New York NY-1 New York City Fire and Police Depts.
Ohio OH-1 Miami Valley, Ohio
Pennsylvania PA-1 State of Pennsylvania
Tennessee TN-1 Memphis/Shelby County E.M.A.
Texas TX-1 State of Texas
Utah UT-1 State of Utah
Virginia VA-1 Fairfax County Fire Dept.
VA-2 Virginia Beach Fire Dept.
Washington WA-1 Pierce/King Counties
VOICE COMMUNICATIONS PROCEDURES
A - alpha (AL fah) N - november (no VEM ber)
B - bravo (BRAH voh) O - oscar (OSS car)
C - charlie (CHAR lee) P - papa (pah PAH)
D - delta (DELL tah) Q - quebec (keh BECK)
E - echo (ECK oh) R - romeo (ROW me oh)
F - foxtrot (FOKS trot) S - sierra (SEE air rah)
G - golf (GOLF) T - tango (TANG go)
H - hotel (HOH tell) U - uniform (YOU nee form)
I - india (IN dee ah) V - victor (VIK tah)
J - juliet (JEW lee ett) W - whiskey (WISS key)
K - kilo (KEY low) X - x-ray (ECKS ray)
L - lima (LEE mah) Y - yankee (YANG key)
M - mike (MIKE) Z - zulu (ZOO loo)
TREATMENT PRIORITIES The treatment priorities for the TF Medical Team are:
First TF personnel, TF search canine and support staff
Second victims directly encountered by the TF
Third other injured as practical.
The TF Medical Team, being medically sophisticated, may be handing off a potentially unstable patient to a less sophisticated, interim level of medical provider for transport to definitive care. This is considered to be standard practice under the circumstances of disaster operations.
Upon activation, the Medical Team of each TF operates under the authority of the NDMS. Prior to any deployment a Task Force Medical Team member must have an Application for Federal Employment (OF-612), Employment Eligibility Verification (I-9), NDMS Member Information form, Declaration of Federal Employment (OF-306), Appointment Affidavit (SF-61) and NDMS Volunteer Agreement on file with USPHS. These forms are available at: www.opm.gov/forms/index.htm.
Upon activation, the Appointment Affidavits (SF-61), Declaration of Federal Employment (OF-306) and NDMS Volunteer Agreement can be sent via Federal Express to NDMS. A roster of Medical Team personnel being deployed must be faxed to NDMS at: 800-450-3595 or 800-USA-KWIK (800-872-5945).
The TF Medical Team Manager and IST Medical Unit Leader will need to consider the following medical infrastructure factors from point of departure staging, travel, point of arrival staging, base of operations activity, field operations, and through demobilization:
Local in-patient medical facilities
Location, points of contact, staffing, contact numbers, hours of operations, capabilities, biohazardous waste disposal resource, and transportation mode.
Capabilities include: clinic or basic or comprehensive emergency department, radiology (plain films and computed tomography), pharmacy, trauma (including replantation), burn, pediatrics and percutaneous coronary interventions.
Structure (fire, private, third service), access, capabilities, medical oversight, closest first response units, closest ALS units, HAZMAT, air medical evacuations (public or private), air rescue, communications, familiarity with US&R BoO, contact information and points of contact.
Dental clinics and dentists: location, hours of operation.
Veterinary medical facilities
Veterinary hospitals with emergency services: location, points of contact, contact information, hours of operations
Veterinarians: access for telephone consultations, office locations, availability, familiarity with working dogs, contact information, hours of operation.
Medical/pharmaceutical resupply (other than DHS/FEMA and NDMS)
Local pharmacies, locations, hours of operations, fax copy of US&R physicians medical license and DEA certificate, methods of payment.
US&R IST contact information
Medical examiner/coroner contact information
Poison Information Center contact information
ESF-8 and ESF-9 contact information
Biohazardous waste disposal options
Forms ICS 215 and US&R 15 are used to track and organize this information.
