International Search and Rescue Response Guidelines

Table of Contents:

• Introduction
• Preparedness Phase
  • Treatment Priorities
  • Medical Equipment Stock
• Activation Phase
• In transit Phase
  • Home Base to Affected Country
• Operations Phase
  • Patient Documentation
  • Medical Care and Evacuation of Injured SAR Team Members
  • Death of a SAR Team Member
• Reassignment/Stand down phase

The SAR Team Medical Group is organized, staffed, and equipped to provide advanced life support and prolonged out-of-hospital care throughout the course of a mission. It is recognized that both serious injuries and illnesses may be encountered and will require treatment. The medical personnel are also responsible for limited treatment of hazardous materials exposures for SAR Team personnel and in addition, must be capable of providing treatment for the search canines. The SAR team is composed (generically) of three functional components as well as a management component supported by the safety/security, information and planning, liaison and public information functions.

Staffing for the Medical Group should ensure that all members are capable of providing advanced life support and must be able to provide this care either as an emergency residency-trained doctor or emergency-trained paramedics. These members must be capable of performing continuous operations and have the ability to provide endotracheal intubation, establish intravenous routes of fluid administration, perform bio-medical monitoring, stabilize fractures and administer medications in a confined space environment.

The treatment priorities for the SAR Medical Group are:

• First - the SAR Team personnel, canine and other assigned support staff.
• Second - victims directly encountered by the SAR Team.
• Third - other persons as possible.

It is not the intent of the Medical Group to be a freestanding medical resource at the disaster site. Capable local medical systems will be considered the primary providers of general medical care to disaster victims.

The Medical Group equipment stock should be selected to provide immediate life-saving medical treatment for the SAR Team (including canine) as well as victims encountered during operations at a work site. It is recommended that the quantity of equipment and medicines in the equipment stock provide for anticipating on average the following injuries during a mission:

• 10 critical cases.
• 15 moderate cases.
• 25 minor cases.

Appropriate medical equipment, medicines and supplies should be pre-assembled to ensure continuous availability to provide medical care to SAR Team members while in transit, and to provide immediate care to victims upon arrival in the affected country.

Medical Managers must address several issues when the SAR Team is activated for a mission.

• Additionally, medical surveillance should be conducted to gather necessary information concerning infectious disease and other health-related issues specific to the disaster area.
• Other information may be obtained by monitoring local sources such as radio, television, or the Internet for disaster-related information.
• Attempts should be made to identify veterinary resources within the affected country and identify the needs and health concerns of the SAR Team canine element.

All SAR Team members should have identification documentation on file that includes pertinent personal information to assist in deployment activities. Information required would include the member's name, address, telephone numbers, blood type, emergency contacts, passport information, medical history, immunization records, etc. Other actions include:

• A review of each member's (and canine) personal information.
• Team personnel and canine passing a physical exam.
• Team personnel having current inoculations for the affected country.
• Canine having current inoculations and health certificate for the affected country.

The Medical Group Manager, in conjunction with the SAR Team Leader, should review the function's tasks and assignments for the mission. All SAR Team members should be briefed on the indigenous environmental conditions and health concerns in the affected disaster area, including a review of stress and health maintenance issues.

Home Base to Affected Country

• Appropriate ALS supplies must be available to the Medical Group at all times.

• Certain elements of the medical equipment stock should be prioritized for initial movement to the assigned SAR Team Base of Operations.

It would be beneficial to identify and meet with the local medical authority of the affected area and the senior authority for medical operations at or supporting the work site.

The medical plan must include:

Objectives.

Strategies and tactics.

Contact with local medical system.

Resource availability.

Re-supply needs.

Deceased victim management.

Indigenous health concerns.

Local victim transfer of care.

Team member and canine evacuation process.

The Medical Manager should coordinate with the Safety Officer and Hazardous Materials Specialist regarding:

The potential for hazardous materials contamination or other exposures.

Decontamination information for various contaminates or exposures.

The treatment options for general hazardous materials exposures.

Close coordination between Team Medical and Rescue Groups is important to ensure a safe effective operation and optimal patient care.

• Rescue operations must be monitored for potential impact on trapped victims, as well as rescuer's, to dust creation, carbon monoxide generation, oxygen consumption, hypothermia, etc. Medical actions to prevent these situations may be necessary.
• It is expected that under normal circumstances, medical function "fixed asset" equipment (i.e., defibrillators, monitors, ventilators, etc.) is a limited resource and will not leave the work site with patients. A high priority is placed on maintaining such assets at the operational work site for the continued protection of SAR Team personnel and other victims being extricated. The organization responsible for patient transportation and follow-up medical care should be prepared to provide such equipment, if necessary, for patient transfer to a medical facility.

Patient and team member's physical assessment and/or medical intervention performed by the Medical Group must be documented.

• This document would also be used to record any real or perceived nuclear, chemical or biological exposures, with a copy made available when a patient is transferred from the Team's control to other medical resources.
• The Team must maintain a copy of each completed document for their files.
• A patient treatment log must be maintained.

The Medical Group Manager shall:

Evaluate the team member's injury or illness.

Treat as necessary.

Recommend the team member's duty status/capability to perform.

Evacuate as appropriate, if necessary.

Investigate and document the occurrence.

Coordinate with the UN OSOCC, the LEMA and home base.

The Medical Group Manager shall:

Verify the identity and confirm death.

Secure remains and personal effects.

Investigate and document the cause of death.

Forward information to appropriate officials.

Evaluate the effects on the SAR Team.

Coordinate with the UN OSOCC, the LEMA and home base.

The Medical Group Manager should:

Evaluate general physical and mental condition of the SAR Team.

Evaluate the equipment stock capability for reassignment.

Determine equipment/supplies that may be donated to the affected country.