U.S. Department of Homeland Security Federal Emergency Management Agency Typed Resource Definitions Health and Medical Resources FEMA 508-5 May 2005 U.S. Department of Homeland Security Federal Emergency Management Agency Background The National Mutual Aid and Resource Management Initiative supports the National Incident Management System (NIMS) by establishing a comprehensive, integrated national mutual aid and resource management system that provides the basis to type, order, and track all (Federal, State, and local) response assets. Resource For ease of ordering and tracking, response assets need to be categorized via Typing resource typing. Resource typing is the categorization and description of resources that are commonly exchanged in disasters via mutual aid, by capacity and/or capability. Through resource typing, disciplines examine resources and identify the capabilities of a resource’s components (i.e., personnel, equipment, training). During a disaster, an emergency manager knows what capability a resource needs to have to respond efficiently and effectively. Resource typing definitions will help define resource capabilities for ease of ordering and mobilization during a disaster. As a result of the resource typing process, a resource’s capability is readily defined and an emergency manager is able to effectively and efficiently request and receive resources through mutual aid during times of disaster. Web Site For more information, you can also refer to the National Mutual Aid and Resource Management Web site located at: http://www.fema.gov/nims/mutual_aid.shtm. Supersedure This document replaces the Health and Medical resource definition section in Resource Definitions, dated September 2004 Changes Document is reformatted. Content is unchanged. FEMA 508-5 Typed Resource Definitions - Health and Medical Resource Page 2 of 13 05/31/2005 U.S. Department of Homeland Security Federal Emergency Management Agency Table of Contents Background............................................................................................................................. 2 Resource Typing ..................................................................................................................... 2 Web Site .................................................................................................................................. 2 Supersedure............................................................................................................................ 2 Changes .................................................................................................................................. 2 Disaster Medical Assistance Team (DMAT)—Basic...............................................................4 Disaster Medical Assistance Team (DMAT).Burn Specialty ................................................6 Disaster Medical Assistance Team (DMAT)—Crush Injury Specialty.....................................7 Disaster Medical Assistance Team (DMAT)—Mental Health Specialty..................................8 Disaster Medical Assistance Team (DMAT)—Pediatric Specialty..........................................9 Disaster Mortuary Operational Response Team (DMORT)..................................................10 International Medical Surgical Response Team (IMSuRT)...................................................11 NDMS Management Support Team (MST) ..........................................................................12 Veterinary Medical Assistance Team (VMAT)......................................................................13 FEMA 508-5 Typed Resource Definitions - Health and Medical Resources Page 3 of 13 05/31/2005 U.S. Department of Homeland Security Federal Emergency Management Agency RESOURCE: Disaster Medical Assistance Team (DMAT)—Basic CATEGORY: Health & Medical (ESF #8) KIND: Team MINIMUM CAPABILITIES: TYPE I TYPE II TYPE III TYPE IV OTHER COMPONENT METRIC Team See Note 1 Patient-care Capabilities Same as Type II Triage and treat up to 250 patients per day for up to 3 days without resupply Augment or supplement Type I or II team within this team’s local area Personnel may be used to supplement other teams Team Readiness Roster Fulfillment, Equipment Loading Upon alert, full 35-person roster within 4 hrs. After activation, deployment ready within 6 hrs Upon alert, full roster within 6 hrs. After activation, deployment ready within 12 hrs Upon alert, 75% rostered within 12 hrs. After activation, deployment ready within 24 hrs Does not meet minimal deployable team requirements Demonstrated Readiness Readiness Testing and Deployment History Same as Type II plus: History of prior full deployment to austere environment 100% rating on NDMS readiness test in past 12 mos 75% or greater rating on NDMS readiness test in past 12 mos Less than Type III Personnel See Note 2 Membership Level 105 or more deployable team personnel on NDMS roster 12 or more physicians; 3 or more of each of PA or NP, RN, RPh, and paramedic 90 or more deployable team personnel on NDMS roster 9 or more physicians; 3 or more of each of PA or NP, RN, RPh, and paramedic 50 or more deployable team personnel on NDMS roster 6 or more physicians; 2 or more of each