Download presentation
Presentation is loading. Please wait.
1
Austere Medicine OK-1 DMAT
Arthur G Wallace Jr DO MPH FACEP
2
Objectives Training Infrastructure Team member fitness
5
OK-1 DMAT OK-1 first fly away exercise with 3 other DMAT’s at Walnut Ridge Arkansas practicing patient triage, treatment and aircraft loading of patients with local Air National Guard C-130 transports.
6
DISASTER MEDICAL ASSISTANCE TEAM Federal Deployments by year
OKLAHOMA – 1 DISASTER MEDICAL ASSISTANCE TEAM Federal Deployments by year 92 Hurricane Andrew Hurricane Charley 95 OKC Murrah bombing Hurricane Ivan 95 Hurricane Marilyn Presidential Inauguration 96 Atlanta Olympics Hurricane Katrina 98 NY ice storms Hurricane Rita 98 Hurricane Georges Hurricane Wilma 99 OKC F5 tornado New Orleans surge 99 Kosovo refugee Ft Dix Hurricane Dean 01 Presidential Inauguration Hurricane Gustav 01 Tropical Storm Allison Hurricane Ike 01 World Trade Center NYC 09 Red River Basin ND 02 Salt Lake City Olympics Bold are full team deployments Others are strike team deployments
7
Disaster Medicine = Austere Medicine ?
8
Training ………
9
Disaster Medicine ≠ Austere Medicine
Intact Infrastructure
11
OK-1 Pensacola Florida Hurricane Ivan 2004
OK-1 DMAT on site Pensacola Florida
12
Disaster Medicine ≠ Austere Medicine
↓ Infrastructure
14
St. Thomas USVI This is OK-1’s site on the campus of St. Francis Hospital on St. Thomas US Virgin Island following Hurricane Marilyn
17
Disaster Medicine ≠ Austere Medicine
Austere Practice ↓ Infrastructure
21
Disaster Medicine ≠ Austere Medicine
Standard Practice – Intact Infrastructure Standard Practice - ↓ Infrastructure Austere Practice ↓ Infrastructure
28
HARRM BMI CAD HTN DM Asthma COPD
29
HARRM condition Hazard Risk Modifiers Decision points CAD CVD CHF
Exertion Time to definitive care Time to definitive care < 30 minutes Angina or NTG use in past year CMO only Diet High Na diet Local resources Hx of hospitaliztion for CHF Stress Several post deployment events Stable bypass / stents Lack of rest PCP has provided parameters
30
HARRM condition Hazard Risk Modifiers Decision points
Overweight BMI Medevac Injury Operational airport < 30 min Obesity BMI 30 – 39.9 Heat Heat illness Documented tolerance BMI 30 – 39.9 waived at level of Reg CMO Morbid BMI >40 Trauma Death BMI > 40 waived by CMO
31
HARRM condition Hazard Risk Modifiers Decision points HTN
Hi Na diet stress exertion Increased risk of CVA MI 30 day med supply Diuretics heart – blocking Rx dehydration Parameter provided by PMP Heat Illness Documented experience Unlimited water supply Air conditioning
32
HARRM condition Hazard Risk Modifiers Decision points DM
Blood sugar control Hyperosmolar dehydration Controlled on diet or orals Use of need for insulin in past year only by CMO Hi carb diet Less heat tolerance infection PMP provides parameters Irregular meals and exertion Increased water demands Lack of refrigeration
33
HARRM condition Hazard Risk Modifiers Decision points Asthma COPD
Dry air in flight Bronchospasm status asthma death Short flight no recent use of rescue MDI Limited valid information about conditions on the ground Smoke, soot, dust, mold, insecticides, chemicals Delayed access to definitive care Definitive care < 30 min Use of or need for daily Tx ony by CMO Lack of C-PAP vent No fire, smoke, soot, dust URI croweded living conditions Limited Medevac
34
OKLAHOMA – 1 DMAT HURRICANE GUSTAV
MONROE, LA 2008
Similar presentations
![Overview: 1)Risk Adjustment. Program establish by Centers for Medicare and Medicaid Services [CMS] GOAL: to allocate resources to those patients who most.](/13/4039535/big_thumb.jpg "Overview: 1)Risk Adjustment. Program establish by Centers for Medicare and Medicaid Services [CMS] GOAL: to allocate resources to those patients who most.>")
