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USNORTHCOM Command Surgeon Joint Regional Medical Plans & Operations. NDMS Patient Movement. Lt Col Tony Voirin USNORTHCOM JRMP – NW Branch. Federal Patient Movement Capabilities. National Ambulance Contract 300 Amb/3000 para-transit seats/life-flight Military Ground Ambulance – Humvee
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USNORTHCOM Command Surgeon Joint Regional Medical Plans & Operations NDMS Patient Movement Lt Col Tony Voirin USNORTHCOM JRMP – NW Branch
Federal Patient Movement Capabilities • National Ambulance Contract • 300 Amb/3000 para-transit seats/life-flight • Military Ground Ambulance – Humvee • Military Helicopters – MEDEVAC/CASEVAC • National Guard and Active Duty • Civilian Contract Airlines • Low acuity/Ambulatory/Chronic patients • NDMS Fixed Wing Patient Evacuation
National Disaster Medical System A public/private sector partnershipDHS DHHS DOD DVA
NDMS Patient Evacuation • DoD has primary responsibility • Movement from point of origin to receiving Federal Coordinating Center (FCC) Patient Reception Area (PRA) • Primarily relies on air • AE = Aeromedical Evacuation • System Components • Movement Requests • Staging • Regulating • Lift • Reception & Distribution • Tracking (HHS JPATs)
System Capability • Patient Evacuation can begin 36 hrs from notice • System can move 500 patients per day (up to 20% critical) • Up to four Airfields • Limited capability for patients • Suggest the following patients be evacuated by other modes • High-acuity burn • NICU and PICU • Psychiatric (if requires medical supervision)
What we need to know • How many patients over what period (approx) • What airfields (coordinated approval) • Rate of delivery to the Airfield • Acuity of Patients (higher Acuity, less patients) • Litter/Amb – Space, number of patients/plane • Critical – CCATT and Equipment • Vented – CCATT, Equipment and O2 • How will Patient Movement Requests flow • Will need to know but make best guess
Other factors • Notice vs No Notice • Hurricane vs Earthquake/CBRNE • Catastrophic or Not (Potential or Just Bad) • 7.8 Earthquake/Nuke or Prestorm/Wildfire • State Request Submitted or On Fence • Mission Assignment Driven Process • Single or Multi-State Event
PT MAN PMR NDMS HOSP AMC (TACC) NDMS HOSP LOCAL HOSP PMR PMR PMR GPMRC Crews Alerted Mission Built PMR Regional Hospital Coordinator PT MAN Mission Specifics (MSN #, Times, Etc.) APOE/AMP Ambulances dispatched to hospitals MASF/AELT CRE/CRT Pts moved to APOE and loaded NDMS DMAT/CCT JPRT/QRC Ambulance Control AE movement to APOD APOD/FCC NDMS HOSP AE System Overview State EOC JPMT (GPMRC) LOCAL HOSP LOCAL HOSP Situational Awareness State/Local IC
Challenges • Patient Movement Requests • Number of patients; over period of time (approximately) • FEMA Mission Assignment (MA) to DoD • Identification and allocation of space on Airfields • Rate of delivery to the Airfield(s) • right patient • right airhead • right order/time • Acuity of patients (higher acuity = less patients) • Litter/Ambulatory – space, number of patients/plane • Critical – CCATT, Equipment, O2 (20% max) • Vented – CCATT, Equipment, O2 • # Non-medical attendants (i.e. pediatric patients - 20% max)