Dr Jane Cocks

Report
Multi-Casualty Air Medical
Capability in Asia Pacific Region
Dr Jane Cocks
Clinical Director, MedSTAR Kids
MedSTAR Emergency Medical Retrieval Service
Adelaide, South Australia
ANZCA-HKCA Combined Scientific Meeting 2011
Hong Kong May 14-17th 2011
MedSTAR Emergency Medical Retrieval
Overview
> Multi versus Mass Casualty Events
• Definitions
• Issues
> Mass Casualty Management
•
•
•
•
Needs
Current Capability
Recent Disasters and responses
Issues
> Future Directions
MedSTAR Emergency Medical Retrieval
Definitions
> Multi-Casualty
• More than one victim
• Numbers that can be managed by the
resources of the local region
> Mass Casualty
• Large number of casualties
• Produced in a relatively short period of time
• Exceeds the capabilities of the local region
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Asia Pacific Region
MedSTAR Emergency Medical Retrieval
The Problem?
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The Problem?
> Natural and Man-made events
• Increasing frequency and victims
> Multiple victims
• Alive (variable acuity) and dead
• Health and Governmental Personnel
> Infrastructure decimated
• Access, Power, Sanitation, Water, Space
• Duration of disaster
> Lots of Willing Helpers
• Politics, cultures, religions, language,
expectations
> Coordination of response
• Local and External agencies
MedSTAR Emergency Medical Retrieval
Changing Global Expectation
> Media coverage and the Global Village
• ‘Do Something’
> Foreseeable events?
> International disaster assistance is now
considered a humanitarian obligation
> Relief claimed as a Right not a Charity
> No longer an ‘ad hoc’ response
> Political agendas
> Military fears
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What is required?
> Access to help
• Rapid <24hours post event
• Later and ongoing assistance
> Medical assistance
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•
•
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Advanced and wide range of skills
On scene and locally
Mobile – patients and staff
Destination – local victims vs travellers
> Infrastructure support and rebuilding
> Central control and coordination
> Clear communication
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What can we do now?
Levels of response
> Advance assessment teams
> Urban search and rescue
> Medical Assistance
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•
•
•
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Critical care medical assistance
Acute care medical assistance
Subacute medical assistance
Management local victims
Evacuation and repatriation
> Humanitarian aid
• Financial, infrastructure, supplies
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What can we do now?
Urban Search And Rescue (USAR)
> 11 countries in Asia Pacific Region
registered with the International Search
and Rescue Advisory Group (INSARAG)
• Australia; China; Finland; Japan; Kazakhstan;
Korea; Malaysia; Saudi Arabia; Singapore;
Slovenia; Tajikistan
> Medical components
• Team and initial evacuation of victims
> Self sufficient for 10 days
> Coordination and Communication
• United Nations Office for the Coordination of
Humanitarian Affairs, Field Coordination
Support Section (UN OCHA (FCSS)
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What can we do now?
Medical Assistance Teams
> Military
• MedEvac, CCAT
> Government Civilian response
• AUSMAT (Australian Medical Assistance
Team); DMAT (NZ); JDR (Japan)
> Non-Government Civilian response (NGO)
• Red Cross, WHO, Private insurance
companies
• Self tasking; personal agendas
> Coordination and Communication
• Specific requests for assistance
• United Nations Disaster Relief Organisation
(UNDRO)
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Air Medical Capabilities
> Regional vs International
> Rotary Wing vs Fixed Wing
> Civilian vs Military
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Rotary
Wing
Military
Rotary
Wing
Fixed
Wing
Lear
Jet
Military
Medium
Transport
Military
Heavy
Transport
Speed
(kph)
230
300
450
775
625
800
Range
(km)
760
800
3300
4815
5100
4500
Alt (ft)
10,000
20,000
30,000
45,000
30,000
45,000
Stretcher
Patients
2
12
2
1
76
90
Example
Bell 412
NH90
Pilatus
PC12
36A
C130
Hercules
Boeing C17
Globmaster
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Rotary Wing
BK 117
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Black Hawk
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Black Hawk
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NH90
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NH90
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Fixed Wing
Pilatus PC12
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Pilatus PC12
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C130J Hercules
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C130J Hercules
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C17 Globemaster
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C17 Globemaster
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C17 Globemaster
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Transport to the Airfield?
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Recent Disasters and the Air
Medical Responses
> Bali Bombings – 12th October 2002
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•
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202 dead (including 88 Australians and 38 Indonesian),
240 wounded
Private agencies
ADF
> Indonesian tsunami – 26th December 2004
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230,000+ dead, 125,000+ injured
USAR 11 countries (Australia, Singapore, US), AUSMAT
response
> Samoa tsunami – 29th September 2009
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170 dead, 140 injured
Australian AUSMAT and USAR
NZ response
> Pakistan floods – July 2010
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1980 dead, 2950 injured
USAR (UK); AUSMAT
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Recent Disasters and the Air
Medical Responses
> QLD floods – 10th January 2011
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18 dead
Australia USAR
> Cyclone Yasi, Queensland, Australia – 2nd Feb 2011
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1 dead
333 pt moved within 24 hours to Brisbane; Boeing C17 and
C130J Hercules, ADF medical response augmented by
specialist medical reservists
> Christchurch earthquake – 22nd Feb 2011
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•
182 dead, 1500-2000 injured
Australia (USAR and AUSMAT), Japan (USAR), Taiwan
(USAR), Singapore (USAR), US (USAR), UK (Fire SAR),
China
> Japan earthquake and tsunami – 13th March 2011
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•
28,000 dead, 2800 injured
USAR – US, China, South Korea, Australia, NZ
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Japanese urban search and rescue team in Christchurch, 24 February 2011
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Issues
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Political agendas
Fears of Military involvement
Central Coordination/Control
Rapid response
Multiple roles
Repatriation vs Local management
Equipment and Supplies
Training – teams and locally
Costs
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What do we Need?
> Politically independent
> Centrally coordinated and controlled
> Clear communication systems nationally
and internationally
> Self sufficient
> Extended period of time
> Immediate response capability
> Ongoing assistance capability
> Self funded
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What do we Need?
International Rescue?
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"Do not pray for tasks equal to your powers but
for powers equal to your tasks.“
Reverend Dr. John Flynn
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References
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>
>
Disaster Medical Assistance Teams: A Literature Review.
Health Protection Group, Anton Breinl Centre for Public Health
and Tropical Medicine, James Cook University. April 2006.
www.health.wa.gov.au/hpg Cited 9th May 2011
INSARAG – USAR Directory.
http://vosocc.uncha.org/USAR_Directory Cited 6th May 2011
Civil-Military Coordination during humanitarian health action.
Global Health Cluster – Position Paper, Provisional Version
February 2011.
http://www.who.int/hac/global_health_cluster/about/policy_strat
egy/position_paper_civilmilitary_coordination/en/index.html.
Cited 6th May 2011
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