Disaster medical assistance team
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A disaster medical assistance team (DMAT) is a group of professional and para-professional medical personnel organized to provide rapid-response medical care or casualty decontamination during a terrorist attack, natural disaster, or other incident in the United States.
DMATs are part of the National Disaster Medical System and operate under the Department of Health and Human Services (DHHS). DMATs were founded under the US Public Health Service, operating under FEMA. Post 9/11, U.S. Department of Homeland Security assumed responsibility of DMATs.
There are 80 NDMS Teams of which 55 are DMATs spread out across the country and are formed by local groups of health care providers and support personnel. Under the National Response Framework (NRF, DMATs are defined according to their level of capability and experience. Once a level of training and proficiency has been shown, the higher level of priority is given to the team.
In addition to medical DMATs, there are other response teams that specialize in specific types of medical emergencies such as hazardous material handling and decontamination and LRATs, which are primarily Logistics response teams to support any of the response teams under the NDMS umbrella. Such other types of teams are the DMORTs (Disaster Mortuary Operations Response Teams, NVRTs (National Veterinary Medical Response Teams), IMSuRTs (International Medical/Surgical Response Teams), and the IRCTs (Incident Response Coordination Teams).
A DMAT deploys to disaster sites with the assurance by OPEO that supplies and equipment will arrive at or before the teams arrive at a disaster site, so that they can be self-sufficient for 72 hours while providing medical care at a fixed or temporary medical care site. Responsibilities may include triaging patients, providing high-quality medical care in adverse and austere environments, and preparing patients for evacuation. Other situations may involve providing primary medical care or augmenting overloaded local health care facilities and staffs. DMATs have been used to implement mass inoculations and other immediate needs to large populations. Under rare circumstances, disaster victims may be evacuated to a different locale to receive medical care. DMATs may be activated to support patient reception and distribution of patients to hospitals.
Team composition and equipment
DMATs are composed of physicians, Nurse Practitioners, Physician Assistants, Nurses, Paramedics, Emergency Medical Technicians, Pharmacists and Pharmacy Technicians, Respiratory Therapists, and a variety of other Allied Health and logistical personnel. DMATs typically have 120–150 members, from which the Team Leader chooses up to 50 members to deploy on missions requiring a full team. Smaller strike teams or other modular units can also be activated and deployed when less than full-scale deployments are needed.
DMAT members are termed "intermittent" federal employees and once activated by federal order, their status changes to that of an active federal employee and follow the GS pay scale. Federally activated DMAT members are protected from tort liability while in operation and are also protected by the provisions of the Uniformed Services Employment and Reemployment Rights Act (USERRA) which affords the same protections extended to National Guard and Active Duty Military when they deploy in that their full-time jobs are not placed in jeopardy. This protection was not until 2003 after an act of congress.
DMATs formerly traveled equipped with medical equipment and supplies, large tents, generators, and other support equipment (cache) necessary to establish a Base of Operations, designed to be self-sufficient for up to 72 hours, in a disaster area and treat up to 250 patients per day. However, during the period 2009–2011, ASPR changed the operational tactics and has removed team caches to a small number of federal warehouses, to save money, and thus teams no longer have the opportunity to practice and train with their own caches as was done previously. The capability is similar to an urgent care-level health care facility. In 2005, FEMA increased the response capabilities of DMATs by issuing trucks to teams that have obtained a certain standard of training and capabilities, but these, too, have been reclaimed by ASPR and are only available during actual deployments, to deliver the caches from the federal warehouses.
DMATs have been called to respond to a variety incidents, many of which garnered significant media attention. Teams responded to the World Trade Center site in New York City and the Pentagon, following the 9/11 terrorist attacks. Some DMAT personnel were used to assist in the collection of remains for identification at ground zero.
DMATs are a critical element of the federal response to natural disasters including Hurricane Katrina, During Katrina DMAT teams treated and helped evacuate patients in and around New Orleans, including those at the Louisiana Superdome and Louis Armstrong New Orleans International Airport.
Between January 17 and February 22, 2010, twelve DMATs participated in the international response to the 2010 Haiti earthquake and cared for more than 31,300 patients, including 167 surgeries and the delivery of 45 infants.
- "DMAT". National Disaster Medical System. Retrieved September 11, 2012.