of PA or NP, RN, RPh, and paramedic Less than Type III Equipment and Supplies Logistics Status Same as Type II Full DMAT equipment cache properly managed, stored and inventoried per NDMS requirements Full or partial DMAT equipment cache properly managed, stored, and inventoried per NDMS requirements Less than partial cache Vehicle Transportation Status Same as Type II Pre-arrangement for obtaining primary and alternate use vehicles Incomplete transportation arrangements None Didactic Training Basic (Core) and Advanced Training Modules 90% completion of NDMS basic core training plus 50% of advanced training modules (By 08/05) 80% completion of NDMS basic core training plus 25% of advanced training modules (By 08/05) 50% completion of NDMS basic core training plus 25% of advanced training modules (By 08/05) Less than Type III FEMA 508-5 Typed Resource Definitions - Health and Medical Resources Page 4 of 13 05/31/2005 U.S. Department of Homeland Security Federal Emergency Management Agency RESOURCE: Disaster Medical Assistance Team (DMAT)—Basic CATEGORY: Health & Medical (ESF #8) KIND: Team MINIMUM CAPABILITIES: TYPE I TYPE II TYPE III TYPE IV OTHER COMPONENT METRIC Training experience Field Exercises (FEXs) Same as Type II Participate in at least 2 NDMS approved FEXs, one observed Participate in at least 1 NDMS approved FEX N/A COMMENTS: Definition: A DMAT is a volunteer group of medical and nonmedical individuals, usually from the same State or region of a State, who have formed a response team under the guidance of the National Disaster Medical System, or under similar State or local auspices. Note 1: Type I = fully operational; Type II = operational ; Type III = augmentation/local team; Type IV = developmental. Note 2: Standard DMAT deploys with 35 personnel for all missions. Personnel include a mix of physicians, nurses (RN), nurse practitioners (NP), physicians' assistants (PA), pharmacists (RPh), emergency medical technicians (EMT), other allied health professionals, and support staff. FEMA 508-5 Typed Resource Definitions - Health and Medical Resources Page 5 of 13 05/31/2005 U.S. Department of Homeland Security Federal Emergency Management Agency RESOURCE: Disaster Medical Assistance Team (DMAT).Burn Specialty CATEGORY: Health & Medical (ESF #8) KIND: Team MINIMUM CAPABILITIES: TYPE I TYPE II TYPE III TYPE IV OTHER COMPONENT METRIC Team See Note 1 Deployment Readiness; Staffing; Equipment Status; Training Status; Patient Treatment Capacity Deploy to site within 24 hrs. of notification with all necessary staff and equipment; Function for 72 hrs. in austere locations without resupply Deploy to site within 24 hrs. of notification with all necessary staff; Function in existing fixed facility using facility’s equipment and supplies (Note 2) Personnel roster only; May be less than full complement Equipment Logistics Status Full complement Limited to specialized items for burns None COMMENTS: A Burn Specialty DMAT is a volunteer group of medical and nonmedical individuals, usually from the same state or region of a state, that have formed a response team under the guidance of the National Disaster Medicial System (or state or local auspices), and whose personnel have specific training/skills in the management of burn trauma patients. Note 1: Variable number of personnel; includes medical providers with specialty training/skills in management of burn patients. Usually includes a mix of physicians, nurses, nurse practitioners, physician's assistants, pharmacists, emergency medical technicans, other allied health professionals and support staff. Deployment rosters are usually constituted on an ad hoc basis, depending on situational need. Note 2: Current NDMS burn teams are Type II; they are not fully equipped teams, but rather they usually co-deploy, providing specialized equipment, supplies and skills on those missions that involve burn casualties. FEMA 508-5 Typed Resource Definitions - Health and Medical Resources Page 6 of 13 05/31/2005 U.S. Department of Homeland Security Federal Emergency Management Agency RESOURCE: Disaster Medical Assistance Team (DMAT)—Crush Injury Specialty CATEGORY: Health & Medical (ESF #8) KIND: Team MINIMUM CAPABILITIES: TYPE I TYPE II TYPE III TYPE IV OTHER COMPONENT METRIC Team See Note 1 Deployment Readiness; Staffing; Equipment Status; Training Status; Patient Treatment Capacity Deploy to site within 24 hrs. of notification with all necessary staff and equipment; Function for 72 hrs. in austere locations without resupply Deploy to site within 24 hrs. of notification with all necessary staff; Function in existing facility using facility’s equipment and supplies See Note 2 Personnel roster only; May be less than full complement Equipment Logistics status Full complement Limited or none None COMMENTS: A Crush Injury Specialty DMAT is a volunteer group of medical and nonmedical individuals, usually from the same State or region of a State, who have formed a response team under the guidance of the National Disaster Medical System (or State or local auspices), and whose personnel have specific training/skills in the management of crush injury patients. Note 1: Variable number of personnel; includes medical providers with specialty