it's it's powerpoint but look at that's
anaheim i did like a cool like time
lapse oh
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Disasters.
They don't ask if the system is ready.
They expose whether it is.
It's like bar rescue.
It's a stress test.
It's going to go sideways.
Just figure out where it's going to go
sideways now before it actually goes
sideways.
Our next guest is pushing physical therapy
into emergency response,
disaster medicine,
and primary care chaos where it's already
desperately needed.
Live from Anaheim, this is Megan Mitchell.
Back to the show.
Megan, welcome back.
Thank you for having me again.
The first time we spoke,
I had never thought or...
I never heard anything that PTs could or
should be where you are.
I was like, didn't know.
And I love when I sort of have
that little moment where I'm like, ooh,
never thought about that.
So let's start.
Why is disaster response everybody's
problem, not just specialists?
Why is it all of our problems?
So I think it's important to remember that
disasters impact everybody.
They don't pick and choose.
They don't select who gets impacted.
It's widespread and it takes down
everybody.
So within the United States,
I think what we need to reflect on
is that the frequency of these large scale
disasters,
these one in a million sort of events
are happening at a higher frequency and
they're reaching a lot more people.
Which is great.
Including PTs.
So we're seeing everybody getting impacted
and then we're seeing all of these
downstream effects from the lack of
engagement from the PT profession.
Why is it all of our problem?
And that kind of guessing from your
response because it's happening more and
like we're either going to get run over
or we lean in to prevent being run
over.
Every single disaster,
if we look at just scale and scope,
is in every part of the environment that
we work in.
So it's hospitals where I tend to lean
into.
It's nursing facilities.
It's school-based settings.
It's community settings.
It's rural spaces and large population
centers.
Understood.
Good.
There's a reason.
Where is PT underutilized during disasters
specifically?
Where could we be more helpful?
So within the United States we're not
included in any of the planning or
response operations,
but we really should be engaged up front
in the planning roles in the pre hospital
hospital receiving side of things,
those of us who work in the emergency
department need to have a direct role in
response.
to share that care burden between our
critical care providers and those who are
non-critically injured but still have an
injury.
And then all of the downstream locations,
so hospital decompression, rehab centers,
specialty rehab centers,
and then even into the home health
setting.
We help.
We speed things up.
And we speed it up.
We decompress the system.
We provide the right care at the right
time for the right patient population.
Yeah, you brought up emergency department.
I had never thought of that because I
was a second career PT.
I was like,
I don't know where these things are.
And then I listened to Rebecca Griffith
for a hot ten minutes.
And I was like, oh, this makes sense.
I get it.
That makes sense.
I like that.
How come we're not doing more of that?
And, of course,
that's your mission and her mission is
let's be doing more of that.
What skills, let's go in,
someone listening going, okay,
but not me because I don't have those
right skills.
What skills do clinicians already have
that translate to emergency care that
people are probably, I don't have that,
but they do?
So the thing is,
is that you already have it.
You're just not applying it fast enough.
So the vast majority of all injuries in
any kind of disaster,
regardless of the hazard,
is going to be musculoskeletal.
And for those of us who work in
the critical areas,
the folks who have the catastrophic
injuries will go inpatient to ICU level
care where we're already providing care.
But I think we need to sort of
stop thinking about the large scale piece
of it and remember that the one person
in front of us has the most immediate
need.
A lot of those folks are going to
be minor injuries with musculoskeletal
being the primary.
Right.
How can people like look inside themselves
and say like, well,
I don't belong there because I'm not.
What are the reasons they don't show up
or they don't think they belong that
you've seen?
So I think that people actually do think
that they belong there.
There's just no identified location for
them.
So I think there is a door.
We just didn't know what it was.
So you can't just volunteer in a disaster
and say, I have these skills.
I have my licensure.
I can help with all of these things.
That is generally not well received by the
folks who are running the show.
And so you really have to engage ahead
of time with organizations like the
Medical Reserve Corps or within the
hospital.
You have to work on your emergency
response team so that people fundamentally
understand where your skills are and they
can check your licensure ahead of time so
that you've been pre-vetted in order to
engage.
Don't just show up in the middle of
the fire and be like,
I know how to hold a hose.
Be like, my man,
you got to show up before that.
Yeah, nobody cares in the moment.
Get out of the way.
Slow me down.