Patient Transfer Considerations
Medical Team members and essential non-replaceable equipment should not be transported away from the work site for continued patient care. The only exceptions may be for the transport of injured or ill TF personnel or seriously ill victims who need to be accompanied by a TF Medical Team member. This may occur at the Medical Team Manager's discretion if it does not compromise the capability to care for TF members and additional victims.
The NDMS Patient Care Report creates written documentation of each patient's assessment and any medical intervention performed by the TF Medical Team.
These forms will be used to record all care, including that provided to TF personnel, and will:
Provide documentation of the transfer of a patient from the TF's control to other medical resources; and
Assist tracking follow-up care for patient outcome studies.
Prior to transport, the NDMS Patient Care Report will be completed documenting the complete patient care performed by the TF Medical Team (per instructions) and will be attached to the victim. A copy of each completed Patient Care Report must be maintained by the Medical Team.
For minor medical care given to Task Force members, documentation of injuries or illnesses is made in the Task Force Injury/Illness Log. This log is submitted to the IST Medical Unit Leader at the end of each operational period and is used to track trends in injuries or illnesses and design appropriate interventions.
Controlled Drug Accountability
The Controlled Drugs Accountability Form will be used for tracking and documenting the disposition of controlled-substance medications. The Medical Team Managers are responsible for maintaining all medical-related forms throughout the course of the mission.
Medical Care For Injured Task Force Members
Any TF member requiring medical attention shall have documentation completed, including but not limited to:
The Patient Care Report;
Their sponsoring agency's internal reports and forms; and
U.S. Department of Labor form CA-1 (refer to the Federal Injury Compensation Guidelines in the National Disaster Medical System (NDMS) Disaster Medical Assistance Team (DMAT) manual for copies and explanation).
The Medical Team should assist with all other documentation to support follow-up investigation (Worker’s Compensation, etc.).
EVACUATION PROCESS FOR TASK FORCE MEMBERS
The IST Medical Unit Leader shall recommend the optimal medical destination and method of transport to that destination.
TF personnel may be assigned to escort the injured member to assure optimal care for the injured member.
The TFL will communicate all pertinent details through the local ICP, and DHS/FEMA communications channels back to the injured member's sponsoring organization.
The TFL or Medical Team Manager will brief all personnel on the occurrence, the member's condition, destination, and the care provided. Periodic updates of TF members' injuries and condition will be conducted as warranted.
The TF/IST must identify, in advance, the medical evacuation system for any seriously injured or ill TF member (or canine). The evacuation system should include plans for continued management of the TF member's illness or injury until delivery to an appropriate definitive care center.
Death of a Task Force Member
In the event of death of a TF member, the Medical Team Manager shall verify the identity and confirm the death of the individual. The probable cause of death should be specified, if possible. This information must be provided to the TFL as soon as possible.
Security should be ensured for the deceased member's personal items, such as wedding rings and watches, etc.
The TFL should assign a TF member to accompany the remains to original Point of Departure. Transfer of the remains must be coordinated with:
Local Incident Command staff
Local Medical Examiner/Coroner
ESF #8 Disaster Mortuary Operations Team (DMORT) representative
Department of Defense (DoD) officials.
The Medical Team Manager must initiate all appropriate documentation to record the details regarding the cause of death and support the Safety Officer’s investigation.
Reassignment And Demobilization
The Medical Team Manager must assist in evaluating the capabilities of the TF medical personnel, equipment, and supplies to accept a new assignment, if necessary.
The evaluation of the TF personnel's physical and mental capabilities, as well as the operations and stressors already sustained, will weigh greatly on this determination.
Any operational losses and potential maintenance requirements of supplies, medicines, and equipment must be documented.
The Medical Team Manager must ensure that appropriate medical supplies and equipment are maintained by Medical Team members throughout the course of a reassignment or demobilization.
The Medical Team Manager should submit documentation to the TF Technical Information Specialist for After-Action Reports. This should include reviewing pertinent position descriptions, operational checklists, and protocols for recommended changes.