Kurt Bramer from Advanced CPR Solutions comes on the show this week with Dr. Joe Holley. Kurt has a background in EMS since 1979 and worked as an emergency manager in Minneapolis. He currently works for Advanced CPR Solutions as a clinical educator.

Sudden cardiac arrest is a global disaster that rivals the recent viral pandemic in scope. Cardiac arrest is by far the number one killer worldwide according to every public health agency of note. Over the years, treatment of this problem has a less than 4 or 5 percent survival rate with only minor incremental changes to treatment modalities.

CARES Registry for Cardiac Arrest Stats

The regular treatment updates that go out every five years feature only relatively minor adjustments to treatments that aren’t all that effective. Part of the problem is that it’s nearly impossible to accurately study the effects of various treatments on cardiac arrest victims due to the wide variety of variables present.

Follow up on more of these segments as we continue to look at the current research trends in future episodes and what is on the horizon for the future.

The episode was co-hosted by Sam Bradley and Jamie Davis.

Scroll down for Podcast Discussion Summary

Thank you as always to Paragon Medical Education Group for their long-term support of the Disaster Podcast. Dr. Joe Holley and the team at Paragon continue to provide excellent and customized disaster response training to jurisdictions around the U.S. and internationally as well.

Podcast Discussion Summary

Jamie, Sam, and Kurt discussed the global disaster of sudden cardiac arrest, highlighting its prevalence and the low survival rate despite advancements in CPR. Kurt explained the distinction between evolutionary and revolutionary changes in resuscitation, emphasizing the need for significant innovations like public access defibrillation and rescue CPR.

The group planned to explore these topics further in upcoming episodes, aiming to engage both EMS professionals and emergency managers in addressing this critical issue.

The group discussed the evolution of CPR practices and the impact of scientific research on patient outcomes. Kurt and Jamie shared their experiences with skepticism and complacency among emergency responders regarding cardiac arrest cases, noting that previous protocol changes often had limited effectiveness.

The conversation highlighted the importance of evidence-based practices and the potential for new techniques, like active compression and decompression, to improve survival rates.

The group discussed the challenges and limited success rates in resuscitating cardiac arrest patients, with Joe noting that despite advancements, survival rates remain around 10-11%, equivalent to a 90% failure rate. Kurt explained that while the Cardiac Arrest Registry for Enhanced Survival (CARES) data shows a 10% overall survival rate, the rate for neurologically intact survival has remained below 9% since 2013.

The discussion highlighted the difficulties in conducting research on cardiac arrest due to variables like CPR quality, EMS response models, and patient characteristics, leading Kurt to suggest that randomized control trials may not be the most effective research paradigm for this field.

The group discussed challenges in conducting randomized controlled trials (RCTs) for pre-hospital resuscitation, with Joe highlighting significant variability in CPR quality and ventilation techniques. Kurt mentioned Peter Safar’s work and his belief that high-quality animal studies are needed before deploying therapies in uncontrolled EMS environments.

The discussion also touched on the American Heart Association’s guidelines, with Joe noting that while these represent the state of science, local factors and resource constraints must be considered when implementing recommendations.

The meeting focused on a series discussing cardiac arrest as a global disaster, with a particular emphasis on improving CPR techniques. Kurt Bramer shared a case study from a ski slope where a patient’s recovery was attributed to the use of a rescue pump and the gravitational effect of being in an inclined position.

The group discussed the potential of “head-up CPR” as a promising technique, and Jamie Davis announced upcoming episodes in the series. The participants agreed to continue exploring these topics in future discussions.

The group discussed the importance of disaster preparedness and the role of specialized training, with Jamie highlighting the sponsorship of the Disaster Podcast by Paragon Medical Education Group.

Catch the full episode using the player above or on your favorite podcast platform, and don’t forget to subscribe to the Disaster Podcast for weekly insights from leaders in disaster response and research!

Marcus Coleman Vice President of Community Resilience Strategy, for the United Way Worldwide joins the podcast episode. He talks with the team about the 138 year history of the United Way and its commitment to 4 areas of community resilience: Disaster, Resilient Ecosystems, Economic Resilience, and Personal Resilience (personal connectedness and social capital). They commit to being there for people before, during, and after disaster strikes.

Also joining us to participate in the discussion is our disaster emergency management expert, Becky DePodwin. She brings her background to asking Marcus questions about the ways local communities are adapting to the rapidly changing Federal response system in the current environment.

Tip Sheet PDF for United We Prepare Initiative

United We Prepare Program Homepage

The episode was co-hosted by Sam Bradley and Jamie Davis.

Scroll down for Podcast Discussion Summary

Thank you as always to Paragon Medical Education Group for their long-term support of the Disaster Podcast. Dr. Joe Holley and the team at Paragon continue to provide excellent and customized disaster response training to jurisdictions around the U.S. and internationally as well.

Podcast Discussion Summary

The group welcomed Marcus Coleman, Vice President of Community Resilience Strategy for United Way Worldwide, and discussed his role in establishing public-private partnerships to promote community resilience and address the climate crisis. They briefly touched on recent weather patterns and the success of a recent podcast episode.

Marcus explained United Way’s 138-year history as an interfaith organization that mobilizes communities during crises, with a focus on disaster response, environmental resilience, economic resilience, and social connectedness. He detailed how United Ways activate locally during disasters through partnerships with organizations like the Red Cross and Salvation Army, leveraging their 2-1-1 information service and existing community relationships.

Marcus highlighted their role in both immediate disaster response, as seen in recent events in Texas and Alaska, and long-term recovery efforts, particularly during the COVID-19 pandemic, where they focused on mental health support and trauma recovery.

The discussion focused on the importance of mental health support in disaster recovery, with Becky highlighting how survivors cope with both physical and psychological impacts after disasters. Marcus shared an example from Valdosta, Georgia, where the local United Way, in partnership with Resilient Georgia and Legacy Behavioral Health Services, has expanded mental health training and support for both survivors and first responders following three hurricanes in 18 months. The conversation emphasized the role of United Ways in connecting communities to mental health resources, particularly in the long-term recovery phase when emergency responders have departed.