So show up before.
You got to show up ahead of time.
Be part of the team.
You got to train.
You got to speak the same language.
Why aren't PTs consistently included in
disaster planning?
Are we just not raising our hands enough
to be on the team?
Is that, I mean, is it simple?
This is kind of a loaded question.
So I think there's a lot of it
that people don't understand that they can
do it.
But on the other side of it,
I don't think a lot of our colleagues
within emergency management or emergency
medicine really have a good understanding
of our skills and our scope.
So they're not writing us into the plans
because they just don't know how to use
us.
But someone else not understanding where I
might have value,
I might want to take a little ownership
of that and say,
let me show you how I might be
able to help.
Tell me what problems you have.
Let me see if I can help.
Instead of just saying,
they don't think we're valuable.
Yeah.
We're locked out of the team.
Why aren't you letting me in?
It's like, hey, man,
did you explain it in a way they
could understand?
If you give the ownership of writing your
response to somebody else,
they're going to do that with what they
think that you do,
which tends to be a lot of like
move patient from A to B and then
get out of my way.
Right, right.
And please don't do that.
Just communicate clearly and frequently.
If you don't want to be in the
disaster in the front line, by all means,
move patients from A to B.
But if you have the skills and you're
ready to step into that space,
you've got to take ownership of your own
professional voice.
Understood.
So let's break this down.
I like things when they're actionable or a
PT we call it, Monday morning applicable.
What's an actionable step clinicians can
take?
to prepare where like if someone's nodding
along going cool i've heard of this now
it's not really on the fringe now i'm
starting to hear about it more where do
you tell them to go or do what's
step one step one is um connecting with
your emergency manager whoever that person
is sometimes it's a director of safety
sometimes it's an emergency manager it
could be your environment of safety person
whoever writes your disaster and emergency
plans for your facility
It's required by law for anybody who
receives federal dollars for health care.
They have to have both a disaster plan,
including an evacuation plan.
And I would say sit with it,
read it,
and then look at those plans through the
lens of a PT.
There it is.
Where do I apply myself?
And how can I better this process?
I like that.
Smart.
How does advocacy intersect with emergency
response?
Is it everything you were just talking
about?
Is it showing up and asking how I
can be helpful and making sure people
understand that you're there?
I've stopped asking how I can be helpful.
I have started asking where do you need
help.
Where are the gaps in your response?
So we really need to change the
conversation from lessons learned into
lessons applied.
And so we know from all of the
events that happened before,
there have been gaps in the response.
There's gaps in the operational planning.
And then where do we fill in those
gaps going forward?
Yeah, any resource.
I like tactical things,
PT's love brochures and websites and
whatnot.
Where are the good resources?
Where can people go to find out a
little more,
a little bit closer to the end of
the diamond before they take a jump?
You know,
we put out a brand new updated emergency
response guide through the APTA that came
out in October.
And it has a whole bunch of resources
on there,
both for incident command education as
well as in-person training.
APTA where?
Like through what?
Academy?
Where are they going to find it?
I think it's through the federal,
like the C-suite folks.
Got it.
The fancy people in the big office.
The fancy people who get paid money to
do this stuff.
It's their job.
It's the PT and PTA emergency and disaster
response,
and there's a full action plan in there.
Perfect.
There's a lot of things that APTA does
that people have no idea because they
don't know to go look for it,
but now they do.
Now they do.
It's out there.
We have a tradition on the show.
We call it the parting shot.
This is the parting shot.
One last mic drop moment.
No pressure.
Just your legacy on the line.
All right, your parting shot.
I'm going to ask you the question and
you answer.
Okay.
All right, so your parting shot.
What's one action item every PT should
leave CSM with related to disaster
preparedness?
Everybody needs to leave CSM understanding
that they have a role in disaster response
and preparedness is part of that sequence
of events.
Yeah.
I mean,
we don't want a disaster to happen in
your neighborhood,
but that's where disasters happen.
They happen in people's neighborhoods.
Yeah.
If it happens in yours, Boy Scout motto,
right?
Be prepared.
Exactly.
Megan, where can people connect with you?
So you can reach me through my university
website.
It's through megan.mitchell at
cuanchutes.edu.
It's through University of Colorado.
Love it.
Megan, appreciate you coming on the show.
Here we are live at CSM.
Thanks for having me.