JULY 11, 2011

Special team will mobilize for global disasters

BY JOHN SANFORD

Sara Wykes, 2010 description of photo

Bob Norris (left) and Denise Greci Robinson (right) are part of a special Stanford medical team created to quickly mobilize to disaster zones. This photo was taken in 2010 as Norris, Robinson and Anil Menon, a former clinical instructor, helped pack supplies for a relief mission to Haiti.

As Bob Norris, MD, attended to victims of last year’s devastating earthquake in Haiti, he was vexed by a question: What if he and his team had been able to get there even a day or two earlier?

“The more quickly injured people receive care, the more likely they are to survive,” said Norris, professor and chief of Stanford’s Division of Emergency Medicine.

Although Norris and the seven other Stanford Hospital & Clinics doctors and nurses who joined him on the relief mission were among the first international medical responders to arrive, three days elapsed between the quake and their departure for the island nation. Those 72 hours were spent locating volunteers and getting immunizations, travel documents, drugs and medical equipment, as well as other supplies.

When they finally arrived in Port-au-Prince on Jan. 17, 2010, after a grueling 48 hours in transit, some victims of the earthquake had succumbed to infections from their wounds.

“By that point we recognized the need for a small, nimble team — a team that stayed in a state of readiness with pre-planned equipment and pharmaceuticals so it could be out the door within six hours,” Norris said.

Thus was born the Stanford Emergency Medicine Program for Emergency Response. Its acronym, SEMPER, is Latin for “always.” The group serves several functions. Foremost is to quickly provide emergency medicine to acutely and severely injured victims of a disaster. To this end, the program holds regular classes in disaster medicine for its members. It also plans to conduct research into the practice of medicine in disaster situations.

Norris said he believes the program is unique among nongovernmental organizations.

Medical relief missions tend to be big and slow, Norris said. A SEMPER team, however, would be relatively small and able to ship out at a moment’s notice to catastrophes ranging from floods to wars. The program maintains a list of volunteers from Stanford Hospital with current immunizations and training who would be ready to depart within six hours.

Each responder would have enough supplies and equipment to be self-sufficient for three days, as well as a cache of medications and medical equipment to treat patients for at least that period of time. Before shipping out, however, the team would rely on established humanitarian relief organizations, such as the International Medical Corps, to put out a request for medical assistance and organize transportation.

And while many programs focus on the broader needs in a disaster — such as providing food, clean water and security — most do not teach medical techniques that are valuable immediately after a catastrophe. Through a series of ongoing classes and seminars, SEMPER members have the opportunity to develop and hone the skills needed to treat large numbers of victims in the austere, chaotic environment of a disaster area. The program holds regular courses on topics such as managing wounds and tropical diseases, as well as on surgical techniques for the field, including amputations, incisions in connective tissue to relieve circulation-blocking pressure, caesarean sections and psychological first aid.

The program also plans to conduct original research to help develop science-based practices for disaster medicine. “Many key decisions made in disaster settings are made using anecdotal experience, intuition and ‘gut feelings,’” Norris said. “While these may have merit, there is a lack of objective data on which medical professionals can base their decisions.”

SEMPER’s membership now includes more than 40 Stanford doctors and nurses, as well as some key administrative personnel from the School of Medicine, Stanford Hospital and Packard Children’s Hospital. Its intent, however, is to be as inclusive as possible. Membership is open to any Stanford medical provider with a strong desire to serve in disaster settings. Nonclinical personnel with valuable expertise are invited to participate as well.

Tom Major, RN, CEN, a member of the group, said he hopes that others at Stanford will take an interest in the program. “With such a diverse talent set here, it would be great to tap some of that expertise,” he said.

For those interested in more information about the program, contact Norris at bob.norris@stanford.edu or Major at tmajor@stanfordmed.org.


John Sanford is a writer in the communications office at Stanford Hospital & Clinics.  

Stanford Medicine integrates research, medical education and patient care at its three institutions - Stanford University School of Medicine, Stanford Hospital & Clinics and Lucile Packard Children's Hospital Stanford. For more information, please visit the Office of Communication & Public Affairs site at http://mednews.stanford.edu/.

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