Volume 87 - Number 1

January - February 2008
Disaster Training Enters the 21st Century

Atraumatic Tooth Preparation

Atypical Odontalgia: A Review

The Dean

Classified Ads
MDA News


Disaster Training Enters the 21st Century

Frederick W. Nolting, D.D.S.*


In 2006, the National Disaster Life Support arm of the American Medical Association developed an on-line version for its Core National Disaster Life Support Course. The AMA chose five sites nationwide to test the effectiveness of the on-line course. Fortunately, Minnesota was one of them.

The Core Disaster Life Support course (CDLS) is one of a family
of courses (see sidebar), all of which are designed to provide a uniform
and coordinated approach to any disaster. The CDLS is a four-hour course that covers the basics of managing disasters both natural and man made. The course has been developed to offer an “all-hazard” approach that trains its students in the basics that health care workers would need to help victims of a disaster. Coursework is based upon the
D-I-S-A-S-T-E-R paradigm:


          D        -        Detection

          I        -        Incident Command

          S        -        Scene Safety and Security

          A        -        Assess Hazards

          S        -        Support

          T        -        Triage and Treatment

          E        -        Evacuation

          R        -        Recovery


The group participating in the tabletop exercise consisted of the MDA Disaster Preparedness Subcommittee of the Health and Safety Committee, and representatives from the the Olmsted County Public Health Disaster Preparedness Advisory Group, the University of Minnesota School of Public Health, the University of Minnesota Emergency Readiness and Training (MERET), University of Minnesota Center for Infectious Disease and Policy (CIDRAP), and the University of Minnesota Medical Reserve Corps. More than 1,000 members of these organizations were invited to take the on-line course. Thirty-five were invited to take part in a tabletop exercise after successfully completing the course. Drs. Sandra Houk, Thomas Rumreich, and I represented the MDA at the tabletop exercise.

The Problem

The tabletop exercise was a simulation of a mass dispensing of medication during an influenza pandemic. Dr. Italo Subbaroa and Surajkumar Madoori from the American Medical Association conducted the tabletop training, set the scenario, and acted as Incident Commanders.

The group was divided into sections matching the four sections of Incident Command: Planning, Logistics, Operations, and Finance. Each section was assigned to list its responsibilities, groups it would work with, and actions it would take. Each section presented their findings to the whole group. We then reviewed the goals of responding to a Mass Casualty Incident and compared our actions with those goals.


During the review of the goals of responding to a Mass Casualty Incident, we realized the importance of being prepared. This preparation insures that the response is quick, organized, and effective. We saw how using a common termin-
ology made commun-
ication smooth. Using the Incident Command System made each of our jobs clear. We knew our responsibilities and could focus on what we needed to do, knowing that the other sections were taking care of theirs and that this would result in the most effective response possible.

A great example of a fast and effective response was that following the collapse of the I-35W bridge in Minneapolis last summer. Citizens helped immediately, and as law enforcement, fire fighters, and all other first responders arrived at the scene, there was a very organized and speedy triage and transport of the victims. The comments from the AMA regarding this response were highly complimentary. They felt that the situation was handled extremely well.

The advantages of an on-line course are clear. More people can access the material, learn at their own pace, and learn at their own computers. One suggestion that was made to the AMA was to provide the course on CR-ROM for those who do not have high-speed internet.

This course will be offered on-line through the Department of Homeland Security later this year, and it will be offered at no charge. When the course is offered on-line, the URL will be passed on to all members through MDA News. The AMA plans to develop a family of courses that will be patterned after the Basic NDLS course specific to each health care profession.

Recent events here in Minnesota, most notably the 35W bridge collapse and the flooding in southeastern Minnesota, illustrate the need for disaster response training with an all-hazards approach. The AMA has developed an excellent series of courses that are designed to train all of us to effectively respond to any disaster.


American Medical Association
National Disaster Life Support Courses

CDLS-Core National Disaster Life Support. Designed as an introductory course, CDLS gives an overview to the all-hazards approach to disaster response. This course is for health care workers, police, firefighters, administrators, planners, and EMT personnel. (4 Hours)

BDLS-Basic National Disaster Life Support. Includes CDLS with further training in mass casualty and MASS triage. Included is the role of the health care professional in public health, incident management systems, community mental health, and special needs of vulnerable populations. This course is designed for all allied health care professionals. (8 Hours)

ADLS-Advanced National Disaster Life Support. This course is designed for those who have successfully completed the BDLS course. It prepares the participant for mass decontamination, use of personal protection equipment, essential disaster skills, and mass casualty incident communications and technology. The course uses volunteer patients and high fidelity mannequins for true-to-life practical training. (2 Days)

NDLS-D. Advanced course for training in decontamination for a chemical, radiologic, or biological event. The training includes classroom plus 8 hours additional instruction in victim decontamination, personal protection equipment, and a tabletop exercise. (2 Days)

NDLS-Instructor Course. This is a course to prepare advanced providers for instructing all levels of NDLS program courses. Successful completion of the ADLS course is a prerequisite. (4 Hours)


Disaster Preparedness: How the University of Minnesota Has Made Personal Preparedness Easier than Ever

The University of Minnesota School of Public Health and MERET (Minnesota Emergency Readiness Training) have developed an on-line tool for you and your family to easily plan for any disaster. The web site is:    www.codeReady.org.

CodeReady is specifically geared toward Minnesota.   In one hour you can generate an entire disaster plan, including survival kits and communications plans.  When you enter your name and the names of everyone in your household, your address, and medical information, codeReady will generate a complete communication section, including all of your city, county, and state telephone numbers, and web sites needed in a disaster.  The “kits” that are generated include food and water, first aid, and “go” kits (for when you must evacuate your home).  Kits for time durations from three days to one year are in the program.  CodeReady will calculate the amount of food, water, and first aid supplies, as well as everything else you will need, based upon the family information you have entered. 

CodeReady generates your family specific plan. This can be printed and can be saved on your computer.  From your printout, you can gather all the food, water, and supplies that will be needed by you and your family.

The only area that codeReady does not cover is preparing you and your family against crime and violence. Unfortunately, in disasters there is an increase in violence and crime.  Our law enforcement officials cannot be everywhere.  Response time to a 911 call during a disaster may be much longer than normal.  Be sure to take measures to protect yourself and your family. 

Now there are no excuses for being unprepared.  Take one hour at your computer and generate a complete disaster plan for you and your family. If you do not have access to a computer, have your children or grandchildren help you.  If you have no children or grandchildren, go to the public library and use a computer there.  Your fate and the fate of your family is now in your own hands.


*Dr. Nolting is chair of the Disaster Preparedness Subcommittee of the Minnesota Dental Association’s Health and Safety Committee. He is a general dentist in private practice in Byron, Minnesota.

Copyright 2008. Minnesota Dental Association
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