SMAT

The terrorist attacks of September 11, 2001 and subsequent anthrax exposures have ignited a renewed commitment in the state of North Carolina to strengthen our readiness and our capacity to respond to a terrorist attack. Numerous local, state, and regional agencies are collaborating on multiple scenarios that exist now that the threat of terrorism is real.

Specifically, four agencies have recently joined efforts to consider the treatment and response phase of a terrorist event. The agencies include the: 

North Carolina Office of Emergency Medical Services (NC EMS)	North Carolina Division of Emergency Management  (NCEM)
North Carolina Division of Public Health Epidemiology & Communicable Disease (NCPH)	Special Operations Response Team (SORT)

These agencies represent the management system responsible for coordinating a disaster response, ensuring that treatment and prevention strategies are implemented, as well as disease surveillance and medical preparedness.

 The goal of this effort is to assure our citizens that when a terrorist attack occurs in North Carolina, they will be able to get the medical care services they need to protect their health and prevent the further spread of disease. Priorities include enhancing disease monitoring and investigation systems, improving communication capabilities among health agencies and building the medical response capacity.

The agencies have collaborated to develop the following tiered State Medical Response System (SMRS) plan:

Type I (State Level) . SORT is a private non-profit organization located in Winston-Salem, is a federally supported disaster medical team that responds nationwide. The Type I initiative will expand the equipment and personnel of SORT which will allow them to have a dedicated set of equipment for response to incidences in North Carolina if the federal committed resources are not available.

Type II (Regional Level) , will begin to address our hospital-based capabilities (medical surgical capabilities). Each county and hospital in North Carolina is currently included in at least one of seven Regional Advisory Committees or RACs. The plan envisions that the RACs will create a sub-committee to serve as the lead coordinating organizations across the state to serve as the conduit for information, training and medical mobilization in preparation for a terrorist event. To facilitate these efforts, each RAC's sub-committee will include the health directors from each of the counties included in its geographic area and representatives from local Emergency Medical Services (EMS) and Emergency Management.

SERAC - Disaster Preparedness Committee fulfills this “sub-committee” role for the Southeastern region of NC

As proposed, a Type II  involved the delivery of seven "mobile" packages  to each of the eight lead hospitals within the RACs. These equipment trailers or shipping containers will be mobile. The equipment inventory consists of personal protective equipment, decontamination materials, medications, etc. The Type II plan entails the lead RAC hospitals in identifying medical augmentation personnel at each hospital within their respective RAC areas to respond for as short term to respond to an incident with the mobile package, without taxing the medical resources within any one facility.

Type III (Local Level) ,employs another element of the SMRS and would consist of pre-hospital disaster teams, including Advanced Life Support providers, often the first line of defense. This will involve North Carolina purchasing and distributing, throughout the state, highly mobile packages with basic personal protective equipment, decontamination equipment and medications. While much of the tiered SMRS plan is still in the developmental phase the agencies are quickly moving to outline a comprehensive plan that will account for the need to develop and train regional medical teams. Current coordination of medical activities during activation is through the existing Disaster Medical Section as written in the existing State Emergency Operation Plan.

Additional teams addressed within the SMARS plan include teams already in existence:
Regional Response Teams (HAZMAT)
Public Health Regional Surveillance Teams  (PHRST)
State Urban Search and Rescue Teams (USAR)