DEPLOYMENT

The TADMAT will be prepared for a deployment within 12-24 hours. The following activities will be performed:

  1. Pre-Alert: When information regarding a disaster is obtained by whatever means, the TADMAT Unit Commander or Executive Officer or a majority vote of the Executive Committee have the option of putting the Executive Committee on "pre-alert". Usually the pre-alert will precede notification but it is possible to run these concurrently. At this time all Executive Committee members may be told to report for a briefing and planning. A member of the Executive Committee will place a message on the TADMAT voice mail system regarding the present situation.
  2. Notification/Alert: This occurs only after contact between the requesting agency and the TADMAT Unit Commander. At this time, the pagers and/or phone tree system will begin placing calls to all team members to put the team on alert and request their availability for the deployment or if they will be available for TBOT/"Home Team" operations. It is important for team members to understand that response to a notification is up to the individual and totally voluntary. Information regarding the particular disaster and possible deployment will be available as described during the call up. Generally, this information will be posted by members of the Executive Committee on the voice mail system. Written intelligence reports may be faxed to all personnel on the fax distribution list for postings at the local hospitals.
  3. Activation: For a Federal activation, the TADMAT will be activated under the terms specified in the Memorandum of Understanding between NDMS and The Medical College of Ohio (Appendix D). Upon federal activation, individual team members become employees of the federal government, specifically the Public Health Service. For a State or local disaster, the team will be activated under the same plan however compensation is provided for the team members at the discretion and pre-arrangement with the activating agency and team members should be aware that they may not receive any reimbursement. In both events, they will receive workers compensation insurance and malpractice insurance in accordance to arrangements made with State and local governments or by arrangements with the OEP/NDMS office.

Voice mail system: Individual team members will be kept informed of the progress toward activation by calling a pre-set telephone answering machine which will contain pertinent, updated information (419) 381-5163. The decision to utilize individual team members on an activation will be made by the Executive Committee upon approval of the Unit Commander.

  1. That final selection of team staffing will be based upon evaluation considerations listed within this policy manual, the needs of the team for the specific deployment situation, the point system, and other criteria deemed significant by the majority of the available Executive Committee and / or Unit Commander.
  2. The list generated during call up of persons available for deployment will be provided to the Executive Committee
  3. Team members chosen for activation will be notified by phone or in person (if possible) if they are to go with the team or be used as part of the TBOT / "Home Team".
  4. Upon notification, the team member should get the activation checklist (appendix B) and the personal equipment list (Appendix A) and go through them for completeness. Keep in touch with the TBOT / "Home Team" for updates via the answering machine.

MEL Master List: A Medical, Event and Logistics (MEL) master List is prepared by the Executive Committee during a pre-alert in preparation for a full activation (Appendix F). The MEL requires information on:

Information required to complete the MEL should be requested from the appropriate state or federal liaison officer. A more complete MEL will be duplicated for the Executive Committee who will then concentrate on areas of greater concern. The MEL will be used for DMAT briefings from stand-by through deactivation.

Deployment Procedures:

Cargo and loading rules: Team items will be packaged according to International Air Transportation Association (IATA), or DOT regulations for ground transport. Certain members of the team have been trained to enable the TADMAT to pack and load team and individual gear to comply with those regulations. If the Civil Reserve Air Fleet (CRAF) is used, compliance with the individual airline's regulations will be followed. Team members will may also need to have their individual gear weighed prior to boarding an aircraft. Weight is crucial in computing the overall aircraft load plan. Weight for individual packs should not exceed 70 pounds.

Team members may also be asked to leave items forbidden by IATA or DOT regulations or items deemed inappropriate by the Unit Commander for a specific disaster site. All team members will be asked to assist with last minute loading, packaging, crating and unloading of items.

Inspection: Individuals gear will be checked to assure the flight crew that no materials exist which could be used to hijack an aircraft. As well, these inspections are used as a safety check to prevent unauthorized items such as pressurized gas containers being carried on the aircraft or hazardous materials that may violate a IATA or DOT transport regulation.

Safety: When preparing for deployment the safety of team members is extremely important. Public Health Service and Military regulations do not allow members to:

  1. Have weapons on their person while flying.
  2. Have large knives, guns or explosives in their baggage.
  3. Have pressurized or fueled containers such as butane or gasoline.
  4. Have non-prescription / classified drugs, recreational drugs, or alcohol.

An USPHS/NDMS and / or TADMAT Picture ID must be carried to board the plane and at all times throughout the deployment.

Immunizations should be up to date at all times. Contact your local health office or personal physician to update your immunizations. Special immunizations required to deploy to a certain location will be provided by the TADMAT prior to deployment.

Family Emergencies: Active team members should keep their families apprised of the notification and begin making tentative arrangements for child care, etc. upon notification, even if the member ends up not being deployed. Members should understand that there will be limited seating and cargo capacity on any deployment.

The TADMAT TBOT / "Home Team" can be contacted by family for reports on the progress of the team, reports on safety of the personnel, and for passing information from the team members to their families, etc. All team members should make sure the appropriate Emergency Contact information is updated prior to deployment (Appendix E). Family members, who need to contact a deployed member during a family emergency can do so by calling the TADMAT information hotline at (419) 381-5163.

