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Introduction to Disaster Medical Assistance Teams

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					      Introduction to
Disaster Medical Assistance
           Teams
       James Fenn, RN, EMT-P
      Don McConnaughy, EMT-I
            Discussion
• Federal Response Plan
• National Disaster Medical System
• Disaster Medical Assistance Teams
  – Form and function
  – Ohio teams
Federal Response Plan
         Federal Response Plan
       Emergency Support Functions
USDA   AID                                   DOE
DOJ    ARC                 USDA                               DOT
DVA    EPA                                   Energy
DOD    FEMA                     Food
DOT    GSA      EPA                                                     NCS
DOE    NCS             Hazardous
                       Materials         11 12 1          Communication
                                    10                2
                     Urban Search
              FEMA   and Rescue     9        ESF          3    Public Works
                                                                             DOD
                                                               (USACE)
                                     8
                                     8                4
                       Health and
                       Medical
                                         7    6 5             Firefighting

               HHS                                                      USDA
                             Resource          Information              & FS
       HHS                   Support Mass Care & Planning

                          GSA                         FEMA
                                             ARC
      ESF #8 - Health & Medical Services


• Functions
– Preventive Health Services
– Environmental Health Services/Surveillance
– Medical Services*
– Mental Health Services*




                       * (performed by NDMS)
        ESF #8 - Health & Medical Services


• Functions
 – Federal Augmentation for Medical
   Response to Terrorist Incidents
   Involving Weapons of Mass Destruction
   (WMD)*




                         * (performed by NDMS)
National Disaster Medical
         System
 National Disaster Medical
      System (NDMS)

NDMS is a public/private sector partnership
 HHS DOD VA FEMA
        National Security Decision
         Directive 47 (NSDD-47)

• Approved by the President (July,
1982)

• Set forth Emergency Mobilization
  Preparedness Principles for:
   – National Security Emergencies
   – Domestic Emergencies
             NDMS Purpose

A Nationwide Medical Response System to:

  Supplement state and local medical
   resources during disasters or major
   emergencies
  Provide backup medical support to the
   DOD/VA medical care systems during an
   overseas conventional conflict
       Major Components


 Medical Response
 Patient Evacuation
 Definitive Medical Care
Federal Health and Medical
        Response

    Natural Disasters

    Transportation Disasters

    Terrorism


    Technological Disasters
                                       NDMS Organizational
                                           Structure
                               President                                                  Homeland Defense

National Security Council                   Domestic Policy Council


  Senior Policy Group (SPG)
  Members:                                       NDMS Directorate
  •Asst. Sec. for Health, HHS (Chair)
  •Asst. Sec. for Defense, Health Affairs      Members:
  •Director, FEMA                              •Deputy Asst. Sec. for Health, HHS
  •Undersecretary of Health, DVA               •DASD(HA) Medical Readiness
                                               •Asst. Associate Director,
  Responsibilities                              Mobilization Preparedness, FEMA
  •Set policy and Goals for National           •Director, Emergency Management
                                                Strategic Healthcare Group, VA       NDMS Directorate Staff
  Medical Preparedness
  •Oversee Directorate and Panel               •Responsibilities
                                                                                    Members:
                                                Implement Policy
                                                                                    •HHS/PHS - Director, NDMS (Chair)
                                                                                    •DOD
                                                                                         •OASD (HA)
                                                                                         •ARMY
                                            NDMS Participating                           •NAVY
  State Agencies                            Organizations
                                                                                         •AIR FORCE
                                                                                    •VA
                                                                                    •FEMA
        NDMS Response Teams

           (HHS Lead)

•   DMAT
•   DMORT
•   VMAT
•   NMRT/WMD
          NDMS Patient Evacuation

Lead Responsibility - DOD

  Provide Patient
   Movement from the
   Disaster Area

  Utilize All Types
   of Transportation

  Primarily Relies on
   Aeromedical
       NDMS Definitive Medical Care


• Civilian - Military Contingency
  Hospital System
  – Network of approximately 2,000 non-
    Federal hospitals
• 63 FCCs, which coordinate in
  excess of 80 receiving areas
       NDMS Definitive Medical Care

 Lead Responsibility - DOD/ VA

 Concentrated in Major Metropolitan Areas

 Air Access

 Federal Coordinating Centers (FCCs)
 Available Hospital Support
 Patient Reception and Distribution
  Capabilities
     NDMS Readiness Activities


• Maintenance of Plans
• Training
• Exercises
• Special Events
• Annual Conferences
System Activation
      Circumstances for Which NDMS
            May be Activated

• Military Contingency - Overseas Conventional
  Armed Conflict Involving U.S. Forces

