DMAT San Diego CA-4 * December 2003              Newsletter
*****  Volume 12,  Number 12   *****
A 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
California and with the IRS.

Co-Sponsored by: UCSD 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:
DMAT CA-4 WEB site:

Calendar Of Events..........................................Page 1
Commander's Log.......................................... .Page 2
Update on Logistics .........................................Page 2
Minutes, Nov, 2003 team meeting.......................Page 4


December 17, 2003

5:30 PM -9:00 PM
at our Ops Center

TEAM MEMBERS are authorized to  bring up to 2 mangers or supervisors from their work. We welcome member's employers, since we rely on them to get you deployed!
. Please either have them RSVP to Zona, or you can RSVP to her for them.
email address:
You can also bring your significant other.
Additional VIPs have been invited. DMAT members urged to wear their team shirts, so  visitors can see who the members are.
This is a great time for  members who have been  inactive, to come out and see our
Ops Center for the first time, and maybe rejoin our activities.

HAPPY HOLIDAYS TO ALL, & to All a Happy New Year without Disasters.

Next Team meeting --
Wed., January 28, 2004 @ 1800 hrs.
Where?  DMAT San Diego CA-4 Operations Center

8830-G Rehco Road,  San Diego

*NDMS Annual Meeting,
Dallas, TX Apr. 17-21, 2004.

The 12th Annual Tri-Service Combat Stress Conference dates are 30 April (Friday) through 6 May (Thursday) 2004 at the San Luis Rey Officers Club, Camp Pendleton.  Conference segment 1-2 May; Critical Incident Stress Management (CISM) certification courses 3-4 May and 5-6 May.

REMINDERS: Make sure to submit your nomination for member of the year.

Commander's Log
The holiday season is upon us, This is a time to reflect on our activities, our goals in medical care, and our expectations for the future.   The activities of DMAT CA-4 are ongoing. The frenzy of getting ready for an overnight exercise.... Back to Basics 03, at March Air Reserve Base... was clearly  a major effort, to get ready, to prepare for our  organizational, teaching and training tasks, and an  opportunity to get comfortable with what goes into a disaster deployment. Here is a  stream of thoughts that might have run thru your  brain at some time preparing for the participating in that weekend....  Picking what personal items might be needed for a deployment ... Making sure  you had everything....and always remembering the things you wished you had brought, but didn't. The hard work.. loading the truck, long drives, heat.  Taking our load off the truck, putting  up the tents,   staking them down...why do we do these things? Things will be fine.... The tents won't blow away...Trying to figure out the different venues at a new place for some, but  an old site for  others. Sleeping in a tent with 17 other people. Some might be strangers, to the newer members... And lots of old friends from deployments and exercises past for the "veterans."
Why didn't I bring some sort of easy-wear night clothes? Even scrubs would have been great. Why didn't I listen and bring a headlamp instead of a flashlight? 
Saturday afternoon came, and then of a sudden, things are happening, the air is bad, the temperature and the wind  is really hot.!!.. the wind picks up, the fire is just over the hills to the west.... The sand is blowing, feels like  getting sandblasted. Tents are threatened by the high winds, did they get staked down?. ..with enough stakes? Were the  floors attached correctly? How many stakes are enough?      So we go to help out. Staking  tents. Spreading sandbags around on all the tents. Do we have particulate masks to allow us to breathe out there? Whose idea was it anyway to put our tents up in such a sandy area, during
Santa Ana season?  It wasn't this way at our last exercise in August, at the Navy Sub base.  News is in the air... late at night and early in the morning. Wildfires in San Diego have begun to kickup in east county.. and north county,  spreading quickly. How did people find out? Cell phone calls to and from   home..Whose home is threatened? Who has to evacuate? What about my home? What about our ops center?  How can we go to training classes when real stuff is happening, and we need to know about it, and make decisions?

   The rest is now history. We should be better for it. We were trainees, we were trainers. Then we were almost victims.. Some of us may have been victims.  Sounds like a disaster. But we are better for it. Humbled by reality.
  Many thanks to Sara Ontiveros for all the effort she put into the planning of Back to  Basics 2003; Your participation certificates from the State of
CA EMSA have arrived, and I  will have them to distribute at the holiday Open House.

