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 partnership
DHS
DHHS
DOD
DVA
Major Components of the
NDMS System
DHHS
VA
Definitive
Care
Medical
Response
DHS
Patient
Evacuation
DoD
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)
Reception Sites
(FCC)
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
AE System Overview
LOCAL
HOSP
State EOC
JPMT (GPMRC)
LOCAL
HOSP
LOCAL
HOSP
P
M
R
Regional
Hospital
Coordinator
PTPMR
MAN
Mission
Built
GPMRC
AMC
(TACC)
Situational
Mission Specifics
(MSN #, Times, Etc.)
PT MAN
Awareness
Ambulance
Control
Crews
Alerted
APOE/AMP
MASF/AELT
State/Local IC CRE/CRT
NDMS
HOSP
NDMS
HOSP
NDMS
HOSP
Pts moved
to APOE
and loaded
APOD/FCC
JPRT/QRC
NDMS DMAT/CCT
AE
movement
to APOD
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)
Questions?