FEMA's Organized Response With a Pediatric Subspecialty Team: The National Disaster Medical System Response: A Pediatric Perspective

Abstract

A hurricane in New Orleans, Louisiana, was no longer just a threat but a reality. At the New Orleans Louis Armstrong International Airport, a small group of Boston-based National Disaster Medical System (NDMS) physicians met with military officers, who informed us that 5 years ago they were charged with preparation for potential national disasters. A hurricane in New Orleans was 1 of 3 scenarios they predicted. As a nation, as individuals, and as a disaster team we were living that prediction. Although we took care of disaster victims of all ages and disaster-relief workers, for those of us in the field of pediatrics, our focus was on the youngest victims of the disaster. Preparation begins not days but years before a disaster. Teams deployed to areas affected by Hurricane Katrina are part of the NDMS, a federally coordinated system that augments the nation's emergency medical response capacity. In 1984 the NDMS, by declaration of the President, became an agency of the US Public Health Service within the Department of Health and Human Services. It is a public/private partnership between government agencies, Disaster Medical Assistance Teams (DMATs), civilian hospitals, and emergency-response organizations. The role of the NDMS is to provide civilian medical support to the US government for victims of domestic disasters. A national network of teams provides a single integrated medical response to assist state and local authorities with medical care. The first NDMS team was formed in 1986. In March 2003, the NDMS was transferred from the US Public Health Service to the Response Division of the Federal Emergency Management Agency under the Department of Homeland Security. The NDMS, using government and private-sector resources, is mandated to provide medical response, patient evacuation, and definitive medical care. Specifically, the NDMS assesses health/medical needs; coordinates, mobilizes, and manages teams of medical … Address correspondence to Debra L. Weiner, MD, PhD, Emergency Medicine, Children's Hospital Boston, 300 Longwood Ave, Boston, MA 02115. E-mail: debra.weiner{at}childrens.harvard.edu