Emory leads two-day radiation response exercise at Emory University Hospital and Dobbins Air Reserve Base

At Dobbins Air Reserve Base (DARB) in Marietta on Saturday morning, Sept. 17, Emory nursing and public health students walked onto the airfield and into the cavernous body of a C-130 Hercules aircraft, where they were cheerfully strapped onto stretchers piled five-high. Moments after the two back flaps of the airplane were folded up behind them, they heard the call: “the exercise has begun.”

Georgia State Defense Force and Cobb Medical Reserve Corps personnel walked in formation onto the airplane, secured the stretchers, and briskly carried the volunteers, who were simulating patients with radiation injuries, into a bustling triage area established in a huge aircraft hangar nearby.

Emory and Atlanta VA Medical Center physicians and nurses performed simulated medical evaluations, and EMTs from Atlanta Fire and Rescue and Gwinnett County Fire and Emergency Services placed the most severely injured “patients” onto rolling stretchers, wheeled them into two mobile ambulance buses, and placed them on stretchers stacked in bunk-bed fashion. Cobb/Douglas Public Health personnel assisted the VA with command and control functions.

This mock scenario was part of a drill named “Operation Gateway,” which included more than 250 people representing over 15 health care and government agencies simulating the local response to a mock radiation incident with mass casualties. The drill began in reverse at Emory University Hospital the day before, as medical personnel and EMTs simulated unloading the injured patients from the mobile ambulance buses.

Sam Shartar, senior administrator of Emory’s Office of Critical Event Preparedness and Response (CEPAR), directed the full-scale exercise. “This exercise is important because we are able to test the processes required to receive large numbers of casualties. Improvised nuclear detonations are low probability, high consequence events. Having said this, these same processes will be utilized for response to hurricanes, floods or earthquakes, which are a higher probability event,” says Shartar.

The drill was conducted by the Emory Radiation Injury Treatment Network (RITN), which is part of the national response plan for  a mass casualty radiation incident resulting in bone marrow-toxic injuries. Emory University Hospital (EUH) is a RITN center. If a nuclear device were detonated somewhere in the United States, the National Disaster Medical System (NDMS) would be activated. Military aircraft would transport persons injured by ionizing radiation to DARB. The patients would then be transported to Emory University Hospital and Northside Hospital for treatment. Radiation injuries would include bone marrow damage, with some patients potentially requiring bone marrow transplants.

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Full scale emergency exercise conducted showcases local history

The National Disaster Medical System (NDMS) conducted a full-scale exercise involving all Centr


al Region Hospitals that tested the transfer, wellness check, and loading of patients from four area hospitals, utilizing the Virginia Air National Guard and the Chesterfield County Executive Airport. Volu

The scenario for the exercise is that an earthquake has struck Richmond, within the Central Virginia Seismic Zone. The earthquake has killed and injured thousands of individuals. Local, regional, and state resources have been depleted. In response to the disaster, the president has declared a federal disaster, resulting in the activation of the NDMS. The Federal Coordinating Center and Chesterfield County Fire & EMS have been activated to send patients out to Feder See more…

Homeland Security Today: Getting Ahead of the Impact: Emergency Preparedness Key to Biodefense

The more prepared we are, the faster and better we will respond. Of course, budgets are finite and we cannot possibly prepare for every contingency. Prudent emergency managers, therefore, often first consider the threat and use that assessment to drive allocation of preparedness dollars. Many of them have recognized that the biological threat from nature and terrorists alike is real and present. The key to biodefense and management of biological emergencies therefore, is getting ahead of the impact of these inevitable incidents. The public and private sectors have taken many important steps to prepare, but we remain far from capable of responding optimally to events with the potential for far-reaching consequences.

The Blue Ribbon Study Panel on Biodefense recently released the report, A National Blueprint for Biodefense: Leadership and Major Reform Needed to Optimize Efforts. This bipartisan report contains 33 recommendations, each with action items designed to aid implementation. Six of the recommendations address emergency preparedness in particular, and, if acted upon, will enable the Nation to get ahead of the impact of biological incidents.

Allow emergency service providers to protect themselves

Intelligence will only get us so far in addressing the biological threat, so we must take other measures to mitigate the impacts of an outbreak. Vaccination is one of our best defenses, preventing illness if intelligence fails us or if a serious threat emerges from nature. For instance, the events of 2001 demonstrated the reality of the anthrax threat, yet each month, the federal government discards hundreds of thousands of short-dated, excess or expired anthrax vaccine doses.

After years of consideration, the Department of Homeland Security (DHS) should pilot a program to offer these vaccines before they expire to emergency service providers that want them. If successful, DHS should subsequently develop a more comprehensive voluntary vaccination program addressing additional biological threats faced by emergency service providers. Pre-deployment of medkits and the establishment of personal protective equipment guidelines and requirements would have significant downstream benefits, and the Department of Health and Human Services (HHS) carry these out.

Forward deploy Strategic National Stockpile assets

The federal government has resisted putting medkits in the hands of emergency service providers, fearing loss and misuse of their contents – despite pilot programs demonstrating the opposite. Similarly, requests for forward deployment of Strategic National Stockpile (SNS) assets have met with resistance. The Centers for Disease Control and Prevention (CDC) should forward deploy elements of the SNS to at-risk jurisdictions that have demonstrated they can manage the contents of their allotment responsibly. New York City, for instance, has shown it can stand up points of distribution faster than federal SNS assets can arrive. This wasted time unnecessarily puts lives at risk.