Marcus explained United We Prepare, a national initiative by United Way to enhance disaster preparedness, focusing on risk understanding, family communication plans, and safeguarding valuables. He highlighted the role of local United Ways in coordinating volunteers, supporting caregivers, and integrating preparedness into existing community programs. Marcus also discussed how United Ways conduct community needs assessments to address housing insecurity and provide data for emergency operations planning.

Marcus discussed United Way’s efforts in addressing food and financial insecurity, highlighting their partnerships with food banks and financial education initiatives. He also talked about their focus on hurricane recovery and preparedness, emphasizing the importance of building strong relationships with meteorologists and other emergency management professionals.

Becky, a meteorologist, agreed on the importance of year-round preparedness and suggested that United Way continue to build relationships with local weather forecasting offices and private sector weather companies. She also expressed interest in how United Way might step in to fill gaps left by the federal government in disaster response.

Marcus reflected on lessons learned from past FEMA administrators, emphasizing the importance of whole community engagement, locally-led emergency management, and maintaining core values such as compassion and fairness. He highlighted the need for continued investment in emergency management systems and the role of United Way in supporting communities during crises.

Marcus also discussed the challenges posed by pandemics, extreme weather, and misinformation, and the importance of positioning United Way as a partner of choice in navigating these disruptions.

Marcus explained the role of 211 as a free service connecting people to resources through referrals and partnerships with nonprofit organizations and government agencies. He highlighted that disaster-related assistance calls increased by 50% in 2024, with top needs including housing, utility, and food assistance. Marcus also noted that 211 complements local government services, providing support for non-emergency crises, and praised Heather Black for her leadership in mobilizing 211 systems across the United States and Canada.

Marcus explained the United We Prepare initiative, and discussed how it involves community-based organizations in 14 markets. He emphasized that the initiative provides resources for individual preparedness and encourages collaboration with local United Ways, which cover 95% of the country. Marcus also outlined various ways for individuals and nonprofits to get involved as volunteers, including connecting with local United Ways and utilizing the dedicated volunteer page on the United Way website.

The conversation ended with positive feedback about Marcus’s participation and an agreement to have him return for future episodes, particularly to discuss disaster preparedness, response, and recovery efforts. Jamie expressed interest in featuring United Way representatives again and encouraged them to reach out for future discussions.

Marcus offered to connect Jamie with local CEOs for more localized insights and emphasized the importance of community resilience. The group also discussed the upcoming release of the podcast episode and the potential for sharing it on the United Way’s website.

The group discussed the importance of disaster preparedness and the role of specialized training, with Jamie highlighting the sponsorship of the Disaster Podcast by Paragon Medical Education Group.

Catch the full episode using the player above or on your favorite podcast platform, and don’t forget to subscribe to the Disaster Podcast for weekly insights from leaders in disaster response and research!

Tonight on the Disaster Podcast we dig into the expected impacts Hurricane Melissa will carry into Jamaica as it impacts the island country in the Caribbean. Disaster meteorologist Dan DePodwin and disaster emergency management expert Becky DePodwin join us this evening to look at the storm’s origins and projected track.

Melissa threatens multiple countries with hurricane and tropical storm force winds. In addition to Jamaica, Cuba, the Bahamas, and Bermuda are all in the projected cone of travel. Additionally, Haiti and the Dominican Republic are getting peripheral storm effects.

The episode was co-hosted by Sam Bradley and Jamie Davis.

Scroll down for Podcast Discussion Summary

Thank you as always to Paragon Medical Education Group for their long-term support of the Disaster Podcast. Dr. Joe Holley and the team at Paragon continue to provide excellent and customized disaster response training to jurisdictions around the U.S. and internationally as well.

Podcast Discussion Summary

Jamie hosted a mid-week update episode of the Disaster Podcast to discuss Hurricane Melissa, which is expected to be the strongest storm recorded worldwide in 2023. Jamie, Sam, and Dan discussed the storm’s potential impact, with concerns raised about entire communities being wiped off the coastline due to storm surge and prolonged winds. The team planned to bring in meteorologists and disaster management experts for further updates, and Jamie noted that this episode would be shorter than usual due to another episode already scheduled for Friday.

Dan explained that Jamaica and eastern Cuba are facing a dire situation due to an extremely strong Category 5 hurricane, Melissa, which rapidly intensified over the weekend. He noted that the storm is moving unusually slowly, which will prolong the impacts, including prolonged hurricane-force winds, significant infrastructure damage, and several feet of rain.

Sam mentioned that this year has seen three Category 5 hurricanes, the most in a single season since 2005, and asked Dan about the rarity of such events, to which Dan responded that it is concerning, especially given the potential impacts of climate change on hurricane intensity.

Dan explained that rapid hurricane intensification, such as Melissa’s recent rapid development, has become more noticeable due to improved monitoring and reporting, though the exact rate of such events is unclear. He noted several recent examples of rapid intensification, including Hurricane Michael and Otis, which caused significant damage.

Sam asked about factors influencing hurricane speed, and Dan clarified that steering winds in the atmosphere determine a hurricane’s movement, with weak steering winds allowing Melissa to meander slowly across the Caribbean. Jamie raised concerns about the impact of storm surge on coastal communities, particularly critical infrastructure, and questioned how to effectively communicate such risks to the public.

Jamie and Becky discussed the challenges faced by Jamaicans as Hurricane Melissa approaches, noting the lack of evacuation options due to economic dependencies on fishing and limited resources. Becky highlighted the storm’s well-forecasted nature but expressed concern about the prolonged impact and Category 5 intensity, emphasizing the logistical hurdles in providing aid post-storm.

Dan provided an update on the storm’s projected path, predicting significant impacts in Jamaica, Cuba, the Bahamas, and Bermuda, with Jamaica expected to bear the brunt as the first landfall. He advised residents to remain in safe shelters and outlined the expected wind, flooding, and landslides in affected areas.

Becky expressed concerns about the impact of the upcoming hurricane in the Caribbean, particularly in Jamaica, noting that while the island has experienced hurricanes before, this one is expected to be significantly more severe. She highlighted the limited evacuation options and infrastructure challenges, suggesting that many residents may not be prepared for the magnitude of the disaster. Jamie mentioned that a Hurricane Hunter flight was aborted due to extreme wind conditions, an unusual occurrence that Dan might be able to provide more context on.

