Alamo Medical Response Group

Photos from Captain Elaine Milam Vetter

The attached are photos taken at the New Braunfels Command Center and at the shelters.  The first one is of General Powers and the AMRG Team during his visit to the New Braunfels Command Center .  Captain Elaine Vetter, General Powers, Sgt. Clark, Major Kathleen Carter and 1^st Lt. Melissa Medina greet General Powers.

The second photo is of evacuees who had recently immigrated to Texas from Burma .  This was at the Churchill Shelter.  This is the shelter where the baby was born.  Texas State Guard members were very involved with helping the new mother.  Most of the people did not speak English.  As we were getting ready to close this shelter the “leader” of the evacuees stopped to tell us that when they were told that people in the guard would be looking out for them they were afraid.  But he wanted someone to know that the care his people received at the shelter and the way we respected their culture made them feel comfortable dealing with people in uniform.    I experienced this first hand.  On my first visit to the shelter the people looked down as I passed them.  On the last day the children AND ADULTS were waving and smiling at us.

If you do not have a scanner, save the Medical Screening Form on your computer, complete the medical information requested, type “Signed” in the signature block area, type your name were it says to Print it, and HQ will accept that as "signed".  

After completing the Medical Screening Form, attach the document to an email and send it to MAJ Mary Jo Gunnison <JI.JO@cox.net>.

You may Fax your medical Screening Form to HQ using 512-782-5951.  If yoy fax your medical Scrrening Form to Austin, please email Maj Gunnison (above) and let her know that you sent in form via Fax.

To all AMRG, Corpus and Austin personnel:  Please read, sign and return via email attachment the Medical Screening Fom and the Prohibition Against Consumption of Alcoholic Beverages Forms that appear to the right.

Completed forms may be emailed to peterforsberg@sbcglobal.net .  These Forms must be received by AMRG HQ prior to deployment.  You will need to sign, scan and email these documents asap.

Thank you.

TAPA has been monitoring Hurricane IKE and its impact on Texas PAs.  If a state of emergency is called by Governor Rick Perry or the US Government and medical teams are needed, our emergency PA laws will come into effect.  If this happens, contact your local hospital and/or city government to see what you can do to help.  You will need to have documentation to prove you are a licensed PA.  Below you will find the language from the statute concerning PA emergency rules in case you have additional questions.

Also, these links can be utilized if you have left your license and DEA certificates at the office:

http://www.tmb.state.tx.us/

https://www.deadiversion.usdoj.gov/webforms/dupeCertLogin.jsp

Occupations Code

Chapter 204

SECTION 1.  Subchapter E, Chapter 204, Occupations Code, is amended by adding Section 204.2045 to read as follows:

Sec. 204.2045.  SERVICES PERFORMED DURING DISASTER.  (a)  The supervision and delegation requirements of this chapter and Subtitle B do not apply to medical tasks performed by a physician assistant during a disaster under the state emergency management plan adopted under Section 418.042, Government Code, or a disaster declared by the governor or United States government.  This section does not apply to medical tasks performed by a physician assistant for compensation or other remuneration.

(b)  A physician assistant performing medical tasks under this section is entitled to the immunity from liability provided by Section 74.151, Civil Practice and Remedies Code.

(c)  A physician assistant may perform tasks described by this section:

(1)  under the supervision of any physician who is also performing volunteer work in the disaster; or

(2)  without the supervision of a physician, if a physician is not available to provide supervision.

(d)  A physician assistant employed by the United States government or licensed in another state may perform medical tasks in this state in circumstances described by Subsection (a) without holding a license in this state.

To All AMRG Personnel,

0700 hrs, 8 September 2008

I've just been told that the Brigade will be called up tomorrow.

Those who have or will provide availability starting tomorrow will be asked to report for duty - No Later Than 1300 hrs.  Location TBA

If you are unavailable tomorrow, but wish to participate at a later time, you may have the opportunity. 

