Greetings from Rhode Island!

1. Greetings from Rhode Island! 1

2. Rhode Island Disaster Initiative (RIDI) Program Overview

3. Grateful Thanks Acknowledgment: "This material is based upon the work supported by the Office of Naval Research." "The Rhode Island Disaster Initiative (RIDI) is work performed under Chemical-Biological Information Analysis Center (CBIAC) Contract number SP0700-00-D-3180, Task Number 128, Delivery Order # 0122 sponsored by the U.S. Office of Naval Research (ONR)." Disclaimer: "Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the Office of Naval Research"

4. RIDI Outline • What is RIDI? • Why RIDI? • Hypotheses • Mission • Background • Collaborators/Team Members • Funding Source • Major Tasks and Deliverables • Phase I • Phase II • Phase III • Summary • Website/Contacts

5. What is RIDI?

6. Rhode Island Disaster Initiative • A research project with three phases • Phase I: Background and Planning • Phase II: Study • Phase III: Recommendations • Designed to • identify shortfalls in current disaster response, • test proposed solutions, and • demonstrate these proven best practices

7. Why Study Disaster Response?

8. Traditional Civilian Disaster Plans Differ from daily EMS practice in many ways • Are based on a single event that creates only trauma victims. • Victims are easy to find, not trapped, and wait for care. • Are a coordinated response that is well equipped, and follows the plan. • Transport the patients in priority order to hospitals with a capacity for definitive care.

9. Challenges Communications Logistics Documentation Care delays Patient tracking Perimeter Control Equipment and Clothing Funding More?

10. RIDI Background • Recurring challenges in medical disaster response • UEMF brainstorming session 1999 • Greg Jay • Tom Lawrence • Selim Suner • Francis Sullivan • Ken Williams • White paper in 1999 • Phase I 2001-2002 • 3 Consortia • Vulnerability Risk Assessment (VRA) • Expert Panels • Technology Review/Acquisitions • Annotated Bibliography • Phase II 2002-2003 • Drills • Focused • Full-Scale • Best Practices • Disaster Control Panels (DCP) • IT Support • Phase III 2003-2006 • Dissemination and Demonstration Project

11. What Happened? • September 4 we were starting slowly on a 3-4 year research project • September 11 everyone wanted our results that day.

12. RIDI Hypotheses • Familiar, flexible and scalable plans work. • Structure and familiarity breed teamwork. • It’s over before “help” arrives. • If soldiers fight like they train, EMTs work like they work – daily job is “training” for the disaster, so daily practice must allow for surge and flexibility in a disaster.

13. RIDI’s Mission To measurably improve emergency medical responseto disasters through research, training and technology. The primary objectives of the RIDI project are to: • Assess the current level of preparedness • Identify gaps and opportunities for improvement • Develop and testing improved readiness, technology, and training solutions • Design and acquiring a demonstration vehicle • Identify and implementing best practices • Make improvements available for use throughout Rhode Island and in other states

14. RIDI Support, Collaborators, and Partners • Lifespan/RIH/HCH • Battelle Memorial Institute • CBIAC TAT 128 • Office of Naval Research • Department of Health & Human Services (DHHS)

15. RIDI Team Members RIDI is administered and operated by members of the Rhode Island medical community with affiliations to Rhode Island Hospital and the University Emergency Medicine Foundation. Principal Investigators Kenneth A. Williams, MD, FACEP Principal Investigator, RIDI University Emergency Medicine Foundation Brown University / Rhode Island Hospital Past President, AMPA Associate Professor, Brown University Associate Professor of Emergency Medicine, Brown University Frances Sullivan, MD Principal Investigator, RIDI Active duty with USPHS Attending physician, Brown University / Rhode Island Hospital Member Rhode Island Disaster Medical Assistance Team Participant in the World Trade Center deployment

16. RIDI Team Members Selim Suner, MD, MS, FACEP Principal Investigator, RIDI Brown Medical School, Biomedical Engineering Attending physician - Rhode Island Hospital Commander, Rhode Island Disaster Medical Assistance Team (DMAT) Office of Emergency Preparedness Chair, Emergency Preparedness Committee, Rhode Island Hospital WMD Leader/Instructor (locally and nationally) Charlie Seekell, MS, Marine Affairs University of Rhode Island, Masters degree in Marine Affairs Retired Coast Guard officer Radiological Emergency Response Plan Commission, Plymouth, Mass. Employed by Battelle Memorial Institute Additional Investigators Greg Jay, MD, PhD Bert Wollard, MD

17. Research Staff The project research efforts administration are supported by a number of staff affiliated with the Brown University Medical School and UEMF RIDI Research Assistants Whit Hill, BA, NREMT-P, CCEMT-P Flor Trespalacios Phase I RIDI Research Interns Zachary Litvack Jordan Bonamo

18. Funding Source • Congressional Appropriation • Supported by entire RI delegation • Phase I: $882,000 • Phase II: $1,411,200 • Phase III: $1,137,000

19. Phase I: Major Tasks and Deliverables • Vulnerability and Risk Assessment • Website development/fielding • Consolidated Literature Review and Annotated Bibliography • Technology review/acquisition • Expert Panels • Training Analysis/readiness Outcome Measure • Integrated Focused Study and Full-Scale Exercise Design Phase I Detail

20. Phase I: Summary • Identification of limited equipment availability (PPE and WMD) • Inability to promptly detect widespread events; i.e., epidemics or WMD attacks • Realization of a shortage of qualified emergency response staff and surge capacity • Lack of training for all first responders • Inadequate communications systems • Identification of a need for improved plans and/or additional training

21. Phase II: Major Tasks and Deliverables • Focused studies to test specific processes/technologies and finalize study design • Full-scale exercises to test system-wide applications • Documentation of best practices • Information technology support • Web site hosting • Collaborative services (using Hyperwave) • Medical Disaster Control Panel (using EMAdvantage) Phase II Detail

22. Phase II: Summary • Phase II tested • EMT ability to perform core tasks in PPE • A disconnect • EMT ability to search, locate, and possibly track victims • A challenge • Various paradigms for approach and treatment that facilitate rapid deployment and use of resources • Fight like you train?

23. Phase III: Major Tasks and Deliverables • Develop the specifications for and acquire a RIDI demonstration vehicle to support training and best practice dissemination • Disseminate RIDI best practices • Enhance the RIDI website Phase III Detail

24. Phase III: Summary • Best practices will be disseminated through lectures, training, and a conference. • A demonstration project and vehicle will bring RIDI best practices to the scene of disasters, drills, and multiple-casualty incidents in Rhode Island. • First responders, EMS agencies, and others will be applying best practices identified in Phase II and providing field evaluation to complete the project. • Efforts are under way to find sustaining funds to continue research and training.

25. Rhode Island Disaster InitiativeSummary • A research project with three phases The primary objectives of the RIDI project are to: • Identify vulnerabilities facing emergency medical responders in Rhode Island (and across the United States) • Design measurable means of assessing care for victims of real and simulated disasters • Apply resources to identify best practices and insert novel technologies • Validate the identified best practices through testing • Assess and communicate the validity of these results through a statewide demonstration project • Disaster response comes in ambulances, not trailers.

26. RIDI Websitewww.RIDIproject.org • Vulnerability assessment executive summary • Annotated bibliography • Summaries of Phases II and III

27. Contacts Website: • www.RIDIproject.org Email: • kwilliams@lifespan.org • contact@ridiproject.org

28. Questions?