training/skills in management of crush injuries. Usually includes a mix of physicians, nurses, nurse practitioners, physician’s assistants, pharmacists, emergency medical technicians, other allied health professionals and support staff. Deployment rosters are usually constituted on an ad hoc basis, depending on situational need. Note 2: Current NDMS crush injury teams are Type II. FEMA 508-5 Typed Resource Definitions - Health and Medical Resources Page 7 of 13 05/31/2005 U.S. Department of Homeland Security Federal Emergency Management Agency RESOURCE: Disaster Medical Assistance Team (DMAT)—Mental Health Specialty CATEGORY: Health & Medical (ESF #8) KIND: Team MINIMUM CAPABILITIES: TYPE I TYPE II TYPE III TYPE IV OTHER COMPONENT METRIC Team See Note 1 Deployment readiness; Staffing; Patient Treatment Capacity Deploy to site within 24 hrs. of notification with all necessary staff and equipment Function for 72 hrs. in austere locations without resupply Deploy to site within 24 hrs. of notification with all necessary staff Function in existing facility using facility’s equipment and supplies See Note 2 Personnel roster only May be less than full complement Equipment Logistics Status Full complement Limited or none None COMMENTS: A Mental Health Specialty DMAT is a volunteer group of medical and nonmedical individuals, usually from the same State or region of a State, who have formed a response team under the guidance of the National Disaster Medical System (or State or local auspices), and whose personnel have specific training/skills in the management of psychiatric patients. Note 1: Variable number of deploying personnel; includes medical providers with specialty training/skills in treating psychiatric patients. Usually includes a mix of physicians, nurses, nurse practitioners, physician’s assistants, pharmacists, emergency medical technicians, other allied health professionals and support staff. Deployment rosters are usually constituted on an ad hoc basis, depending on situational need. Note 2: Current NDMS mental health teams are Type II. FEMA 508-5 Typed Resource Definitions - Health and Medical Resources Page 8 of 13 05/31/2005 U.S. Department of Homeland Security Federal Emergency Management Agency RESOURCE: Disaster Medical Assistance Team (DMAT)—Pediatric Specialty CATEGORY: Health & Medical (ESF #8) KIND: Team MINIMUM CAPABILITIES: TYPE I TYPE II TYPE III TYPE IV OTHER COMPONENT METRIC Team See Note 1 Deployment Readiness; Staffing; Patient Treatment Capacity Deploy to site within 24 hrs. of notification with all necessary staff and equipment Function for 72 hrs. in austere locations without resupply Deploy to site within 24 hrs. of notification with all necessary staff Function in existing facility using facility’s equipment and supplies See Note 2 Personnel roster only May be less than full complement Equipment Logistics status Full complement Limited to pediatric items or none None COMMENTS: A Pediatric Specialty DMAT is a volunteer group of medical and nonmedical individuals, usually from the same State or region of a State, who have formed a response team under the guidance of the National Disaster Medical System (or State or local auspices), and whose personnel have specific training/skills in the management of pediatric patients. Note 1: Variable number of deploying personnel; includes medical providers with specialty training/skills in pediatrics and use of pediatric equipment. Usually includes a mix of physicians, nurses, nurse practitioners, physician’s assistants, pharmacists, emergency medical technicians, other allied health professionals and support staff. Deployment rosters are usually constituted on an ad hoc basis, depending on situational need. Note 2: Current NDMS pediatric teams are Type II; they do not deploy as a fully functioning team but generally codeploy and augment another team. FEMA 508-5 Typed Resource Definitions - Health and Medical Resources Page 9 of 13 05/31/2005 U.S. Department of Homeland Security Federal Emergency Management Agency RESOURCE: Disaster Mortuary Operational Response Team (DMORT) CATEGORY: Health & Medical (ESF #8) KIND: Team MINIMUM CAPABILITIES: TYPE I TYPE II TYPE III TYPE IV OTHER COMPONENT METRIC Standard Team See Note 1 Deployment Readiness, Patient Treatment Capacity Deploy to site within 24 hrs. of notification Provide on-site victim identification and morgue operations Provide family assistance services See Note 2 WMD Team Deployment Readiness, Patient Treatment Capacity DMORT - WMD is the same as above except adds additional capability to deal with residually contaminated chemical, biological, or radiological dead Personnel DMORT functions Add-on Deployable Portable Morgue Unit (DPMU) when no local morgue facilities available Fully equipped to support either standard DMORT or DMORT-WMD. See Note 3 COMMENTS: A Disaster Mortuary Operational Response Team is a volunteer group of medical and forensic personnel, usually from the same geographic region, who have formed a response team under the guidance of the National Disaster Medical System (or State or local auspices), and whose personnel have specific training/skills in victim identification, mortuary services, and forensic pathology and