The Texas Disaster Medical System and

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1 The Texas Disaster Medical System and T Trauma S Service i A Area - E

2 Topics for discussion: What is the Texas Trauma System and Trauma Service Area? What about our TSA and what is the RAC? What is the Texas Disaster Medical System? What is an Emergency Medical Task Force?

3 Texas Trauma System Texas Administrative Code 157 Established 22 geographic Trauma Service Areas (TSA) Established dregional ladvisory Councils (RACs) Identified essential components of required regional trauma plans Includes emergency preparedness Outlined trauma facility designation process Established the Texas Trauma Registry to monitor the Trauma System and the incidence / costs of injury in Texas.

4 TSA-E 19 Counties in North Central Texas (NCT) Same boundary area as NCT Council of Governments (COG) and TEXOMA COG together 6.7 million people in TSA - E 28% of Texas Population 2.2% 2% of US Population In 2007, Dallas - Ft. Worth was the fastest growing metropolitan area in the nation

5 TSA is the geography and RAC is the people NCTTRAC is a Texas 501(c)3, Non Profit Organization Current NCTTRAC Membership 4 EMS Air Providers 87 EMS Ground Providers 13 First Responders 77 Hospitals 7 Professional, Physician, and Educational Organizations Trauma Centers Level I: BUMC, Children s, JPS, and Parkland Level II: Cook, MC of Plano, Methodist Dallas, TH Harris FW The Trauma System Plan is approved by the General Membership

6 What are ESFs? ESF #2 Communications ESF #3 Public Works and Engineering ESF #4 Firefighting ESF #5 Emergency Management ESF #6 Mass Care and Sheltering ESF #7 Logistics Management / Resource Support ESF #8 Public Health and Medical ESF #9 Search and Rescue ESF #10 Oil and Hazardous Materials Response ESF #11 Agriculture and Natural Resources ESF #12 Energy ESF #13 Public Safety and Security ESF #14 Long-term Community Recovery ESF #15 External Affairs

7 ESF-8 Functions Assessment of health and medical needs Health surveillance Medical care personnel Health and medical equipment / supplies Patient evacuation In-hospital care Food / drug / medical device safety Worker health and safety Rad / chem / bio hazards consultation Mental health care Public health information Vector control Potable water / waste water and solid waste disposal Victim ID / Mortuary services Veterinary services

8 Texas Disaster Medical System Acute Public Health Amb Busses Nurse Strike me Amb Strike ESRD Long Term Care TSA Hospital Regional MOC MACC Epi Team CASPER Team Enviro Health Team RAT Team Medical Staffing Contracts Food Safety Admin CAT Bus Staging Team ROC MMU MIST Local MOC Mortuary Team MSN Shelters TxMAT TxMAT 1 Tx Military Force MRC LPH L.P.H. D.B.H. Red Cross NOTE: Federal and EMAC assets will augment these teams and strategies

9 ESF 8 Coordination The Keystone TDMS Steering Committee Acute Care Public Health A collaboration of all public health and acute medical care preparedness initiatives within Texas relating to the mitigation of, response to, and recovery from natural and man made disasters

10 What is TDMS?

11 TDMS Texas Disaster Medical System Courtesy TDEM Website The Texas Disaster Medical System is the collaboration of all public health and acute medical care preparedness initiatives within the State of Texas relating to the mitigation of, response to, and recovery from natural and manmade disasters and other significant events within any region in Texas, with respect to Emergency Service Function (ESF)-8 functions.

12

13 Where does TDMS get its authority? The Texas Disaster Medical System (TDMS) Steering Committee was established under the direction of the Texas Department of State Health Services (DSHS) in DSHS is the lead agency for Emergency Support Function (EDF)-8 (Public Health & Medical Services) per the state of Texas Emergency Management plan, Annex H, Texas Government e Code , (13), 3), and (a).

14 TDMS Acute Care Components Emergency Medical Task Forces (EMTFs) Medical Incident Support (MISTs) Ambulance Staging Managers (ASM) Hospitals (evacuating and receiving) End Stage Renal Disease network (ESRD)

15 Texas Emergency Medical Taskforce (EMTF) Project

16 EMTF Integrated Medical Response Goals: Capability Rapidly deployable for statewide incidents Builds upon regional capability Integrated command/control elements Self-sufficient for short periods of time(72hrs) NIMS compliant Modular deployment options ASPR Funded strategy for FY11 and FY12

17 Emergency Medical Task Force Regions (EMTF) May, 2011 EM TF 1 A, B EM TF 2 C, D, E EM TF 4 F, G EM TF 6 H, Q, R EM TF 7 L, M, N, O EM TF 8 P, S EM TF 9 I, J, K EM TF 11 T, U, V vw May 2011

18 Emergency Medical Task Force Emergency Medical Task Force Leadership Team Command/General Staff (from EMS agencies/hospitals in local jurisdictions) ICS 100, 200, 300, 400 and AHIMT certs, with position specific certs as well Must have EMS/ER/IMT management experience Full Comms package to communicate with all Groups and Local EOC/DDC/MACC/DSHS/GDEM SOC Logistics package to support all Groups 5 Ambulance A b l St ik Strike 5 Ambulances in each Strike Team (25 total ambulances) Each Strike Team has pre assigned Strike Team Leader are Pre rostered 10 min launch time for <12 hr deployment 4 hour launch time for minimum for 72 hr p y with deployment additional gear as needed. 5 RN Strike 2 Ambuses 5 RN s in each Strike Team (25 total RN s) Each Team has p pre assigned Strike Team Leader 3 ER Strike 1 ICU Strike Team 1 Specialty area (Burn (Burn, OB, Pedi, NICU, etc) 6 hour launch time for minimum of 72 hr deployment Ambuses are capable of transporting up to 24 litter p patients at one time. Pre plumbed for O2, Suction, medical gases, etc Assigned g to EMS agencies that will deploy 5 6 paramedics 10 min launch time for 12 hour deployment 4 hour launch time for 72 hour deployment Field Fi ld Deployable D l bl Medical Station bed capacity Able to provide emergency g y stabilizing g care (23 hrs only) Fully staffed with EM physicians, ER nurses, techs, pharmacy, logistics, g clerical and other support 6 12 hour launch time for 72 hr deployment

