Major Incidents, Patient Care

Mo. EMS Provider Details Role in Midwest Floods

Since May 2008, flooding rivers have submerged communities in Indiana, Iowa, Illinois, Missouri, Minnesota and Wisconsin. The flood waters have destroyed homes and businesses, displaced thousands of people and ruined tens of thousands of acres of crops.

On a bluff overlooking the Mississippi River valley, the Winfield, Mo. sand-bag staging area was located behind the local high school in a large parking lot. Resembling sand dunes at a beach, huge mounds of newly dumped sand stretched for nearly 100 feet along the lot. Several hundred volunteers surrounded the mounds and worked to fill sandbags that once filled would have a weight of 30-plus pounds. Several small Bobcat loaders picked up pallets stacked with sandbags and placed them on National Guard trucks, which then transported them to the various levees along the river.

Adults, teenagers, entire families and even some prisoners from the county jail made up the contingent of volunteer workers. Local and national television news trucks were staged in an adjacent lot, and their crews wandered through the area recording the frenzied sandbagging process for the evening news.

In response to the 90-degree weather and the number of volunteers, Lincoln County Ambulance District (LCAD) put into service an extra ambulance and crew as well as an additional supervisor in a QRV to work solely with the disaster volunteers. Moving through the volunteers and maneuvering over mounds of sandbags, three LCAD paramedics kept an eye out for overheated and injured volunteers. They were armed with bottles of ice water, cold towels and spray-on sunscreen, sounding like ball park concessionaires when calling out to the volunteers, “cold water here!” In addition to the roving paramedics, LCAD also established a cooling tent with high-powered fans and cots for overheated volunteers and staffed it with a paramedic.

Prevention, treatment and transportation were LCAD’s top priorities during the disaster, said Greg Maddock, LCAD supervisor and public information officer. “We needed to staff the extra crews to minimize the EMS calls from our normal EMS units”, Maddock said. “We made sure they [the volunteers] stayed hydrated. If we saw someone starting to get overheated, we would pull him or her out. We were actually preventing injuries as opposed to calling for an ambulance every time someone got hurt or overheated.”

LCAD began planning for the disaster as part of the EMS arm of the Lincoln County Emergency Operations Center. “EMS has always been heavily involved with the EOC,” Maddox pointed out. “We have our role in there just as much as the fire department, police department, hospital, and emergency management.”

The EOC was activated about two weeks before major flooding began in Lincoln County. LCAD Chief of Operations Jim Holloway participated in regular meetings with other county chiefs and administrators who were planning for the impending disaster. Just how much the flooding would impact emergency resources was on everyone’s mind.

“In the beginning, we didn’t know just how high the water would get,” said Holloway. “The flood level predictions were changing daily, and we all wondered if this was going to be as high as in 1993.”

At times, LCAD EMS crews were also deployed to remote levees to provide EMS support for volunteers and National Guard personnel. In some cases, boats were the only means to get sandbags to the already fragile and waterlogged levees. “As with the sandbagging staging area, our concerns on the levees were prevention of heat-related complications and treatment of injuries,” Maddock said. “With the remote locations and the volume of volunteers, we felt it prudent to have an EMS crew there with them.”

Hundreds of Lincoln County residents were evacuated from their flooded homes, but several residents elected to stay with their homes. Some of these residents actually lived in tents pitched on their roofs. This became a concern to the EOC. To determine whether those who stayed behind had any special needs, the EOC conducted an audit, during which employees went door-to-door in rescue boats and talked with those who had stayed behind. All the area’s flooded homes were without power and telephone service, so follow-up visits by fire and EMS were in order.

Rescue boats from the Winfield-Foley Fire District and boats from neighboring fire districts were deployed daily to check on the welfare of those who did not evacuate, many of whom were elderly. The boats were stocked with food, water and pet food for disbursement to flooded residents.

Few remaining residents had special medical needs. “There were a couple diabetic patients back there, and we offered to check their blood sugar and provide blood sugar supplies. We just wanted to make sure everyone was OK, and that they had enough fresh water and food. If they needed to be checked out by„EMS, that’s what we were there for,” Maddock said.

He credits LCAD’s constant attention to prevention as their most profound role during the disaster. “I think all-in-all we prevented a lot of injuries and heat exhaustions, which could have resulted in actual EMS calls that could have allowed our EMS resources to get out of hand.”

The Mississippi River crested to within a couple feet of the 1993 record in Winfield. With the floodwaters now receding, the residents of Lincoln County will begin the task of returning to their flood-damaged homes. As that happens, LACD might have a role in the upcoming cleanup.

“This may not be over for us just yet,” said Maddock. “Accidents and heat complications may still be an issue for us, and depending on that we may still need to provide additional EMS resources during cleanup, just as we did during the flooding.”

Ray Kemp is a contributing photographer for JEMS and the owner of 911 Imaging, a professional EMS, fire, rescue and police stock photography company. His photography work has appeared in numerous EMS publications and textbooks. During his 17 years in EMS and fire services, he spent six years as public information officer for the St. Charles County Ambulance District in Missouri.