anthropology methods. Note 1: Standard DMORT has 31 personnel plus basic load of equipment. Usually includes a mix of medical examiners, coroners, pathologists, forensic anthropologists, medical records technicians, fingerprint technicians, forensic odentologists, dental assistants, radiologists, funeral directors, mental health professionals, and support personnel. Note 2: DMORTs are mission tailored on an ad hoc basis, and usually deploy only with personnel and equipment specifically required for current mission. Note 3: There are currently two Portable Morgue Units within NDMS. FEMA 508-5 Typed Resource Definitions - Health and Medical Resources Page 10 of 13 05/31/2005 U.S. Department of Homeland Security Federal Emergency Management Agency RESOURCE: International Medical Surgical Response Team (IMSuRT) CATEGORY: Health & Medical (ESF #8) KIND: Team MINIMUM CAPABILITIES: TYPE I TYPE II TYPE III TYPE IV OTHER COMPONENT METRIC Team See Note 1 Deployment Readiness; Staffing; Patient Treatment Capacity Able to begin deployment to OCONUS location within 3 hrs. of notification Staff 2 OR suites providing emergency surgery, treatment, and stabilization Usually deploys with all necessary equipment See Note 2 Some mix of capabilities less than Type I Equipment Logistics Fully equipped to provide free-standing surgical capability, etc. See Note 2 Limited to none COMMENTS: Definition: An International Medical/Surgical Response Team is a volunteer group of medical and nonmedical individuals, usually from the same State or region of a State, that have formed a response team under the guidance of the National Disaster Medical System and the State Department, and whose personnel and equipment give it deployable medical and surgical treatment capability, worldwide. Note 1: IMSuRT is equipped and trained to provide surgical care outside CONUS. Full team consists of roughly 26 personnel. This is the only NDMS medical team with surgical OR capability. Currently a single IMSuRT exists at level 1, being a successor to the previous IST specialty DMAT. Two additional teams are being formed. Note 2: IMSuRT does not usually function in an austere environment without additional support. FEMA 508-5 Typed Resource Definitions - Health and Medical Resources Page 11 of 13 05/31/2005 U.S. Department of Homeland Security Federal Emergency Management Agency RESOURCE: NDMS Management Support Team (MST) CATEGORY: Health & Medical (ESF #8) KIND: Team MINIMUM CAPABILITIES: TYPE I TYPE II TYPE III TYPE IV OTHER COMPONENT METRIC Personnel See Note 1 Deployment Staffing Treatment Capacity Deploy to site within 24 hrs. of notification Provide Federal supervision, coordination, and support at site of any NDMS team deployment, to include ambulatory care (sick call) for federal personnel See Note 2 Deploy to site within 24 hrs. of notification with limited staff and communications equipment, but no tentage See Note 2 Equipment Logistics Full complement Communication and administration only COMMENTS: An MST is a command and control team that provides support and liaison functions for other NDMS teams in the field. Note 1: Supervisory, Logistics, Communi-cations, and Other Support Personnel. MSTs are normally staffed by a mix of Federal employees from NDMS headquarters, the PHS2 team, or the CCRF. Although rostered, MSTs do not exist except when actually deployed in support of a mission. An MST (perhaps as small as one or two individuals) always accompanies an NDMS unit on a deployment. Note 2: MSTs are mission-tailored on an ad hoc basis, and usually deploy only with personnel and equipment specifically required for current support mission. FEMA 508-5 Typed Resource Definitions - Health and Medical Resources Page 12 of 13 05/31/2005 U.S. Department of Homeland Security Federal Emergency Management Agency RESOURCE: Veterinary Medical Assistance Team (VMAT) CATEGORY: Animals and Agriculture Issues KIND: Team MINIMUM CAPABILITIES: TYPE I TYPE II TYPE III TYPE IV OTHER COMPONENT METRIC Team See Note 1 Deployment Staffing Treatment Capacity Deploy to site within 24 hrs. of notification Provide animal care, treatment, and shelter Food and water testing Basic epidemiologic capabilities See Note 2 Some mix of capabilities less than Type I Equipment Logistics Status Full complement Limited or none COMMENTS: Veterinary Medical Assistance Teams (VMATs) are volunteer teams of veterinarians, technicians, and support personnel, usually from the same region, who have organized a response team under the guidance of the American Veterinary Medical Association and the NDMS, and whose personnel have specific training in responding to animal casualties and/or animal disease outbreaks during a disaster. Note 1: 60 personnel plus equipment. Usually includes a mix of veterinarians, veterinary technicians, support personnel, microbiologists, epidemiologists, and veterinary pathologists. Note 2: VMATs are usually mission tailored on an ad hoc basis, and usually deploy only with personnel and equipment specifically required for the current mission. All VMATs within NDMS are considered Type 1. Epidemiologic capabilities are limited. FEMA 508-5 Typed Resource Definitions - Health and Medical Resources Page 13 of 13 05/31/2005