Update on  Logistics :
1) Two time clocks for the Kubota generators were purchased.   Gene Adkins is picking them up from the supply house and bringing them down from 
Escondido. They will be available at ops center soon for installation on our Kubotas.
2) The replacement weather cap for the badly damaged one  has been received and is in the warehouse. We will retire the older one which was significantly  bent out of shape.   New springs for securing  the caps to the tent  have also been received for the older tent weather caps.   If the older weather caps and tent crowns do not have holes, for the springs to fit, they will need to have holes  drilled in them, in order to accommodate the springs to avoid their blowing loose in extreme conditions, as were seen at  Back To Basics on other tents. Tent items are now located in a specific TENT SUPPLY  shipping crate, in the #400 series. For those who always ask, the weather caps for the tents   do not have a flutter flap on them/ they are perfectly fine for use. The ones with the flutter flaps are in case someone wants to use a heater that requires a Flue, and that is where the flu can extend up thru the roof. Since we don't use a flue, we really don't need the weather caps with the flutter flaps on them, we just happen to have them as they came with the original tent shipment.    3) Many thanks to the team members who assisted in getting started with the cleaning and tent floor repairs at last work party. Thanks  to Jay Thompson for completing our commo inventory, and thanks to all others who assisted on the inventory.
4) I have assigned a G
RAY  NDMS Property tracking tag to the forklift, as it  remains federal property because it cost more than $2,500.00. It must be tracked in our inventory.  It was listed in the  submitted inventory.[the BLACK US Govt property tags are affixed to many items, but they are not tracked currently by NDMS--that may change, and thus we are going to  list ALL tracking numbers in the inventory log, whether they are black or gray, for our inventory purposes. If an item has both a gray one and a black one, the GRAY one will be reported on the inventory form, as they are all  unique numbers and should not cause confusion.The GRAY inventory stickers are the priority ones, for high-priced or valued or security items,  while we are free  to place the BLACK  US Govt. numbered stickers  on any item we want to track.
5) I have completed the 2003 inventory and it has been submitted to NDMS, as of Nov 10th.  It was about 6 wks later than the deadline. I have since added  to it some of our team owned property, which also must be maintained on the inventory. As soon as all team items  are added, the inventory will be updated to NDMS. (Loretta McGill is our logs liaison for our team).
6)  I did go through almost all the boxes again to retrieve expiration dates for many of the expendible supplies...Government tracking numbers are listed in the spreadsheet. The master copy of this inventory is on one of the Team's  Laptops. I have sent copies to  many of you. It is expected that this inventory master will be updated and maintained throughout the year, whenever new items are received., whether they be federal or team opened property.  And if items are expended, such as MREs recently for the Back to Basics Exercise,  these will then need to be immediately reflected in the inventory master.  Planning is underway to get this onto a controlled, secure section of our web site in the near future. Until it is available on the web, if you have not received a copy of it, please let me know and I will resend it to you as an excel file.

7)  I will be interviewing outside logistics personnel to  hire an outside contractor, to work 10  hours per week on a regular basis, over the year, to maintain  the inventory and  cache, since too many things were not completed  through our all-volunteer system in a timely fashion, and we now have the funding support from NDMS to do so, as a recognized need for our team. This is becoming even more important as FEMA takes over NDMS.FEMA has been  is highly logistics oriented,and will I am sure be making changes in the near future as to how we do business on the DMATs. Until such person is chosen, I will be the acting Logistic Director.  Larry Griffin is still our Supply/Property Manager.
8) Each of the full-time and part-time logistics folks on our team should still be aware they they may be called upon to be a Logistics officer for a deployment for our team, and could be made available to other teams if they are short a logistics person for a deployment.  In addition  we may have other logistics responsibilities during exercises or state-related deployments, such as for the recent Wildfire Medical support activation.
---Jake  Jacoby
Nov 19, 2003 CA-4 Team Meeting Minutes

I. Greetings Everyone was asked to  introduce themselves and  new visitors were welcomed.

-Commander's Report/updates:
Loretta McGill (Logistic for NDMS assigned to our team) lost her husband about 2 months ago. Jake passed around a sympathy card for team members to sign for Loretta during her difficult time.
-A BIG THANKS was extended to  Kevin Spuhler who   put away boxes, put up dry  marker board, secured shelves for books.. etc. and cleaned up the DMAT Op Center over the past weekend. 
*There are now 38 Deployable  DMAT teams (used to be 21 teams) nationwide.

