National Disaster Medical System

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National Disaster Medical System logo.

The National Disaster Medical System (NDMS) is a section of the United States Department of Health and Human Services (HHS) responsible for managing Federal government's medical response to major emergencies and disasters.

The overall purpose of the NDMS is to supplement an integrated National medical response capability for assisting State and local authorities in dealing with the medical impacts of major peacetime disasters and to provide support to the military and the Department of Veterans Affairs medical systems in caring for casualties evacuated back to the U.S. from overseas armed conventional conflicts.

NDMS’s federal partners include the Federal Emergency Management Agency, Department of Defense (DOD), and the Department of Veterans Affairs (VA).

NDMS also interfaces with state and local Departments of Health, as well as private hospitals.

Organization

NDMS has three major components:

1. Emergency medical response by civilian medical teams, equipment, and supplies to a disaster area when local medical resources are overwhelmed
2. Movement of ill and injured patients from a disaster area to areas unaffected by the disaster
3. Definitive care of patients at hospitals in areas unaffected by the disaster.

Over 8,000 NDMS civilian volunteer medical personnel are organized into a number of types of medical teams, designed to accomplish the emergency medical response mission.

NDMS Teams

The NDMS is made up of several smaller teams that each focus on a particular area of disaster relief.

• Disaster Medical Assistance Team (DMAT) - provides medical care during a disaster or other incident.
• National Medical Response Team (NMRT) - provides mass decontamination and medical care to victims of a release of Weapons of Mass Destruction, or a large scale release of Hazardous Material.
• Disaster Mortuary Operational Response Team (DMORT) - provide victim identification and mortuary services during a disaster or other incident.
• National Veterinary Response Team (NVRT) - provides assistance in assessing the need for veterinary services following major disasters or emergencies
• Federal Coordinating Centers (FCCs) - recruit hospitals and maintain local non-Federal hospital participation in the NDMS and coordinate exercise development and emergency plans
• National Pharmacy Response Team (NPRT) - assists in chemoprophylaxis or vaccination of large numbers of citizens in response to an emergency involving a disease outbreak
• International Medical Surgical Response Team (IMSuRT) - widely recognized as a specialized team, trained and equipped to establish a fully capable field surgical facility anywhere in the world.
• National Nurse Response Team (NNRT) - A specialty DMAT designed for a scenario requiring hundreds of nurses to assist in chemoprophylaxis, mass vaccination programs, or situations that overwhelm the nation’s supply of nurses.

• Incident Response Coordination Team (IRCT) - Provides the field management component of the Federal public health and medical response. The IRCT provides liaisons in the field to coordinate with jurisdictional, Tribal, or State incident management and provides the field management and coordination for deployed HHS and other ESF #8 assets to integrate those assets with the State and local response.

Over 1,800 civilian hospitals in the U.S. are members of NDMS. Their role is to provide approximately 100,000 treatment beds to support NDMS operations in an emergency. When a civilian or military crisis requires the activation of the NDMS system, participating hospitals communicate their available bed space to a central control point. Patients can be distributed to a number of hospitals without overwhelming any one facility with casualties.

Operations

Under the NDMS, movement (evacuation) of patients from a disaster area is coordinated by the FCCs in each of the 10 FEMA regions. The actual transport is conducted by the Department of Defense. Patients arriving in a region are then dispersed to a local NDMS participating hospital.

In the aftermath of Hurricane Katrina in the fall of 2005, the NDMS system activated almost all of their civilian medical teams to assist victims in Texas, Louisiana, and Mississippi; helped evacuate hundreds of medical patients from the affected areas; and augmented medical staffing levels at hospitals impacted by the evacuations.

Parent Agencies

NDMS was originally under the U.S. Public Health Service (USPHS) within The Department of Health and Human Services(DHHS). In 2003, as a direct result of the September 11 attacks in 2001 the newly formed Department of Homeland Security (DHS), requested, and was granted convening authority over NDMS which was then placed under the direction of the Federal Emergency Management Agency (FEMA).

After Hurricane Katrina, amidst allegations of mismanagement (etc.), NDMS was removed from FEMA and sent back to DHHS, as legislated by an Act of Congress entitled. "the Pandemic and All Hazards Preparedness Act (PAHPA)", (Public Law 109-417), effective January 1, 2007.

This positioned NDMS, organizationally, within the Assistant Secretary for Preparedness and Response (ASPR) Office of Preparedness and Emergency Operations (OPEO).

The OPEO is responsible for developing operational plans, analytical products, and training exercises to ensure the preparedness of the Office, the Department, the Federal Government and the public to respond to domestic and international public health and medical threats and emergencies. OPEO is also responsible for ensuring that ASPR has the systems, logistical support, and procedures necessary to coordinate the Department's operational response to acts of terrorism and other public health and medical threats and emergencies. OPEO maintains a regional planning and response coordination capability, and has operational responsibility for HHS functions related to the National Disaster Medical Systems (NDMS).

OPEO acts as the primary operational liaison to emergency response entities within HHS:

• the U.S. Food and Drug Administration,
• HRSA,
• SAMHSA,
• Centers for Disease Control and Prevention,

OPEO also acts as the primary operational liaison to emergency response entities outside HHS:

• HDS,
• United States Department of Veterans Affairs,
• United States Department of Defense),
• and the public..

Other sources

• Knouss RF, "National Disaster Medical System", Public Health Rep, 2001;116(suppl 2):49–52.

External links

• National Medical Response Team - Central
• OH-1 Disaster Medical Assistance Team - Toledo, Ohio
• RI-1 Disaster Medical Assistance Team - Rhode Island
• CA-11 Disaster Medical Assistance Team - Sacramento, California