Hurricane Rita Response

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Hurricane Rita Response

• A Review of Command and Control Challenges

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Overview

• Initial deployment
• First week and half in the field
• Command and Control
• Lessons learned
• Minnesota questions
• Avian Flu

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Deployment

• FEMA Request
• Notified on Sept. 22
• 30 day deployment
• Told to be self sufficient for 30 days
• 1 ALS ambulance, Supervisor vehicle and disaster
  trailer
• 2 Paramedics, 2 EMTs and 1 Manager
• Left on Sept. 23 at 1200 p.m.

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FEMA GSA Contract

• Definitions
• BLS
• ALS
• CCT
• Staffing
• 12 hours vs. 24 hours
• What does the contract cover?????

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Minnesota Convoy

• Lakes Region EMS
• Ambulance, Durango and Disaster Trailer
• Woodbury Ambulance Service
• Lakeview EMS
• Truman

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Disaster Area

• Texas

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Arrival in Texas

• 0600
• North of Dallas
• National Command advises us to divert to Tyler
• Rita came a ground at 0400
• Houston not safe until sustained winds fall below
  40 MPH
• Given 12 hours of down time, showers and hot meals

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Tyler Texas

• Staged at area ambulance service
• Fuel???
• Theory vs. reality
• Durango and trailer

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Plans Change

• Only ambulances available for missions
• One hour rest
• Showers
• First convoy mission/strike team
• Began serving as strike team leader

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Mission 1

• Evacuate Shelters
• Move closer to disaster area

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Mission 2

• Woodville Texas
• Evacuate hospital
• Strike team of 100 ambulances
• No power, water, or food
• Heart of the destruction

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Mission 2 Update

• Redeployed to High School where triage center had
  been setup
• Requested to respond to elementary school in Fred
• 80 critical patients
• 150 walking wounded
• 220 miles one way to closest hospital
• No fuel

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Rest

• 48 hours straight
• Local community center
• 8 hours sleep
• Moved to Houston
• Put on 12 hours of rehab

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Mission 3

• 5 hours of rest, not 12
• Provide interfacility transport for critical
  patients
• Hospital with limited power, limited water and
  limited food

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Mission 3 Update

• No patients needing transport
• Requested to setup command
• Fast tract triage
• Establish emergency operations
• Stayed for four days

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Return to Houston

• Reliant Center

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Change of Roles

• EMS Command
• All non-Texas
• Established in Houston
• Three divisions
• Command
• Communications
• Dispatch (staging)

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Structure

• SEOC
• Texas office of EMS, part of larger Health
  Department
• Montgomery Dispatch
• Houston Command
• EMS Commander
• Dispatch
• Communications

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Move of EMS Operations

• Houston
• One hour one way from deployment area
• County Facility (Tax revenue)
• No destruction in Houston
• Traffic
• Beaumont
• Forward staging area
• Ford Park

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EMS Arrival

• All units sent into the field for 48 hours
• Command moved
• No space for command
• No technology
• No indoor sleeping

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Command and Control

• Chain of Command
• MCI vs. reality
• Logistics
• Strike Teams
• 12 hrs vs. 24 hrs
• Communications
• Who pays?
• Incidents

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Command and Control

• Govt vs. Non Govt
• Convoys
• BLS vs. ALS, whats ALS?
• Sending people home
• Town hall meetings
• Rescue vs. recovery
• Internet
• EMS and ICS
• Protocols

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Hospital Surge Capacity

• 500 Patient Capacity
• Reality vs Plans
• EMS role
• A new Paradigm

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Questions?

• Thank you for your time!

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Contact Information

• Aarron Reinert
• Executive Director
• Lakes Region EMS, Inc.
• [phone]
• aarronr_at_lrems.com