DMAT San Diego CA-4
SEPTEMBER 2003 Newsletter
Volume 12, Number 9
deployable Disaster Medical Assistance Team. Affiliated with the National
Disaster Medical System. Founded 1991
DMAT San Diego CA-4 is a public benefit, non-profit 501(c)3 corporation.,
registered in the State of
and with the IRS.
Medical Center & International Relief Teams
Mailing Address: 200 West Arbor Drive, San Diego, CA 92103-8676
DMAT CA-4 Information Line: 619-543-6216
eMail address of Newsletter Editor, Jake Jacoby: email@example.com
DMAT CA-4 WEB site: http://www.dmatca4.org
Calendar Of Events..........................................Page 1
After Action Report: Joint training event........... .Page 1
Minutes, Aug 27, 2003 team meeting...................Page 2
Commander's Report........................................Page 3
Next Team meeting --
Wed., September 24, 2003 @ 1800 hrs.
Subject: Head Injuries and Burr holes: how to manage in the field
by Dr. Hal Meltzer,
Professor of Neurosurgery, UCSD School of Medicine/Children's Medical Center
Where? DMAT San Diego CA-4's New Operations Center
8830-G Rehco Road, San Diego
From I-805: Take Miramar Rd Exit EAST. Go 1.3 miles EAST to Camino
Santa Fe, Make left, proceed 0.5 miles to Carroll Road, Make another LEFT
onto Carroll Road, proceed west to the next light (Rehco Road) and make a LEFT .
Look for DMAT Ops Center on the Right.
From I-15: Take Miramar Road exit and head WEST on Miramar Road for 2.3
miles to Carroll Road. Make a RIGHT turn on Carroll Road (immediately past the
Pyramid building). Proceed approximately 1.0 miles to Rehco Road (It's the first
light after Camino Santa Fe).. Make LEFT turn on Rehco Road, DMAT Ops Center
is first driveway on the right. Remember, we have no mail box at the
Center, so never use this address for mailing purposes.
* Operation "BACK to BASICS 2003. March Air Reserve Base, October
24th-25th and 26th, 2003. Joint exercise with all CA DMATs plus visitors
from other DMATs. Planning in progress, Sara Ontiveros, Planner for CA-4.
Sign ups now being accepted.
*NDMS Annual Meeting,
Apr. 17-21, 2004.
After Action Report
DMAT San Diego CA-4/USPHS CCRF JOINT TRAINING EVENT
Tuesday, August 5 and Wednesday, August 6, 2003
US Navy Submarine Base Point Loma(NSBPL)/ Anti-Submarine Warfare Training Center
Names of all CA-4 participants:
Chavez, Rachel - RN
Domino-Snyder, Valerie - RN
Downey, Robert -Lab Technician
Forney, Harold - Physician/Orthopedic Surgeon
Hicks, Toni - RN
Jacoby, Irving "Jake" - Physician/Emergency Medicine/Unit Team Leader
Leung, Susana - Pharmacist
Lyell, Amelia -Respiratory Technician
Norton, Scott- Logistics/Information Technology
Reeves, Mark - Chaplain
Rymer, Therese- Nurse Practitioner/Deputy Unit Team Leader
Snyder, Ed -Logistics/Information Technology
Soderbery, Robbin - LVN
Sohmer, Michael - Pharmacist
Spuhler, Kevin -RN/Critical Care Nurse
Thoreson, Jack - EMT-1/Acting Logistics Officer
Van den Hout, Carla - RN
Wahrenbrock, Zona - RN/Administrative Officer
Participants from USPHS Commissioned Corp Readiness Reserve: Course Director,
Dr. Renee Joskow, USPHS plus 53 trainees (names available-contact Renee
Narrative description of the activity:
At request of USPHS CCRF, DMAT San Diego CA-4 provided a staff of
instructors to give CCRF Course Attendees "hand-on" training of field medical
and living skills needed for field deployments. None of the USPHS course
attendees had ever deployed with a DMAT before.