On-Site Issues:

  1. Food: Food and water resupply will be provided for all team members through federal, state or local channels. Upon deployment, members are required to have a 12 hour supply (2 quarts) of water included with their personal gear. Resupply meals will usually be Meals Ready to Eat (MRE's) or donated food. The TADMAT will provide shelter and other team items necessary to accomplish the mission.
  2. Camp Conduct: All team members, regardless of their status or professional licensure are expected to participate as a team in all activities especially during loading and unloading, setting up equipment, sharing food and equipment and looking out for their fellow team members' well being. Nowhere is attention to detail more important than around the camp site. It is extremely important to pay attention to safety at all times while in the camp area due to the increased fatigue and stress all team members will experience during deployment. All team members must follow the rules of good camp conduct.
  3. Personal and Camp Sanitation: Material which needs to be discarded is to be placed in plastic trash bags. Personnel from each tent will be responsible for cleaning its own area.

Rest room facilities are usually primitive at best. Human waste may be collected in what are called "honey buckets". It may be necessary to burn the contents of these buckets using a combustible fuel. This camp chore, along with a variety of others, will be assigned to team members through use of a working assignment matrix.

Other cleaning and sanitation chores may arise which are vital to the smooth operations of the site. Potential active team members should be aware that a great deal of time and effort will be spent doing non-medical chores such as hauling water, carrying and unpacking or repacking boxes, setting up tents, digging trenches around tents, etc. Each team member will usually be physically and emotionally spent by the end of an activation period. Members should be prepared for such physical and sensory stress.

Personal Conduct: During Federal deployments, the federal government has very straightforward expectations of its employees as does the TADMAT. They are representatives of the United States and should conduct themselves accordingly. Drug and Alcohol use will not be allowed. See Appendix (TADMAT Alcohol & Drug Policy).

As the tents will be shared by men and women, serious consideration must be paid to modesty in dress and behavior while on-site.

Tents: TADMAT personnel will be assigned to the various sleeping tents based upon which shift and group they are working with. It will be the job of the shift supervisor to post sleeping hours (lights out) for each tent. TADMAT members are encouraged to not use the sleeping tents for general gatherings.

  1. Each tent has an equipment box that contains a fire extinguisher and tools. The shift supervisor of each tent will have the responsibility to ensure the fire extinguisher is available and that all personnel in the tent know its location and usage. The personnel will also be responsible for digging a trench around their tent to prevent water from seeping under the tent during bad weather. Each tent will be cleaned prior to folding and storage at the end of a deployment.
  2. Campfires are not permitted unless otherwise specified by the Unit Commander.
  3. Smoking will NOT be permitted in the tent at any time.

Power Supplies: The team will take generators for the radio equipment and lighting around the tent and/or patient areas. Generators are not for personal use.

Communications: Radios will be available for team communications. Due to the limited resource, only those members designated as needing a radio for their duties will be issued one. If team members wish to purchase their own radio or own a HAM radio that can be tuned to the correct frequencies, they are encouraged to do so. Personal communication equipment operators must only operate that equipment for team function. The communications team will attempt to make contact with the TBOT communications station. This method can be utilized for non-emergent personal messages back home. This function however, is a low priority duty for the communications team (emergent communications to family at home will be considered a high priority).

Personal Illness/Death: If a member becomes ill, he/she will be treated by an ALS qualified team member who is designated by the Medical Operations Officer. If specialized care is needed, the Unit Commander or designate will make arrangements for immediate transport to the nearest medical facility or back to Toledo, Ohio. An injured team member is categorized as a RED patient and given immediate treatment and stabilization / evacuation regardless of the severity of their injury. If a member dies on site and the body is recoverable, the body will be returned to Toledo, Ohio in accordance with family wishes in concert with federal authorities. If the body is not recoverable, the location of the body will be turned over to the federal authorities for further attempts to recover the body by US Military or other appropriate agencies. Notification of the next of kin will be the responsibility of the Unit Commander or designee.

Critical incident stress management will be held on-site as described in this document.

Leaving Camp: Leaving camp must be approved by the TADMAT Unit Commander, Executive Officer or Safety & Security Group Leader. Team members will be required to sign out of camp whenever leaving the area or boundaries which have been designated. Members are required to sign back in when returning to the camp site. Dress and behavior while off site will be in accordance with local laws and customs. In most situations, persons leaving camp should do so under the "buddy system". For safety reasons, no single individual should leave camp. When available, radio communications will be provided to persons leaving the campsite. Briefings will address any such considerations.

Leisure time will be coordinated through the Executive Officer or designee. Due to the teams high profile nature during activation, leave from the team must be approved. Use of alcohol while enroute, on call or on duty is prohibited. Use of illegal drugs is prohibited.

Present team policy requires that the team members sign in and out when leaving the team area. The Safety & Security Officer or their designate must be aware of anyone who is leaving the area at any time. If during a deployment a team member is negligent in following this procedure, there will be an inquiry of the incident at the next available convening of the Executive Committee and disciplinary action will be recommended by the Committee. If the situation becomes habitual during a deployment, the Unit Commander or Executive Officer will be notified of the situation and will take immediate action commensurate with the situation.

Deactivation: After a deployment, the TADMAT will not stand down from the current deployment but begin preparation for another deployment within two (2) weeks by implementing the following:

  1. The Executive Committee will write an "After Action Report" summarizing the effectiveness of the TADMAT and how to improve upon the next deployment.
  2. Suggestions from team members for improving the performance of the TADMAT for future activation will be elicited by means of a survey. The Executive Committee will review this survey in preparation of the After Action Report.
  3. Critical Incident Stress management (CISM) meetings will convene within 2-5 days post deployment. Meetings will continue as needed. CISM team members may be contacted at any time by team members if they so desire.
  4. Individual section chiefs will report to the Executive Committee personnel performance and what equipment or training is required to prepare the TADMAT for another deployment within 2 weeks.