Nuclear Radiological Disaster Casualty Management NRDCM): A Mul&- Na&onal Global Ini&a&ve Recent advances in NRDCM consequence management for nuclear disaster medicine assistance teams NDMATs) Na9onal Disaster Life Support Educa9onal Consor9um Annual Mee9ng Atlanta Airport Marrio5 Gateway, Atlanta, Georgia July 22-23, 2014
Session ObjecIves Define the Nuclear Radiological Disaster Casualty Management NRDCM) iniiaive Describe recent advancements in NRDCM modeling and consequence management analysis Discuss NRDCM constructs, research, and educaional aciviies
What is the NRDCM IniIaIve? A muli- naional workgroup focused on the following: Concepts, principles, and methods to prepare health professionals and the public for clinical management of casualies during nuclear and radiological disasters and resuling public health emergencies.
NRDCM SituaIonal Awareness Is the threat real? Hazard Vulnerability Opera9onal Importance Can a medical response acutely access the ill and injured casualies? Will a medical response improve outcomes in the acute phase of a nuclear disaster?
NRDCM Consequence Management Analysis NDMAT Strategic Deployment in Nuclear Disasters Recent advancements in modeling and consequence management analysis: Demonstrated largely predictable casualty injury and illness paterns Early appropriately trained medical response will save lives Strategic placement of DMAT resources
Unique Opportuni9es for Nuclear Disaster Medical Assistance Teams NDMATs) Need for mobile medical teams to reach paients with criical needs in areas difficult to reach, and hard to transport paients from, awer nuclear events Strategic triage at criical junctures near nuclear events, to manage paient care and transport NDMAT placement 1) in the glass breakage zone, 2) at the edge of zones for thermal burn and trauma casualies, 3) and outside of the significant radiaion zone. This keeps workers away from unstable buildings and unsafe radiaion, but sill enables maximum access for ingress to paients and their subsequent transport with minimal worker risk.
NDMATs awer a 10 Kt Nuclear Weapon Blast Washington, D.C.
Poten9al Hospital Bed Availability ALer a 10 kt Nuclear Detona9on in Washington, D.C. 200000 180000 4 hr Vacancies 160000 140000 24 hr Vacancies Available Beds 120000 100000 80000 60000 48 hr Vacancies Threshold for Needed Available Beds - NaIonal Planning Scenario Threshold for Needed Available Beds - Dallas 40000 20000 0 25 50 100 150 200 300 Distance from Detona9on Point Miles) Calculated for the Ins9tute of Medicine and Na9onal Academy of Sciences Workgroup for the Medical Response to an Improvised Nuclear Device
NDMAT deployment aler mul9ple 10 Kt Nuclear Weapon Detona9ons Tel Aviv, Israel
Worried well crowd surges and access to health care
Patient Transport will be hampered.
Air Evacua9on in radiological and nuclear events Limited Resource that will be in great demand Reality of helicopter unavailability except VIPs) C130 transport planes of significant uility if 4,000 W runways can be cleared in Ime
Lack of screening tools and adequate training for radia9on exposure assessment
Loss of confidence in the government
What is needed? Well- informed health and medical personnel Global accepted NRDCM competencies and milestones for educaion and training Interoperable NRDCM prepared disaster medical teams FuncIonal role for medical/support personnel Trained public ciizens in our communiies A willingness to paricipate in management
Why a NRDCM workgroup? A muli- naional group of common- purposed experts, colleagues and friends working together and building consensus InvitaIon for others to join and paricipate Begins with a clear vision, mission, and purpose defined Focused on improving readiness for each country and to assist each other collecively
NRDCM IniIaIve - Vision Create a worldwide network of health professionals and trained public to meet the medical, health and safety needs of all persons and communiies at risk of a nuclear or radiological disaster.
Vision Statement Addresses: Overcoming barriers to an effecive response DemysIfy myths and concerns of radiaion StandardizaIon of pracice methods Seamless integraion among personnel Foster a ready, willing and able response Coordinated muli- naional response effort
NRDCM IniIaIve - Mission Achieve and promote excellence in educaion, training, research and operaions related to nuclear and radiological disaster medicine and public health preparedness for all health professionals and trained public based upon sound educaional principles, scienific evidence, global consensus, and best clinical and public health pracices.
Mission Statement Addresses: Built on quality science and medical pracices Surge volume / sustained demand management Preparing crisis care provider workforce Trained public ciizen workforce Assuring quality care and paient safety
NRDCM IniIaIve - Purpose Preparing health professionals and the public, to do the greatest good for the greatest number of potenial survivors of a nuclear or radiological disaster.
Purpose Statement Addresses: UIlizaIon of scarce or limited resources Crisis standards of care Moral and ethical decision making
Nuclear Radiological Disaster Casualty Management NRDCM): A Mul&- Na&onal Global Ini&a&ve Workgroup Projects
Workgroup Project- 1 Health & Medical Personnel NRDCM Survey ACEM 2013 approved research survey Assess willingness and learning points about providing care for vicims of radiological and nuclear events Your paricipaion, and the paricipaion of every conference atendee is important
Workgroup Project- 2 Use of exis9ng na9onal disaster teams DMAT, MERT, etc.) in Radiological and Nuclear Disaster Mass Casualty Response Assess preparedness and idenify areas of improvement needed in exising naional disaster teams in paricipaing countries PresentaIon and abstract at IPRED III, Tel Aviv, Israel, January 2014
Workgroup Project- 3 Mul9- Na9onal Standardized NRDCM Educa9on and Training Program IdenIfy science- based expert consensus NRDCM competencies and milestones Review exising related programs compliance Assist partnering naions with implementaion of standardized T&E programs to improve NRDCM readiness
OperaIonally Focused MulI- NaIonal Response: Establish and idenify standardized methods and pracices Improve interoperability and integraion of a global health professional workforce Manage casualty burden and reduce health system demands on affected naions
Workgroup Caveats Focus - CauIon to avoid overreaching its aim or stated ambiions Validity Preparedness on science, global expert consensus, and best clinical pracices CollaboraIon - CooperaIon and coordinaion of resources across borders UIlizaIon ImplementaIon may be limited or parial in some countries
Workgroup CooperaIon Foster global consensus building Friendly invitaion to encourage other experts, naions, and regions to paricipate Share with those who have a like- minded interest and desired outcomes, an opportunity to partner and work together
Nuclear Radiological Disaster Casualty Management NRDCM): A Mul&- Na&onal Global Ini&a&ve Ques9ons? Thank You