Dan discussed the National Hurricane Center’s report about a NOAA aircraft that encountered severe turbulence while flying through a storm, highlighting the challenges of flying into rapidly intensifying hurricanes. He explained that while commercial flights experience turbulence, hurricane flights can be significantly rougher, with large altitude changes and intense shaking.

Dan also mentioned a notable incident during Hurricane Hugo in the late 1980s when an aircraft lost an engine, leading to changes in procedures. Becky and Sam discussed their interest in hurricane hunting, with Becky recalling a Hurricane Hunter Tour event they attended in Harrisburg, and Dan emphasized the importance of these flights for gathering critical data on hurricane structure and intensity.

The group discussed the recent hurricane and its impact on the islands, with Dan providing detailed information about weather research planes and their sensor technology. Jamie suggested reaching out to Nick for potential contacts and mentioned that Commonwealth nations might provide aid. The team expressed concern for the islands and emphasized the importance of preparedness, thanking Paragon Medical Education Group for their sponsorship. They agreed to follow up after the storm passes on Thursday and encouraged listeners to check out Paragon’s disaster training programs.

Catch the full episode using the player above or on your favorite podcast platform, and don’t forget to subscribe to the Disaster Podcast for weekly insights from leaders in disaster response and research!

Tim Conley, Emergency Management Supervisor Mercy Health Care System. He’s also the co-founder of the IDMC (Interstate Disaster Medical Collaborative) with our co-host Sam Bradley. Sam invited Tim on the show to talk about his Illinois Regional Healthcare Coordination system. This allows local healthcare systems to collaborate to provide emergency and disaster preparedness systems to their regions.

Joining us on the show tonight are our two disaster weather experts, Kyle Nelson and Dan DePodwin. We also have disaster emergency management expert, Becky DePodwin. We discuss how collaboration before disaster strikes is essential to maximizing the ability to respond in a timely fashion when major events occur.

The episode was co-hosted by Sam Bradley and Jamie Davis.

Scroll down for Podcast Discussion Summary

Thank you as always to Paragon Medical Education Group for their long-term support of the Disaster Podcast. Dr. Joe Holley and the team at Paragon continue to provide excellent and customized disaster response training to jurisdictions around the U.S. and internationally as well.

Podcast Discussion Summary

Jamie, Sam, and Joe welcomed Tim Conley to the show to discuss his work with the Illinois Preparedness and Response Coalition. Tim explained that his hospital has the Regional Healthcare Coordination Center (RHCC) for the northwest part of the state, and he helps with it but does not run it himself. The group briefly discussed Tim’s background and his previous appearances on the show. Jamie then introduced Tim to the audience and announced they were ready to start recording the episode.

The meeting began with a casual discussion about weather conditions on the East Coast, where Jamie described mild October weather with some rain from a nor’easter. Sam and Joe discussed the weather in Memphis, which had cooled off slightly due to the same storm. The group welcomed meteorologists and show regulars Becky, Dan, and Kyle to the meeting, and Dan provided an update on tropical weather, noting that while the Atlantic hurricane season is winding down, there is still potential for one or two more storms in the Caribbean over the next six weeks. The conversation then shifted to discussing a video Tim Conley had shared about the Northwest Illinois Preparedness and Response Coalition.

Tim described his roles in emergency management, including his position as an emergency management supervisor for Mercy Healthcare System and his work with Medglobal’s chemical weapons training programs. He also discussed the Interstate Disaster Medical Collaborative, which helps states coordinate for preparedness, particularly through Regional Health Coordination Centers (RHCCs). Sam noted the potential shift of FEMA responsibilities to the state level, emphasizing the importance of his involvement given the uncertainty in federal requirements for RHCCs.

Tim explained the function of Regional Health Coordination Centers (RHCCs), using Illinois as an example, and described their role in disaster planning, training, and maintaining disaster warehouses. He highlighted the importance of establishing relationships and understanding capabilities before an event occurs, emphasizing that no single organization can meet all needs.

He also discussed the Northwest Illinois Preparedness and Response Coalition, mentioning its two dedicated employees, medical director, and ongoing efforts to prepare the region for potential disasters through training, budgeting, and equipment maintenance.

Tim discussed the importance of an all-hazards approach in emergency management, emphasizing collaboration with various agencies and the establishment of MOUs with big-box stores to ensure 96-hour sustainability. They explained the setup and logistics of field alternate care sites, which are modeled after DMATs, and highlighted the complexity of logistics involved.

He also mentioned the presence of ALS and hospital-based equipment in these sites, though they are not equipped for full ER care. Joe shared that similar networks exist in Memphis, with ongoing challenges in logistics and coordination, and mentioned an upcoming drill at the airport to test these systems.

Sam, Jamie, and Kyle discussed the importance of coordinated emergency response programs, particularly in rural areas. Kyle explained that Colorado has 11 RETACs to provide a coordinated approach for emergency medical and trauma care at the regional level, with each region having its own talk group on the state radio system.

He emphasized the need for collaboration between hospitals, EMS agencies, and other response agencies to effectively handle planned events and emerging incidents, highlighting the vital role of coordination in areas with limited resources.

The group discussed emergency coordination in Pennsylvania, with Tim sharing an example from Illinois where a tornado at the Apollo Theater resulted in multiple casualties and required medical dispersion across the region. They highlighted an ongoing IDMC project led by a Tennessee RHCC, which aims to connect emergency coordination centers across 20 states, with Tim encouraging RHCCs to participate. Dan, who was in New York City at the time, shared his observations about the differences between urban and rural emergency response settings.

The group discussed the current La Nina weather conditions in the Pacific Ocean and its potential impact on winter weather patterns across the United States. They also talked about the upcoming Winter X Games in Aspen, which will include snowmobile events and concerts. The conversation then shifted to disaster preparedness and the importance of creating links between different organizations before disasters occur, especially given the current uncertainty at the federal level. The participants emphasized the need for states to be prepared to respond to their own disasters and highlighted the work being done by various states in this area.

The group discussed the importance of disaster preparedness and the role of specialized training, with Jamie highlighting the sponsorship of the Disaster Podcast by Paragon Medical Education Group.

