1. Thank you to the 2015 Virginia Emergency Management Symposium Sponsors

2. Virginia Emergency Management Symposium March 18, 2015
Emergency Management Meets Incident Management Team: Conducting a Multi-Agency Full Scale Exercise
Intros
Thanks for being here…
Virginia Emergency Management Symposium
March 18, 2015

3. Agenda National Disaster Medical System Overview 2014 NDMS Exercise
Components
Phases
History in County
2014 NDMS Exercise
Planning Team Make up
Week of Exercise
Day of Exercise
Critical Concepts (Lessons Learned)
Walk through outline for presentation

4. NDMS Overview National Disaster Medical System (NDMS)
Combines Federal and non-Federal medical resources into a unified response system
Also serves to expand medical support for military casualties that may exceed the capabilities of DoD and VA resources
What is NDMS?
Can be disaster victims (Haiti EQ) or hospital transfer from disaster area to allow victims to be treated in area hospitals

5. NDMS Overview Three Primary Components
Response Teams (Disaster Medical Assistance Team (DMAT), Disaster Mortuary Operational Response Team (DMORT), NMRT, NVERT, etc.)
Patient Movement and Reception (Department of Defense (DoD), TPMRC-A, Federal Coordinating Center (FCC))
Definitive Medical Care (participating local NDMS hospitals)
What is NDMS? – On FCC side

6. NDMS Federal Coordinating Center (FCC) Locations
Hawaii
Locations – who is responsible
Army
Navy
Air Force
Veteran’s Affairs
Puerto Rico

7. NDMS Overview - Chesterfield
NDMS Plan - Annex of the County’s EOP
Coordinating Agency
Emergency Management
Cooperating Agencies
Fire and EMS – Operations and EMS
Police, Sheriff
General Services (Airport)
Public Affairs
Public Schools (Transportation)
Health, Social Services, Mental Health
Area NDMS Participating Hospitals
Annex to EOP
Talk about the responsibilities of each department
Health, Social Services, Mental Health – primarily responsible for care of the companions / family members and/or pets that travel with the patients.

8. NDMS Overview - Chesterfield
Other guiding documents
FCC NDMS Plan
Old Dominion Emergency Medical System Alliance (ODEMSA)
Mass Casualty Plan
CFEMS - Emergency Medical System Policy #07
Mass Casualty Incidents
Make reference to the ODEMSA Mass Casualty Plan and other – Triage, treatment & transport based on MCI, even though there are major differences.
Classified as an MCI to activate the use of Medical Control at VCU Hospital.

9. NDMS Phases of Activation
Alert / Standby: hours to 24 hours prior to arrival
Event has occurred
Potential need for assistance
No patients expected within 24 hours
FCC contacts hospitals for bed counts
Local Actions
Fire & EMS notified of potential for activation
Airport notified to begin process of getting hangar
Process of Alert etc.

10. NDMS Phases of Activation
Activation hours prior to arrival
Funds authorized
Patient Manifest sent to Emergency Management and shared with VCU Hospital (Medical Control) for patient hospital assignments
Local Action
Fire & EMS notified of expected arrival time
Activate the County NDMS Plan and the ODEMSA Mass Casualty Plan
Process of Activation

11. NDMS Phases of Activation
Full Activation –Arrival
Triage and Transport units set up on scene
C-130 lands at airport with ~ 50 patients
Patient condition reevaluated via triage according to Mass Casualty Plan
Patient Tracking
Transported to predetermined hospitals based on assignments by Medical Control

12. NDMS Exercise Designated receiving site since 2005
Chesterfield County Airport (Richmond Executive Airport)
NDMS Federal Coordinating Center (FCC) requires exercise every 3 years
FCC is at McGuire Veteran’s Hospital

13. NDMS Exercise History
2005 – Deputy Chief and EM at airport with FCC Coordinator
2008 – Plane (C-130) landed. Simulation of deplaning and triage for transport to local hospitals.
2011 – Picked up where 2008 left off with patients triaged and ready to be transported.

