Disasters Don’t Wait — Why PTs Can’t Either

WEBVTT

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it's it's powerpoint but look at that's

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anaheim i did like a cool like time

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lapse oh

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All right,

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this episode is brought to you by Empower

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That is EmpowerEMR.com.

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Disasters.

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They don't ask if the system is ready.

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They expose whether it is.

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It's like bar rescue.

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It's a stress test.

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It's going to go sideways.

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Just figure out where it's going to go

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sideways now before it actually goes

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sideways.

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Our next guest is pushing physical therapy

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into emergency response,

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disaster medicine,

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and primary care chaos where it's already

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desperately needed.

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Live from Anaheim, this is Megan Mitchell.

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Back to the show.

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Megan, welcome back.

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Thank you for having me again.

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The first time we spoke,

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I had never thought or...

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I never heard anything that PTs could or

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should be where you are.

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I was like, didn't know.

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And I love when I sort of have

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that little moment where I'm like, ooh,

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never thought about that.

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So let's start.

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Why is disaster response everybody's

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problem, not just specialists?

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Why is it all of our problems?

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So I think it's important to remember that

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disasters impact everybody.

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They don't pick and choose.

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They don't select who gets impacted.

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It's widespread and it takes down

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everybody.

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So within the United States,

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I think what we need to reflect on

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is that the frequency of these large scale

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disasters,

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these one in a million sort of events

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are happening at a higher frequency and

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they're reaching a lot more people.

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Which is great.

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Including PTs.

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So we're seeing everybody getting impacted

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and then we're seeing all of these

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downstream effects from the lack of

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engagement from the PT profession.

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Why is it all of our problem?

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And that kind of guessing from your

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response because it's happening more and

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like we're either going to get run over

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or we lean in to prevent being run

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over.

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Every single disaster,

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if we look at just scale and scope,

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is in every part of the environment that

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we work in.

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So it's hospitals where I tend to lean

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into.

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It's nursing facilities.

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It's school-based settings.

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It's community settings.

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It's rural spaces and large population

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centers.

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Understood.

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Good.

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There's a reason.

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Where is PT underutilized during disasters

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specifically?

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Where could we be more helpful?

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So within the United States we're not

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included in any of the planning or

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response operations,

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but we really should be engaged up front

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in the planning roles in the pre hospital

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hospital receiving side of things,

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those of us who work in the emergency

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department need to have a direct role in

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response.

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to share that care burden between our

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critical care providers and those who are

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non-critically injured but still have an

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injury.

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And then all of the downstream locations,

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so hospital decompression, rehab centers,

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specialty rehab centers,

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and then even into the home health

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setting.

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We help.

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We speed things up.

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And we speed it up.

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We decompress the system.

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We provide the right care at the right

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time for the right patient population.

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Yeah, you brought up emergency department.

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I had never thought of that because I

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was a second career PT.

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I was like,

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I don't know where these things are.

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And then I listened to Rebecca Griffith

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for a hot ten minutes.

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And I was like, oh, this makes sense.

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I get it.

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That makes sense.

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I like that.

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How come we're not doing more of that?

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And, of course,

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that's your mission and her mission is

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let's be doing more of that.

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What skills, let's go in,

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someone listening going, okay,

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but not me because I don't have those

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right skills.

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What skills do clinicians already have

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that translate to emergency care that

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people are probably, I don't have that,

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but they do?

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So the thing is,

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is that you already have it.

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You're just not applying it fast enough.

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So the vast majority of all injuries in

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any kind of disaster,

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regardless of the hazard,

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is going to be musculoskeletal.

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And for those of us who work in

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the critical areas,

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the folks who have the catastrophic

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injuries will go inpatient to ICU level

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care where we're already providing care.

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But I think we need to sort of

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stop thinking about the large scale piece

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of it and remember that the one person

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in front of us has the most immediate

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need.

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A lot of those folks are going to

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be minor injuries with musculoskeletal

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being the primary.

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Right.

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How can people like look inside themselves

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and say like, well,

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I don't belong there because I'm not.

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What are the reasons they don't show up

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or they don't think they belong that

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you've seen?

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So I think that people actually do think

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that they belong there.

