Science & Technology Directorate

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Science & Technology Directorate Rural Mass Casualty Response Workshop 4 August 2010 Washington, DC James Grove, Regional Director Interagency & First Responder Programs Division DHS Science and Technology Directorate

DHS S&T Mission: Strengthen America s security and resiliency by providing innovative science and technology solutions for the Homeland Security Enterprise.

1 st Responder Capstone IPT Requirements First Responder RDT&E Working Group Associations & Practitioners DHS First Responder RDT&E Coordinating Council Federal FEMA Commercialization Funding S&T First Responder Technology Council Solutions T&E and Standards

Metrics Assumptions for Rural EMS Communication/Consultation essential Advance delayed patient care over time Improve on-scene patient care with limited advanced EMT resources Determine improvement/degradation of patient over time Initial care to reception Triage and evacuation decision Decision Aides Evacuation Priority Receiving Facility Transport Mechanism

Methods of Evaluating Concepts & Metrics Limited Objective Experimentation with Rigorous Analysis Advanced Concept Technology Demonstration (ACTD) Concept for addressing rural mass casualty treatment Tactics, Techniques, Procedures (Protocols) Analytical/Research Based Decision Aides Introduction/Evaluation of Technology Aides Leverage US Joint Forces Command Joint Concept Technology Demonstration Potentially addresses similarities with rural EMS response and rural mass casualty events

US Joint Forces Command Joint Medical Decision Support & Evacuation JCTD Joint Combat Casualty Care System Current medical monitoring and support systems adapted and integrated to provide combat casualty care in operational environments. Communications between evacuation support and forward receiver enabled through audio and still images Remote monitoring of vital signs and medicine Medical reach back (consultation) Efficient management of low density, high demand field medical personnel and evacuation assets Apply medical care to most critical casualties while monitoring and remotely caring for others Facilitate critical medical care to forces in denied or remote areas unreachable by evacuation assets in the short term.

US Joint Forces Command Joint Medical Decision Support & Evacuation Casualty support capability and force multiplier for evacuation assets through the following: Advanced communication systems to assist in casualty monitoring and care from a distance Virtual triage support: efficiently manage low density high demand evacuation assets Provide real-time reach back Apply metrics for evacuation assets Increase their effectiveness by evaluating medical situations at a distance Applying medical care to most critical casualties while monitoring and remotely caring for others Critical medical care in denied or remote areas Protocols for patient stabilization and monitoring systems Proof of concept for transport of critical casualties short distances

Joint Concept Technology Demonstration Technology Integration Physiological Monitor (Tempus IC) HH Device (Motorola MC-70) Electronic Information Carrier Modem Radio or other Transmit Device

Rural Medical Care Application Rural communities and Indian Country Medical consultation over dispersed area No single trauma center consult overwhelmed Increase decision making data at physician level Long term, multi-sensor monitoring Improvement and degradation of patient over time Improve evacuation and receiving facility decision making Increase monitoring capability with limited EMT providers Expand use of EMT-P in mass care treatment Improve mass care treatment versus 1:1

Potential Application Risks Cost of monitoring equipment Approximately $35k versus a $25k Lifepak Limited bandwidth in rural areas Increased cost of communications (satellite or other) Ensuring efficacy of approach before implementing Technology not always the answer