International Response A Strategy for DMAT Training

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International Response A Strategy for DMAT
Training
Bill Barker, MD, FACEP Virginia Task Force 1
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Urban Search and Rescue

• Mission is primarily heavy rescue
• Perform rescues beyond local capability
• Specialized equipment training and personnel
• Secondary dispatch
• Limited medical capability
• Force protection
• Specialized care for victims of entrapment and
  crush injury

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Urban Search and Rescue

• Domestic Deployments for DHS/FEMA
• Medical personnel are NDMS credentialed
• Type I deployment
• 4 paramedics
• 2 physicians
• Type III deployment
• 2 paramedics
• 1 physician

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Urban Search and Rescue

• International Deployments USAID/OFDA
• Fairfax County, VA VATF-1
• Los Angeles County, CA CATF-2
• Disaster Assistance Response Team
• International Heavy Team Deployment
• 6 paramedics
• 3 physicians
• Medium Team Deployment
• Current expected staffing is 2 paramedics and 2
  physicians

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DMAT Preparation and Planning

• Administration and Leadership
• Not always the same
• Attention to detail
• Chain of command must be clear
• Should be in place and rehearsed prior to
  deployment
• Consider ICS principles
• Command officer may be a physician but frequently
  should not be

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DMAT Preparation and Planning

• Change Expectations
• Not an intact tertiary care facility
• High quality care at the level you can support
• Some will die or become disabled that might not
  at home facilitythats not good but it is OK and
  it is reality
• Provide the best care possible in an environment
  that makes it a challenge to do so

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DMAT Preparation and Planning

• Change Expectations
• Not an intact tertiary care facility
• High quality care at the level you can support
• Some will die or become disabled that might not
  at home facilitythats not good but it is OK and
  it is reality
• Provide the best care possible in an environment
  that makes it a challenge
• KNOW YOUR LIMITATIONS

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DMAT Preparation and Planning

• Self Sufficiency
• Water and food to support initial response
• Shelter
• Care for your own
• Health and sanitation including designated
  officer
• Mental health/comfort care
• Safety
• Do Not Become a Burden on the Disaster

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DMAT Preparation and Planning

• Team Health and Safety
• Have a designated officer(s)
• Medical procedures for team members

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Pre Travel Activities

• Regular physicals
• Personnel go through check-in
• Administration
• Weigh in
• Medical
• Communications
• Team briefing
• Family support plan

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DMAT Preparation, Planning, and Performance

• Team Health and Safety
• Have a designated officer(s)
• Medical procedures for team members
• Designated equipment
• Designated personnel

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DMAT Planning and Performance

• Team Health and Safety
• Have a designated officer(s)
• Medical procedures for team members
• Designated equipment
• Designated personnelan internal EMS?
• Evacuation procedures
• Intact facility assessments
• Civ/Mil transport
• Travel insurance?

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DMAT Planning and Performance

• Team Health and Safety
• Medical procedures for team members
• Evacuation procedures
• Intact facility assessments
• Civ/Mil transport
• Travel insurance
• A higher standard for your own?
• Especially in regards to evacuation and tertiary
  referral
• Teams ability to continue to function
• Mental well being of your members

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DMAT Planning and Performance

• Team Health and Safety
• A higher standard for your own?
• Especially in regards to evacuation and tertiary
  referral
• Teams ability to continue to function
• Mental well being of your members
• Unexpected consequences of not doing so
• Inability to perform at the highest level

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DMAT Planning and Performance

• Team Health and Safety
• A higher standard for your own?
• Especially in regards to evacuation and tertiary
  referral
• Teams ability to continue to function
• Mental well being of your members
• Unexpected consequences of not doing so
• Inability to perform at the highest level
• House guests that wont leave

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DMAT Planning and Performance

• Team Health and Safety
• Have a designated officer(s)
• Medical procedures for team members
• Designated equipment
• Designated personnel
• Mental health considerations
• Less experienced team members
• Situational gravity
• Rest and recuperation

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Base of Operations BOO
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DMAT Planning and Performance

• Team Health and Safety
• Have a designated officer(s)
• Medical procedures for team members
• Mental health considerations
• Less experienced team members
• Situational gravity
• Rest and recuperation
• Daily team health assessments
• Take care of your buddies
• Keep the information flowing AKA rumor control

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DMAT Mission Performance

• Action plans
• Daily updates for all functions
• May be changed as situation does
• Available to all team members
• Planning process consolidates information from
  multiple sources

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DMAT Mission Performance

• Action plans
• Daily updates for all functions
• May be changed as situation does
• Continuing Assessments
• Test transport and evacuation system daily
• Update facility reports regularly

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The road up the holler might be out for a while
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DMAT Mission Performance

• Action plans
• Continuing Assessments
• Test transport and evacuation system daily
• Update facility reports regularly
• Recovery of native capability
• Additional disaster relief organizations

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DMAT Mission Performance

• Action plans
• Continuing Assessments
• Test transport and evacuation system daily
• Update facility reports regularly
• Recovery of native capability
• Additional disaster relief organizations
• Confirm all information
• Direct observation by team member best
• Information from chain of command
• Confirm other information through multiple
  sources

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DMAT Mission Performance

• Patient Tracking
• For appropriate care and reunification
• Follow-up for interest and education

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DMAT Mission Performance

• Patient Tracking
• For appropriate care and reunification
• Follow-up for interest and education
• Epidemiology
• Internal trends
• Exchange information for regional and local trends

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DMAT Mission Performance

• Mission Flexibility
• Bam, Iran Earthquake
• IMSuRT East
• Supplemented staffing with additional primary
  care prior to departure
• Worked with the DART to obtain supplementary
  pharmaceuticals
• Staff performed different functions than they may
  have signed up for
• Attentive to cultural concerns

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DMAT Mission Performance

• Incorporate Local Providers
• Supplement your staffing
• Know local resources and traditions
• Provide relief for your staff
• Carry on your mission when you leave
• Train them on your equipment
• Learn to function in austere environment
• Helps them start to rebuild their lives

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International Opportunities

• International Medical Surgical Response Team
  IMSuRT
• East
• West
• South
• US Military including reserves
• Faith Based Organizations
• International NGOs

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International Opportunities

• International Red Cross
• NGOs with medical components
• Mercy Corps
• Doctors Without Borders, MSF
• International Medical Corps
• International Rescue Committee IRC
• Medical Teams International
• And many others

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International Response A Strategy for DMAT
Training
Bill Barker, MD, FACEP Virginia Task Force 1
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International Opportunities
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International Opportunities
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Urban Search and Rescue
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DMAT Mission Performance
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DMAT Preparation and Planning
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DMAT Planning and Performance
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Pre Flight Activities

• Personnel go through check-in
• Administration
• Weigh in
• Medical
• Communications
• Team briefing

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Where have we been?
Izmit, Turkey
Pentagon
Armenia
Oklahoma City, OK
Taiwan
Düzce, Turkey
Atlanta, GA
Topsail Beach, NC
Philippines
Kenya
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International Response A Strategy for DMAT
Training
Bill Barker, MD, FACEP Virginia Task Force 1
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