Surge Capacity Planning to Inform the Need for International and Domestic Emergency Medical Team Deployments Following a Severe Wellington, New Zealand Earthquake

Abstract

Introduction:Wellington, New Zealand has a significant earthquake risk with unique response challenges posed by its geography and limited road, rail, and sea access. In 2014, the World Health Organization (WHO) Emergency Medical Team (EMT) initiative published minimum and technical standards for EMTs in response to failures by responding teams to deliver appropriate and ethical clinical care during a number of disasters (Norton, 2014). The initiative has evolved to develop national and International EMTs in addition to a support capacity building within Ministries of Health to better coordinate clinical capacity during an emergency.Aim:Over the last two years, the WHO EMT Coordination Cell (EMTCC) course has trained over 300 health personnel globally to coordinate clinical surge capacity using a three-step Impact Assessment, Needs Assessment, and Tasking process informed by disaster epidemiology and mass casualty ratios.Methods:EMTCC planning methodology was applied to the “Wellington Earthquake National Initial Response Plan” (MCDEM, 2017) to develop a Health Action Plan for a significant Wellington earthquake. Known earthquake impact modeling for injuries was applied against predicted capacity in receiving hospitals in the affected region, and the ability to transfer patients nationally to determine unmet response needs. EMT minimum standards and operational insights from recent disasters were then used to determine the number of EMTs required for optimal tasking.Discussion:The surge planning methodology provided a theoretical framework for national and local health emergency management staff to engage with clinical colleagues. This allowed likely EMT assistance to be pre-planned, which facilitates further planning with national and local emergency management, border, and registration agencies for rapid entry into NZ, including onward transport and logistical support. While injury treatment ratios had to be refined to reflect NZ context, the methodology proved useful for Ministries of Health to pre-identify the need for international assistance in national emergencies.