Catch the full episode using the player above or on your favorite podcast platform, and don’t forget to subscribe to the Disaster Podcast for weekly insights from leaders in disaster response and research!

This week’s Disaster Podcast episode is a stump the weatherman episode with our disaster meteorologist, Dan Depodwin. Co-host Sam Bradley and Dan’s wife and disaster emergency management expert, Becky DePodwin take turns with the terms.

Dan rises to the occasion as he does every year and answers most of them correctly. Scroll down for more of the terms as he works through events like snow rollers, halos, seiche, and toad strangler.

Frost Flower Image Link

Hair Ice Image Link

The episode was co-hosted by Sam Bradley and Jamie Davis.

Scroll down for Podcast Discussion Summary

Thank you as always to Paragon Medical Education Group for their long-term support of the Disaster Podcast. Dr. Joe Holley and the team at Paragon continue to provide excellent and customized disaster response training to jurisdictions around the U.S. and internationally as well.

Podcast Discussion Summary

Dan discussed the current and forecasted tropical storm activity, noting that Humberto and Imelda impacted Bermuda before moving towards Europe, bringing significant wind and rain to the UK. He explained that the tropical storm season typically ends on November 30th, with October averaging 3-4 named storms and November about 1.

However, this year could see more activity due to favorable conditions like low wind shear and above-average water temperatures. Sam suggested they take turns monitoring the weather, finding the early part straightforward but anticipating more complexity as they progress.

Becky shared her experience of seeing large hail during storm chasing in Oklahoma, noting that hail can grow up to 4 inches in diameter and record sizes have reached 7-8 inches. Dan and Becky discussed the definition of a Seiche, which Becky explained as a standing wave in an enclosed or partially enclosed body of water caused by long-period waves.

The team discussed several natural phenomena, including snow rollers, halos, and toad stranglers. Sam explained that snow rollers are rare formations that require specific weather conditions, while Dan and Becky discussed sun and moon halos caused by light refracting through ice crystals. Becky then challenged the group with the term “toad strangler,” which refers to heavy rain leading to flash flooding in the southern United States.

The group discussed various types of clouds, including Mattis Clouds, Gray Lady, and Mare’s Tails. Dan explained that Mattis Clouds are common with severe thunderstorms and indicate an unstable atmosphere. Becky mentioned the Gray Lady, referring to Nantucket’s nickname due to its frequent fog and gray architecture.

Jamie shared that the term “Gray Lady” is also used in a science fiction series about Nantucket being swapped with a Bronze Age version of itself. Dan described Mare’s Tails as another name for cirrus clouds, which are the highest clouds and often signal an approaching change in weather.

The group discussed various weather phenomena, including a Williwaw, a sudden blast of wind from mountainous coasts, and a Monkey’s Wedding, which refers to a sun shower in South Africa. They also explored the concept of a fire tornado, or a wildfire so intense it creates its own weather, and discussed pyrocumulus clouds formed by fires. Jamie shared insights on how wildfires and weather are interconnected, particularly in Western states like California.

The group discussed various weather-related terms, with Dan explaining that a Nor’easter is a storm that gets its name from the prevailing northeast wind direction, occurring most commonly in fall, winter, and spring but also happening in summer, often causing beach erosion and travel issues. Dan also clarified that a Pineapple Express is a flow of moist air from Hawaii that can bring significant flooding to the West Coast, particularly California, and is sometimes referred to as an atmospheric river. The discussion included other terms like Alberta Clipper, Manitoba Mauler, and Saskatchewan Screamer, which refer to specific storm tracks, and the concept of a Snow Eater, which describes a warm wind that quickly melts snow, particularly in the Rockies.

The group discussed various weather phenomena and natural ice formations. Dan explained the concept of a “blue norther,” where temperatures drop rapidly from 50 to 0 degrees in about 4 hours. Sam shared information about “air ice,” a fungus that grows on tree bark and forms ice-like structures.

Becky and Dan discussed the differences between sleet, graupel, and freezing rain, with Dan explaining that freezing rain is rain that freezes on contact with a surface below freezing, while sleet is partially melted snow that refreezes, and graupel is similar to sleet but forms in cold core systems. Sam also introduced the concept of “nieve penitente,” tall, sharp ice formations that resemble monks’ robes and form in high, dry environments through a process called sublimation.

The group discussed several natural phenomena, including ball lightning, glory, and types of frost. Dan and Becky shared information about hoarfrost and rime ice, with Becky mentioning a notable hoarfrost event in State College. Jamie explained that ball lightning is thought to be caused by plasma bubbles formed from sunlight and lightning interaction. The group also discussed frost flowers, which Becky described as delicate strands of frost, though the exact formation process was unclear.

The group discussed various weather phenomena, including “weather whiplash” which refers to rapid changes between drought and flooding, and an “ACSL” or Alto Cumulus standing lenticular cloud, which Dan described as looking like a spaceship. Sam introduced the concept of a “space hurricane,” a newly coined term for a cyclone-like aurora where electrons rotate around a central eye.

Becky explained the phenomenon of “anvil crawlers” – lightning bolts that crawl across thunderstorm anvils and can result in “bolts from the blue” when the anvil extends beyond the precipitation. The discussion concluded with the “lemon technique,” a method used by meteorologists to study updrafts and thunderstorm cells, which Dan revealed was named after Leslie Lemon, co-creator of the supercell conceptual model.

The group discussed the importance of disaster preparedness and the role of specialized training, with Jamie highlighting the sponsorship of the Disaster Podcast by Paragon Medical Education Group.

Catch the full episode using the player above or on your favorite podcast platform, and don’t forget to subscribe to the Disaster Podcast for weekly insights from leaders in disaster response and research!

In this week’s episode of the Disaster Podcast, we start off with a discussion of the possibility of dual hurricanes in close proximity inside the Atlantic Basin. This gives rise to the term Fujiwara Effect, which discusses the impacts two nearby storm systems have on each other based upon their relative storm strengths. Disaster meteorologist Dan DePodwin joins us to describe the tropical weather systems affecting the U.S. at this time and define this specialized weather event.