Only those personnel who are actually available for duty tomorrow, Monday, 8 September 2008 will be asked to report tomorrow.  The rest of the unit should stand-by.

It is essential that I receive your availability information this evening. I will be working in the ER at University Hospital all night and phone calls will be a problem.  If you need to call please try to call after 0800 hrs on Mon, 8 Sep 08 (tomorrow).

AMRG members will receive further instructions from me.

Austin and Corpus Christi members will receive instructions from their company commanders re: where to report.  I will contact the Austin and Corpus comanders this evening

See the instructions for TXSG Med Bde Shelter Medical Support (below)

. . . . . . . . . . .

TO:         BG Marshall Scantlin

RE:  Shelter Management HQ Team Force Package - Medical Support Assignment

ACTION Level: Urgent

COL Miller has informed me that the TXSG Shelter Management plan has been revised to include a Medical Support Team for each Shelter Management Hub.   This change is effective immediately and will apply to the next deployment.  This could mean next week.  This change is internal to the TXSG and is not an OPORD JOC tasking for a hurricane.  The tasking is Shelter Hub Management and the Medical Support Team is part of the Shelter Hub Team now.

What is mission of a Shelter Management HQ Team Force Package?

Prior to a hurricane making land fall TXSG Shelter Management Teams are deployed to open and operate local mass care general population shelters.  Once 3 or more shelters are located in an area a Shelter Management HQ Team Force Package is dispatched to support those individual TXSG Shelter teams.  If the total number of shelters exceeds the ICS span of control standard then a second Shelter Management HQ Team Force Package is dispatched to maintain that 2 to 9 ratio of shelters to a Shelter Management HQ Team Force Package. 

In the Hurricane plan, shelters must be operational at H-72 so that the TXSG shelter teams are activated in the H-96 to H-72 time period.  This is when we will now be expected to activate the Medical Support Teams.

What is the mission of Medical Support Team?

1. To provide screening and triage of entering general population evacuees and diverting those with chronic conditions who require MSN levels 3 to 5 to Medical  Special Needs shelters or appropriate hospitals.

2. To provide immediate stabilization of acute patients and transfer them to local
EMS units for transport to a hospital.

3. To provide trended epidemiological information on emerging conditions in the evacuee population.

What is the make up of a Medical Support Team?

The team consist of four individuals:

1 MD/OD/PA/NP or Nurse Manager (Team lead, with ED or triage experience)

1 RN/LVN with triage nurse experience

1 Medic (Paramedic, EMT-I or EMT-B)

1 Administrative Support (with medical registration experience)

How will the Medical Support Teams function?

The MST will work for the Shelter Management HQ Force Package Commander and be assigned to individual shelters as they are opened and filled.  Once a single shelter is nearly full a second is opened and the team would move there.  TMB command will manage the staffing and rotation of staffing on the MST’s.

What actions are needed to implement this?

1. Concurrence with this concept and assignment.

2. Notification of Group Commanders of the assignment.

Group and Company Commanders to define available qualified resources to man the needed teams.

3. Once the WARNORG for Shelter Management Teams is issued, notify qualified team members.

4.Once an OPORD tasking Shelter Management Teams of TXSG, activate and deploy the number of teams required for support of each HUB Shelter Management HQ Team Force Package. 

5. Activate a TMB-HQ command staff team to support the MST deployment.

How many MST’s could be activated?

From two to nine MST’s could be required or from 8 to 36 personnel.

What medical equipment will be provided?

See attached spreadsheet.  Most equipment will be provided from ARNG MedCom.  This will be coordinated through the Jt State Surgeon Office.  Individual MST member will need to bring personal medical equipment.

What consumable medical items will be provided?

See attached spreadsheet.  This will be coordinated through the Jt State Surgeon Office.

Prepared by:

COL Frank Stead

Deployment Commander

PETE FORSBERG

LTC (TX) TXSG MED BDE (MRC)

COMMANDER

AMRG

210-317-3363

peterforsberg@sbcglobal.net