Concept of Forward Movement of Patients

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Concept of Forward Movement of Patients

• CAPT Alvin Lee, USPHS
• National Disaster Medical System

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Cascadia Subduction Zone

• Every 500 years, 200-1000
• 9.0 plus after shocks
• Brooks Penninsula to Cape Mendocino
• 800 mi
• Tsunami 30 ft. high within minutes
• 10-12 hr sequence
• 101 impassible-roads, railways, runways
• Tall bldgs, bridges susceptible to long waves
• Landslides isolate coastal communities for weeks

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Major Components of NDMS

• Medical Response-Teams
• Definitive Medical Care
• Patient Evacuation-FCCs

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Cascadia TTX forecast needs

• Priorities for the first 72 hours
• Lifesaving, communication, utilities
• Roads, bridges
• Debris removal for responders
• Priorities for the first 30 days
• Temp shelter, food, water, medical care
• Repair transportation routes
• Priorities for 30 days to 6 months
• Continue support and infrastructure recovery

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If you dont have a plan, thats one less thing
to go wrong. -S. Benson NYC OEM

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New Orleans Catastrophic Response Plan
Lilly Pad
Shelter
Lilly Pad
Temporary Medical Staging and Operations
Area (TMOSA)
Search and Rescue Base of Operations (SARBOO)
Lilly Pad
Lilly Pad
New Orleans Hospital
Lilly Pad
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Self Referrals
Lilly Pad
Shelter FULL
Spontaneous TMOSA (Causeway)
Lilly Pad
Temporary Medical Staging and Operations
Area (TMOSA)
Search and Rescue Base of Operations (SARBOO)
Lilly Pad
Lilly Pad
Spontaneous TMOSA (Superdome)
New Orleans Hospitals
Lilly Pad
Self Referrals
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Initial Response is Local?

• 911
• Hospital Control
• National Guard assets
• EMAC
• Private sector
• Who ya gonna call??

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CatastrophicIncident Supplementto the National
Response Plan

• Mission-evac ill or injured to reception
  facilities
• Assumptions limited evac within 96 hours
• State/local transport to pt collection pt

• Various pt tracking systems need coord.
• GPMRC single pt movement mgr
• No preferred mode

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Catastrophic Incident Supplementto the
National Response Plan

• FEMA establishes Fed mob ctr
• State and local collect and transport to hubs
• NDMS Med. Inter-agency coord gp
• TRANSCOM coord movement from collection points to
  airfields, etc

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Catastrophic Incident Supplementto the National
Response PlanResponse limitations

• Federal capability limited with non-amb pt
• Contaminated/contagious pts

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DoD Responsibilities

• Alert GPMRC
• Activate FCCs
• Manage and evacuate to NDMS pt reception areas
• In coord with DOT transport support agencies,
  personnel, equipment/supplies
• Logistical support
• Provide active duty medical and other missions
  including aeromedical evac.

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Common thoughts

• Command and Control
• Communication
• Special needs
• Security

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Who needs to go?
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What do you have to work with?
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Questions ?
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From the Audience

• Tribal issues?
• Colville, Warm Springs
• Rural Wyoming?
• East Coast
• KY, SC
• Public Health

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CAPT Alvin Lee, USPHS Emergency Coordinator,
Region X National Disaster Medical System 130
228th St SW Bothell, WA 98021 Alvin.lee_at_dhs.gov
[phone]