Modular Emergency Medical System: Concepts for Building Surge Capacity
Michael Richards, MD, MPA, FACEP
Version 3 SummaryJuly 2006
New Mexico MEMSNew Mexico MEMS
Overview Background of MEMS
The MEMS Model
Patient Flow
Components
Philosophy of Care
Application of MEMS to New Mexico
MEMS Components
NEHC – Neighborhood Help Center
ACC – Acute Care Center
BACKBONE MODULES
MCC – Medical Command and Control
CTS – Casualty Transport System
CO – Community Outreach
MP – Mass Prophylaxis
KEY MODULES
PI - Public Information
Fatality Management
ADDITIONAL ELEMENTS
MEMS components provide the general framework on
which we will “hammer out” the details.
Original MEMS Assumption/Parameters Non-communicable BW
Civilian population
Hundreds to hundreds of thousands of patients and worried well
Overwhelmed health infrastructure with limited surge capacity
Federal resources not immediately available
New Mexico MEMS will be adapted for an All Hazards Approach
MEMS Assumption/Parameters NEHC & ACC are scaled to care for
1000 patients a day each
Most persons seeking care will be ambulatory
Community based outpatient centers are the most efficient manner to provide care
Adjusted “standard of care”
MEMS Flow Map
Community Outreach
HOME
Physician Office
NEHC
ACC
Hospital
FatalityManagement
MEMSComponent
CasualtyTransportSystem
RegularTransportation
System
MEMS Flow Map
HOME
Physician Office
Hospital
Regular patients (non-event) and all critical patients are transported directly to the hospital.
NEHC – Neighborhood Help Center
“Green Book”
• Primary triage and evaluation site designed for “high volume” (1000/24hr)
• Services:
• Outpatient/Ambulatory Care
• Limited treatment scope
• Prophylaxis
• Self help information
• Patients arrive by their own means
• Referrals to hospital or ACC with transport by CTS
NEHC – Adaptation
“Alternate Outpatient Care Area”
May be located within the hospital
Serves as alternate point of presentation and care
Can be scaled to needPMAC – Hurricane Katrina 2005
ACC – Acute Care Center• Expansion of inpatient/hospital ward for
patients requiring admission
• Located near hospital
• “Level of Care Philosophy”
• Limited to BW patients
• Agent specific & supportive care
• No advanced life support
• Limited triage function (admissions)“Blue Book”
ACC – Acute Care Center• Staff intensive
• Per 50 bed unit/per shift:
• 1 – Physician
• 1- Mid Level
• 6 – Nurses
• 4 – Nursing Aids/Techs
• 2 – Clerks
• 1 – Respiratory Therapist
• 1 – Case Manager
• 1 – Social Worker
• 2 – House Keepers
• 2 – Patient Transporters
UMB – Unified Medical BranchMCC – Medical Command and Control UMB
Equivalent to ICS Medical Branch (Operations)
Ultimate MEMS command and control
Composed of the MCC MCC
The MCC is the hospital sector (and supporting modules) IC element
A single hospital can have its own MCC
The module IC structures report to the MCC
New Mexico MEMS will be integration into our existing ICS structure.
CTS – Casualty Transport System• External to the jurisdictional EMS
• Hospital inter-facility transfers
• Primary MEMS causality transport
• Stationed at NEHC
• Designated routes
• Not necessarily “medical”
• Initial CTS configuration: one ambulance, one bus, two wheelchair vans.
CO – Community Outreach
MP – Mass Prophylaxis Mass Prophylaxis Program
NEHC should be integrated into mass prophylaxis program
CO can/should augment effort Community Outreach
Disseminate information Assessment of community/area Conduct mass prophylaxis if
indicated
New Mexico MEMS will be adapted to accommodate the work done in this area.