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CAPT Alvin Lee
Concept of Forward Movement of Patients
CAPT Alvin Lee, USPHS
National Disaster Medical System
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
CAPT Alvin Lee
Major Components of NDMS
• Medical Response-Teams
• Definitive Medical Care
• Patient Evacuation-FCC’s
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
CAPT Alvin Lee
“If you don’t have a plan, that’s one less thing to go wrong”.
-S. Benson NYC OEM
–
CAPT Alvin Lee
Search and Rescue
Base of Operations(SARBOO)
TemporaryMedical Staging and
Operations Area(TMOSA)
New OrleansHospital
Shelter
Lilly Pad
Lilly Pad
Lilly Pad
Lilly Pad
Lilly Pad
New OrleansCatastrophic Response Plan
CAPT Alvin Lee
Search and Rescue
Base of Operations(SARBOO)
TemporaryMedical Staging and
Operations Area(TMOSA)
New OrleansHospitals
Shelter
FULL
Lilly Pad
Lilly Pad
Lilly Pad
Lilly Pad
Lilly Pad
SpontaneousTMOSA
(Causeway)
SpontaneousTMOSA
(Superdome)
Self Referrals
Self Referrals
CAPT Alvin Lee
Initial Response is Local?
• 911
• Hospital Control
• National Guard assets
• EMAC
• Private sector
• Who ya gonna call??
CAPT Alvin Lee
CatastrophicIncident 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
CAPT Alvin Lee
Catastrophic Incident Supplementto 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
CAPT Alvin Lee
Catastrophic Incident Supplementto the National Response Plan
Response limitations
• Federal capability limited with non-amb pt
• Contaminated/contagious pts
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.
CAPT Alvin Lee
Common thoughts
• Command and Control
• Communication
• Special needs
• Security
CAPT Alvin Lee
Who needs to go?
CAPT Alvin Lee
CAPT Alvin Lee
What do you have to work with?
CAPT Alvin Lee
CAPT Alvin Lee
CAPT Alvin Lee
Questions ?Questions ?
CAPT Alvin Lee
From the Audience
• Tribal issues?– Colville, Warm Springs
• Rural Wyoming?
• East Coast– KY, SC
• Public Health
CAPT Alvin Lee
CAPT Alvin Lee, USPHS
Emergency Coordinator, Region X
National Disaster Medical System
130 228th St SW
Bothell, WA 98021
(425) 482-3708
