The morning of September 26, 2024, saw the peaceful mountain towns of western North Carolina waking up to their usual weather notifications. Even though the area was accustomed to storms, information about Hurricane Helene caused worry because it was growing stronger at a faster pace than anticipated.
The stronger the storm became, the greater the responsibilities of local Emergency Medical Technicians (EMTs). From organizing for the possibility of extensive evacuations to offering essential treatment in hazardous and uncertain settings, EMTs were at the ready.
Two recent hurricanes — Helene and Milton — serve as stark reminders that natural disasters can strike with little warning, leaving a trail of chaos and devastation in their wake. Saving lives and keeping people safe during a disaster, and cleaning up in its aftermath, requires the coordinated efforts of a diverse army of professionals, including doctors, police, members of the military, heavy-equipment operators, carpenters, electricians, plumbers, and more.
Also on the front lines are EMTs, such as the ones we train here at The National Center for Outdoor & Adventure Education, typically serving as part of the local rescue response. National emergency services, including the military and larger medical teams, are usually dispatched later. But they also require the dedication and expertise of EMTs.
In this post, I explore the indispensable contributions of EMTs during natural disasters, highlighting their training, the challenges they face, and the profound impact they have on saving lives when every second counts. Join me as I delve into the role of these first responders and call attention to their unwavering commitment to helping others in times of crisis.
The ‘First’ First Responders
Local EMTs, along with local police, firefighters, and caring neighbors, are often the very first to respond during a crisis — whether it’s a relatively limited incident, such as a car crash, or a massive event, such as a hurricane, flood, or earthquake. EMTs are among the first professionals on the scene to provide essential medical care, stabilize victims, and manage life-threatening conditions.
As first responders, EMTs are often deployed to disaster zones to assess the situation and triage victims, based on the severity of their injuries and the urgency of treatment required. Triage involves sorting and prioritizing patients according to their medical needs to ensure that people with the most serious and urgent conditions are treated first and to optimize the use of resources, limited or otherwise. As you might imagine, triaging can be extremely stressful, especially amid a disaster. EMTs often must make quick, accurate decisions with limited or even conflicting information.
Providing Immediate Care in Potentially Dangerous Conditions
In a disaster scenario, EMTs are counted on to save lives and optimize patient outcomes in less-than-ideal conditions. Their responsibilities early in a disaster include the following:
- Preserving life and limb: EMTs administer first aid, cardio-pulmonary resuscitation (CPR), wound care, and other emergency interventions.
- Transporting the injured: EMTs coordinate with other emergency services to evacuate the injured to medical facilities, especially in hard-to-reach areas.
- Preventing additional injury: EMTs may operate in dangerous environments, such as flooded areas, amidst debris, or in structurally unsound buildings. In these settings, they need to protect their own lives and safety as well as the lives and safety of their patients and others who may be nearby.
Collaborating with Other Responders
EMTs don’t work in a vacuum. They must coordinate and collaborate with other emergency responders to ensure that operations run as smoothly as possible and to optimize outcomes. In this context, their responsibilities include the following:
- Coordinating with government and medical agencies: EMTs work closely with firefighters, police, rescue teams, and even military personnel to maximize response effectiveness.
- Reporting to on-site command centers: EMTs often report to incident command centers, where they are integrated into a broader disaster response plan.
- Handling stress and emotional trauma: EMTs must manage not only their own stress but also the emotional trauma of victims, families, and colleagues. This requires resilience and emotional control in high-stress situations (more on this below).
Supporting Relocation and Evacuation Efforts
In addition to treating ill or injured patients, EMTs play an important role with evacuations, making sure that vulnerable populations — such as the elderly, injured, and disabled — are transported safely to medical facilities or shelters. They may provide continuing care to patients as they’re being transported.
Psychological/Emotional First Aid
Although EMTs focus primarily on physical safety and well-being, they also tend to people’s psychological and emotional needs, providing comfort to soothe their often-troubled minds. Their presence alone can ease people’s worries, assuring them that they’re being heard and in good hands.
Even after an immediate threat has passed, EMTs often offer psychological support to disaster survivors and others nearby, helping them navigate the emotional aftermath of shock, grief, and loss. One of their common roles is to help connect victims to mental health professionals for long-term emotional recovery.
Restoring Normalcy and Supporting Recovery
After the initial response, EMTs often support ongoing recovery efforts. These efforts may take the form of one or more of the following:
- Medical support for reconstruction teams: As recovery efforts begin, EMTs may support reconstruction workers and volunteers by providing medical care in the field.
- Community health initiatives: EMTs often participate in public health campaigns aimed at promoting hygiene, preventing injuries, and ensuring safety in the aftermath of disasters.
- Continuing medical care for long-term injuries: Many disaster victims face ongoing medical issues, such as infections or complications from injuries, which EMTs help manage as recovery efforts continue.
- Preventing disease outbreaks: EMTs assist in efforts to prevent the spread of diseases, especially in makeshift shelters or areas with compromised sanitation.
Special Challenges Faced by EMTs
Natural disasters pose unique challenges for EMTs — challenges that aren’t typical of those they face during a normal shift, such as the following:
- Resource limitations: Often, EMTs must work with limited medical supplies, equipment, and personnel, especially in remote or heavily damaged areas.
- Inaccessibility: Reaching people in remote locations, especially those whose areas are often obstructed by debris or flooding and which pose significant logistical challenges.
- Communication breakdowns: Natural disasters often damage infrastructure, making it difficult for EMTs to coordinate with hospitals and other agencies due to disrupted communications.
Future Considerations for EMTs in Disaster Response
Unfortunately, trending data suggest that natural and manufactured disasters, such as mass shootings and terrorist attacks, are likely to become more frequent, not less so. The field of emergency medicine needs to evolve accordingly. Here are a few growing needs we have identified as being critical for future EMT success:
- Advanced training: EMTs may need specialized disaster response training, including handling mass casualty incidents, providing care in resource-limited settings, and navigating environmental hazards.
- Use of technology: Telemedicine, drones for delivering supplies, and mobile medical apps could assist EMTs in providing faster, more efficient care in disaster scenarios and remote rescue operations.
- Collaboration with disaster response teams: EMTs will continue to play an increasingly integrated role in national and international disaster response frameworks, working closely with organizations including the Federal Emergency Management Agency (FEMA), Red Cross, and global humanitarian agencies.
The role of EMTs in disaster situations cannot be overstated and is certain to grow. Their quick actions save lives and provide essential care when the healthcare system is overwhelmed and as communities recover in a disaster’s aftermath. Training and preparation are the keys to their success. Here at The National Center for Outdoor and Adventure Education (NCOAE), we are committed to educating future generations of EMTs and providing continuing education to the dedicated and hardworking EMTs who currently serve our communities.
If you’d like to review our emergency medicine course offerings — including the NCOAE Standard “Intensive” EMT Course, the NCOAE “Intensive” Hybrid EMT Training Course (which can be taken in Oregon, Idaho, or North Carolina), and the NCOAE Wilderness EMT Training Course — please visit the Emergency Medicine Courses page on our website. You can also learn more by calling our North Carolina at (910) 399-8090 or email us at info@ncoae.org.
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About the Author: Zac Adair, MA, W-EMT, is the Co-Founder and Executive Director of The National Center for Outdoor & Adventure Education (NCOAE) — an award-winning organization that creates and facilitates wilderness-based experiences that foster personal growth, professional development, and acquisition or improvement of technical outdoor and urban / wilderness medicine skills.
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