National Disaster Medical System

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Table of Contents

Introduction
History, Goals, and Objectives
Program Funding
Relation to Emergency Management at the State and Local Levels
Conclusion
References

Emergency management becomes more and more relevant with the increase of population and the advancement of technology. The National Disaster Medical System (NDMS) is designed to address disaster-related issues, which impact national healthcare and citizen wellbeing. The purpose of the paper is to determine the primary goals and objectives of the NDMS as well as identify its structure and functions. The paper also aims on investigating program funding aspects and NDMS’s correlation with the principles of emergency management on diverse levels. The methodology included an examination of relevant literature and governmental financial statements. It was found that NDMS plays a significant role in the emergency management of the United States and may require more funding.

Introduction

As technology developed, humanity learned to control almost every aspect of human life. Medical advancements increased life expectancy significantly, huge cities were built, and traveling around the world became highly accessible. People learned to overcome most limitations and challenges introduced by nature itself. However, there are important exceptions, which are impossible to control. It may not be possible to prevent such natural disasters as hurricanes, earthquakes, or tornadoes. Moreover, in some cases, humanity may play a considerable role in causing these disasters. The list also includes events such as fires, hazardous spills, and even floods that are closely linked with human activity. As it may not always be possible to prevent such events from occurring, it is vital to introduce highly efficient frameworks to handle the consequences.

It is critical to successfully overcome the damage of emergency situations regardless of their origin as quickly as possible. Disasters may deliver a devastating blow to the functionality of the community, may destroy infrastructure, and may lead to a large number of victims (Wang, 2017). Therefore, there is a number of aspects that require consideration in terms of the impact of the disaster. First, there are victims who need a wide variety of supporting measures, including medical support. Second, it is essential to deal with socio-economic consequences to recover stability. The National Disaster Medical System (NDMS) focuses primarily on the first aspect as it provides the victims of the above-mentioned emergencies with the required help. It might be economically rational to maintain the volume of healthcare services that correspond with the amount of average demand. Nonetheless, such an approach may lead to insufficient medical equipment, low numbers of ambulance cars, lack of medical staff and hospital space in case of an emergency. Therefore it may be vital to utilize a program such as the NDMS to prevent such consequences.

The NDMS is a system coordinated on a federal level, which is designed to provide necessary humanitarian emergency-related support. Disaster management consists of three fundamental elements, including preparedness, response, and mitigation. In some cases, recovery is included as an essential component of disaster management (Wang, 2017). These four elements are fully reflected in the principle of the NDMS. As already mentioned, there is a wide variety of disasters, which may cause distinct types of damage. Different disasters require a different approach to preparing, responding, mitigating, and recovering. It is particularly true in terms of medical support as the harm may vary from physical injuries to chemical burns or poisoning. Disaster medicine might be an inseparable part of comprehensive emergency management, and hence it should be adequately introduced to combat health-related consequences of natural and manmade disasters.

History, Goals, and Objectives

The history of the NDMS dates back to the Cold War, as the initial idea occurred as a response to potential war casualties. During its development, the NDMS has undergone significant changes, which forged it into a system that is designed to provide medical support in case of any disasters. The system consists of three major elements, which directly correlate with its primary functions and goals. First, it provides medical assistance and supplies required equipment to the disaster area. The decision-making is conducted by State or local authorities as they evaluate the severity of the situation and request help. The first component is mainly provided by Federal Intermittent Employees, who are medically trained civilians.

The second component is patient evacuation, which is primarily provided by the Department of Defense. In many cases, it may be possible to prevent health-related threats by evacuating people from the area before the disaster happens. However, may not be possible to accurately predict the occurrence of disasters, and hence patient evacuation is required to handle the consequences. The Department of Defense provides a wide variety of transportation methods to achieve that goal. Timely evacuation regardless of the possibility to predict the disaster is the key to minimizing victim numbers and providing sufficient medical help. Patient evacuation also serves several related functions, including patient reporting and regulating. Another vitally important aspect is comprehensive planning of special places, which are suitable to accommodate survivors and provide them with needed food and sleeping areas.

Definitive medical care is one of the most important components of the NDMS, as providing sufficient and timely medical help is its key objective. The third component is closely linked with the second, as it is only possible to provide the necessary medical care in the areas unaffected by the disaster. Therefore, it is critical to evacuate the patient to the hospital outside the area to provide help. Definitive medical care also implies medical equipment delivery to different affected areas. It is maintained by the Civilian Military Contingency Hospital System. The NDMS played a significant role in coordinating the actions of several agencies and utilized both the public and the private sector resources. Conclusively, hospital support, medicine distribution, patient reception, and medical assistance are the key functions of the third component of NDMS.

NDMC functions are maintained by several teams, which focus on various critical aspects of emergency management. There are six teams and two centers, which are normally active for fourteen days if necessary. These teams include Disaster Medical Assistance Teams (DWAT), Trauma and Critical Care Teams (TCCT), Disaster Mortuary Operational Response Teams (DMORT), National Veterinary Response Team (NVRT), and Incident Response Coordination Team (IRCT). Two centers are the Federal Coordinating Centers (FCCs) and Victim Information Center (VIC) (Dawson, 2020). Each of these teams provides necessary help on different levels and areas.