19

20 State EMTF Response Regional (EMTF) Response Local Incident Local Response Mutual Aid Response

21 ESF 8 liaison DDC County / Regional MOC (RMOC) requests State assistance for PH&M resources through DDC State Operations Center (SOC) ESF 2 ESF 6 ESF 11 ESF 8 Lead Agency DSHS State Medical Operations Center (SMOC) Local area requests mutual aid assistance from surrounding areas Mutual Aid not available EMOC Local area requests assistance from county or LMOCs such as DMOC Local MOC / PH&M EMTF Coordinator Local area runs out of PH&M resources Disaster

22 Ambulance Strike

23 Mass Evacuation Emergency Medical Task Force Leadership Team = 100 Ambulances 200 critical patients EMS/Medical Incident Management Team (Type III IMT) 5 Ambulance Strike 5 RN Strike 2 Ambuses Mobile Medical Unit EMS/Medical Incident Management Team (Type III IMT) 5 Ambulance Strike 5 RN Strike 2 Ambuses Mobile Medical Unit EMS/Medical Incident Management Team (Type III IMT) 5 Ambulance Strike 5 RN Strike 2 Ambuses Mobile Medical Unit EMS/Medical Incident Management Team (Type III IMT) 5 Ambulance Strike 5 RN Strike 2 Ambuses Mobile Medical Unit

24 Emergency Medical Task Force Rapidly deployable Mobile Medical Unit Project Quad 19 6 X X EMTF 2 36 X x 38 6

25 Mobile Medical Unit

26 EMTF Ambulance Bus (AMBUS) Multi Patient Vehicle (MPV)

27 MPV / Ambus Goals Ambus capable of transporting >12 litter patients at one time. Pre-plumbed for O2, Suction, medical gases, etc Assigned to EMS agencies that will deploy 4 paramedics No Notice Regional ldeployment MCI STRUCTURE FIRES Rehab for Long duration events High Profile Incidents & Events State-wide tasked mission assignments

28 Current Response Statewide Response Within 30 Minutes

29 Current Response Statewide Response Within 1 Hour

30 Current Response Statewide Response Within 1.5 Hours

31 Current Response Statewide Response Within 2.0 Hours

32 Current Response Statewide Response Within 2.5 Hours

33

34 2012 Response Statewide Response Within 30 Minutes

35 2012 Response Statewide Response Within 1 Hour

36 2012 Response Statewide Response Within 1.5 Hours

37 2012 Response Statewide Response Within 2 Hours

38 2012 Response Statewide Response Within 2.5 Hours

39 Texas Regional Emergency Medical TF s Hospital Overwhelmed Scenario Emergency Medical Task Force Leadership Team = 100 Qualified RNs in various specialties = 160 bed Medical Station EMS/Medical Incident Management Team (Type III IMT) 5 Ambulance Strike 5 RN Strike 2 Ambuses Field Deployable Medical Station EMS/Medical Incident Management Team (Type III IMT) 5 Ambulance Strike 5 RN Strike 2 Ambuses Field Deployable Medical Station EMS/Medical Incident Management Team (Type III IMT) 5 Ambulance Strike 5 RN Strike 2 Ambuses Field Deployable Medical Station EMS/Medical Incident Management Team (Type III IMT) 5 Ambulance Strike 5 RN Strike 2 Ambuses Field Deployable Medical Station

40 EMTF Activation Emergency Medical Task Force Leadership Team = 100 Ambulances 200 critical patients = 4 MMUs 128 patient care beds EMS/Medical Incident Management Team (Type III IMT) 5 Ambulance Strike 5 RN Strike 2 Ambuses Mobile Medical Unit EMS/Medical Incident Management Team (Type III IMT) 5 Ambulance Strike 5 RN Strike 2 Ambuses Mobile Medical Unit EMS/Medical Incident Management Team (Type III IMT) 5 Ambulance Strike 5 RN Strike 2 Ambuses Mobile Medical Unit EMS/Medical Incident Management Team (Type III IMT) 5 Ambulance Strike 5 RN Strike 2 Ambuses Mobile Medical Unit

41 May 22 nd 2011

42 Texas Regional Emergency Medical TF s EF-5 Tornado Scenario Emergency Medical Task Force Leadership Team 100 Ambulances 200 critical patients 8 Ambuses 192 urgent patients 100 Qualified RNs in various specialties 160 bed Medical Station EMS/Medical Incident Management Team (Type III IMT) 5 Ambulance Strike 5 RN Strike 2 Ambuses Field Deployable Medical Station EMS/Medical Incident Management Team (Type III IMT) 5 Ambulance Strike 5 RN Strike 2 Ambuses Field Deployable Medical Station EMS/Medical Incident Management Team (Type III IMT) 5 Ambulance Strike 5 RN Strike 2 Ambuses Field Deployable Medical Station EMS/Medical Incident Management Team (Type III IMT) 5 Ambulance Strike 5 RN Strike 2 Ambuses Field Deployable Medical Station

43 EMTF is getting Ready for the Storm! Contact tncttrac if you have what tit takes.

44

45 Questions?

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