Manual.

1. MEMBERSHIP REQUIREMENT

We do not know where or in what form disaster will strike at any time. We can surmise in view of world history that disaster will strike somewhere, and perhaps soon. We plan to maintain a roster of volunteers who are prepared to offer aid to victims requiring medical care of some degree who can leave on short notice and be efficient enough to be of real benefit. We may need to deploy a team next week or it may be five years, so we cannot say how long it will be or if it will ever be necessary to call upon a given person to be deployed. If one would like to be frequently active in Disaster Relief, he should choose Feeding or Chain Saw as a primary interest, but if he is willing to serve with ODRMRC we would like to keep his name on the roster if we should need what he can offer in a given disaster. The more skill the better, but unskilled persons may be needed as well. Obviously, if a call is for three doctors and three nurses, we will not try to enlist untrained persons, but untrained persons often are needed. We will keep you on the roster if you are willing. The primary qualification is the willingness to serve in whatever capacity is presented at the time and documentation and passport are up to date.

Physician--M.D. or D.O. currently licensed (Either active practice or by special
license for charity and MRC).
Nurse--RN, LPN currently licensed in Oklahoma
Dentists currently licensed in Oklahoma
PA, RN-P currently licensed in Oklahoma
Pharmacist currently licensed in Oklahoma*
Veterinarian currently licensed in Oklahoma*
EMT, First Responders currently certified in Oklahoma*
Search and Rescue*
Various other disciplines related to medical care*
Untrained but willing to serve in any capacity
These criteria apply to OKMRC. If deployed outside USA, the requirements may be a little less but MD/DO must lead the team roster.

* Those who are trained but certification expired may be able to work outside USA with DR teams, so are carried on the roster although they may not be eligible for deployment within the USA.

2. DEPLOYMENT REQUIREMENTS

DR Training/Orientation

Every person to be deployed by Disaster Relief must attend the initial training and receive an ID badge. The initial training for the ODRMRC is the feeding team training which includes DR Orientation and qualifies the volunteer to work under the DR and in partnership with the Red Cross. This is universal for ALL DR volunteers at present. It also gives the volunteer information relating to operation of DR and its relationship to Baptist General Convention of Oklahoma, North American Mission Board, Baptist Global Relief, and your church.

OKMRC

When your application to the ODRMRC is received and entered into the database, the information is also entered into the Oklahoma Medical Reserve Corps database. It is a government agency composed of volunteers to serve inside the USA during medical crises. Because of licensure and other legal restraints, we cannot work inside the USA in the ODRMRC except under the umbrella of OKMRC. Their records are all electronic so it is mandatory to have a User Name and Password to access their database to update your data when there is any change. That will be part of the information in the application. There are some online training requirements by OKMRC and that can be done anytime after the application is rendered. OKMRC will also provide an ID badge when the Orientation, Training, and Background Check are complete. Any deployment inside the USA will be requested, supervised and coordinated by OKMRC. We can wear our ODRMRC logo while working under OKMRC and so far we have had no problem serving in the same way we have done with all the other divisions of DR.
Current requirements for Orientation and Training are:
1. Orientation (Can be done on internet or by OKMRC)
2. Background Check (Must be done before deployment. OKMRC does it).
3. Incident Command system (Current requirements are stated in the OKMRC website and training available online).
4. Life support (Basic and advanced are recommended and may be required for some specific requests for hospital services).
5. First Aid Certification and CPR Training are suggested for all our members, but not required. It will aid the members to be of service when deployed, even with other teams (Feeding, Chain Saw, Mud Out, Child Care, etc.).

Foreign deployment

When the NAMB requests a team from Oklahoma to serve in a medical crisis in a foreign country, there will be no relationship with the government agencies. We shall operate independently of OKMRC and our team will be directly supervised and operated under the Disaster Relief of BGCO, which will be coordinated by NAMB and Baptist Global Relief. When we operate under the DR only we do not need to carry or wear the OKMRC badge, but in most areas of the world badges confer a little authority so we carry them along.

A major requirement of foreign deployment is a valid passport with at least 6 months before expiration. We will have difficulty re-entering the USA without out the passport and some countries will not admit us without 6 months validity. It is also mandatory to recognize that we shall be under the laws and regulations of the host country and US laws and regulations do not apply except in our relationship to our country. Foreign jails are formidable and must be avoided by remaining law-abiding in all activity. It is advisable to be aware of local laws insofar as we can determine what they are, but some are peculiar to the host country (Be especially aware of laws relating to proselytizing).

While most countries with severe need for medical care will allow us to work in their country without a valid license in that country, we feel it is wise to carry a copy of our licensure in Oklahoma when we go abroad. It may not be necessary but it is little trouble to do and may be invaluable should there be any adverse event in our operation.

Uniform

Our shirts and caps with DR logo allow everybody to recognize us as volunteers offering aid to the country we are in. We have a logo for ODRMRC which does not directly display a Christian symbol, so we can go to a country that may be opposed to Christianity without offending citizens or running afoul of government officials who may be unsympathetic with our faith.

As with all other DR apparel and equipment, the logo is to be displayed only during official activity. That includes recruiting, reporting after deployment, during active deployment and traveling to and from sites. It is not to be worn to play baseball, shop at Walmart, or for casual wear to meetings or church.

3. Training and CME

At present we have no specific training or continuing educational activity. We anticipate offering training in CPR, First Aid, and perhaps later on we will offer training in more advanced skills such as Search and Rescue, First Response. If continuing education classes will be advantageous to the ODRMRC, that may be added also. Your interest and suggestions are invited.