DMATs are responsible for the provision of medical care and support in case of any emergencies related to manmade or natural disasters. The list also includes acts of terrorism, virus outbreaks, and some other emergency-related events. DMAT is provided with sufficient resources to maintain its work for three days without the need to resupply. Health care providers and non-clinical support staff represent the main labor resources available to DMAT. Staff is typically divided into teams of seven, fourteen, or thirty-five people who are ready to deploy within seven hours to provide required medical help (Dawson, 2020). TCCT is essential in terms of trauma and critical care as they provide highly professional medical workers who support DMAT in critical situations. Their main responsibilities are patient evacuation, medical facility support, and field hospitals organization. TCCT are typically divided into groups of nine, ten, twenty-eight, or forty-eight medical professionals to provide trauma and critical care in distinct areas.

DMORTs are responsible for managing the facilities, which are affected by the emergency. DMORTs have many functions, such as victim identification, fatality assessment, and morgue operations management. These teams also play a significant role in providing relevant information regarding the emergency. NVRT is designed to help animals affected by natural or manmade disasters and other emergency events (Dawson, 2020). It consists of one team of veterinaries who are trained to provide animal care in emergency situations. IRCT plays a significant role in coordinating help on jurisdictional, State, Tribal, and local levels. The team is designed to maintain cooperation between agencies of different levels and responsibility fields.

As mentioned before, there are also two centers, which are an inseparable part of the NDMS. FCCs are essential in terms of recruiting hospitals and maintaining cooperation with the NDMS on local levels. Moreover, these centers are responsible for patient reception-related issues, including planning and coordination. VIC’s area of responsibility is local too, as it works with local authorities to maintain antemortem data collection and communication with victim’s families. In general, VICs are designed to help DMORT on local levels.

Program Funding

NDMS program funding changes are closely linked with the recent pandemic. COVID-19 has shown that NDMS is not provided with sufficient funding and hence is not able to introduce comprehensive medical care in case of a global emergency. Therefore, program funding was significantly increased in 2019 and 2021. NDMS costs are primarily covered by the HHS Public Health and Social Services Emergency Fund. Even though the funding amount was increased to $73 million in 2019, only $57 million were provided in 2020 (US Department of Health and Human Services, 2021). The budget was increased to $88 million in 2021 in order to address a number of essential issues (ASPR FY 2020 Budget-In-Brief, 2020). First, the pediatric care program received an additional $20 million to build o progress made in 2019. Second, both the infectious disease response program and portable dialysis unit maintenance program received $5 million each. Finally, the enPOWER program, which is designed to improve federal-to community awareness, adoption mechanisms, and innovation implementation, received an additional $1 million.

As already mentioned, NDMS has a large number of functions and utilizes a wide variety of teams and agencies in order to address distinct emergencies. The recent pandemic inflicted significant damage worldwide and has proven that modern healthcare is not fully capable of handling such emergencies. Hence, it may be highly beneficial to increase NDMS funding even further. However, it may also be critical to comprehensively assess the vulnerabilities of the program to introduce adequate systematic funding, which may improve NDMS’s efficiency.

Relation to Emergency Management at the State and Local Levels

NDMS is a relatively universal program, which addresses a large number of emergency-related problems. A significant number of teams, which implement distinct functions, allows NDMS to provide sufficient medical support on different levels. According to some sources, the NDMS supports state, local, and tribal authorities to handle the consequences of manmade or natural disasters (Mihalek, 2016). Therefore, NDMS represents a well-structured system that has specific mechanisms to react to emergencies on state and local levels. For example, FCCs and VICs are specifically designed to address local issues and help local facilities. In contrast, DMAT and TCCT are controlled by the state and may handle emergencies regardless of their size.

A large number of teams allows NDMS to rationally utilize forces depending on the severity of the disaster. Furthermore, in many cases, there are multiple areas affected by a disaster, and hence it may be critical to providing several teams. In addition, there are teams of various sizes, which allows NDMS to deploy forces in accordance with the need. Local public health communities also play a significant role in emergency management. They have been proven to be particularly effective during the pandemic as a sufficiently staffed local health community can adequately respond to such events (Rubin, 2020). Conclusively, NDMS provides a comprehensive emergency management framework with high flexibility, which allows it to provide high-quality support on both state and local levels.

Conclusion

Emergency management is becoming more and more relevant as the world’s population increases and more unsafe areas are inhabited. In addition, COVID-19 has shown that the world community is not able to effectively handle infection-related emergencies, and hence further development of emergency management is needed. The National Disaster Medical System plays a key role in the emergency management of the United States. Human life is the most significant value, which requires comprehensive support and protection on different levels. NDMS is the primary program that is related to protecting human lives in case of emergencies. Therefore, it may be vitally important to introduce sufficient funding and expand its capabilities in order to provide effective emergency management. NDMS represents a large interrelated system that consists of diverse entities and addresses a considerable number of problems. I believe that it may be one of the most important emergency-related programs, which requires broader attention. NDMS provides multi-level medical care regardless of location and emergency characteristics. Therefore, I think it may be possible to significantly improve emergency management in general by improving the principles of NDMS.

References

ASPR FY 2020 Budget-In-Brief. (2020). Public Health Emergency. Web.

Dawson, L. (2020). The National Disaster Medical System (NDMS) and the COVID-19 Pandemic. KFF. Web.

Mihalek, D. J. (2016). When disaster strikes in the U.S., the National Disaster Medical System responds. EMS1. Web.

Rubin, R. (2020). Better HHS Planning Needed for National Disaster Medical System. JAMA, 324(4), 326. Web.

Wang, S.-J. (2017). Comprehensive Disaster Medical System to Threat of Nuclear Emergency and Disaster. Prehospital and Disaster Medicine, 32(S1). Web.

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