We shift gears to our clinical topic, effects of various penetrating trauma on body systems. Dr. Joe gives and overview of the topic in various situations. Becky DePodwin, our disaster emergency management expert, asked about penetrating trauma caused by high speed wind events like tornados and hurricanes.

Co-hosts Sam Bradley and Jamie Davis ask Joe about different aspects of penetrating thoracic trauma including a look at simple and tension pneumothorax injuries. Joe gives a great overview of this particular injury and field assessment and treatment. He says that the sign of tracheal deviation and jugular vein distention are over-valued as useful assessment tools in pneumothorax. Catch the episode for his full discussion.

The episode was co-hosted by Sam Bradley and Jamie Davis.

Scroll down for Podcast Discussion Summary

Thank you as always to Paragon Medical Education Group for their long-term support of the Disaster Podcast. Dr. Joe Holley and the team at Paragon continue to provide excellent and customized disaster response training to jurisdictions around the U.S. and internationally as well.

Podcast Discussion Summary

The Disaster Podcast returned after a few weeks of absence, with Jamie Davis and Sam Bradley discussing current Atlantic storms and the Fujiwhara effect with meteorologist Dan. Dan explained that Tropical Storm Humberto and a potential Tropical Storm Imelda could interact in a rare phenomenon where storms circle each other, potentially steering Imelda away from the U.S. East Coast.

He noted that while this interaction is less common in the Atlantic than the Western Pacific, the second half of hurricane season is expected to be more active due to favorable conditions. The discussion concluded with Jamie and Sam considering a potential disaster movie plot, while Dan clarified that while the Fujiwara effect adds complexity to storm modeling, accurate intensity predictions are crucial for forecasting its impact.

Dr. Joe Holley explained the mechanics of penetrating trauma, focusing on how bullets transfer energy and cause damage through blast cavitation, which can be more severe with high-velocity, jacketed bullets designed to mushroom upon impact. He noted that while knowing the caliber or type of injury can influence treatment decisions, the primary focus is on controlling hemorrhage and addressing specific injuries like damaged organs or foreign objects.

Becky raised questions about penetrating injuries from high-speed wind events, such as tornadoes, which Dr. Holley described as similarly violent but often more complicated due to the nature of the projectiles and increased risk of infection.

Sam and Joe discussed the complexities of chest trauma, focusing on the differences between open and tension pneumothorax. Joe explained how air escapes from the lung in a pneumothorax, leading to lung collapse, while in a tension pneumothorax, air is trapped in the chest cavity, causing increased pressure and potential damage to surrounding structures.

Jamie highlighted the importance of transporting patients with such injuries to specialized trauma centers, as local hospitals may not have the expertise to handle these cases. Joe also mentioned that EMS can provide initial interventions like using a one-way valve bandage or inserting a needle to relieve pressure in a tension pneumothorax, but these patients often require more advanced care, including chest tubes and possible surgery.

Dr. Joe provided an in-depth explanation of head injuries, ranging from concussions to severe brain damage, including the causes and treatments of subdural and epidural hematomas. He emphasized the importance of managing intracranial pressure and described the use of a pressure monitor and spinal fluid drainage in severe cases.

Dr. Joe also discussed the challenges of diagnosing tension pneumothorax in the field, noting that tracheal deviation and jugular venous distension are not reliable indicators and that healthcare providers should focus on listening for differences in breath sounds and chest movement, as well as assessing respiratory distress and hemodynamic compromise.

The group discussed the importance of understanding the reliability of clinical signs in emergency medicine, particularly focusing on the distinction between positive and negative indicators. Joe emphasized that while tracheal deviation and jugular venous distension are often taught as reliable signs, they are actually uninterpretable if not present, and students need better training in understanding the context of these findings. The team also discussed their social media presence and ways listeners can connect with them, including through the Disaster Podcast Facebook group and various social media platforms.

The group discussed the importance of disaster preparedness and the role of specialized training, with Jamie highlighting the sponsorship of the Disaster Podcast by Paragon Medical Education Group.

Catch the full episode using the player above or on your favorite podcast platform, and don’t forget to subscribe to the Disaster Podcast for weekly insights from leaders in disaster response and research!

In this episode of the Disaster Podcast, the team brings in professionals from across several hospital systems to look at how they prepare for incoming mass casualty patients. We talk about the kinds of drills the systems run, and also look at the various departments and how they respond in each type of situation.

On the show are Dr. Joe Holley from Paragon Medical Education Group as well as working as a EMS medical director in Memphis, Tennessee. Joining us as well is Dr. Brian Froelke, one of the founders of IDMC (Interstate Disaster Medical Collaborative) and an ER doctor based in Missouri. We also are lucky to be joined by Rebecca Dougherty, LCSW, C-MHIMP, a mental health professional working specifically with medical professionals in the disaster response setting. She now works in private practice in St. Louis, Missouri.

Minneapolis School/Church Mass Shooting

Orlando Hospital Response to Pulse Night Club Shooting (Disaster Podcast Episode)

Disaster Podcast Episode on Joplin, Missouri Tornado Response

The episode was co-hosted by Sam Bradley and Jamie Davis and our disaster emergency management expert, Becky DePodwin, joined in.

Scroll down for Podcast Discussion Summary

Thank you as always to Paragon Medical Education Group for their long-term support of the Disaster Podcast. Dr. Joe Holley and the team at Paragon continue to provide excellent and customized disaster response training to jurisdictions around the U.S. and internationally as well.

Podcast Discussion Summary

Sam discussed a recent shooting incident in Minneapolis that resulted in 22 gunshot victims, including two children killed and 18 others injured, with 15 being children. The emergency response was efficient, with ambulances reaching the scene within minutes and all injured individuals requiring hospital attention being transported within 25 minutes.

Sam inquired about the hospital alerting system, which used the Zip it emergency messaging system to provide clear information about the injuries and estimated time of arrival. Brian, an EMS physician from St. Louis, was invited to share his expertise on emergency response systems and disaster medical response.

Brian discussed the frequency of shootings at their level one trauma center in St. Louis, noting that it’s due to selection bias from the greater area. He explained their early management of penetrating trauma and the use of whole blood products, which have been successful in saving patients.