    2)Submissions for month:
Jake received the inventory list on a CD. The updated inventory list has expiration date listings                          -Jake will make the file available to team members. The file size is 1.4 MB on Excel 2000
      -Schedule of Training for 2003:
                          -Jake reported that the schedule of training for the remainder of 2003 had been submitted on Nov 19,2003
 -Jake reported that the Federal fund of $125,000 was held up for 2 weeks due to inventory was not ready to submit to NDMS on time. CA-4 have 70 deployable members, we need  to maintain our cache, MREs, and be compliance with policy and procedure
                          -Jake announced that San Diego County CMS GERM Commission presented a symposium  on SARS sponsored by Sharp Healthcare and the SD County Medical Society will be presenting    "SARS:  What you need to know" symposium on Tue Dec 2, 2003 at Mission Valley Hilton, Carmel Room  901 Camino Del Rio South, SD, CA 92108 Buffet dinner begins at 5:30 pm; presentation from 6:40-8:40 pm .Registration required by Nov 27,2003 Call SDCMS at 858-565-8888 Cost $25.00
Speakers: Dr. Arjun Srinivasan MD Infectious Disease CDC
 Dr. Allison McGeer Microbiologist, Mt Sinai Hospital, Toronto, Ont.

II. Exercise After Action Reviews
   1) Operation BACK to BASICS
Jake reported that on Oct 24 through Oct 26, 2003 EMSA CA sponsored the annual exercise  "Operation Back to Basics" for DMATs in CA and with out-of-state participants from  DMATs in NV, MN, and OR.
      -Operation Back to Basics was a comprehensive review of basic skills, tent and patient treatment sites set up, mission support team (MST)  training
      -On Sat Oct 25 due to the Santa Ana wind and dust storm, metal weather caps  on top of half a dozen of the 20 tents that had been put up , blew off, causing unsafe condition for participants. Tent city was temporarily shut down  and participants were evacuated to a hanger until the wind quieted down.  The outdoor training sessions were  canceled, and the issue of CE credits is uncertain at this time.

      -Overall this was a good exercise for MST to control and manage the exercise. There were 6 people  trained who can work with Western MST from Sacramento during deployment
      -On Sun morning Oct 26 due to residence evacuations from the wildfires back in San Diego, several members of our team and CA-2's team  left early to tend to their homes and family members.

2) San Diego & San Bernardino Counties Wildfire Medical Support
      -CA Wildfire Medical Support was set up through CA-6 with CDF.     CA-4 team members deployed to the wildfire medical support were Deanna Polk,  Michael Martinka, Beverly Fitzgerald, Jeff Keely, Leia Mehlman, & Adele Schwartz.
     - After Action report forms for  the wildfire-deployed team members to fill out were distributed.
      -Deanna Polk gave a short report on her deployment-
          -Most treatments were for burns, sililates, poison oak, insect bites, dehydration, "camp gut," and wet  feet
          -Pharmaceutical cache was inadequate due to the cache being divided among 3 sites
          -Security and communication were also inadequate;  one pharmaceutical cache was late to arrive, CA-4  arranged for pain meds through Fallbrook Hospital,  drugs arrived at Valley Center on 10/27 Monday at 2 am, Great advantage in dropping Peggy Perkins' name.
      -Beverly Fitzgerald presented CA-4 with a copy of CD photos from Lakeside fire,  photos and maps from CDF, including one of historic fires in the area.

III. Old Business
 1) County of San Diego Contract for Study of Hospital Bed Surge capacity
      -Jake reported that the Surge capacity study is in the draft form, and is being  put into publishable format  with references
       -Jake reported that the Hospital Bed Surge capacity Study is the number one issue the Federal and State government are looking into; our report will be submitted to the county in 2-3 weeks, if there are no further snafus.
  2) Skills Training Day
      -Jake reported that the Skills Training day is being  tentatively planned for  Sat, Jan 17,2004;  plans are being considered  to have quarterly skills training day on quarterly schedule, due to the turnover of team members.
      -Tentative schedule for skills training day is June and Oct.   April 17-21 is NDMS Conference in Dallas
  3) Harvard Medical Int'l Manual of Disaster Medicine
     -Jake reported that the second shipment has not arrived, and one team member has not picked up the  book from the first shipment of quantities of 25., 2nd order was for 15 more manuals. [Ed. note: books from 2nd order are now in and you can arrange with me to pickup your copies].

