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3 rd Annual Disaster Medicine Symposium. Austere Medical Care. 1 st Annual Disaster Medicine Symposium. A tornado strikes a hospital. ESF-6. ESF-6. 2 nd Annual Disaster Medicine Symposium. Housekeeping. First....A few announcements to make life a little easier for all of us.

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3 rd annual disaster medicine symposium
3rd Annual Disaster Medicine Symposium

Austere Medical Care

1 st annual disaster medicine symposium
1stAnnual Disaster Medicine Symposium

A tornado strikes a hospital....

Esf 6


2nd Annual Disaster Medicine Symposium


  • First....A few announcements to make life a little easier for all of us.


We understand you are all busy... but please put phones on silent or vibrate...

Housekeeping cont
Housekeeping... cont.

  • Keep questions till speaker finishes, please...

    • We will endeavor to answer questions then.

  • Note the fire exit nearest your location...

    • We wouldn’t be into DM without pointing it out...

  • Rest rooms are located in the hallway

    • Back entrance of the lecture hall, turn to the right.

Rest rooms
Rest Rooms

  • Rest rooms->


  • Back of Auditorium --->

  • Vending Machines------>

    • (Off of Founder’s Hall)

Housekeeping cont1
Housekeeping... cont.

  • Lunch...

    • You are on your own for lunch

    • There is a cafeteria in the main Schusterman hall

    • There are many restaurants locally

    • Vending machines are in “Founder’s Hall”

  • We are taking limited breaks... feel free to take a break on your own, if you need.

    • The mind can only absorb what the butt can endure.

Housekeeping cont2
Housekeeping... cont.

  • Evaluation -

    • We want to find out how we did... and what you want from us next. Without your input, that’s difficult... Help us, please.... This will be emailed to you via Survey Monkey

    • Certificates will be mailed to your physical address.

      • Make sure we have it! We need you to register.

  • Survey -

    • We are looking at starting new Education programs. Help us set priorities... fill out the survey!

Housekeeping cont3
Housekeeping... cont.

  • The handouts and slides are located at:


    and drill down to disaster symposium.

Austere medicine magnitude of the problem
Austere MedicineMagnitude of the Problem

Charles Stewart MD EMDM

Disaster medicine is a growth industry
Disaster MedicineIs a GROWTH Industry!

It s not gonna happen here we aren t a third world country
It’s not gonna happen here… We aren’t a third world country…

Like Haiti?

Or…Japan?Happened here…

Or…USA?Happened here too…

Recent austere opportunities
Recent ‘Austere’ Opportunities

  • 2004 Indian Ocean Tsunami

  • 2005 Katrina – (of course)

  • 2007 December Ice Storm

    • This left far more than the Tulsa and OKC areas without power.

  • 2010 Haiti Earthquake

    • (One could argue that Haiti was austere medicine PRIOR to the earthquake)

  • 2010 Chili Earthquake

  • 2011 Japan Earthquake and Tsunami

    • Forget the nuclear problem…. Nearly a M are without power.

2004 indian ocean tsunami
2004 Indian Ocean Tsunami

  • A between 9.1 and 9.3 Richter subduction earthquake triggered a series of devastating tsunamis along landmasses bordering the Indian Ocean

    • Third largest earthquake measured

      • There were no tsunami warning systems in the Indian Ocean

    • Killed over 230,000 people in fourteen countries

    • Inundated coastal communities with waves up to 30 meters (100 feet) high

A host of problems
A host of problems


Medical care in the usual places is not available

They had supply problems




Even… fatality management


  • At least 1,836 people died in the actual hurricane and in the subsequent floods,

    • the deadliest U.S. hurricane since the 1928 Okeechobee hurricane;

    • total property damage was estimated at $81 billion (2005 USD)

    • Many private caregiving facilities that relied on bus companies and ambulance services for evacuation were unable to evacuate their charges because they waited too long.


  • Forget the nukes…

    • Look at the damage caused by the waves and the earthquake.


  • 20th March - over 8277 dead and 12722 missing

  • The “dead” are the number of the bodies found by police and rescue workers.

  • The “missing” are those reported missing by friends and family.


  • According to Japanese government reports, 392,000 evacuees are housed in over 2200 locations as of the 19th.

  • This is clearly an area of AUSTERE medical care.

Tomorrow in ok
Tomorrow in OK?

  • Locally…

    • New Madrid earthquake fault?

    • Another 1999 Moore tornado?

    • Another Katrina-style hurricane?

  • USA

    • California faults?

    • Wash/OR faults?

    • Yellowstone volcano?

A predictable problem
A Predictable Problem

  • How do you plan to give care when the power is out… when the roads aren’t passable, when the buildings aren’t standing or aren’t safe?

  • Where do you store your supplies?

  • Where do you house your staff?

  • Where do you keep the patients?

Today s discussion
Today’s discussion.

  • Dr. Contiguglia will talk about Austere Medicine – Planning and Execution in the Real World.

  • Dr. Risk will discuss Damage Control measures in RealTime.

  • Dr. Wallace will review our Oklahoma DMAT experience with austere medicine

  • Mike Murphy will discuss the application of Altered Standards of Care

Today s discussion1
Today’s discussion.

  • Dr. Hogan will continue to talk about Oklahoma’s experiences with Austere Medicine.

  • Dr. Harry Hazelwood will tell us about the World Health Organization experience in Haiti.

  • Johnny Gilpin will discuss Austere Medical Care in the Military Environment.

3 rd annual disaster medicine symposium

Charles Stewart MD EMDMcharles-e-stewart@ouhsc.edu