Brian also described their communication system with EMS providers through Javari, which uses a half-bed resource system for emergencies. Sam and Joe discussed other communication tools like Pulsara and Tennessee’s in-house system, with Joe mentioning its effectiveness for state-wide emergency responses.

Joe described Baptist Hospital in Memphis as a level 2 trauma center that coordinates with a downtown level 1 trauma center and pediatric facility. He explained that Memphis experiences significant gun violence but fewer active shooter incidents compared to other cities.

Joe detailed their multi-level response system, which initially relies on the trauma team and ED staff before expanding to other hospital departments and external resources as needed, while also coordinating with EMS to direct patients to appropriate care facilities based on injury severity. Brian confirmed that their area’s trauma response system operates similarly, with both adult and pediatric centers prepared to handle various age groups and emotional support needs through chaplains and social workers.

The discussion focused on hospital preparedness and response to multiple casualty incidents. Brian and Joe explained that hospitals have internal response policies and conduct disaster preparedness exercises at least twice a year. They described how hospitals manage surges in patient volume by activating different teams and utilizing flexible spaces like hall beds. The conversation also touched on the importance of managing limited resources, such as emergency stabilization rooms and blood supplies, during overflow situations.

The group discussed mass casualty incidents and hospital preparedness, with Joe and Jamie sharing insights from their experiences. They noted that hospitals near the scene often become overwhelmed as people with minor injuries arrive first, followed by more critically injured patients.

Jamie mentioned a previous episode about the Pulse nightclub shooting in Florida, where a nearby hospital was quickly overwhelmed by walk-in patients. The discussion highlighted the challenges hospitals face in preparing for such incidents and the importance of being ready for a second wave of more severely injured patients.

The group discussed the impact of pediatric trauma events on emergency medical services, with Brian noting that while only about 10% of patients are pediatric, they have a disproportionate effect on providers due to factors like drug dose calculations. Rebecca shared her experience as a mental health specialist in disaster response, highlighting her work with first responders and the importance of delayed emotional responses to traumatic events.

Jamie raised questions about managing stress in non-medical hospital staff during major incidents, to which Rebecca responded about the challenges faced by registration staff and administrative personnel who deal with families’ emotional needs.

Rebecca shared her experience with the Joplin tornado in 2011, emphasizing the need for early intervention to help people process traumatic events. Brian discussed his role as the chief medical officer for the disaster response system and his involvement with the Interstate Disaster Medical Collaborative (IDMC) to coordinate resources.

Sam mentioned a creative approach used by a psychologist to identify and describe children in the aftermath of the tornado. The group highlighted the importance of supporting both trained and untrained personnel in disaster response, with a focus on the critical first 24 hours after an incident.

The discussion focused on the impact of traumatic events on volunteers and community members, particularly in religious and school organizations. Brian highlighted how volunteers, despite their critical role, may not be adequately prepared for mass casualty events and can suffer emotional and health consequences.

Rebecca elaborated on the need for targeted support programs, emphasizing the importance of addressing different groups such as first responders, schools, and faith-based communities with tailored approaches. She also described how schools and archdioceses often have existing protocols for such events, though they may lack trained counselors and other resources.

The group discussed the challenges faced by emergency responders and storm chasers in the aftermath of disasters, highlighting the mental health impact on those involved. Joe emphasized the ripple effect of incidents on families, coworkers, and media personnel, while Becky noted the recent efforts to provide mental health support for weather scientists conducting damage surveys.

Sam and Becky shared insights on the overwhelming nature of initial responses and the need for preparation and support, with Jamie concluding that the discussion provided valuable insights into community readiness and long-term recovery efforts.

The group discussed the importance of disaster preparedness and the role of specialized training, with Jamie highlighting the sponsorship of the Disaster Podcast by Paragon Medical Education Group.

Catch the full episode using the player above or on your favorite podcast platform, and don’t forget to subscribe to the Disaster Podcast for weekly insights from leaders in disaster response and research!

Julie Roberts from JK Roberts, LLC drops by the podcast this week to address business disaster continuity plans. Julie led communications efforts at both the Federal and State levels including NOAA.

Julie discusses the importance of building a disaster plan for businesses of all sizes. These plans include creating contingencies around suppliers and employees to ensure operations can resume at the time when it is safe to return to work.

PSEMA (Private Sector Emergency Management Agency)

Also on the show were Dr. Joe Holley who brought up a news item about the termination of National EMS Advisory Council members at the federal level which could have long lasting effects on training and education of providers nationwide.

The episode was co-hosted by Sam Bradley and Jamie Davis.

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Thank you as always to Paragon Medical Education Group for their long-term support of the Disaster Podcast. Dr. Joe Holley and the team at Paragon continue to provide excellent and customized disaster response training to jurisdictions around the U.S. and internationally as well.

Podcast Discussion Summary

The meeting began with introductions, including Dr. Joe Holly, who works with FEMA’s search and rescue team in Tennessee. Julie discussed a new initiative to distribute NOAA weather radios to camps across the country, inspired by recent flooding events where early warnings could have made a difference.

The group agreed on the importance of NOAA weather radios as a reliable alert system, especially during power outages or when mobile phones are not functional. Jamie and Sam prepared to record a podcast episode, with Jamie handling the technical aspects and Sam introducing the guest.

Julie K. Roberts, a disaster management expert with over 20 years of experience in both public and private sectors, discussed her background, including her work at FEMA, NOAA, and Florida Emergency Management.

She highlighted her role in building relationships between government and private sectors, particularly during the Pulse Nightclub shooting in Orlando, where she coordinated with companies like JetBlue and Uber to provide support. The conversation touched on disaster preparedness and the importance of collaboration between public and private sectors in managing emergencies.

Julie discussed her work with private sector partnerships during disasters, highlighting a successful collaboration with Airbnb and Jump Blue that provided 2,501 flight tickets and housing for victims’ families in Orlando and Las Vegas.

She explained that this experience led her to create the Private Sector Emergency Management Association four years ago to facilitate private sector involvement in disaster response and recovery. The organization focuses on helping businesses of all sizes develop continuity plans and access resources, with recent activations during hurricanes, wildfires, and other emergencies.