DMAT CA-4 also made this event a training event for recent new members. The
training event was used to simulate an actual deployment.. A rental truck was
leased, and items needed for the hands on training were loaded on the morning of
August 5th. Truck was then moved to the US Navy Sub Base Point Loma (NSBPL),
Anti-Submarine Warfare (ASW) Training Center. The initial plan was to set up the
tent outdoors, and have team members set up the tent for sleeping overnight, and
then use the tent in the morning for training the CCRF on how to do a field tent
set up as a patient treatment site.
was done in the evening, after formal lectures were over, to a group of CCRF and
new team members of CA-4 on first night of training..
The following morning,, the CCRF members were broken up into groups of 4 and
were given individual hands-on exposure and training to the following equipment
and skills, and taught by instructors listed::
: Life Pack-12 (Kevin Spuhler); Impact Portable Suction devices (Jake
Jacoby); I-STAT Clinical Analyzer and other field laboratory equipment (Robert
Downey & Therese Rymer); Broslow-Hinkle Pediatric Resuscitation System
Jake Jacoby); Emergency Field Extremity Splinting ( Hal Forney);
Western Shelter Tents (Mark Reeves); Field computers ( used to present
photographs of prior deployments)(Therese Rymer);
Litter bearer training was provided by CA-4 team members for both CA-4 members
and CCRF trainees. (Kevin Spuhler)
Ongoing opportunities were present for one-on-one and small group interactions
and networking between CCRF and CA-4 members.
Provide a brief critique summarizing the Lessons Learned and recommended
changes for improvement:
1) This was an excellent interaction between CCRF and DMAT members. Should
be considered as part of theCCRF Training in the future when it is done in other
2) Difficulty with Navy Sub Base personnel thwarted the plan to have the team
stay overnight in tents outdoors as part of the training exercise. Although
advanced approval was obtained from the Sub Base Security to put up two tents
on site, this was negated on the first day of the training event by
groundskeepers at the ASW Training Center, and the impediment had to be
resolved by applying for and receiving permission to set one tent up indoors.
This affected our team to some degree, but in fact the opportunity for the same
experience will be occurring in less than 2 months at a larger field exercise,
Rough and Ready 03, in which CA-4 will be participating .
(3) This training exercise could be improved by:
(A) Having planned an alternate location for the tent instruction, such a site
might have been found if we had known with more advance planning what alternate
nearby locations might have been available, without use of busses or other added
expense for participation.
(B) having it extend for an additional day. This would free up our team members
to participate in more of the other didactic training sessions being conducted
for the CCRF, and increase the interactions of both groups.
(C) Better planning of mealtime to include a joint meal, either MREs or BBQ
Provide an accurate summary of the costs associated with the activity (please
include any equipment purchases made to support this activity):
Truck leasing for 2 days, to transport tents, biomedical equipment, cots,
Diesel fuel for truck: $14.00
Reimbursement of team members for participation: $6,505.36
Reimbursement of team members for mileage to and from site + per diems:
Batteries for I-STAT clinical analyzer: $43.06
Total identifiable cost: $8,959.08 (all charges and costs to be paid for from
team budget via VW Int'l, or by CA-4 team funds ($43.06)
AUGUST 27th Team
Aug 27, 2003 Team Meeting Minutes
I. Training Subject: "WORKSHOP ON FIELD SPLINTING OF EXTREMITIES"
By Dr. Hal Forney Professor of Orthopedics, UCSD School of Medicine
Dr. Forney with the help of Jo Markland, demonstrated the techniques
of field splinting of extremities
III. Nursing Director's Report
1)Critique of Training event with USPHS Commissioned Corps held on
Tuesday, Aug 5th
& Wednesday, Aug 6th, at US Navy Anti-Submarine Warfare, San Diego
Overall CCRF were very impressed with the whole training events, and
would like to continue having similar training with DMAT. One request was to
include straps for the litter exercise
2) Peggy reported that CA-4 did not get put on alert in the month
of August at all because there were 10 teams, instead of the usual 6, up first
for the month. The last two teams put on alert on the 21st were AR-1 and NY-1
reported that CA-4 purchased a used forklift per Dave Holland from Hawthorne
Lift Equipment. It is a CATERPILLAR, 5000 pound lift capability, with lights,
side shift, 187 inches lift capability. Current lease will be terminated at the
end of September.