IV. Committee Reports
    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 INCORPO
RATED LONG BEACH UNIFORM,  8841 Claremont Mesa Blvd., San Diego, CA 92123
           voice: 858-505-1900
           fax: 858-505-1940
       -Jake reminded team members to have TAPE changed from USPHS to NDMS on uniforms, and each member should remove their own old tape before having the new tape sewn on uniforms at Galls or other stores
       -Zona reminded team members to pay dues and submit copy of the current license; exchanged new ID  cards with old ones
       -Zona reported that there are 50 direct deposit forms missing; and she urged team members to do so if they want to be able to deploy in the future.        -Zona passed out roster for team members to update
       -Zona passed out  notices  for NDMS Conference from April 17-21, 2004 in Dallas, Texas

    2)Communications (Jay Thompson)
      -Jay reported that the communication equipment room is coming along;  FEMA has cut the budget down to almost nothing, there will be no overtime and  NDMS just hired a third communication person to help with the workload

    3)Financial (
Jake Jacoby)
      -Jake reported that there will be a formal audit of balance sheet through June 30 by CPA
      -end of fiscal year  tax forms  and end of the year statement are being prepared, records and info have already been passed to the accounting firm which processes our team financial paperwork (Hinzman

      -Currently CA-4 team  bank account has a balance of $64,000;
    4)Fund raising (Sylvia Martinez,
Susana Leung)- nothing to report
    5)Logistics (
Jake Jacoby, Acting Director)
      -Jake reported that Chuck Perkins had resigned after 7 years serving as Logistics Director. A BIG  THANKS TO CHUCK FOR HIS TIME, HARD WORK, AND LOYALTY TO CA-4
      -Jake reported that the plan is to hire a logistic person to work 10-15 hours per week; and we do need to  have three logistic chiefs available for deployment

    6)Nursing (Peggy Perkins)- no report

    7)Pharmacy Committee (
Michael Sohmer)
      -Michael reported that he participated at the State Hospital Drill at Sharp Chula Vista involving setting  up Mass Treatment tent at the hospital
      -He participated at the SD County Operation Safeguard Exercise involving flu shot  administration for the mass flu outbreak scenario

     8)Safety Committee (open)

     9)Supply/Property Management (Larry Griffin) - no report. -Absent.

    10)Tactical Strike Team Committee (
Sal Ruiz)
Sal reported that Coast Guard has paid EMTs on the budget, so there could be a problem with  overlapping service  utilizing DMAT CA-4
       -Sal reported that Immigration Custom Enforcement being part of DHS and has no money, no medical coverage; DMAT CA-4 could have a working relationship with  the agency
    11)Training (Sara Ontiveros)
     -Sara reported that EMT/Paramedic competency needs to be completed
     -Jake reminded team members to complete the first block of core training program in a timely fashion. Our work plan requires us to have 35% of all our members finish the Core Curriculum, and we are currently at less than 5%.

    12)Web site Committee (John Johnson,
Michael Sohmer)
     -Michael reported that Volunteer member of the year nomination form will be available on line; paid up  members could vote on line (deadline is Dec 31, 2003).

V. New Business
    1) Planning Section - Jake reported that CA-4 needs to be in compliance with ICS, team members  interested in helping out   please email Jake;  FEMA  has a self-study ICS c course on the web
    2)Operation Section - Jake relayed current information regarding VMAT-4 to the team.
- Dec 17 Wed at the Op Center we will have a holiday party
instead of meeting, Sara Ontiveros is organizing  the party committee and volunteers should please email Sara. Each member should be bringing something to support  the Open house/Holiday Party, list will be sent out by Sara Ontiveros of items needeed..  Each team member can invite two persons who are their supervisors or owners of the businesses they work at,  to demonstrate how important we thing their contribution is by allowing their employees to deploy and participate in exercises.  Make sure to RSVP to Zona, with how many people are  coming.

VI. Work Party
      -Jake reported that volunteers are needed to help repair the floors of Tent 1,2,& 3 to replace the torn  cords; and there were 5 volunteers who could stay to  help.

VII. Adjourn at 7:30 pm
       -Payment of Dues - see Zona
       -Sale of Team Shirts, sweatshirts - see Carla
       -Sign out Federal uniforms - see Lois. 

Minutes prepared and submitted by Susana Leung


Irving "Jake" Jacoby, MD, FACP, FACEP
Team Leader, DMAT San Diego CA-4
Attending Physician, Dept. of Emergency Medicine, UCSD Medical Center, San Diego, CA
Associate Director, UCSD Hyperbaric Medicine Center, San Diego, CA
Clinical Professor of Medicine, UCSD School of Medicine, La Jolla, CA

200 West Arbor Drive
San Diego, CA 92103-8676
Telephone: 619-543-6216
FAX: 619-543-3115
Pager: 619-290-2700

DMAT CA-4 24 hour STATUS/Information Line: 619-543-6216