• Presidential Declaration of Disaster

• Request for Major Medical Assistance
       Federal Activation
• Federal EOC activated
• Push Package deployment/EST
• Disaster Field Office (DFO) established
• Representative to Incident Command
  Post
• Mission assignment and direction per
  local Incident Command
Disaster Medical Assistance
          Teams
        NDMS Medical Response
    Disaster Medical Assistance Teams (DMATs)



– Volunteer Groups Affiliated with NDMS
– Approximately 100 Persons per Team
  (>7,000 personnel)
– Variety of Health/Medical Skills
– Locally Sponsored
– Community Based
  • Local / State Asset
        NDMS Medical Response
    Disaster Medical Assistance Teams (DMATs)



– Volunteer status until activated
– Additional training
  • HAZMAT
  • WMD
  • Disaster response
            NDMS Medical Response
       Disaster Medical Assistance Teams (DMATs)



• Federal Enrollment of Team Members
• Federalization Upon Activation
  – Special Needs Authority
  – Accepted Volunteer Services Authority
• Importance of Federalization
  – Licensure / Certification
  – Liability
  – Compensation
             NDMS Medical Response
        Disaster Medical Assistance Teams (DMATs)



• DMAT Deployment Asset
  – 35 member team
    •   Command
    •   Finance
    •   Communications
    •   Logistics/security
    •   Pharmacy
    •   Medical care providers
       NDMS Medical Response
                   DMAT Missions

At Disaster Site
   Triage
   Medical Care in
    austere conditions
   Casualty
    Clearing/Staging
At Local NDMS Reception Area
   Patient Reception
NDMS Medical Response


         Fully
      Deployable
       LEVEL - I



   Augmentation
     LEVEL - II



   Local Response
     LEVEL - III
             NDMS Response Assets

   AK
                                                                                                                                 ME
                       WA             MT
                                                ND                                                                    VT
                                                               MN
                                                                                                                            NH

                  OR
                                                                          WI                                     NY         MA
                                                SD                                        MI                               CT
                            ID
                                      WY
                                                                                                           PA         NJ
                                                                IA                  RI




                                                                                                OH               MD   DE
                                                     NE
                       NV                                                                IN
                                                                MO                                    WV
                                 UT                                            IL                               VA
                                           CO
             CA
                                                     KS                                        KY

                                                                                          TN                     NC
                                                                                                          SC
                                                          OK
                             AZ       NM                             AR
                                                                                          AL         GA
                                                                               MS
                                                     TX               LA
        HI                                                                                                 FL
                                                                                                                                 USVI



GUAM
                   NMRT               DMORT
                                                                                                                           PR
                   DMAT-1             NMRT-DC

                   MMST (*Local Asset)
             Limitations
•   System activation time
•   Out the door time
•   Employer right to deny leave
•   In State Response
DMAT as a local resource
          HHS Strategic National
          Counterterrorism Plan


• Create local resources - rapid response time
  required
• Develop partnerships to:
  – Improve local health and medical system
    capability to respond effectively (MMST)
  – Improve Federal health and medical capability to
    rapidly augment State/local response
• Includes the National Disaster Medical
  System (NDMS)
       Ohio DMAT


OH-5               OH-6



          OH-1
       Ohio Assets




DMAT
                      DMORT
MMRS (*Local Asset)
                      OH-1
• Location: Toledo             • Level I team
• Formed 1986                  • Full basic load
• Membersip - 120              • Pharmacy cache
  –   Command - 5
  –   EMT - 19
  –   Nursing - 30
  –   Physicians - 19
  –   Veterinarian - 1
  –   Logistics/Support - 12
  –   Cross trained
                       OH-1
• Experience             • Training
  – Hurricane Andrew       –   HAZMAT
     • 700 patients
                           –   WMD
     • 3000 health
       assessments         –   180th ONG
  – Hurricane Marilyn      –   Lucas County EMS
     • 1200 patients
  – Hurricane Floyd
  – Kosovo refugee
    response
  – Atlanta Olympics
  – NATO Summit
  – 2001 Inauguration
                 OH-5
• Location - Dayton   • Achieved Level I
• Membership            status 2001
  – 50                • Acquiring basic
                        load
                   OH-5
• Experience             • Training
  – New York Ice           – Medical
    Storms                 – Communications
  – NATO Summit
  – Hurricane Georges
  – Hurricane Floyd
  – Atlanta Olympics
  – World Trade Center
                      OH-6
• Location:
  Youngstown
• Level III team
• Experience
  – NATO Summit
  – Hurricane Floyd
  – OH-1 drills
Questions

				
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posted:4/23/2013
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