4. Deployment

Deployment will always be requested and coordinated by OKMRC within the USA and will be offered directly from OKMRC without coordination by BGCO-DR. Any deployment by BGCO within the state will be under direct supervision of Oklahoma Disaster Relief at the request of OKMRC. Any deployment at the request of NAMB will be coordinated by the Oklahoma Disaster Relief and supervised directly by BGCO but served outside the USA.

Expense of transportation, housing, and food will be the responsibility of the volunteer unless advised otherwise at the time of the request by the DR office. For those going outside the immediate neighborhood, there will be coordination by the DR office to aid all persons to be transported to arrive and be housed together. If bedding, tent, etc. are expected to be needed this will be advised at the time of request.

Volunteers are advised to get whatever immunizations or prophylaxis will be needed. If these are kept up to date it will facilitate deployment efficiency. Adult DT, Hepatitis B, Hepatitis C, typhoid, malaria, poliomyelitis, are advisable for almost every country where we are likely to be deployed. Special needs may be advised such as yellow fever, rabies, etc. and can be had at the Oklahoma State Health Department, usually by appointment. Carrying a second supply of personal medications is advisable (one in purse or carry-on and one in check–in) to cover possible loss in transit.

Team organization:

Personnel
Blue Cap
Tour guide and spokesman for the team
Need not be a physician but must understand clinic operation.
Personnel skill to manage local volunteers (clerks, interpreters, etc.) and team personnel to work together smoothly.
Oversee devotional time, briefing, debriefing, recording, and reporting.
Physician-leader
Needs knowledge of medications and supplies and equipment available
Personnel skill to see and correct deficiencies and manage disagreements

Clerks
Must be able to spell, file, understand terminology for reception.
Can be RN, LPN, EMT, or anyone with enough understanding to do BP, Wt, Ask for Chief complaint, write legibly
Nurses
Enough understanding of medicine to serve as PA (unofficially) to substitute for physician, pharmacist

Pharmacy
Can be Phar, PhA, EMT, PA RN, LPN, but must be familiar enough with handling meds to accurately dispense (choose, count, package).

Ancillary
Anyone who has worked in a medical facility or oriented enough to assist in handling patients, setting up equipment, etc.

Chaplain
Trained as a Chaplain and able to tolerate working among sick and injured people.

Equipment
Basic equipment:
Stethoscope
Sphygmomanometer
Scale
Otoscope/Ophthalmoscope
Headlight

Optional
Dental chair and drill (with charger)
Suction
Surgical
Minor surgical tray and sterilization ability
Wireless electric cautery
Anesthetic equipment (Ambubag)

Medicines
Basic formulary and inventory
Name, size, recommended dosage, number, how packaged
Code for abbreviating name
Code for diagnoses

Charting
Standard chart for mobile clinic using standard terminology and legible writing
Need Date, Name, Surname, Age, Wt, BP, Chief Complaint by Receptionist
Hx, Px, Dx, Rx, Physician legible using standard codes and instructions

In most deployments outside the USA, we shall need to carry our personal stethoscope, etc. and as much medicine as we can obtain prior to leaving. We advise traveling light enough to keep personal needs to one check-in and allow the second check-in bag for supplies we can carry. This will help keep excess baggage costs to a minimum. We will be advised about what clothing will be needed and what facilities will be available so we need not carry tents, mattress, etc. unless really needed.

f.	Each volunteer will need to carry personal funds for incidental expenses and his own camera, phone, etc. In many areas recharging power will not be available, so there may be restrictions for phones, computers, etc. Keep in mind everything will often be exposed to theft. Do not take keepsakes or valuable jewelry.

5. OPERATION

OKMRC

The OKMRC will provide whatever equipment or supplies are needed beyond the volunteer’s apparel and personal instruments (stethoscope, pen, etc.). Transportation to the work site will be at the expense of the volunteer unless the site is away from the volunteer’s community. In that event, the supervising person for the team will advise the team members regarding expenses and facilities.

ODRMRC

1)	General—The location and time of deployment will be coordinated, assigned, and monitored by NAMB. Direct supervision of the team will be by BGCO and team leader assigned by the Partnership and Volunteer Missions office and the state Disaster Relief Director. Cost of the trip (travel, housing, and sustenance) will be advised prior to team organization so everyone can arrange for the funds prior to assignment to the team. Transportation to the site will be arranged by the office and onsite housing, transportation, and provisions in coordination with Baptist Global Relief and/or NAMB. Generally, the team will carry to the site what medicines and supplies they expect to use. This may be augmented by what is available locally, but that option may be delayed by the disruption of the local infrastructure and supply logistics. All personal purchases must be arranged by the volunteer. Any expense in touring will be in excess of the initial cost for the trip.
2)	Medicines—The ODRMRC Formulary¹ will be based on past use during deployment. The medicines and supplies will be provided according to the stated list of medicines and supplies. When time allows, there will be a copy of the medicine and supplies inventory² for each member of the team. Insofar as is practical the medicines will be packaged for individual distribution and labeled with a code to allow quicker ordering and dispensing. The formulary list will give all the information needed to prescribe and dispense the medication. The code will identify each medicine to aid in prepackaging and quickly dispensing most of the medicines prior to departure. There will also be a list of diagnosis codes to make uniform notation for efficiency and accuracy. The formulary printed in Appendix 1 in this manual is the initial copy and can be modified as needed for each team deployed, depending on experience and advice for each team and a copy supplied to each team member at the time it is called up. The medications will be packaged in small plastic bags or plastic bottles and labeled with the medicine, size, dosage, and the number of units.
3)	The written record for each patient will be entered on a card³ supplied for that purpose. It will also serve as a record of medications dispensed (or needed if not available) so we can better prepare the inventory for future teams. It will be printed in such a way that the name and address of the patient can be cut off and remain with the local church for reference without damaging our ability to assess the data.