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	LETTER FROM CHRIS CAMP Chris Camp, CERT Volunteer, Whatcom County, Washington As members of CERT all of us have endeavored to prepare ourselves for that day when an emergency strikes and we are called upon to apply the skills we have learned. Just as we all wondered how we were going to do on the CERT final, I’m sure all of us have at one time or another wondered how we would do when it was real. I recently answered that question for myself and would like to share with you the lessons I took from it.
I feel that I should preface this with a disclaimer in the form of a short (I promise) biography. I’ve been involved with the CERT program in Whatcom County literally since its inception and have been privileged to work with most of the CERT classes as a victim for the finals. I’m also a CERT graduate and a qualified instructor. In addition, I’m a volunteer firefighter with Fire District 14 in Kendall and so I have a somewhat different perspective. That said, here is what I learned.
I was headed to Hardware Sales one fine afternoon last month to get parts. Just after I turned onto State St from Ohio St, I heard an impact and looked in the mirror to see a multi car accident in the intersection. I pilled over and put on my hazard lights, grabbed the ubiquitous cell phone and headed in the direction of the scene. As we all remember, scene size-up is crucial, but it can also be very difficult in the real world. I had the 911 dispatcher on the phone and reported that I was on scene with a 4 car blocking accident, unknown injuries.
The first two cars I came to the occupants were out of and were on the sidewalk. I relayed this to the dispatcher and proceeded to the third vehicle, which still held an elderly gentleman. I reached in and turned off the car to reduce the risk of a fire and started trying to do a quick assessment on him. He was conscious, alert, appeared to be breathing normally (more than I was doing), and was talking to another person who had come in to help. I relayed to the dispatcher what I was seeing while at the same time trying to assess the patient and also keep an eye on the traffic that continued to flow past the scene. My patient seemed a bit confused and when I asked him if he had any pain he said his chest hurt some. I asked if he remembered what had happened and he said he did. When asked if he had hit the steering wheel he replied that he didn’t think so. Next big question with chest pain…”Do you have any heart history?” Answer: “Well, I had a bypass last week”. He also told me he thought his pain was from that. I asked him if he had any neck or back pain and he said no. At about this point the dispatcher asked me if I needed an ambulance and suddenly I had to make a decision. In my mind this patient was borderline for needing Emergency Medical Services, but on the other hand, chest pain plus recent heart history plus possible traumatic injury added up to more than I could deal with so I told them yes, I needed an ambulance there. As I continued another passerby came up and asked if I had any medical training. I replied that I was a firefighter and he said he had some sort of an advanced Red Cross First Aid training I had never heard of and asked what he could do. I said I thought I had this patient stabilized, and asked him to check on the people on the sidewalk from the other vehicles. About this time the Police Dept began to arrive, and while I noticed they were around, none of the officers approached me. Shortly thereafter the Fire Department and Medic unit arrived on scene and began their triage and treatment. Because of my Fire Department experience I was able to assist them, but in ways that are outside the scope of CERT training.
To paraphrase a very wise instructor I once had, “The only guy who doesn’t make any mistakes is the one who never leaves the house”. I made two mistakes in this incident, one bigger than the other. The small one was that I completely forgot to grab my first aid kit when I left my vehicle. The only item in it that would have been of any use was my gloves, but not having them did not limit the things I felt comfortable doing. Part of the reason I didn’t grab the kit was initially I wasn’t sure if this was going to be an injury accident or not and when I discovered it was, it was too late to go back and get them. On the Fire Department, if there is any chance we might be dealing with a patient we glove up as soon as we get into a rig, weather it’s the aid car or the engine.
The second, larger, mistake I made was in the size-up. I told the dispatcher I was on-scene with a 4 car accident, but only mentioned three of the cars. What I didn’t know was that there was another patient in the fourth car with hip and abdominal pain. I became so fixated on the first patient I came to that I stopped looking. The irony of this is that the second patient was less than ten feet from where I was working on the first, but I became so tunneled in that I never picked up on her. In fact, it wasn’t until after the medics arrived and took over patient care that it dawned on me that there was someone in the car RIGHT NEXT TO ME! This sort of tunnel vision can happen to even trained, professional responders, and it can be deadly. In addition to the lessons I learned from my mistakes, there were also some things I learned from what worked. First off, the stress in that sort of a situation is incredible. I never felt afraid, but I had enough adrenaline in me to stun a herd of elephants. Another element that surprised me is how alone I felt in the middle of the situation. As soon as I showed up and identified myself as knowing what to do, I became in charge by default. In addition to the other convergent responders who were looking for guidance, I also had dispatch on the phone asking me to make decisions on the level of response needed.
	As a volunteer firefighter I have been to much more serious incidents, but never one that was as stressful. After giving that statement some thought, I came to realize why it was true. The first reason has to do with the suddenness. When my pager goes off and I respond to a fire or aid call I’m thinking about what I’m going into on the way to the station and mentally preparing myself. In the rig on the way to the scene we’re discussing what we’re going to do and what we’ll need when we get there. In this incident I didn’t have time for that. There was a noise and suddenly I was in the middle of a major scene. The second reason is that when I respond as a firefighter I am never going in alone. We always respond to the scene as a team and while it’s not always the same people on that team, it’s always a team. If I’m not sure what to do I can always ask someone else. If we need more help, the whole world is on the other end of that radio. In this incident I felt like I had to do it all and was totally alone.
I did draw some comfort from knowing that the cavalry was coming, but not much. Another reason was the lack of emotional support afterwards. After a fire or aid call, especially a stressful one we return to the station and discuss it. We go over who did what and what worked and what didn’t and this discussion allows us both to improve and also to deal with any Critical Incident Stress with other people who were there. In this incident, the patients were loaded, the medics said thanks and suddenly I was just another person on the way to Hardware Sales. This suddenness didn’t allow for decompression and it took me a lot longer to calm down than any fire call has. This is where that team aspect comes in. Unless the person you’re talking to has been there it is very difficult for them to understand that you need to go over the incident with someone and describe it to them in detail in order to come to terms with it yourself. I have a friend who had been a volunteer firefighter for 23 years and recently moved here and joined the Mt. Vernon FD. Before he got on the MVFD he was first on scene of a similar accident and despite his years of experience, despite the fact that he has been to thousands of accident scenes, he still needed someone to talk to who understood in order to deal with it in his own mind. So what’s the point of this long rambling discourse? Mostly this: When the balloon goes up and you find yourself in a situation where you have to use your training, you will do OK. Don’t fear your mistakes, do the best you can with what you have and reach out to those that understand when it’s over. When the call comes, we have two choices, we can let our fear of mistakes keep us from leaving the house, or we can go out and just maybe make a difference.

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