Julie and Joe discussed the increasing role of the private sector in hurricane response and recovery, particularly in light of upcoming changes from FEMA and potential funding cuts to essential services. Sam shared his experience with a nonprofit that helps coordinate disaster response between states, highlighting a recent shift back to state-level focus due to changing government policies.

Both Julie and Sam agreed that the first 72 hours of disaster response relies heavily on local and individual efforts, as government resources may not be as readily available as in the past.

Julie discussed the importance of business continuity planning for both large and small businesses, emphasizing the need to prepare for various hazards and have strategies in place for unexpected closures. She explained that small businesses should focus on essential information like employee contact details, vendor relationships, and insurance procedures, while also considering backup resources and recovery plans.

Jamie highlighted the need for small business owners to think through potential disruptions and have contingency plans in place, suggesting that these plans should be tailored to the specific needs and resources of each business.

Julie discussed the challenges small businesses face in accessing potable water after disasters, using Asheville, North Carolina, as an example. She suggested exploring solutions to ensure businesses can reopen quickly, such as splitting costs between government and businesses. Joe highlighted the issue of hospitals being reliant on a single water vendor, which can lead to service disruptions. Jamie shared Waffle House’s preparedness strategy as an example of effective planning for adversity. The group agreed on the importance of supporting small businesses and having contingency plans in place for emergencies.

Julie discussed the importance of flexible planning and clear communication in shaping disaster outcomes, highlighting how social media and the 24-hour news cycle have changed crisis management. She emphasized the need for immediate response and the authority to post information quickly, warning against the delay caused by excessive approval processes. Jamie agreed with Julie’s proactive approach, encouraging companies to be prepared for rapid communication in crises.

Julie emphasized the importance of proactive communication, particularly for companies and governments facing crises, noting that delays in responding to negative stories can harm brands and credibility. She highlighted the value of leveraging the private sector to speak on behalf of governments and the need for timely, credible information dissemination.

Sam agreed, stressing the demand for reliable information sources. Joe introduced a news item about the Federal Interagency Committee on Emergency Medical Services (FICEMS), which has been working for over a decade to coordinate and provide direction on emergency medical services at the federal level.

The meeting discussed recent staff reductions at a government group, with Julie highlighting a new initiative by Pacima to provide NOAA weather radios to camps across the country in response to recent events in Texas. Julie shared her contact information and website details, while Joe clarified that the National EMS Advisory Council had been eliminated, not FICUMS, and provided Paragon’s contact information.

Jamie and Sam discussed the importance of these resources and mentioned their own social media presence. The group discussed the importance of disaster preparedness and the role of specialized training, with Jamie highlighting the sponsorship of the Disaster Podcast by Paragon Medical Education Group.

Catch the full episode using the player above or on your favorite podcast platform, and don’t forget to subscribe to the Disaster Podcast for weekly insights from leaders in disaster response and research!

Dan Zehner from the Natural Hazards Engineering Research Infrastructure (NHERI) drops in the podcast to report on the recent documentary output from the research group. The links below contain a lot of information on how the NHERI research grants have turned into actionable infrastructure and building code improvement suggestions.

Dan and co-hosts Sam Bradley and Jamie Davis also talk about data collection about wild fire affects on infrastructure and buildings. By analyzing the survival of buildings built under different code requirements and from differing materials, NHERI can suggest improvements that would improve survival and lessen the impact of disastrous fires.

Links and Resources Dan Discussed

NHERI RESEARCH IMPACT SHOWCASED

FUNDING MESSAGE FROM THE NHERI COUNCIL, JULY 2025

CALIFORNIA FLOODING FROM THE ARKSTORM

Technology Transfer from NHERI

NHERI Impact 2020

Scroll down for Podcast Discussion Summary

Thank you as always to Paragon Medical Education Group for their long-term support of the Disaster Podcast. Dr. Joe Holley and the team at Paragon continue to provide excellent and customized disaster response training to jurisdictions around the U.S. and internationally as well.

Podcast Discussion Summary

Jamie, Sam, and Dan discussed recent weather events, including thunderstorms and wildfires. Sam mentioned coordinating efforts with 18 states to address the impact of nonprofits assuming roles previously held by the federal government. Dan shared that the northwest has been experiencing hot weather but is now getting some rain, which is helping to control wildfires. The group briefly touched on Hurricane Erin, but no specific information was provided.

The meeting discussed the status and future of the National Hazards Engineering Research Infrastructure (NHERI), which received a no-cost extension from the National Science Foundation to continue operations through September 2026. Dan explained that while there are some uncertainties due to the current political environment, NHERI’s core facilities, tools, and data services will remain available for researchers.

The discussion also touched on recent and ongoing natural disasters, including wildfires and floods, which NHERI continues to support through testing and research efforts.

The group discussed fear and anxiety in medical and emergency situations, with Jessica emphasizing the importance of addressing personal fears and biases to provide better care. Jamie shared advice about trusting parents’ instincts regarding their children’s health, particularly for those with preexisting conditions. The conversation concluded with Jessica encouraging self-compassion and acceptance of imperfection in emergency response work.

The group discussed wildfire research, focusing on the National Science Foundation’s work in the wildland-urban interface, particularly through the Rapid Assessment, Planning, and Response (RAPID) system. Dan explained how RAPID uses advanced tools like fixed-wing drones and lidar to collect high-fidelity data on fire damage before cleanup, which is crucial for understanding infrastructure performance and updating building codes.

Jamie emphasized the importance of science-based infrastructure adjustments, while Sam highlighted the critical role of research in preventing future wildfires, noting that many people are unaware of the work being done in this area.

Dan and Sam discussed the challenges of insurance availability and affordability in high-risk areas, particularly due to the high costs of insurance premiums. Dan explained that the insurance industry relies on actuarial models and historical data to assess risk, but noted that there is no universally accepted standard for wildfire-resistant construction.

They mentioned organizations like the Insurance Institute for Building and Home Safety (IBHS) and the Fire Safety Research Institute (FSRI) that focus on property insurance and loss prevention, but emphasized the need for more scientifically backed methods to ensure communities can be insured based on evidence rather than intuition.