4) Peggy reported that per Jake CA-4 have spent all except $740 of
our federal budget of $99,896.00 and there are a number of items that we paid
for with team funds that we will be requesting reimbursement for, which will
likely get us back that amount of money to our team
5) Peggy reminded team members to pay dues before the first late
fee kicks in on October 1st. (When dues will go up from $20.00 to $25.00);
6) Jake and Therese were both out of town, attending a 3 day course at the Noble
Training Center in Anniston,Alabama, called "Hospital Executives Leadership and
Decision-making for WMD."
IV. Old Business
County of San
Diego Contract for Study of Hospital Surge capacity
Peggy reported that the Surge capacity study is still on going, and
Peggy reported that skills tracking for RNs will be scheduled on
one Saturday morning in October
1)Administrative Officer (Zona)
-Zona reported that 100 uniforms were purchased. There will be forms
to sign out uniforms to take to
the uniform store
GALLS INC./ LONG BEACH UNIFORM, 8841 Clairemont Mesa Blvd., San
Diego, CA 92123
-Zona reminded team members to pay dues and submit copy of the current
-Zona reported that construction work will start on Sept 8 for about 25
days, will need team members to sign up a 4 hour block of time to safe guard
the Op Center during the remodeling period
-Bob Downey passed out copies of lab order form and ask for feedback
-Ed Snyder expressed interest in filling the vacancy
3)Financial - deferred
4)Fund raising - no report
5)Logistics - no report
6)Nursing - no report
-Michael reported that Jake Jacoby and Michael saw a demonstration of
the FFI Pharmacy Program, but the cost of $5000 is too costly for the team and
the vendor was unwilling to reduce the cost even though we area non-profit
-Michael reported that CA-4 purchased 5 HP-IPAQ 5400PC to download medical
information for deployment
-Michael announced that on Aug 28 Thur & Aug 30 Sat SDRxERT presented "The
San Diego Emergency Plan, Emphasis on Mass Prophylaxis and the Role of the
Pharmacist" at North County and South Bay respectively. Both
and Susana Leung will present part of the program
8)Safety Committee (open)
9)Supply - no report as Larry was absent
10)Tactical Strike Team Committee - no report
-Sara reported that 2004 budget requires 35% of team members complete
the core modules
-Sara reported that currently only 4% completed the core modules, 17% had
logged on the training program
-Sara reported that Rough and Ready 2003 name has changed to "Operation
Back to Basics" and will be on Oct 24-26 at March Air Reserve Base. (1.5 hour
drive one way from San Diego)
-CA 6 & CA 11 will be flown in. NV 1, OR-1, HA-1 and MN-1 were invited to
participate, in limited numbers.
-CA 4 have been assigned to be in charge of medical equipment training and
administration forms and provide cots
-Friday Oct 24 will be Commo set up
-Saturday Oct 25 CA 4 will have THREE 2 hour each session of training on
medical equipments and will need volunteers to sign up to instruct.
V.New Business - none
VI.Adjourn at 7:10 pm
-----Submitted by Susana Leung
* The allowed tenant
improvements began at our Ops Center on September 8th, being done by Starrett
Construction Company in El Cajon. Many of you have signed up to man the Ops
Center during the construction, and it is most appreciated. The computer was set
up so that members can use the Internet to sign on and get some of the training
modules done, and other members are invited to come down between the hours of 7
AM and 2 PM to take advantage of the opportunity, if you do not have access to
high speed internet connection at home or work. Thanks to
installing the new software and modem, and getting us up and running. Thanks
also to the following persons who have worked at the site the first week:
Jeff Keely, Kevin Spuhler,
Michael Sohmer, Zona Wahrenbrock,
Susana Leung, Hal Forney, Amanda Lyell, and Ed Snyder.
