Altered Standards of Care in Mass-Casualty Events - Preparing Hospitals for Bioterror - page 412

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MEMS

Private M.D.s
and Clinics

Note:
All components within the MEMS area
have established communication
and coordination links

Neighborhood
Emergency Help
Centers (NEHC)

Mass
Prophylaxis

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Medical Command
and Control (MCC)
(Out-of-Hospital)

There are communication links
between the MCC, ACC, Area
Hospitals and Fatality
Management

Casualty
Transportation
System (CTS)

Community
Outreach

Acute Care
Centers (ACC)

Area Hospitals

Fatality
Management

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Casualty
Transportation
System (CTS) for
Non-BW Patients

Hospitals Out-of-Area

Flow of BW Patients and
Asymptomatic, Non-exposed
Individuals
MCC In-Hospital Option

Figure G.8 Operation of the modular emergency medical system (MEMS). (Source: U.S. Army Soldier and Biological Chemical
Command. Modular Emergency Medical System: Expanding Local Healthcare Structure in a Mass Casualty Incident. June 2002.
Retrieved Aug. 17, 2004, from http://accem.org/pdf/mems_copper_book.pdf)

the Environmental Protection Agency (EPA), as
well as emergency responders and managers
from multiple States and local communities, to
participate.
MEMS offers detailed standards for a system
of care that can be expanded and contracted in
modular units as the need arises. It provides a
framework for the organization of care, particularly
for setting up predetermined, special-use alternate
care sites. Thus, MEMS answers the questions
of what general kinds of care are provided and
where (alternate site standards). In specifying the
staffing required for alternate care sites, MEMS
also addresses who will provide care. One of the
underlying assumptions in MEMS is that resources
will be brought in or created within the area most
affected by the mass casualty event. Figure G.8 on
the following page graphically depicts the opera-
tion of MEMS.

References
1. J.F. Wackerle. Disaster planning and response. N
Eng J Med , 324:815-821, 1991.
2. L. Romig. The

“JumpSTART” Rapid Pedi-

atric Triage System. Available at: www.

jumpstarttriage.com
3. M. Benson, K.L. Koenig, and C.H. Schultz. Disaster
Triage. START, then SAVE—A New Method of
Dynamic Triage for Victims of a Catastrophic
Earthquake. Prehospital and Disaster Medicine ,
11(2), 1996
4. MEDDAC Non-Commissioned Office Develop-
ment Program. Emergency Management Planning
slide presentation. Fort Carson, CO. Available
at:http://evans.amedd.army.mil/herd/ncopd/EMP%
20ODP.ppt. Accessed December 2004.
5. F.M. Burkle. Mass casualty management of a large-
scale bioterrorist event: an epidemiological approach
that shapes triage decision. Emergency Med Clin N
Am , 20:409-436, 2002