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Medical Surge Planning
Modular Emergency Medical System
In 2003, the Regional Medical Bio-Defense Networks adopted the Modular Emergency Medical System (MEMS) framework to establish alternate care sites within Michigan. The MEMS is designed to provide a systematic, coordinated and effective medical response to a mass casualty incident. Each Regional Medical Bio-Defense Network, working with local public health and emergency management, has identified and established mechanisms to mobilize equipment, supplies, and personnel to standup Neighborhood Emergency Help Centers (NEHC) and Alternate Care Centers (ACC).
During an event, the NEHC is designed to be the medical system entry point for individuals who present for care during a mass casualty incident. The purpose of the NEHCs is to keep non-critical victims away from local emergency departments.
An ACC may be activated when a hospital surges beyond its capacity. The ACC is designed to treat patients who need more extensive care such as hydration, pain management, or end-of-life care. These facilities are not routinely designed to provide acute critical care.
Both the NEHC and ACC facilities are supported through an established Regional Medical Coordination Center (MCC). This critical resource is compliant with the National Incident Management System (NIMS) and functions as a multi-agency coordination system that emphasizes coordination among local/regional medical health agencies and emergency management. As an emergency coordination center, the Regional MCC helps facilitate standardization and interoperability of healthcare operations and ensure optimum and efficient use of resources.
Michigan Transportable Emergency Surge Assistance (MI-TESA) Medical Unit
The Michigan Transportable Emergency Surge Assistance (MI-TESA) Medical Unit is a state resource consisting of a 100-bed mobile field hospital that is stored and maintained by the Region 2 South Medical Bio-Defense Network, and a 40-bed mobile field hospital that is stored and maintained by the District 5 Medical Response Coalition. The MI-TESA Medical Unit expands surge capacity, re-establishs emergency triage, and treatment in an area where the healthcare infrastructure has been disrupted. The unit may be deployed anywhere within the state, and can be deployed to other states through the Emergency Management Assistance Compact (EMAC).
Burn Surge Planning within Michigan
Michigan has been working to develop innovative strategies to provide care to burn patients after an emergency event. The plan develops non-traditional burn care resources to provide surge capacity during a mass casualty incident. This strategy protects those facilities with definitive burn care capacity from being overwhelmed through the use of off-site triage and stabilization. This is done in collaboration and coordination with the University of Michigan Burn Center which serves as the State Burn Coordinating Center.
Ethical Guidelines for the Allocation of Scarce Medical Resources and Services During Public Health Emergencies in Michigan
During a public health emergency, decision-makers must carefully consider the development and implementation of practical, logistical, and scientific methods necessary for effective response and recovery. In 2009, a diverse group of professionals authored a report that provides a template for healthcare personnel throughout the state can make tough choices about resource and service allocation and prioritization.
A significant mass casualty event is a challenge for any community. If a mass casualty incident occurs that overwhelms local resources, the Michigan Mortuary Response Team (MI-MORT) can provide assistance to medical examiners, public health, and emergency management. The response team is comprised of diverse professionals including: forensic pathologists, dentists, anthropologists, funeral directors, x-ray technicians, and many others. This team, when activated, provides technical assistance to local and regional jurisdictions to recover, identify, and process deceased victims in a dignified manner. An additional MI-MORT resource is the Disaster Portable Morgue Unit which contains the equipment and supplies necessary to initiate operations of a fully functional morgue when needed.