Others are still scheduled to work during the next 1 to 2 weeks. Work should be
done by our next meeting, or the day or two afterwards. The new meeting room
will be much roomier, and three additional office spaces are being created,
including a battery recharging room.
2002-2003 Federal contract budget for our DMAT is now history. We were able to
spend 99.994% of it, leaving an unspent amount of only $5.88. without going
over. We will shortly get to work on our current budget for 2003-04. The budget
crunch in Sacramento has left us without a signed contract from the state. That
amounts to $23,000. that we cannot start spending.
DMAT CA-4 will be undergoing an audit on Thursday, Sept 25 and Friday Sept 26th.
It is being done by an accounting company from Omaha, NE, which has been
subcontracted by NDMS. We are told the team was chosen at random, and is one of
8 DMATs to be so audited, as part of an effort by DHHS to demonstrate the
compliance of DMATs with their rules for managing Federal funds. Should any
member's assistance be needed to demonstrate any aspect of our DMAT's
activities, including logistics, we will get in touch with you. The auditors
have been invited to our team meeting on Wednesday evening the 24th. Please
make every effort to welcome them to our meeting and to San Diego.
Our team training officer, Sara Ontiveros, has been actively involved in
planning for this year's joint Statewide DMAT Exercise. It should be an
excellent opportunity to get field living skills basics, if you are a new
member, or refresh your memory as to how things are done, if you have been a
member for awhile. It is especially important that members who did not
participate in the joint exercise with the CCRF take part in this exercise, in
order to get deployability points , in case we need to choose among team members
for deployment slots.
A California DMAT BACK to BASICS 2003 Tee shirt has been designed by Anne
Bybee of the State of CA EMS Authority and the National Guard, and we will need
to know how many members wish to purchase one. This is NOT going to be a
large order, like at R&R 2001, and we will not be opening up the sales as a fund
raiser, they are essentially for team members only. They will be black, with
EMSA and National Guard logos as part of the 2003 Back to Basics Logo., on them.
They will cost $10.00 each, including tax. DMAT CA-4 will be advancing the funds
needed to purchase the shirts, as the budget crunch in Sacramento means that
EMSA cannot be using state funds to purchase T shirts.
* Due to the problem of "No shows" in the past, and the added expense if someone
signs up for the exercise and then does not show up, for the first time the
state has proposed that there will be a $50.00 penalty charged to the team, for
every no show. More on this at the next meeting.
FOR THE TEAM MEETING: MAKE SURE TO BRING A VOIDED CHECK to the next meeting,
to attach to the new direct deposit form for the Dept of Homeland
Security, if you have not already done so. This is a requirement for
everyone, old and new members alike.
And while you are at it, if you have not already paid your dues, bring along a
check for that too. That way you can avoid the late fees which will increase
dues to $25.00 after October 1st, to $30.00 after November 1st, and to $40.00
after December 1st.
* Be prepared with the following items, to complete your sign up for the BACK to
** Valid Driver's License number
**Know your license plate number, color, mode; year, and make of POV
("Privately owned vehicle") if you are driving to the base for the exercise.
**Make sure you have proof of insurance with you when you drive to the base.
Otherwise, you will NOT be allowed to enter, so don't even try. No exceptions.
This is for security reasons, per Guard Base. If you do not have auto insurance,
you will need to carpool with someone.
Plan on spending 30 minutes at the gate on a line in order to gain access, by
going through security.
** Make sure you have your NEW NDMS/ Homeland Security ID card. If you
haven't picked yours up yet, please bring your old card to the meeting, as you
will need to trade it in to get the new one. If you haven't taken your picture,
or if you have been informed that you will need a new photo , make sure you get
this done AS SOONS AS POSSIBLE as time is running out in order to get new ID
cards before the exercise .