The discussion focused on two main topics: wind research facilities and flooding studies. Dan described the University of Florida’s boundary layer wind tunnel and Florida International University’s “Wall of Wind” facility, which can simulate Category 5-level winds with wind-driven rain and variable ground conditions.

The conversation then shifted to flooding research, highlighting a 2023 study that created a publicly available dataset of California’s atmospheric river flooding simulations, which has been useful for FEMA, water resources departments, and emergency services. The discussion concluded with an observation about how dry ground conditions can exacerbate flooding issues, particularly in areas with limited infrastructure to manage water runoff.

The meeting focused on discussing resources and information available through Design Safe and the National Science Foundation. Dan provided an overview of their funding process and highlighted various platforms and resources, including their podcast, Slack channel, and community calendar.

Jamie and Sam discussed the importance of these resources and mentioned their own social media presence. The group discussed the importance of disaster preparedness and the role of specialized training, with Jamie highlighting the sponsorship of the Disaster Podcast by Paragon Medical Education Group.

Catch the full episode using the player above or on your favorite podcast platform, and don’t forget to subscribe to the Disaster Podcast for weekly insights from leaders in disaster response and research!

Midwife and Paramedic Jessica Arno, the Combat Midwife, returns this week to talk focus on pediatric emergencies in the disaster environment. She and the Disaster Podcast team talk about unique challenges facing responders who encounter sick and injured kids.

Jessica stresses the importance of understanding age-appropriate behaviors and presentation. We discuss why it’s necessary to trust the parents’ instincts about their kids. They often realize a problem is present before others would notice a change in the child.

Also on the show this week are disaster emergency management expert, Becky DePodwin, disaster meteorologist, Dan DePodwin, and Dr. Joe Holley, as well as co-hosts Sam Bradley and Jamie Davis.

Scroll down for Podcast Discussion Summary

Thank you as always to Paragon Medical Education Group for their long-term support of the Disaster Podcast. Dr. Joe Holley and the team at Paragon continue to provide excellent and customized disaster response training to jurisdictions around the U.S. and internationally as well.

Podcast Discussion Summary

Jamie introduced the main guest, Jessica Arno, the combat midwife, who was returning for a second episode to discuss more pediatric topics. The group discussed recent weather conditions, including flooding in the Northeast and Midwest, and Joe shared his busy schedule involving alerts for weather events.

The conversation then shifted to the upcoming podcast segment featuring Jessica, who was introduced to the audience as a midwife, paramedic, and expert in pediatric care.

The meeting focused on the unique challenges of providing medical care to children in emergency and disaster situations, emphasizing that children are not simply “tiny adults.” Jessica, a paramedic and midwife, explained the importance of understanding children’s physiological differences, such as their limited blood volume and distinct airway anatomy, which can lead to rapid decompensation.

Jamie highlighted the need for quick decision-making in pediatric emergencies, especially in austere environments where resources may be limited. The discussion also touched on the broader issue of women’s health research, noting that it often falls short due to gaps in scientific focus.

The group discussed fear and anxiety in medical and emergency situations, with Jessica emphasizing the importance of addressing personal fears and biases to provide better care. Jamie shared advice about trusting parents’ instincts regarding their children’s health, particularly for those with preexisting conditions. The conversation concluded with Jessica encouraging self-compassion and acceptance of imperfection in emergency response work.

The group discussed the importance of trusting parents’ instincts and expertise, particularly in medical situations involving their children. Jessica emphasized the need to trust parents’ observations and to act on instincts, even if the reasons aren’t immediately clear. Becky shared her experience of trusting her intuition about her child’s health, highlighting the value of parental insight. The discussion underscored the importance of balancing emotional and professional judgment in medical care, with a consensus that erring on the side of safety is crucial.

The group discussed pediatric medical care, particularly in disaster situations, emphasizing the need for age-appropriate assessment and treatment. Jessica highlighted the importance of vital signs, bleeding control, and understanding the unique challenges of treating children, including the use of appropriate tourniquets and recognizing internal bleeding.

Dan shared his perspective as a parent, emphasizing the value of trusted care in complex situations. The discussion also touched on the potential lack of parental presence in disaster scenarios and the need for practitioners to be prepared to triage and treat children without parental input.

The group discussed emotional preparedness, particularly focusing on how to handle children in chaotic situations. Jessica emphasized the importance of honesty with children, sharing an example of a Coast Guard rescue during recent flooding in Texas where the responder maintained calm by being transparent about the situation’s uncertainties. The discussion highlighted the value of relying on training in crisis situations, even when facing unfamiliar challenges.

The discussion focused on the emotional and psychological challenges faced by children in disaster situations, particularly how their brains process trauma and the role of emotional regulation in parenting. Becky and Sam discussed how children’s reactions to stress are influenced by their parents’ emotional responses, noting that calm parental reactions can help children regulate their own emotions.

They also touched on the importance of emotional intelligence in caregivers and how children learn from their parents’ reactions to situations, particularly in medical contexts.

Jessica shared her experience of being calm in chaotic situations, which was noted as a strength by her colleagues. She discussed the importance of having pediatric medications in austere kits, including basic items like Tylenol and ibuprofen, as well as herbal and homeopathic remedies. She also described a real-life situation where she provided neonatal care in a disaster zone, emphasizing the need for evaluating underlying issues in such complex medical situations.

The meeting focused on a discussion about pediatric and clinical healthcare, featuring Combat as the main expert. Combat shared insights on differential diagnosis and women’s/children’s health, emphasizing the importance of hands-on practice and continuous learning. The participants agreed that while they may not be experts in pediatrics, they should strive to learn and build confidence in handling pediatric cases. Joe mentioned upcoming military training activities, and the group discussed how listeners can connect with various speakers through social media platforms and the disaster Podcast community.

The group discussed the importance of disaster preparedness and the role of specialized training, with Jamie highlighting the sponsorship of the Disaster Podcast by Paragon Medical Education Group.

Jessica, the Combat Midwife, shared her expertise and offered a discount code for her training materials. Use code DISASTER for a discount on her page. The participants agreed to have Jessica return for a follow-up episode the next Thursday.

Catch the full episode using the player above or on your favorite podcast platform, and don’t forget to subscribe to the Disaster Podcast for weekly insights from leaders in disaster response and research!