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Calling on NDMS

The National Disaster Medical System (NDMS) supports state, local, tribal and territorial (SLTT) authorities following disasters and emergencies by supplementing health and medical systems and response capabilities. NDMS also supports its federal partners during National Security Special Events and it may be called on to support the military and Veterans Health Administration health care systems in caring for combat casualties, should requirements exceed their capacity.

The HHS Office of the Assistant Secretary for Preparedness and Response, in its role as Coordinator of Emergency Support Function 8 (ESF-8), Public Health and Medical Services, of the National Response Framework, employs the NDMS to provide patient care, patient movement, and definitive care, as well as veterinary services, and fatality management support when requested by authorities from States, localities, Tribes and Territories, or other federal departments.

NDMS is a federally coordinated health care system and partnership of the Departments of Health and Human Services, Homeland Security, Defense, and Veterans Affairs.

The mission of the Division of NDMS is to supplement our nation’s public health and medical resources, the Division of NDMS mobilizes resources through specialized teams that provide human and veterinary healthcare, mortuary assistance, patient movement coordination, and definitive care during times of need.

Getting Critical Support in a Crisis

NDMS teams provide many different types of public health and medical support to SLTT partners. NDMS personnel are required to maintain appropriate licensure and certifications within their discipline. When personnel are activated as Federal employees, licensure and certification is recognized by all States.

  • Disaster Medical Assistance Teams
  • Trauma and Critical Care Teams
  • Disaster Mortuary Operational Response Team
  • Victim Information Center Team
  • National Veterinary Response Team

A Disaster Medical Assistance Team (DMAT) is a group of professional and para-professional medical personnel designed to provide medical care during public health emergencies or National Security Special Events (NSSEs).

Teams are capable of performing a wide range of patient-care functions in a variety of mission scenarios, including but not limited to:

  • primary, acute, stabilizing emergency care
  • emergency department decompression
  • inpatient care augmentation
  • supporting patient movement
  • stabilization and transfer of all patients including ill/injured and nursing home patients
  • staffing casualty/patient collection points
  • triage services
  • mass prophylaxis
  • medical site/shelter operations

DMATs are a response resource that incorporates scalable deployment configuration sizes with specific clinical, non-clinical and leadership personnel. DMAT team members include advanced clinicians (nurse practitioners/physician assistants), medical officers, registered nurses, respiratory therapists, paramedics, pharmacists, safety specialists, logistical specialists, information technologists, communication and administrative specialists.

DMATs deploy to disaster sites with sufficient supplies and equipment to sustain themselves for a period of 72 hours while providing medical care at a fixed or temporary medical care site. The personnel are typically activated for a period of two weeks.

The Trauma and Critical Care Teams (TCCT) are composed of medical professionals responsible for providing trauma and critical care support during public health emergencies and special events including National Security Special Events (NSSEs).

TCCTs can provide a deployable advance unit, augmentation to existing medical facilities, or establish a stand-alone field hospital. The capabilities of the TCCT include:

  • critical care
  • operative care
  • emergency care
  • advanced trauma life support

TCCT deployments often occur in austere environments. Personnel are deployed for fourteen day periods or longer and they leave when local medical resources are sufficiently recovered or have been supplemented by other organizations.

Disaster Mortuary Operational Response Team (DMORT) provide victim identification and mortuary services. DMORT provides expertise and support for:

  • tracking and documenting of human remains and personal effects
  • establishing temporary morgue facilities
  • assisting in the determination of cause and manner of death
  • collecting ante-mortem data
  • collection of medical/dental records or DNA of victims from next of kin to assist in the forensic identification of the victims
  • performing postmortem data collection
  • documentation during field retrieval and morgue operations
  • performing forensic dental pathology and forensic anthropology methods
  • processing and re-interment of disinterred remains preparation

DMORT can also provide other technical assistance and consultation on fatality management and mortuary affairs as appropriate. Teams are composed of funeral directors, medical examiners, pathologists, forensic anthropologists, finger print specialists, forensic odonatologists, dental assistants, administrative specialist, and security specialist.

While DMORTs works under the delegated jurisdictional authority of the local or state Coroner or Medical Examiner, DMORT personnel, work under the overall command and control of the HHS Emergency Management Group (EMG) and/or the Incident Response Coordination Team (IRCT).

DMORTs may deploy with a Disaster Portable Morgue Unit (DPMU). The DPMU includes equipment and supplies for deployment to a disaster site. It contains a complete morgue with designated workstations for each processing element and prepackaged equipment and supplies.

The Victim Information Center Team (VIC) is responsible for providing support to local authorities during a mass fatality or mass casualty incident by collecting ante-mortem data and serving as liaison to the victims’ families or other responsible parties in support of another NDMS team.

The VIC Team provides support by:

  • collecting dental records, medical records, DNA, and other ante-mortem data
  • providing subject matter expertise in mass fatalities management and victim information procurement
  • training partners to appropriately gather the information required for victim identification from the family interview process
  • explaining the HIPAA Privacy Rule Exemption for Medical Examiners and Coroners at 45 CFR 164.512(g)(1) to the medical and dental providers of the victims to facilitate obtaining these records
  • coordinating and sharing data with morgue and forensic staff on a regular basis for potential identification
  • coordinating with federal, state and local law enforcement agencies by gathering ante-mortem data to facilitate victim identification and manage the missing persons list
  • updating the Victim Identification Program (VIP) database
  • coordinating the release of remains

The National Veterinary Response Team (NVRT) is the primary Federal resource for the treatment of injured or ill animals affected by disasters. The NVRT is comprised of individuals with diverse expertise, including veterinarians, animal health technicians, epidemiologists, safety specialist, logisticians, communications specialists, and other support personnel. During a response, NVRT provides assessments, technical assistance, public health and veterinary services. Additionally, during a response, they are supported by a cache of equipment, supplies and pharmaceuticals.

NVRT members can provide support in the areas of veterinary medicine, public health and research. NVRTs can support SLTT partners by providing:

  • assessments of the veterinary medical needs of animals and communities
  • veterinary medical support to working animals which might include search and rescue dogs, horses, and animals used for law enforcement
  • veterinary public health support including environmental and zoonotic disease assessment
  • veterinary medical support to other deployed NDMS deployed teams

Requesting a Team

ASPR Regional Administrators (RAs) and Regional Emergency Coordinators (RECs) can facilitate a request for NDMS support from a state, tribal or territorial authority. Local authorities must make a request for NDMS assistance through the state. The RA or REC will work with the requestor to define the requirement and identifying the type of support needed for the response.

Federal agencies may request NDMS services in support of special activities and events. These requests are formalized through Memoranda of Understanding, Interagency Agreements, and/or Memorandum of Agreement between the requesting agencies and the U.S. Department of Health and Human Services.

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