MMRS Matures

[Originally published in the Tidewater EMS Council newsletter, Response, September-October 2007]

We periodically use this newsletter, Response, to provide updates for the EMS community on the continuing development of the Hampton Roads Metropolitan Medical Response System (MMRS). A 2005 article focused on the availability of WMD antidote kits throughout the region. Previous articles highlighted development of the regional MMRS plan and employment of an MMRS program manager and program staff. We reported on purchases of huge amounts of antidotes, personnel protective equipment for responders, decontamination tents for hospitals and trucks, trailers and equipment for a strike team. This article reviews MMRS progress and introduces the Metropolitan Medical Strike Team (MMST), an asset now available to incident commanders.

MMRS planning began in 1999 as a federal initiative to prepare some of the most populous cities around the country to respond to the medical consequences of terrorism. The terrorism focus evolved to one of “all hazards.” Today, the 16 jurisdictions in the MMRS region have a highly developed system to respond to mass casualty incidents.

The Hampton Roads Planning District Commission serves as fiscal agent for MMRS and the Tidewater EMS Council is contracted to provide program management and oversight. Over 240 individuals from some 88 different jurisdictions and agencies serve on MMRS committees dedicated to regional mass casualty improvement. MMRS also works closely with the hospital preparedness region and the Virginia Department of Health to coordinate other funding sources to avoid duplication and to enhance overall effects.

The focus of MMRS is to build upon existing plans and systems already available in the region. Federal funding is combined with local jurisdiction funding to provide program planning, purchases, strike team development, exercises and training.

An increasing focus of MMRS is training and exercises. The most recent series of exercises, called Operation Chain Reaction, were funded and coordinated through a joint cooperative of the MMRS, Virginia Department of Emergency Management and the City of Virginia Beach. A full scale field exercise followed tabletop and functional exercises, all designed to evaluate emergency response to a radiological dispersion device and mass casualty incident. The field exercise involved more than 400 moulage victims, 300 responders from 12 public safety agencies, 11 hospitals, others from various state agencies, plus controllers, evaluators and support staff. This effort resulted in the largest mass casualty exercise to date in the region.

Another initiative to support and improve regional disaster training is the Kent J. Weber Emergency Response Training and Simulation Center. Located in the Tidewater EMS Council offices, this 3600 square foot center features a large lecture room and four break out practice rooms. Combined with high fidelity human patient simulation manikins, advanced audio visual systems, mass casualty simulators and other medical equipment and supplies, the center offers a range of medical and disaster preparedness educational opportunities.

Simulation Center namesake Kent J. Weber with a geriatric simulator (Kent is on the left)

Responder training continues to be a priority for the MMRS. Through the website www.tidewaterems.org/hrmmrstraining a number of local mass casualty and disaster training courses are made available, usually at no cost, to responders. Near future exercises include a biological simulation scenario and a regional airport drill. MMRS staff is available to assist with planning and coordination of local and regional exercises as well as providing or arranging mass casualty training courses. We expect that responder preparedness will shift from purchasing “stuff” to increased training and exercises.

During the past year the MMRS has purchased and distributed radiation detectors for a majority of emergency response vehicles. These GammaRAE II detectors may be the first clue to a potential radioactive incident and provide responders with a life-saving warning.

A continuing MMRS focus is medical facility disaster preparedness. Nationally, hospitals struggle to identify and prepare for patient “surge”. Combining MMRS and HRSA funding, stand-off surge tents were purchased for each hospital and efforts continue to identify alternate care facilities and equipment special-needs patient friendly shelters. Efforts also continue to support six Medical Reserve Corps programs, community dispensing centers and programs to distribute mass medications in the event of biological outbreak. The MMRS purchased some 100,000 N95 respirators, stockpiled in public health facilities, to help medical and essential employers protect their personnel during such outbreaks.

Public information messages, and effective means for educating the public during disaster, are being addressed as a cooperative effort between MMRS, the region’s emergency managers, and local media. One such effort includes the “PrepareHR” campaign involving a website portal as a central point to access the variety of local jurisdiction, Red Cross, and other websites with disaster information.

In the year ahead, the region’s responders will learn more about the MMST. The strike team consists of 47 individuals especially trained and equipped to support local response to mass casualty incidents. The team comes from a larger call group of some 242 individuals sponsored by local fire and EMS departments throughout the region. There are two strike team equipment caches: one each on the Southside and the Peninsula to ensure response and availability. With a call depth of 3 team members in each role on both the Southside and the Peninsula, the strike team is available on short notice when requested by a local incident commander.

The MMST can serve as a specialized mutual aid asset to help support incident response from early in an incident for one or two days until additional state and federal assets arrive as needed. The team brings expertise, equipment, supplies and communications and is flexible to meet various incident needs including triage, treatment, decontamination and asset coordination. Strike team leaders have begun to meet with public safety officials in each jurisdiction to review team capabilities and notification procedures.

Another MMRS project currently underway is purchase of eight identical, fully equipped disaster trailers (four for TEMS region, four for Peninsulas region). With equipment, supplies and packaging similar to the larger MMST trailers, these trailers will be provided to jurisdictions for local and regional mass casualty response.

For more information or to arrange an MMRS briefing, contact the MMRS program at 757 963-0632 or visit the website www.tidewaterems.org/hrmmrs.

Hampton Roads MMRS Mission

Support and enhance Hampton Roads public safety, hospital, public health and emergency management response capabilities to manage mass casualty incidents during the early hours critical to life-saving and population protection to include terrorist acts, disease outbreaks, natural disasters and hazardous materials incidents and to support and enhance existing disaster and emergency operations plans.