AMR's Emergency Response Team

[EpiEMS]

Mutual aid agreements and federal agreements are in place. You still operate under your own protocols.

Makes sense to me.

So when we had strike teams come in for Sandy they operated as if they were home. We had teams from Delaware, Indiana, western PA, and the state DOH just issued a waiver for everyone to operate under their local standing orders and were given a bookey if hospital phone numbers

Oh boy...that would not work out well for many places, I would wager.

...which for Sandy, what very amusing for a few PA friends of mine who went and had hospitals giving them all sorts of flack for following PA protocols, some of which were MUCH more aggressive than what they were used to. Heh.

That's kinda funny, actually.

 

[RedAirplane]

Might I ask, what is the ERT? How does it work?

I know AMR has a FEMA contract but I didn't know specifics about it. I thought it just meant that they would coordinate mutual aid and stuff... what's all this stuff about bags, airplane, 72 hours, etc?

 

[DesertMedic66]

Might I ask, what is the ERT? How does it work?

I know AMR has a FEMA contract but I didn't know specifics about it. I thought it just meant that they would coordinate mutual aid and stuff... what's all this stuff about bags, airplane, 72 hours, etc?

AMR's team used to be called the DRT (Disaster Response Team) but changed it to the ERT (Emergency Response Team). In the event of federally declared disasters AMR has the contract to send out resources. AMR will send out their own resources but will also sub contract out for additional help.

All employees who are on the ERT must have what is called a 72 hour to go bag packed at all times. The bag has personal items to keep that team member alive and working for 72 hours without any additional resources. In the event we get activated team members will have 30-90 minutes to get to their meeting location so there is no time to pack.

AMR will set up how you get to the incident location (drive or fly). AMR has a massive stockpile of completely stocked ambulances where employees will normally be flown to.

 

[DesertMedic66]

So when we had strike teams come in for Sandy they operated as if they were home. We had teams from Delaware, Indiana, western PA, and the state DOH just issued a waiver for everyone to operate under their local standing orders and were given a bookey if hospital phone numbers

...which for Sandy, what very amusing for a few PA friends of mine who went and had hospitals giving them all sorts of flack for following PA protocols, some of which were MUCH more aggressive than what they were used to. Heh.

You operate completely under your own scope from where you are employed at. Since I was a Riverside county EMT I operated under that scope.

The first thing we did when we arrived at the base was meet up with the national guard and all the paramedics signed out the narcs they are allowed to carry based on their protocols. So some were only signing out Morphine and Versed while others had Fent, Ativan, Ketamine, etc.

 

[dutemplar]

Yeah, one of my buddies was using PA protocols and the hospitals were not expecting the extra medications (especially above the command line), or things like CPAP, calling codes in the field, etc... Doctors yelling, and calling NJ, and PA then flipping them the metaphorical bird and emailing back a copy of the protocols for them to read.

I was heading that way, but then RTBd once DC declared a state of emergency.

 

[TransportJockey]

When i deployed for isaac we literally touched four patients the entire deployment. Nine days of hurry up and wait, but a great paycheck.

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[DesertMedic66]

For anyone who is interested number wise:

Hurricane Isaac:
Deployed August 27 -- September 6, 2012
FEMA contracted EMS in Louisiana
111 ground ambulances deployed (76% ALS, 24% BLS)
20 paratransit vehicles deployed
306 mission assignments
410 patient contacts

Hurricane Sandy:
Deployed October 27 – December 4, 2012 (38 days)
FEMA contracted EMS in New York City metropolitan area
368 ground ambulances deployed (73% ALS, 27% BLS)
2,172 mission assignments
46,471 patient contacts

Hurricane Irene:
Deployed August 26 – August 31, 2011 (6 days)
FEMA contracted EMS in New York City metropolitan area
188 ground ambulances deployed (70% ALS, 30% BLS)
1,188 mission assignments
1,170 patient contacts

https://www.amr.net/solutions/federal-disaster-response-team/references-and-resources

 

[EpiEMS]

https://www.amr.net/solutions/federal-disaster-response-team/references-and-resources

Sounds like a lot of ALS resources. I'd be curious to hear the rationale for the 70/30 ALS/BLS setup.

As far as staffing goes, it seems like FEMA standards (based on the FEMA EMS NIMS typed resources definitions, you're EMT/Medic staffed for ALS and EMR/EMT for BLS, at a minimum. How did you guys staff on your deployment?

 

[TransportJockey]

Sounds like a lot of ALS resources. I'd be curious to hear the rationale for the 70/30 ALS/BLS setup.

As far as staffing goes, it seems like FEMA standards (based on the FEMA EMS NIMS typed resources definitions, you're EMT/Medic staffed for ALS and EMR/EMT for BLS, at a minimum. How did you guys staff on your deployment?

Isaac was medic heavy. A lot of trucks were dual medic. Not sure on that rationale, other than more flexibility in deployment and mobile clinic type care when you're flush with medics

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[EpiEMS]

Isaac was medic heavy. A lot of trucks were dual medic. Not sure on that rationale, other than more flexibility in deployment and mobile clinic type care when you're flush with medics

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Gotcha -- I was thinking that from a resourcing perspective, I'd rather have a mix, and be able to (more cheaply) staff units to do the grunt work. Totally see the point of having the additional medics, though.

 

[NPO]

AMR has armed guards?

Guards, yes. (AMR On Guard)

Armed, not that I can tell.
Perhaps they contract.

 

[DesertMedic66]

Sounds like a lot of ALS resources. I'd be curious to hear the rationale for the 70/30 ALS/BLS setup.

As far as staffing goes, it seems like FEMA standards (based on the FEMA EMS NIMS typed resources definitions, you're EMT/Medic staffed for ALS and EMR/EMT for BLS, at a minimum. How did you guys staff on your deployment?

For us it was dependent on what resources were sent. They tried to keep all employees from the same division together. So we sent an equal number of medics and EMTs. Half of our team we was on ambulances staffed medic/EMT and the other half were used as single resource.

Some of the companies that AMR contracted out with only sent medics while others only sent EMTs.

Once we receive the call out we have absolutely zero idea what we will be doing. We could get sent out and sit on our butts. We could inside a shelter doing medical. We could be doing evacs of SNFs and hospitals and/or running/assisting with local 911 systems. ALS units are overall a better resource to have (IMO) since they are able to do everything that is needed since BLS usually will not be placed into the local 911 system.

 

[EpiEMS]

Once we receive the call out we have absolutely zero idea what we will be doing. We could get sent out and sit on our butts. We could inside a shelter doing medical. We could be doing evacs of SNFs and hospitals and/or running/assisting with local 911 systems. ALS units are overall a better resource to have (IMO) since they are able to do everything that is needed since BLS usually will not be placed into the local 911 system.

Ok, I see what you're saying. I was thinking more from a cost/availability standpoint -- but I definitely follow your logic, especially given the potential diversity of tasks.

 

[TransportJockey]

Once they get deployed, FEMA is picking up the tab, so amr is not concerned about price lol

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[EpiEMS]

Once they get deployed, FEMA is picking up the tab, so amr is not concerned about price lol

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Yeah, fair enough. One would think (hope?) FEMA cares about cost, though...
And needs versus cost.