Medical Care - Public Health Settings

a. Hospital surge capacity, namely how many rapidly unexpected or unannounced patients a hospital can evaluate and treat, is a critical consideration in medical care of mass casualties. This will vary from day-to-day and hospital to hospital depending on bed availability and staffing patterns or availability.

Community healthcare facilities may be able to fulfill the expanded patients and their needs, however when those resources are overwhelmed. Plans should include when for moving or relocating patients to other facilities must be considered.

The National Disaster Medical System (NDMS) includes the coordination of this patient transferring through formal agreements and the National Response Plan. (NRP NDMS includes a contractual agreement which has been codified through national legislation. It supports the ESF# 8 (Health and Medical Services) annex of the National Response Plan, but can also be used without activation of the NRP. A Disaster Medical Assistance Teams (DMAT) may provide additional medical support and assist in large scale or prolonged responses and recovery efforts as were seen with Hurricanes Rita and Katrina. These federally sponsored teams require the allowance of time for deployment of equipment and personnel to travel to the area requiring disaster relief.

Notification of a terrorist event should progress through the local, state then federal emergency management system chains of communication through NIMS and ICS appropriate command staff. Response activities by these various levels are coordinated by the National Response Plan.

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