South Florida Regional Disaster Medical Assistance Team, Inc'

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Hurricane Charley

• On the morning of August 13, 2005, Hurricane
  Charley was heading for Tampa St. Petersburgh,
  Florida.
• Patients were being evacuated out of the Region
  in preparation for a 6 PM landfall.
• At 430PM the Storm became a CAT 4 and veered to
  the right slamming into Punta Gorda approximately
  100 miles South of Tampa.

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Charolette Regional Medical Center

• The Hospital was badly damaged with the 3rd Floor
  ICU suffering extensive damage.
• The ICU was full with numerous patients having
  been transferred from Tampa.
• When the storm hit, the nurses moved the patients
  across the hall.
• The back-side of the storm hit the patients a
  second time.
• When FL-5 DMAT arrived 76 patients were trapped
  and severely injured.

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The Beginning

• FL-5 DMAT arrived in Punta Gorda at approximately
  10PM.
• A medical team was immediately sent into the
  hospital while the logistical team set up the
  treatment tents
• By 1115PM we were able to see patients in our
  treatment tents.

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Lesson 1 Bring the Pharmacy Cache!

• When FL-5 DMAT was Deployed we were told NOT to
  bring any of our Team or State Owned equipment.
  A Patient Care and Pharmacy Cache was being
  shipped and would meet us in Punta Gorda.
• Fortunately, our trucks were packed earlier in
  the day and the Pharmacy Cache had been loaded on
  the front of the truck. We did not have time to
  reload the trucks.
• We would not receive the Pharmacy Cache until day
  10 of the deployment

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Lesson 2 You Never Know When you will need
medications.

• At 2AM on 14August04, a FL-2 Team member was
  stung by a spider and developed an anaphylactoid
  Reaction.
• He was transported to FL-5 DMAT where he received
  0.3 mg IV Epi x3, 50 mg IV diphenhydramine and
  125 mg of IV prednisolone.

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The Pharmacy Cache finally Arrived on Day 10

• We had treated nearly 3200 patients, dispensed
  2400 prescriptions, and filled 2,200 medication
  and IV administration orders.
• We were able to get a few medications and IV
  fluids from the flooded Hospital Pharmacy.
• On Day 5 Lee Joffee, R.Ph. from NY-1 arrived at
  the MST, came to visit and was able to arrange an
  emergency order with Cardinal to replace items we
  were running low on. Lee Saved the Day.
• NDMS now permits Teams to temporarily donate
  their Team owned Pharmacy Cache and equipment to
  NDMS. You can take anything you have room for
  after filling out a single form.

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Lesson 3 Pharmacist Staffing

• The current Table of Organization allows Teams to
  deploy with one Pharmacist and one Pharmacy
  Technician.
• It would be impossible to SAFELY operate 24 x 7
  x14 days.
• Deployed as a Deputy Commander, I had to work 12
  hours/day as a pharmacist.
• The ideal staffing should be
• Two Pharmacists
• Two Pharmacy Technicians

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Lesson 4 These meds are needed in large numbers!

• Td toxoid pre-filled
• Albuterol 2.5 mg/3mL
• Prednisone 20 mg tabs
• Cephelexin 500 mg caps
• Cephazolin 1 gm IM/IV
• Morphine 10mg/2mL
• Cephtriaxone 1 gm
• Levofloxacin 500 MG tabs
• Gentamicin 0.3 Ophth.
• Diazepam 10 mg/2 mL

• Ibuprofen 400 mg tabs
• Ketorolac 30 mg IM
• Albuterol MDI
• Acetaminophen 325 mg
• Cyclobenzaprine 10 mg
• Regular NPH Insulin
• Prochlorperazine 5mg/mL
• Propofol 10 mg/mL
• Augmentin 875/125mg
• CoTrimoxazole DS

All current ACLS Medications
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Lesson 5 Prepare Emergency Kitsfor Rapid
Clinical Use

• RAPID SEQUENCE INTUBATION
• Etomidate 0.3 mg/kg, Succinyl Choline 2 mg/kg,
  Vecuronium 0.1 mg/kg
• ACUTE ONSET SEIZURE
• 50 mL 50 Dextrose, Diazepam 10 mg, O2 Canula
• ACUTE CORONARY SYNDROME
• NTG 0.4mg, ASA 325mg, metoprolol 5mg IV x3,
  Heparin, Retavase
• ACLS MEDICATION CRASH CART
• CARDIAC DYSRHYTHMIA KIT
• Lidocaine 100mg x 2, Amiodarone 300mg, Adenosine
  6 12 mg,
• Atropine 1 mg x2, Propranolol 1 mg x3,
  Procainamide 500 mg.

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Lesson 6 Standard Treatment Protocols
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South Florida RegionalDisaster Medical
Assistance Team
Questions?
www.fl5dmat.com