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There's just no identified location for

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them.

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So I think there is a door.

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We just didn't know what it was.

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So you can't just volunteer in a disaster

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and say, I have these skills.

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I have my licensure.

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I can help with all of these things.

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That is generally not well received by the

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folks who are running the show.

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And so you really have to engage ahead

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of time with organizations like the

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Medical Reserve Corps or within the

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hospital.

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You have to work on your emergency

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response team so that people fundamentally

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understand where your skills are and they

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can check your licensure ahead of time so

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that you've been pre-vetted in order to

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engage.

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Don't just show up in the middle of

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the fire and be like,

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I know how to hold a hose.

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Be like, my man,

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you got to show up before that.

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Yeah, nobody cares in the moment.

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Get out of the way.

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Slow me down.

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So show up before.

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You got to show up ahead of time.

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Be part of the team.

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You got to train.

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You got to speak the same language.

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Why aren't PTs consistently included in

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disaster planning?

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Are we just not raising our hands enough

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to be on the team?

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Is that, I mean, is it simple?

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This is kind of a loaded question.

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So I think there's a lot of it

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that people don't understand that they can

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do it.

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But on the other side of it,

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I don't think a lot of our colleagues

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within emergency management or emergency

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medicine really have a good understanding

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of our skills and our scope.

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So they're not writing us into the plans

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because they just don't know how to use

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us.

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But someone else not understanding where I

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might have value,

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I might want to take a little ownership

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of that and say,

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let me show you how I might be

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able to help.

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Tell me what problems you have.

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Let me see if I can help.

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Instead of just saying,

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they don't think we're valuable.

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Yeah.

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We're locked out of the team.

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Why aren't you letting me in?

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It's like, hey, man,

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did you explain it in a way they

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could understand?

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If you give the ownership of writing your

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response to somebody else,

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they're going to do that with what they

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think that you do,

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which tends to be a lot of like

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move patient from A to B and then

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get out of my way.

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Right, right.

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And please don't do that.

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Just communicate clearly and frequently.

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If you don't want to be in the

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disaster in the front line, by all means,

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move patients from A to B.

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But if you have the skills and you're

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ready to step into that space,

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you've got to take ownership of your own

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professional voice.

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Understood.

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So let's break this down.

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I like things when they're actionable or a

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PT we call it, Monday morning applicable.

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What's an actionable step clinicians can

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take?

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to prepare where like if someone's nodding

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along going cool i've heard of this now

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it's not really on the fringe now i'm

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starting to hear about it more where do

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you tell them to go or do what's

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step one step one is um connecting with

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your emergency manager whoever that person

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is sometimes it's a director of safety

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sometimes it's an emergency manager it

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could be your environment of safety person

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whoever writes your disaster and emergency

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plans for your facility

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It's required by law for anybody who

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receives federal dollars for health care.

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They have to have both a disaster plan,

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including an evacuation plan.

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And I would say sit with it,

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read it,

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and then look at those plans through the

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lens of a PT.

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There it is.

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Where do I apply myself?

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And how can I better this process?

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I like that.

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Smart.

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How does advocacy intersect with emergency

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response?

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Is it everything you were just talking

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about?

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Is it showing up and asking how I

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can be helpful and making sure people

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understand that you're there?

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I've stopped asking how I can be helpful.

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I have started asking where do you need

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help.

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Where are the gaps in your response?

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So we really need to change the

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conversation from lessons learned into

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lessons applied.

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And so we know from all of the

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events that happened before,

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there have been gaps in the response.

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There's gaps in the operational planning.

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And then where do we fill in those

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gaps going forward?

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Yeah, any resource.

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I like tactical things,

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PT's love brochures and websites and

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whatnot.

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Where are the good resources?

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Where can people go to find out a

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little more,

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a little bit closer to the end of

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the diamond before they take a jump?

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You know,

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we put out a brand new updated emergency

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response guide through the APTA that came

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out in October.

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And it has a whole bunch of resources

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on there,

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both for incident command education as

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well as in-person training.

00:08:37.811 --> 00:08:38.511
APTA where?

00:08:38.552 --> 00:08:39.232
Like through what?

