1. Ashes, ashes, we all fall Lou Romig MD, FAAP, FACEP Miami Children’s Hospital FL-5 DMAT

3. Kobe Japan 1995

4. The New Madrid Seismic Zone

5. NMSZ  120 miles long, from Missouri to Arkansas  Crosses 5 state lines  Crosses the Mississippi River in three places and the Ohio River in two  Geology of the area results in force transmission over an area 20x greater than West Coast quakes

6. New Madrid Quakes 1811-12  Three major quakes estimated around 8 on the Richter scale, more than 10x stronger than the Great San Francisco earthquake  More than 2000 shocks over a 5 month period  18 of the shocks rang church bells in Boston  Damage in 8 states  Death toll uncertain (100+)

7. The Future Along the New Madrid  Greatest earthquake risk in the US after the West Coast  6.0 or greater shock ~ every 80 years. Last one in 1895.  >90% probability of a 6.0-7.6 event before 2040  7.5 or greater shock ~ every 200-300 years. The last ones in 1812.  ~ 7% probability of a major quake in the next 50 years

8. 7.5 quake along the New Madrid  Damage expected in at least 20 states, > 1,000,000 sq miles  Tremors felt over half the US  Catastrophic damage in Memphis and St Louis  Unreinforced masonry structures demolished  Damage estimates in the 12 figure dollar range

9. 7.5 quake along the New Madrid  Disruption of transportation routes for the entire country – road, rail, river, air  Disruption of energy supplies for much of the country (LP gas trunk lines)  Likely that everyone in the US will be affected directly or indirectly

10. 7.5 quake along the New Madrid  Flooding  Fires  Landslides  Sand blows  Contamination and disruption of water supplies  Haz-mat releases

11. 7.5 quake along the New Madrid  10 million homeless  500,000 injured  20,000 - 80,000 deaths  6 Children’s Hospitals in Memphis and St. Louis alone

13.  Are you prepared for disasters as individuals and families?  Is your parent facility prepared for a disaster?  Does your team have it’s own disaster plan?  Staff  Equipment  Priorities before, during, after

14.  Has your facility and team done everything possible to join disaster resource networks before a disaster ever happens?  Do you know what you may be getting yourselves into as responders?

15. Some harder questions…

16.  How much risk is your parent facility willing to let you take?  How much of a financial commitment is your facility willing to make?  Is your team prepared to function independently, providing most of your own supplies and support?  Is your team adequately trained to do scene work in potentially dangerous environments? Discipline vs. risk- taking

17.  Are you physically and psychologically prepared to work in austere, dangerous conditions? How much risk are you willing to take?  Does your family support you in your role as a responder?

20. The questions need to be asked. You won’t find the answers in a book.

21. Never add to a disaster. Be honest about your capabilities and your commitment. Every disaster response will be a life-changing experience.

22. Thank you! louromig@bellsouth.net www.jumpstarttriage.com