MMRS Update: WMD Antidotes in Tidewater
(Originally Published in the Tidewater EMS Council's Response Newsletter, January 2005)
By Jim Chandler
For several years, we have been updating the EMS community on progress of the Hampton Roads Metropolitan Medical Response System (MMRS). This update will focus on WMD antidotes available to EMS responders. Preparation is the key to any mass casualty or WMD event, and part of the preparation is knowledge of available resources.
A little over a year ago, the MMRS purchased substantial amounts of WMD antidotes for distribution throughout the region. The MMRS region includes the Tidewater Southside, the lower Peninsula, Surry and Gloucester. Each of the 16 cities and counties was slated to receive an allocation of the antidotes, and each was asked to identify secure, temperature controlled locations where the medications would be stored and available for quick deployment. That step is completed and all of the antidotes have been distributed in orange cases, recognized with large “HRMMRS” lettering. The kits are housed with selected EMS agencies, with each hazardous materials team and with the MMRS Strike Team supply caches on the Peninsula and Southside.
Each WMD kit is sufficient to treat roughly 50 casualties exposed to a variety of chemical agents. The number depends on the severity of exposure and type of chemical. The kits also contain some biological prophylaxis and radiation exposure medications, primarily intended for emergency responders, as well as some masks, WMD protocol excerpts and pediatric dosing aids.
Training materials on the location and use of the WMD antidote kits and medications are available through the Tidewater and Peninsulas EMS Councils, and every EMS responder should complete this training.
Additional backup supplies for the WMD kits are located in hospital pharmacies and with the MMRS Strike Team supply caches. These backups are recognized as large black cases also marked with “HRMMRS”.
The HRMMRS efforts are not the only source of WMD antidotes. At least two other sources of WMD antidotes are available to the medical community. One is federal medication and supply stockpiles, known as the Strategic National Stockpile (SNS) and the other is a forward deployment of a portion of the SNS known as CHEMPACK.
The federal CHEMPACK is the realization that chemical antidotes found in the federal SNS are usually too distant from any emergency to be able to make a real difference if needed. CHEMPACKs are a portion of the SNS which are separated and forward deployed throughout communities and hospitals nationwide. For many communities which are not part of an MMRS or which have not already developed local antidote programs, the CHEMPACK may be their first line of WMD defense.
In the Hampton Roads region and Virginia, efforts are currently underway to finalize locations for CHEMPACK storage and mobilization. The federal government requires extensive security and temperature control with regards to CHEMPACK placement. Local responders can expect more information about the local availability of CHEMPACK during 2005. CHEMPACKs will generally be our second line of defense following use of the HRMMRS antidotes.
Upon realization that a WMD event may overwhelm the local and state resources, communities can request medications, equipment and supplies from the federal SNS. Several federal stockpiles are located around the country and are sent by either land or air transport. Communities can expect the SNS to reach them within about 12 hours after the request has been approved. However, the extensive size of and logistics related to receipt, warehousing, unpacking and redistribution of the SNS means that realistically 24 to 48 hours may pass before SNS items can begin to impact a population.
The SNS request and approval process runs from local leadership (EOC) to the Virginia Departments of Health and Emergency Management, to the Governor, and to the federal government. Receipt of the stockpile is managed by a combination of the state and local emergency management, and the state and local health departments. Extensive plans and training have and continue to occur within the region and state to prepare for such an event.
Responders may never be faced with a terrible WMD event, but we all understand the possibility that such an event may occur and we need to prepare. Knowing the resources available to you will help in that preparation.