[KYHAM] KEN Training for April 7: The National Disaster Medical System

[Ron Dodson]

In times of war such as we are now under and in major
disasters, amateur radio could be asked to interface with
something called the National Disaster Medical System or
(NDMS).  To make you aware of NDMS and what it is and does
this week, our training will focus in this direction.  

To expedite the handling of mass casualties and other
medical needs in a crisis or war period, the federal
government has established the National Disaster Medical
System or (NDMS).  This is not meant to be a supplemental
medical resource but an augmentation resource after all
local and state resources are committed. In Kentucky,
Louisville, Lexington and Northern Kentucky have been
selected to participate as receiving hospitals.

The Federal Department for Health and Human Services is
responsible for actual coordination of NDMS activations. 
Policy guidance will be provided by FEMA. 

The Governor can request activation of NDMS only via a
request for assistance under the PL 93-288 as amended
100-707. The Assistant Secretary for Health, Federal
Department for Health and Human Services (HHS) will be
responsible for the overall coordination of Federal
operations to assist state and local efforts to provide
emergency medical care.  Federal response will be provided
through activation of the national Disaster Medical System
(NDMS) at DHS Headquarters in Rockville, Maryland.  As part
of the NDMS HHS will carry out the following.

1.Establish the National Disaster Medical Operations Center.

2.Assess the Medical situation within the disaster area.

3.Provide guidance to the state.

4.Mobilize and dispatch medical assistance teams to the
disaster area.

5.Activate NDMS hospital and transport elements to move
excess patients to unaffected areas for treatment.

6.Coordinate with state and local governments and
participating hospitals the transportation of patients from
the affected area to participating hospitals.

A military or other Federal hospital and/or a specified
civilian hospital in each designated metropolitan area of
the United States will function as a "coordinating center". 
The coordinating center for the three Kentucky areas is the
local VA Hospital.  The center will coordinate the arrival
of patients from the disaster area.  KyEM and local EM in
cooperation with the involved hospitals will mobilize
volunteer local emergency medical resources including
transportation, communications, and facilities.  In
conjunction with local facilities, organizations, and
governmental jurisdictions, the coordinating center will
establish policies and procedures for receiving, sorting,
and transporting medical evacuees to facilities in the
designated metropolitan area.  The State will appoint a
State Emergency Medical Care Coordinator who will
collaborate with the Federal Emergency medical Coordinator
and direct the following six major functions:

1. Initial care and stabilization,

2. Assessment of numbers of casualties,

3. Coordination of incoming medical assistance,

4. Intra-regional evacuation and sorting of patients,

5. Preparation of casualties for evacuation from the region,
and

6. Transportation of patients to aeromedical evacuation
site(s).

		 
Patient Evacuation.  Patients will be moved from patient
evacuation sites to patient reception sites under a
coordinated evacuation policy agreed upon by Kentucky and
Federal disaster medical coordinators.  In general, the
following guidelines will be observed:  Casualties will be
provided adequate definitive care at a facility within their
own community, county, or state, where feasible.
Out-of-state evacuation of a disaster victim will be
effected only with the best interest of the patient as the
objective.  Distance the patient will have to travel will be
on the main governing criterion for choosing hospitals.
Individual patients will be sent to the participating
hospital for the care required. 

Federal medical assistance to the disaster site will consist
of Disaster Medical Assistance Teams.  A Disaster Medical
Assistance Team is composed of volunteer physicians, nurses,
technical staff and other health professionals as well as
support staff such as litter bearers and food preparation
personnel.  Staff will be trained to respond to a disaster
as an organized team.  There are 2 types of teams:

Casualty Clearing Units - 103 person unit which will triage
and stabilize patients for transport to definitive care. 
This unit has limited surgical capability.

Mobile Surgical Units - 215 person unit which will provide
surgical services to those patients who could not otherwise
survive evacuation.

When Teams are dispatched to the disaster site, they will
bring necessary medical supplies and equipment, and also
food, water, and other supplies necessary to support the
team.  The Commonwealth or local government is responsible
for selecting the site for the Casualty Clearing Units and
or Mobile Surgical Units and insuring the necessary
utilities and other support resources are made available.