Level 1

–         Highest level

–         Major academic medical center

–         24/7 staff and facilities

–         Education

–         Research

–         Prevention

   Level 2

–         Suburban hospitals

–         Teaching hospitals

–         Clinical level same as level I

–         24/7 trauma surgeons and medical staff on call

        Level 3

–         Neighborhood or community hospitals

–         Stabilization of trauma victim

–         Consultation

–         Specialty referral center

•          Severe single system trauma

•          Geared to patient population

•          Examples

–         Emergency Medical Treatment and Active Labor Act

–  Governs when and how a patient may be (1) refused treatment or (2) transferred from one hospital to another when he is in an unstable medical condition 

–National Emergency Medical Services Information System

–         –Repository that will be used to potentially store EMS data from every state in the nation. 

–Includes 4000 data components

–         Overwhelms ability to manage at whatever size

–         Some or all local resource capabilities overwhelmed

•          Personnel

•          Facilities

•          Communications

•          Equipment

•          Transportation

•          Support security

•          Finances

•          Fuel

•       Supplies

•Large-scale disaster

–         Greatly overwhelms local resources

–         More then local response required

• Major disaster

–         Completely overwhelms local and regional

–         Federal disaster assistance

–         Tornados in Oklahoma

•  Catastrophe

–         Extensively overwhelming impact

–         Extreme proportions

–         Katrina

–         Haiti

–         Freezes

–         Blizzards

–         Ice storms

–         Heat emergencies

–         Drought

–         Volcanoes

–         Wind storms

–         Avalanche

–         Epidemics

•          Earth, Wind and Fire, 

–         Earthquakes

–         Thunderstorms

–         Lightning

–         Tornadoes

–         Hurricanes

–         Wildland fires and  floods and tsunami

•          Planning

•          Requires

–         Time

–         Money

–         Commitment

–         Education

–         Coordination

–         Practice

–         Evaluation

–         Refinement

4 components of disaster management

–         Mitigation

–         Preparation

–         Response

–         Recovery

•          Medicaid

–         Federal and state dollars

–         Rate of reimbursement and assignment

•          Contracts

–         Health care facilities

–         Managed care and insurance programs

•          Arrangement in advance to provide service

•          Reduced fee for service charge

•          NHTSA houses the database

–         Technical assistance at University of Utah

•          Operational

–         Dispatch

–         Fleet

•          Clinical

–         PCR

–         Medical facilities

•          Support

–         Human Resources

–         Training