Institute a process to develop infection control guidelines

We can also pre-establish the process for developing infection control guidelines. There is no reason to wait for the next biological incident before emplacing a process that ensures federal agencies such as CDC and Occupational and Safety and Health Administration work together; solicit and incorporate input from non-federal public and private sector experts and practitioners; and communicate new or modified guidelines clearly. While it is not possible to predict exactly which infectious disease will create the next biological event, it is possible to establish in advance a process to develop effective infectious control guidelines when needed.

Create a stratified hospital system

Successful hospitals provide expedient life-saving treatment while executing sound business plans. Some choose to offer specialized care (e.g., pediatric, trauma), which in turn allows them to be reimbursed for a greater variety of increasingly expensive services. A national system of stratified hospitals offering tiered levels of care allows patients to get the treatment they need relatively nearby. Making treatment of highly pathogenic infectious diseases a specialty reimbursable by the Centers of Medicare and Medicaid Services if a hospital is accredited to do so would build on our existing hospital system and leverage an exponentially larger and more reliable source of funding than the much smaller Hospital Preparedness Program.

Strengthen the public health community

Beyond the delivery of healthcare to individuals, surveillance, laboratory testing, bioinformatics and epidemiology are also critical to effective emergency preparedness and maintenance of public health. The public health community depends on federal funding to execute these activities. To ensure the public health community can alert emergency service providers and healthcare deliverers to take action and best direct their limited resources, Congress must increase funding for CDC’s Public Health Emergency Preparedness (PHEP) cooperative agreements.

The Blueprint for Biodefense contains additional recommendations and action items to improve our national ability to prevent, deter, prepare for, detect, respond to, attribute, recover from and mitigate biological incidents. While all of these areas are important, emergency preparedness is key to effective biodefense.

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Military, civilians team up for National Disaster Medical System exercise MAJ Philip Durando, TAMC, PAOAugust 27, 2015

JOINT BASE PEARL HARBOR-HICKAM — Members of the Healthcare Association of Hawaii (HAH) conducted a National Disaster Medical System (NDMS) tabletop exercise on Aug. 7.

Forty participants representing 25 military and civilian medical centers and health care organizations gathered for the tabletop exercise in order to test the readiness of the organizations to respond to emergencies.

The participants worked together to coordinate the transportation and medical care for victims of disasters and emergencies that exceed the capacity of the locality where the event occurred.

The goals of the NDMS are to assist state and local authorities in dealing with medical and health effects of peacetime disasters and to provide support to military and Veterans Affairs medical systems in caring for military casualties returning to the U.S. for hospitalization.

“The objectives of this tabletop exercise were to provide an overview of the National Disaster Medical System to the participating hospitals, medical centers and supporting agencies in Hawaii,” stated Col. James Anderson, administrative chief for the Hawaii Federal Coordinating Center (FCC).

“The exercise outlined the processes associated with the activation of the FCC, in order to coordinate and support patient movement throughout the region.” Toby Clairmont, HAH Emergency Services director, provided an overview of the key components and responsibilities of the civilian medical centers during the activation of the NDMS.

“One of the key responsibilities of the HAH is to provide accurate and timely reporting of bed availability at participating medical centers,” said Clairmont.

“The HAH uses a Web-based NDMS bed reporting module, giving emergency managers real time information on the capacity of local hospitals in order to make decisions on where to send inbound patients.” This year’s tabletop exercise is in preparation for the 2016 RIMPAC Multinational Maritime Exercise, where the NDMS and Hawaii FCC will be tested by coordinating and executing the movement of over 250 live patients using over 30 rotary wing aircraft, between military and civilian medical centers in the Hawaiian Islands.

As a result of the tabletop exercise, the Hawaii FCC and HAH members were able to validate concepts, establish policies and procedures in the NDMS, as well as test and evaluate the alert and activation procedures between the Hawaii FCC and the various participating federal, state, regional, county and city health care partners.

“This tabletop exercise helped reconfirm our strong partnerships within the Hawaii NDMS communities, as well as provided an opportunity to test and evaluate the current NDMS operations plans,” said Anderson.

“It is imperative that the military, civilian and federal health care organizations all speak as one voice during an emergency,” said Thomas Bookman, emergency manager for Regional Health Command-Pacific (Provisional) and Hawaii FCC coordinator. “The Healthcare Association of Hawaii helps us tie it all together in the Pacific Region.” See more…


National Disaster Medical System Sets Up Mobile Hospital In Brevard National Disaster Medical System has been activated in Brevard County due to Hurricane Matthew.

On Monday, a team of 46 doctors, nurses and paramedics began seeing patients at a tent hospital at Holmes Regional Medical Center.

“Our goal is to take some of the patients and treat them that normally would have probably been sitting in the emergency department for hours and hours until they actually got seen because of the patients the ED handles on an every day basis,” said Knox Walk, the team commander for the National Disaster Medical System crew at Holmes Regional Medical Center.

Matthew Gerrell, a spokesman for Health First, said the evacuated Cape Canaveral Hospital has to be cleaned because the air conditioning was turned off during the hurricane.

“We are completing what’s called a thermal clean of the building. Every single part of the building is going to be cleaned so we can return to standard operations. We are on track to have that cleaning done and be open to the public again by Wednesday of this week.” National Disaster Medical System Sets Up Mobile Hospital In Brevard – Health – Health WMFE – Local News – Storms – 90.7 WMFE