Webinar, June, 20th, 2017

EMT :
Introduction

Handoyo Pramusinto

Pusat Kebijakan dan Manajemen Kesehatan (PKMK)

Fakultas Kedokteran UGM
 Emergency Medical Team (EMT)
Definition

The term EMT refers to

groups of health
professionals providing
direct clinical care to
populations affected by
disasters or outbreaks
and emergencies as
surge capacity to
support the local health
Emergency Medical Team
system
| Medical
TrainingTeam Coordination Cell Training
2
 Inaugural by the Secretary General

High vulnerability and risk profile

EMTs are very important
Tsunami experience
Coordination is the challenge
EMT Experience of Hajj (mass gathering)
220,000 pilgrims in 2017
More than 40 days of stay in Saudi Arabia
Develop guidance form this meeting
 WHO Representatives address

Recent disasters in the country and region

Indonesias domestic and international deployment

WHO EMT Initiative and standardization

Solution to EMT Coordination: EMTCC
Challenges:
Immigration, workforce deployment procedure, logistics,
customs, finance, etc
EMT Initiative is improving the response globally

NEPAL 2015 Govt military Govt civilian NGO

Rapid, heavy
deployment by
regional Government
teams (often Type 2
and 3) matched
trauma wave

Note trauma wave

in shaded area
behind graph

Emergency Medical Team

| Medical
TrainingTeam Coordination Cell Training
5
 EMT Classification
Type Description
1 Mobile Mobile outpatient teams Remote >50 outpatients a day
area access teams for the
smallest communities
1 Fixed Outpatient facilities +/- tented
structure
2 Inpatient facilities with surgery
3 Referral level care, inpatient
facilities, surgery and high
dependency
Specialist Cell Teams that can join national
(eg rehab, surgical, facilities or EMTs to provide
paediatric, infectious supplementary specialist care
disease etc) services
Medical Team Coordination Cell Training
6|
Capacity
>100 outpatients a day
>100 outpatients and 20 inpatients
7 major or 15 minor surgeries daily
>100 outpatients and 40 inpatients
Including 4-6 intensive care beds
15 major of 30 minor surgeries daily
Any direct patient care related service can
be termed a specialist cell EMT when given
in emergency response by international
providers/clinicians
 Referral Pathways

Type 3

Type 2

Type 1

Emergency Medical Team

| Medical
TrainingTeam Coordination Cell Training
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Global Mentorship & Verification Program

Emergency Medical Team

| Medical
TrainingTeam Coordination Cell Training
8
 The Concept of EMT Initiative

EMTs have an important role to play in the

saving of life and alleviation of suffering post
impact of a Sudden Onset Disaster (SOD)

Registration and quality assurance of EMTs

(200+ estimated)

Country declarations that they will not accept

teams from the international community that
do not reach the minimum standard
 The Concept of EMT Initiative

Enhancement of national team response and

national capacity to coordinate, with WHO and
UN-OCHA support

Enhanced Knowledge of Classification,

Capability and Coordination Mechanisms

Teams that are predictable, timely and self-

sufficient
No individuals or small groups without equipment,
medications or means of self-caring
388 (78 %) regencies/cities : high-risk
109 (22 %) regency/city : medium-risk
 PREP
MITIGATIO ARED
N NESS

INSTITUTIONAL
/ POLICY

STRENGTHEN
ING
CAPACITY

EARLY
WARNING

PARADIGM
GOVERNMENT CLUSTER APPROCH
PRIVATE SECTOR DRR RESPONSE TIME
CIVIL SOCIETY INTEGRATED IN THE
DEVELOPMENT OF A
COUNTRY
MANAGEMENT
INSTITUTIONAL
SYSTEM
 Crisis Centre

National Strategy
R = H V/C
Concept of EMT in Indonesia
Capacity building of health system
Responsibility of
Government (Civil & Military)
Non-governmental organization
Private sector
EMT as a sub-cluster of Health Cluster
Managed by local health authorities/ HEOC
 Crisis Center 2

National plus 11 Regions: Domestic deployment

One Type III
11 Type II
Specialist Cell
For international registration/deployment
One EMT Type II and Specialist Cell
At district level
One Type II
One Type I Fixed and Mobile
 Example :
Health center outpatient : EMT type I Mobile
Health center inpatient : EMT type I Mobile or Fixed
District Hospital (C,D) : EMT type I fixed or Type II
Province Hospital (A,B) : EMT type II or III
For National : EMT type III and specialist cell
 Pidie Jaya EQ Experience
7th December 2016
App. 100 deaths
Mobilization of local and provincial EMTs
Coordination
Disaster tourism
Inadequate teams, inadequate stay
Needs/recommendations:
Acceptance/Decline Form
Registration and Tasking System
National Accreditation
Daily Reporting
Exit Report
Building area for Temporary Hospital Pidie Jaya
UGMs team with chief of Bandar Barus Health Center, Pijay
After Wound Care Training
 EMT in Disaster situation by Ian Norton

EMTs training and disscussion in Jakarta , divided to 4 group works

 Group Work - EMTs
Group 1: Preparation & pre-stored logistics
Incentives?
Insurance?
Water suplay needed in disaster?
Group 2: Pre-deployment screening & training
Ratio of volunteers/recruits,
Different levels of medical screening
Psychological screening
Vaccination
Database
Training
Exercise Golden Rules

Dea
Eart d : Inju
hqu red
Tsun a ke
a mi
9 1: 3
:1
Seriously injured: 20% of total injured
 Group Work EMTs

Group 3: Activation, offers, acceptance & team

formation
Offer Vs request
Team selection a fair & transparent process
Just in time training
Group 4: On deployment SOPs, coordination &
reporting
Fire SOPs (Plastic, Oxygen, Diathermy/ electric spark)
HEOC
Media/ pictures
 Group Work EMTs

Group 5: Emergency evacuation, demobilization,

after action review
Logistics during team rotation
Team leader bridging across
Mystery meat: Albendezole
Psychological screening: Immediate/Hot, optional,
longer term
Academic colonialism
Forum Disscussion of EMT in INSARAGs Meeting
Thank You