00:08:39.332 --> 00:08:39.793
Academy?

00:08:39.854 --> 00:08:40.894
Where are they going to find it?

00:08:41.971 --> 00:08:43.052
I think it's through the federal,

00:08:43.832 --> 00:08:46.173
like the C-suite folks.

00:08:46.453 --> 00:08:46.813
Got it.

00:08:46.913 --> 00:08:47.974
The fancy people in the big office.

00:08:47.994 --> 00:08:49.453
The fancy people who get paid money to

00:08:49.494 --> 00:08:50.034
do this stuff.

00:08:50.995 --> 00:08:51.674
It's their job.

00:08:52.654 --> 00:08:55.735
It's the PT and PTA emergency and disaster

00:08:55.775 --> 00:08:56.135
response,

00:08:56.176 --> 00:08:57.697
and there's a full action plan in there.

00:08:57.817 --> 00:08:58.216
Perfect.

00:08:58.236 --> 00:08:59.576
There's a lot of things that APTA does

00:08:59.596 --> 00:09:01.298
that people have no idea because they

00:09:01.317 --> 00:09:02.118
don't know to go look for it,

00:09:02.138 --> 00:09:02.658
but now they do.

00:09:03.077 --> 00:09:03.619
Now they do.

00:09:04.019 --> 00:09:04.599
It's out there.

00:09:04.759 --> 00:09:06.359
We have a tradition on the show.

00:09:06.399 --> 00:09:08.259
We call it the parting shot.

00:09:09.101 --> 00:09:11.102
This is the parting shot.

00:09:11.683 --> 00:09:13.085
One last mic drop moment.

00:09:13.745 --> 00:09:14.546
No pressure.

00:09:14.985 --> 00:09:17.148
Just your legacy on the line.

00:09:18.187 --> 00:09:18.948
All right, your parting shot.

00:09:18.969 --> 00:09:20.029
I'm going to ask you the question and

00:09:20.049 --> 00:09:20.570
you answer.

00:09:20.649 --> 00:09:20.750
Okay.

00:09:20.809 --> 00:09:22.030
All right, so your parting shot.

00:09:22.410 --> 00:09:24.173
What's one action item every PT should

00:09:24.232 --> 00:09:27.855
leave CSM with related to disaster

00:09:27.894 --> 00:09:28.436
preparedness?

00:09:29.231 --> 00:09:31.452
Everybody needs to leave CSM understanding

00:09:31.472 --> 00:09:33.975
that they have a role in disaster response

00:09:34.134 --> 00:09:36.397
and preparedness is part of that sequence

00:09:36.417 --> 00:09:36.836
of events.

00:09:36.917 --> 00:09:37.376
Yeah.

00:09:37.397 --> 00:09:37.616
I mean,

00:09:37.876 --> 00:09:39.258
we don't want a disaster to happen in

00:09:39.298 --> 00:09:39.859
your neighborhood,

00:09:39.918 --> 00:09:41.179
but that's where disasters happen.

00:09:41.200 --> 00:09:43.301
They happen in people's neighborhoods.

00:09:43.421 --> 00:09:43.760
Yeah.

00:09:43.860 --> 00:09:46.082
If it happens in yours, Boy Scout motto,

00:09:46.123 --> 00:09:46.283
right?

00:09:46.302 --> 00:09:46.863
Be prepared.

00:09:47.062 --> 00:09:47.543
Exactly.

00:09:48.144 --> 00:09:49.245
Megan, where can people connect with you?

00:09:49.664 --> 00:09:52.105
So you can reach me through my university

00:09:52.125 --> 00:09:52.586
website.

00:09:52.706 --> 00:09:54.628
It's through megan.mitchell at

00:09:54.668 --> 00:09:56.249
cuanchutes.edu.

00:09:56.269 --> 00:09:57.649
It's through University of Colorado.

00:09:57.990 --> 00:09:58.270
Love it.

00:09:58.972 --> 00:10:00.397
Megan, appreciate you coming on the show.

00:10:00.437 --> 00:10:01.360
Here we are live at CSM.

00:10:01.379 --> 00:10:02.683
Thanks for having me.