14. NDMS Exercise History FCC Director
2005
FCC Director
EM, EMS Director & Deputy Fire Chief
2008
C-130
Patient Triage
2011
Patient Transport
OPS out of BC vehicle
2014
Full IMT support

15. 2014 NDMS Exercise June 7, 2014 Same scenario as 2011 drill
Two “planes” with patients to be transported
10 local hospitals participating
Based out of Civil Air Patrol Hangar at Airport
Exercise paid for by NDMS (~ $20,000)
Food
Staff time
Transport Units

16. 2014 NDMS Planning Team Chesterfield Fire and EMS
Emergency Management
Emergency Medical Services Division
Federal Coordinating Center / McGuire Hospital
Army National Guard Unit
Central Region Hospital Coordinator
Chesterfield Health District
General Services / Airport
VCU Medical Center

17. 2014 NDMS Exercise

18. 2014 NDMS Exercise Resources Utilized - EMS Agencies
Ended up with 150 people to manage the day of the exercise
50 volunteer “patients”
50 Evaluators, Controllers, Observers and other exercise staff
50 Players – IMT, CFEMS Ops, Sheriff
PLUS - media

19. 2014 NDMS Exercise Resources Utilized
Chesterfield County Public Schools Buses
Ended up with 150 people to manage the day of the exercise
50 volunteer “patients”
50 Evaluators, Controllers, Observers and other exercise staff
50 Players – IMT, CFEMS Ops, Sheriff
PLUS - media

20. 2014 NDMS Exercise Resources Utilized
2 Army National Guard Black Hawk helicopters
Ended up with 150 people to manage the day of the exercise
50 volunteer “patients”
50 Evaluators, Controllers, Observers and other exercise staff
50 Players – IMT, CFEMS Ops, Sheriff
PLUS - media

21. 2014 NDMS Exercise
Ended up with 150 people to manage the day of the exercise
50 volunteer “patients”
50 Evaluators, Controllers, Observers and other exercise staff
50 Players – IMT, CFEMS Ops, Sheriff
PLUS - media

22. Critical Concepts Check In
One centralized check in & over all scene control = Accountability
Cell phone, emergency Contact

23. Critical Concepts Check In
Ended up with 150 people to manage the day of the exercise
50 volunteer “patients”
50 Evaluators, Controllers, Observers and other exercise staff
50 Players – IMT, CFEMS Ops, Sheriff
PLUS - media
One centralized check in & over all scene control = Accountability
Cell phone, emergency Contact

24. Critical Concepts Communications
EMS statewide radio only worked about 1 mile from the airport. We had to use cell phones beyond that range. We did not know this initially but we were able to contact units based on the information we collected at “check-in”.

25. Critical Concepts Briefings
– Exercise Brief v. Incident Command Brief v. Ops Brief
Had to provide Exercise Brief as over all why are we here – information for everyone, but especially volunteers
Operations success – moving patients to destinations
Then Provide Ops Brief – to be realistic

26. Critical Concepts Volunteers
Should have provided them with more details – This was a transport drill. Some later complained that the medics / EMTs didn’t provide care – it was a transport drill, they didn’t need to. Better communication with the hospital – some weren’t prepared. Some were done with their drill before the patients got there.

27. Critical Concepts Triage Group
Should have provided them with more details – This was a transport drill. Some later complained that the medics / EMTs didn’t provide care – it was a transport drill, they didn’t need to. Better communication with the hospital – some weren’t prepared. Some were done with their drill before the patients got there.

28. Critical Concepts
Transportation Group

29. Critical Concepts
Transportation Group

30. Critical Concept Patient tracking (Volunteer Management) Trilingual –
Tracking of patients – making NDMS tracking number follow Triage Tag number follow hospital tracking AND match with volunteer/ patient name
EMS is really good at getting patients to hospitals. Don’t usually have to worry about getting them back!
Gave them contact numbers because some volunteers for left at the hospitals last time. This time, they were bored and wanted to come back.

31. Critical Concept Patient tracking (Paper Patients) Trilingual –
Tracking of patients – making NDMS tracking number follow Triage Tag number follow hospital tracking AND match with volunteer/ patient name
EMS is really good at getting patients to hospitals. Don’t usually have to worry about getting them back!
Gave them contact numbers because some volunteers for left at the hospitals last time. This time, they were bored and wanted to come back.

32. Questions?
Contact Information: Michelle Oblinsky, Chesterfield County Fire & EMS Deputy Coordinator, EM Bryan Swanson, Chesterfield County Fire & EMS Battalion Chief