Medical Evacuation
Jeffrey Hoogheem – DSHS
Eric Epley - STRAC
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Agenda
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Medical Evacuation Basics
Facility Evacuation
Evacuation Triage Teams
Medical Incident Support Teams (MIST)
Medical Transportation Staging
Medical Transportation Resources
Medical Transportation Triage Process
Summary
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MEDICAL EVACUATION BASICS
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Medical Evacuation
• In the past (prior to
2010) medical evacuees
were evacuated to
multiple locations
across the state of
Texas.
• We now plan to
consolidate Medical
Sheltering in San
Antonio.
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Population Definitions
• General evacuees:
Ability to function independently each day.
Evacuee may or may not have disabilities,
functional or access needs including minor
medical care
• Medical evacuees:
Require skilled medical care and are people
that may or may not have disabilities,
functional or access needs.
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Medical Evacuation Basics
• Identification of medical evacuee is critical
at embarkation hub
– Reduce time on road
– Medical evacuees arrive at the correct
destination – San Antonio
– Reduces evacuee being moved twice
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FACILITY EVACUATION
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Facility Evacuation
1. Evacuating hospitals requesting evacuation
assistance will complete the Patient
Movement Request form and forward to
their respective EOC.
2. EOC Staff (Medical Branch or MOC) will
review forms and determine if evacuation
mission can be carried out utilizing local
resources.
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Facility Evacuation (cont)
3. If local resources are not adequate, the EOC
must request additional resources through
the normal resource request process
through the DDC to the State Medical
Operations Center (SMOC)
4. The SMOC will request appropriate
resources (air or ground) and coordinate
provision of resources back through the DDC
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Medical Evacuation ROG
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EVACUATION TRIAGE TEAMS
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Mission Overview
• To provide support to coastal jurisdictions
with trained personnel support to properly
triage evacuees for:
– Transportation needs
– Shelter Placement
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Goal
• To integrate with local jurisdiction triage
personnel and assist with triage
• To determine if an evacuee needs:
– Medical Shelter
– General Population Shelter
• To determine if an evacuee needs:
– Accessible Transportation
– Medical Transportation
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Team Configuration
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One Task Force (TF) Leader
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Multiple Strike Teams per TF
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Coordination with DDC
Coordination with Local EMC
Coordination with BCFS in San Antonio
Strike Teams assigned to
Evac Hubs
3-6 Person Team
1 Team Lead
MEDICAL INCIDENT SUPPORT TEAM
(MIST)
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MEDICAL TRANSPORTATION STAGING
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MEDICAL TRANSPORTATION
RESOURCES
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School Bus – Medical
• School bus
• Medical supplies
• Medical personnel
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Para-Transit Vehicle
• Medical support
provided by the
person’s caregiver
• Capacity varies from 1
person up to several
people
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Coach Bus - Medical
• Medical crew of 2-4
personnel
• Basic medical supplies
• AED
• Oxygen carried by
individual patients
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AMBUS
• Medical crew of 2-4
personnel
• Medical supplies and
equipment
• Specialty ambulance
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Ambulance
• 2 Crewmembers
• 2 Patients
• Medical supplies and
equipment
• Oxygen on board
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Air Ambulance
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Small Air Assets
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Large Air Assets - TxMF
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Large Air Assets - NDMS
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MEDICAL TRANSPORTATION TRIAGE
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Transportation Triage
MOBILITY IMPAIRED?
Yes
(person using wheelchair)
NEED MEDICAL
CARE?
No
No
Yes
No to ALL
• Daily dependence upon caregivers but traveling alone?
• Require medical support or monitoring?
• Have extensive needs other than a wheelchair?
• Recent rapid onset of fever or illness?
• Recent hospitalization or surgery?
• Mental Health issues
CAN PERSON
TRAVEL SEATED?
Equipped to transport
Wheelchairs.
REGULAR BUS
IS MEDICAL TRANSPORTATION
REQUIRED TO EVACUATE?
Yes
PARA-TRANSIT VEHICLE
Typical “over the road” Bus
used to transport people.
MEDICAL BUS
Equipped with medical staff,
equipment and supplies to
provide for basic needs.
Yes
No
Does person require medical oxygen at greater than
4 liters per minute?
Does person require continuous cardiac monitoring?
Does person require continuous IV medications requiring
Monitoring? (“to keep open” IV’s, peg tubes or vitamin drips
Do not fit this category) .
Does person have orthopaedic injuries requiring appliances
Or other acute medical condition(s) that prohibit patient from
Traveling on alternative method of transport?
LITTER BUS
No to ALL
Equipped with medical staff
and basic supplies to transport
person needing litter.
Yes
AMBULANCE
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Transportation Triage
• DSHS Website
www.dshs.state.tx.us
• FNSS Toolkit
www.preparingtexas.org
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SUMMARY
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Summary
• Medical evacuees to San Antonio
• Facility evacuation assistance starts at the
EOC
• Evacuation Triage Teams to assist with
identifying Medical Evacuees
• Transportation Triage Tool on DSHS
Website or Preparingtexas.org.
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QUESTIONS?
Jeffrey Hoogheem
Texas department of State Health Services
jeff.hoogheem@dshs.state.tx.us
(512)563-4455
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