A Disaster Medical Assistance Team (DMAT) is a group of professional and para-professional medical personnel organized to provide rapid-response medical care or casualty decontamination

Decontamination

Decontamination is the process of cleansing the human body to remove contamination by hazardous materials including chemicals, radioactive substances, and infectious material...

 during a terrorist attack, natural disaster, or other incident in the United States

United States

The United States of America is a federal constitutional republic comprising fifty states and a federal district...

. DMATs are part of the National Disaster Medical System

National Disaster Medical System

The National Disaster Medical System is a section of the United States Department of Health and Human Services responsible for managing Federal government's medical response to major emergencies and disasters....

 and operate under the Department of Health and Human Services (DHHS).

DMAT's, since their origin have all been organized under the National Disaster Medical System (NDMS). NDMS as a branch were originally under U.S. Public Health Service(USPHS) within The Department of Health and Human Services(DHHS). In 2003, as a direct result of 9-11 the newly formed Department of Homeland Security (DHS), requested, and was granted convening authority over NDMS which was then placed under the direction of the Federal Emergency Management Agency (FEMA). After Hurricane Katrina, amidst allegations of mismanagement (etc.), NDMS was removed from FEMA and sent back to DHHS where it is now an asset of The Office of the Assistant Secretary for Preparedness and Response (formerly the Office of Public Health Emergency Preparedness), to which it receives its annual budget from The Office of Preparedness and Emergency Operations (OPEO), which is also under the ASPR. The OPEO is responsible for developing operational plans, analytical products, and training exercises to ensure the preparedness of the Office, the Department, the Federal Government and the public to respond to domestic and international public health and medical threats and emergencies. OPEO is also responsible for ensuring that ASPR has the systems, logistical support, and procedures necessary to coordinate the Department’s operational response to acts of terrorism and other public health and medical threats and emergencies. OPEO maintains a regional planning and response coordination capability, and has operational responsibility for HHS functions related to the National Disaster Medical Systems (NDMS). OPEO acts as the primary operational liaison to emergency response entities within HHS (e.g., FDA, HRSA, SAMHSA, CDC), within the interagency community (e.g., HDS, VA, DoD), and the public. ).

The National Disaster Medical System (NDMS) is a Federally coordinated system that augments the Nation's emergency medical response capability. It was created by executive order by the President of the United States in 1983. The overall purpose of the NDMS is to establish a single integrated National medical response capability for assisting State and local authorities in dealing with the medical and health effects of major peacetime disasters and providing support to the military and Veterans Health Administration medical systems in caring for casualties evacuated back to the U.S. from overseas armed conflicts.

NDMS is a Federally coordinated system that is a private/public partnership between the Federal Emergency Management Agency (FEMA), Veterans Administration (VA), Department of Defense (DOD), US Public Health Service (PHS), volunteer DMAT members, and civilian hospitals throughout the United States.

DMATs are primarily a local asset to their home region and are integrated into the Emergency Response Plan of that area. DMATs become federal assests when activated by the Office of Emergency Preparedness (OEP). They respond as needed to provide first aid, casualty clearing (triage and medical stabilization), emergent surgical stabilization, medical staging, transportation from disaster areas by military or civilian aeromedical transport, and definitive medical care in hospital facility that has dedicated beds for the NDMS when needed.

Organization

There are 80 NDMS Teams of which 55 are DMATs spread out across the country and are formed by local groups of health care providers and support personnel that receive funding from HHS, and other sources such as states, counties, and private donors. Under the National Response Framework (NRF), DMATs are defined according to their level of capability and experience. Once a level of training and proficiency has been shown, the higher level of priority is given to the team. In addition to standard DMATs, there are sister teams to DMATs that specialize in specific types of medical emergencies such as hazardous material handling and decontamination as well as technical services (large scale data communication set ups for command posts, etc.). Working closely along the same methodologies are the sister teams such as: DMORT(Disaster Mortuary Recovery Team, VMAT (Veterinary Medical Assistance Team), NMRT's, IMSERT's, NNRT's, etc.

