1. CAPT Alvin Lee Concept of Forward Movement of Patients CAPT Alvin Lee, USPHS National Disaster Medical System

2. CAPT Alvin Lee Cascadia Subduction Zone Every 500 years, 200-1000 9.0 plus after shocks Brooks Penninsula to Cape Mendocino –800 mi Tsunami 30 ft. high within minutes –10-12 hr sequence 101 impassible-roads, railways, runways Tall bldgs, bridges susceptible to long waves Landslides isolate coastal communities for weeks

3. CAPT Alvin Lee Major Components of NDMS Medical Response-Teams Definitive Medical Care Patient Evacuation-FCC’s

4. CAPT Alvin Lee Cascadia TTX forecast needs Priorities for the first 72 hours –Lifesaving, communication, utilities –Roads, bridges –Debris removal for responders Priorities for the first 30 days –Temp shelter, food, water, medical care –Repair transportation routes Priorities for 30 days to 6 months –Continue support and infrastructure recovery

5. CAPT Alvin Lee “If you don’t have a plan, that’s one less thing to go wrong”. -S. Benson NYC OEM –

6. CAPT Alvin Lee Search and Rescue Base of Operations (SARBOO) Temporary Medical Staging and Operations Area (TMOSA) New Orleans Hospital Shelter Lilly Pad New Orleans Catastrophic Response Plan

7. CAPT Alvin Lee Search and Rescue Base of Operations (SARBOO) Temporary Medical Staging and Operations Area (TMOSA) New Orleans Hospitals Shelter FULL Lilly Pad Spontaneous TMOSA (Causeway) Spontaneous TMOSA (Superdome) Self Referrals Self Referrals

8. CAPT Alvin Lee Initial Response is Local? 911 Hospital Control National Guard assets EMAC Private sector Who ya gonna call??

9. CAPT Alvin Lee Catastrophic Incident Supplement to the National Response Plan Mission-evac ill or injured to reception facilities Assumptions: limited evac within 96 hours State/local transport to pt collection pt Various pt tracking systems need coord. GPMRC single pt movement mgr No preferred mode

10. CAPT Alvin Lee Catastrophic Incident Supplement to the National Response Plan FEMA establishes Fed mob ctr State and local collect and transport to hubs NDMS Med. Inter-agency coord gp TRANSCOM coord movement from collection points to airfields, etc

11. CAPT Alvin Lee Catastrophic Incident Supplement to the National Response Plan Response limitations Federal capability limited with non-amb pt Contaminated/contagious pts

12. CAPT Alvin Lee DoD Responsibilities Alert GPMRC Activate FCC’s Manage and evacuate to NDMS pt reception areas In coord with DOT transport support agencies, personnel, equipment/supplies Logistical support Provide active duty medical and other missions including aeromedical evac.

13. CAPT Alvin Lee Common thoughts Command and Control Communication Special needs Security

14. CAPT Alvin Lee Who needs to go?

15. CAPT Alvin Lee

16. What do you have to work with?

17. CAPT Alvin Lee

19. Questions ?

20. CAPT Alvin Lee From the Audience Tribal issues? –Colville, Warm Springs Rural Wyoming? East Coast –KY, SC Public Health

21. CAPT Alvin Lee CAPT Alvin Lee, USPHS Emergency Coordinator, Region X National Disaster Medical System 130 228 th St SW Bothell, WA 98021 Alvin.lee@dhs.gov (425) 482-3708