EMS World

NOV 2017

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26 NOVEMBER 2017 | EMSWORLD.com EMS officer, notes part of the EMS system's mission in the commonwealth is to support the VA with medical transportation. They provided 25 BLS and ALS ambulances to assist with transporting 180 patients with acute illnesses or injuries (122 of whom were dialysis patients) from the neighboring Virgin Islands, whose only hospital was destroyed in the hurricane. They have also received patients from non-U.S. territory islands in coordinated efforts with the U.S. Depart- ment of Health and Human Services. "We have a multidisciplinary team here in San Juan International Airport with physi- cians, EMTs, intermediate care technicians— who are veterans with previous medical experience in the armed forces—nurses, and a team of logistics and planning we organized to help the patients," Diaz says. "We do triage, we match patients' needs to hospitals' capabilities, talk with the hospital and send the patients to the hospital." 'PRACTICE IS A PAYOFF' Gustavo Flores, MD, director of emergency and critical care training and crew mem- ber for REVA Air Ambulance in Puerto Rico, assisted with flying patients from the other islands to the airport in San Juan. "I'm involved in a volunteer fire-rescue team, and because many of our volunteers are also members of the different government agencies that were activated, we had to step up and cover for them and provide our share of care during the weekend operations," says Flores, reflecting Abo's view of the value of first responders' different roles ensuring efficient patient care. Florida Task Force 1 was not the only team that conducted an exercise oddly similar to Hurricane Irma's impact. Cosme Torres, incident commander for the FCC, helped plan the exercise Tropical Journey 2017 in conjunction with the U.S. Department of Health and Human Services in April. The scenario involved a Category 5 hurricane hitting the U.S. Virgin Islands and the east coast of Puerto Rico, resulting in an influx of patients from the Virgin Islands in need of medical treatment. "Lesson learned: Practice is a payoff," says Torres. "Everybody who is supporting this mission right now participated in Tropical Journey in April. Since we started, the com- munications between the DOH, the NDMS and even the airport operations have been synchronized and constant without any complaints or concerns." While the training exercise was indeed beneficial, it didn't quite prepare providers for the magnitude of Irma's destruction. "When we do the exercises, we usually come to prepare for a 24-hour operation," says Héctor Alonso, MD, chief of emergency medicine at the VA hospital. "We've been ongoing for one week nonstop…it takes double the effort…receiving a constant flow of patients over a week's span." Still, Alonso believes it was "an amazingly help- ful scenario." Torres advises EMS personnel prepar- ing for future disasters to "have some type of preplanning for this type of scenario," like determining how quickly emergency operations centers can open and starting to pre-request support from health services, ambulance services and strike teams that can deploy quickly to areas needing emer- gency assistance. Aside from a few phone calls the night before Irma struck suggesting the islands might need help, EMS officials in Puerto Rico weren't necessarily expecting the operation, but due to their detailed preparations, they were ready for an expedited activation. "We learned how valuable the EMS sys- tem is," says Torres. "The competence of the EMS staff is highly valuable in order for us to use the right resources on the ground to transport patients. It's important because that helps get the right patient with the right condition to the right discipline area to con- tinue improving medical conditions after a disaster like this." ABOUT THE AUTHOR Valerie Amato is assistant editor of EMS World. Reach her at vamato@emsworld.com Members of Miami-Dade Fire Rescue Urban Search and Rescue Florida Task Force 1 prepare for operations. The team had been home in Florida after helping with Hurricane Harvey efforts in Texas for less than 48 hours when they were deployed again to the Florida Keys after Hurricane Irma struck. (Photo: Benjamin Abo)

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