1. 1 Medical Evacuation Jeffrey Hoogheem – DSHS Eric Epley - STRAC

2. Agenda Medical Evacuation Basics Facility Evacuation Evacuation Triage Teams Medical Incident Support Teams (MIST) Medical Transportation Staging Medical Transportation Resources Medical Transportation Triage Process Summary 2

3. MEDICAL EVACUATION BASICS 3

4. 4 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.

5. 5 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.

6. 6 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

7. FACILITY EVACUATION 7

8. Facility Evacuation 8 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.

9. 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 9

10. Medical Evacuation ROG 10

11. EVACUATION TRIAGE TEAMS 11

12. Mission Overview To provide support to coastal jurisdictions with trained personnel support to properly triage evacuees for: – Transportation needs – Shelter Placement 12

13. 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 13

14. Team Configuration One Task Force (TF) Leader – Coordination with DDC – Coordination with Local EMC – Coordination with BCFS in San Antonio Multiple Strike Teams per TF – Strike Teams assigned to Evac Hubs 3-6 Person Team 1 Team Lead

15. MEDICAL INCIDENT SUPPORT TEAM (MIST) 15

16. MEDICAL TRANSPORTATION STAGING 16

17. MEDICAL TRANSPORTATION RESOURCES 17

18. School Bus – Medical 18 School bus Medical supplies Medical personnel

19. Para-Transit Vehicle 19 Medical support provided by the person’s caregiver Capacity varies from 1 person up to several people

20. Coach Bus - Medical 20 Medical crew of 2-4 personnel Basic medical supplies AED Oxygen carried by individual patients

21. AMBUS 21 Medical crew of 2-4 personnel Medical supplies and equipment Specialty ambulance

22. Ambulance 22 2 Crewmembers 2 Patients Medical supplies and equipment Oxygen on board

23. 23 Air Ambulance

24. 24 Small Air Assets

25. Large Air Assets - TxMF 25

26. Large Air Assets - NDMS 26

27. MEDICAL TRANSPORTATION TRIAGE 27

28. Transportation Triage 28 MOBILITY IMPAIRED? (person using wheelchair) IS MEDICAL TRANSPORTATION REQUIRED TO EVACUATE? 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? 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? NEED MEDICAL CARE? PARA-TRANSIT VEHICLE Equipped to transport Wheelchairs. REGULAR BUS Typical “over the road” Bus used to transport people. MEDICAL BUS Equipped with medical staff, equipment and supplies to provide for basic needs. LITTER BUS Equipped with medical staff and basic supplies to transport person needing litter. AMBULANCE YesNo No to ALL Yes No to ALL Yes NoYes No

29. Transportation Triage 29 DSHS Website www.dshs.state.tx.us www.dshs.state.tx.us FNSS Toolkit www.preparingtexas.org www.preparingtexas.org

30. SUMMARY 30

31. 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. 31

32. QUESTIONS? 32 Jeffrey Hoogheem Texas department of State Health Services jeff.hoogheem@dshs.state.tx.us (512)563-4455 jeff.hoogheem@dshs.state.tx.us