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Joint Patient Movement Team Evacuates Hurricane Katrina Survivors

SCOTT AIR FORCE BASE, Ill. (USTCNS) --- Within 48 hours after Hurricane Katrina swept through the Gulf Coast, precipitating on of the worst natural disaster in US history, a small team of specially trained medical personnel at Scott Air Force Base, Ill., prepared to enter devastated New Orleans to evacuate the ill and injured.

This Joint Patient Movement Team is part of U.S. Transportation Command’s Global Patient Movement Requirements Center. JPMTs are teams comprised of personnel trained in medical regulating -- coordinating for the movement of patients, matching patients with the appropriate medical treatment facility that has available bed space. While the GPMRC is the Department of Defense single manager for the regulation of movement of military patients, mostly from overseas, it also has a mission to assist federal authorities inside continental United States in case of natural or man-made disasters.

On August 31, JPMT #1 was put on alert to deploy to New Orleans. Several hours later, the four-person team, with members drawn from the US Air Force, US Navy and even the Canadian Forces, along with a flight surgeon, were setting up shop in Concourse D of Louis Armstrong Airport in New Orleans.

When the team arrived, “…the situation was a little confused,” said Lt. Col Ralph Buddemeyer, the GPMRC Chief of Operations and the man who supervised the team’s training.

Besides lack of all the basics – food, water, and electricity – the issue of who was in charge was unclear. “There was not a clear command and control picture there at the airport, Buddemeyer explained, “and we had alerted the team to our suspicions of this before they left. And that turned out to be true.”

In order to get patients supported and moving, Buddemeyer asked the team chief and the flight surgeon to sort out the situation.

“Dr (Col.) Dave Geyer,” said Buddemeyer, “who went with the team as the flight surgeon, really, for all practical purposes, from the federal stand point, assumed the command and control in terms of patient movement.”

Even so, many challenges still remained for the team, including establishing communications back to the GPMRC and with the rest of the world.

“We didn’t have a telephone line,” said Navy Lt. Keary Ashmore, JPMT#1 Team Chief; “the only phone line we had was a satellite phone and it wasn’t ours – it belonged to FEMA (Federal Emergency Management Agency).”

Even the team’s back up plan of using cell phones wouldn’t work as all the cell phone towers were down along with the telephone lines. This lack of communications kept the team from using its prime tool for coordinating the movement of patients; the TRANSCOM regulating and command and control evacuation system (TRAC2ES). TRAC2ES is a web-based planning and execution system which aids JPMTs in planning and scheduling aeromedical evacuation of patients.

As Ashmore put it, ““If you don’t have access to the web, basically you can’t use TRAC2ES”

They did, however, have an off-line version of TRAC2ES – “TRAC2ES Mobile” or “T-Mobile” – where the critical patient information could be captured and later uploaded once an internet connection or satellite uplink could be established.

“But when you have such a mass casualty event like Katrina,” Ashmore explained, “the best thing – what we came up – with was a tablet of paper. You get the last name, the first name, the diagnosis … you get the basic information from the individual, and then manifest them after the fact,” entering the data into ‘T-Mobile’ as they were able.

“Manpower was the biggest issue,” Ashmore admitted, “We were up at times for 18 to 20 hours a day. After three or four days, that became a problem.”

The JPMT directed the limited number of other military personnel on the scene to physically move patients confined to stretchers from the terminal out to the aircraft, but the sheer numbers were burning out the litter-bearers.

“We finally realized,” said Ashmore, “after about eight hours, that these tugs [baggage cart tractors] that were sitting out [on the tarmac] didn’t need a key to access the vehicle, all we had to do was start them up.”

They were then able to load patient litters on to baggage carts, hook several carts to the tugs, and drove them out to the aircraft where the air crews could assist in loading patients on the aircraft.

“It was a think-on-your-toes situation,” Explained Master Warrant Officer Chris Moffatt, Canadian Forces, who served as duty officer in JPMT#1, “You have to be able to change when you’re on the ground; you have to be malleable with your plans.”

Fortunately, after two days, two additional JPMT members arrived on the scene to provide some relief in the mounting work load.

Another challenge was separating healthy evacuees from the ill and injured evacuees who were the focus of the JPMT’s efforts, “You find that some people become very dedicated to getting on aircraft” Buddemeyer said.

The enormous scope of the suffering all around them presented its own emotional challenges for team members. Ashmore said he had to keep reminding the Navy Corpsman (medics) on the team that the JPMT’s mission was not to provide direct medical care, but to evacuate the patients to a place that will provide medical care.

“I know we love these patients,” he would tell them, “but if we love them enough, we’ll get them out of here faster, safer, where on the other side there’ll be another corpsman, another medical technician to give them love and care they need.”

When the team left on September 4, they had moved more than 2,400 patients in 96 hours; a first in the history of patient movement.

“Preparation is the key,” said Moffatt about how they were able to achieve such a success, “Our teams weren’t supposed to stand up until October. And this was like, ‘Here you go: you are now stood up!’ Excellent! But I tell you now, there is nothing like the test of fire to see if it’s going to work. It worked, now there’s only room for improvement.”

Asked what he would remember of his experience, Moffatt said, “There are faces, but it’s the ones who say, ‘thank you’, that you’re never going to forget. It keeps you going.”

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