A DMAT deploys to disaster sites with enough supplies and equipment to be self-sufficient for 72 hours as individual assets or 14 days as a deployed unit, while providing medical care at a fixed or temporary medical care site. Responsibilities may include triaging

Triage

Triage or ) is the process of determining the priority of patients' treatments based on the severity of their condition. This rations patient treatment efficiently when resources are insufficient for all to be treated immediately. The term comes from the French verb trier, meaning to separate,...

 patients, providing high-quality medical care in adverse and austere environments, and preparing patients for evacuation. Other situations may involve providing primary medical care or augmenting overloaded local health care facilities and staffs. DMATs have been used to implemement mass inoculations and other immediate needs to large populations. Under rare circumstances, disaster victims may be evacuated to a different locale to receive medical care. DMATs may be activated to support patient reception and dispersal of patients to hospitals.

Team composition and equipment

DMATs are composed of physician

Physician

A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

s, nurse practitioner

Nurse practitioner

A Nurse Practitioner is an Advanced practice registered nurse who has completed graduate-level education . Additional APRN roles include the Certified Registered Nurse Anesthetist s, CNMs, and CNSs...

s, physician assistants, nurses, pharmacist

Pharmacist

Pharmacists are allied health professionals who practice in pharmacy, the field of health sciences focusing on safe and effective medication use...

s, respiratory therapists, paramedic

Paramedic

A paramedic is a healthcare professional that works in emergency medical situations. Paramedics provide advanced levels of care for medical emergencies and trauma. The majority of paramedics are based in the field in ambulances, emergency response vehicles, or in specialist mobile units such as...

s, Emergency Medical Technician

Emergency medical technician

Emergency Medical Technician or Ambulance Technician are terms used in some countries to denote a healthcare provider of emergency medical services...

s, and a variety of other health and logistical personnel. DMATs typically have 50-125 members, from which the Team Leader chooses 35 to deploy on most missions. DMAT members are termed "intermittent" federal employees and once activated by federal order, their status changes to that of an active federal employee and follow the GS pay scale. Federally activated DMAT members are protected from tort liability while in operation and are also protected by the provisions of the Uniformed Services Employment and Reemployment Rights Act

Uniformed Services Employment and Reemployment Rights Act

The Uniformed Services Employment and Reemployment Rights Act of 1994 was signed into law by U.S. President Bill Clinton on October 13, 1994 to protect the civilian employment of non-full time military service members in the United States called to active duty...

 (USERRA) which affords the same protections extended to National Guard and Active Duty Military when they deploy in that their full time jobs are not placed in jeopardy.

DMATs come equipped with medical equipment and supplies, large tents, generators, and other support equipment (cache) necessary to establish a Base of Operations, designed to be self-sufficient for up to 72 hours, in a disaster area and treat up to 250 patients per day. The capability is similar to an urgent care-level health care facility. In 2005, FEMA increased the response capabilities of DMATs by issuing trucks to teams that have obtained a certain standard of training and capabilities.

Incidents

DMATs have distinguished themselves in hundreds of large and small-sized disasters, most recently as a critical part of the federal response to Hurricane Katrina

Hurricane Katrina

Hurricane Katrina of the 2005 Atlantic hurricane season was a powerful Atlantic hurricane. It is the costliest natural disaster, as well as one of the five deadliest hurricanes, in the history of the United States. Among recorded Atlantic hurricanes, it was the sixth strongest overall...

. DMAT teams treated and helped evacuate patients at the Louisiana Superdome

Louisiana Superdome

The Mercedes-Benz Superdome, previously known as the Louisiana Superdome and colloquially known as the Superdome, is a sports and exhibition arena located in the Central Business District of New Orleans, Louisiana, USA...

, Louis Armstrong New Orleans International Airport

Louis Armstrong New Orleans International Airport

Louis Armstrong New Orleans International Airport is a Class B public use international airport in Jefferson Parish, Louisiana, United States. It is owned by the City of New Orleans and is located 10 nautical miles west of its central business district. The airport's address is 900 Airline Drive...

, and in many areas in and around New Orleans. DMAT's also participated in the international response to the 2010 Haiti earthquake

2010 Haiti earthquake

The 2010 Haiti earthquake was a catastrophic magnitude 7.0 Mw earthquake, with an epicentre near the town of Léogâne, approximately west of Port-au-Prince, Haiti's capital. The earthquake occurred at 16:53 local time on Tuesday, 12 January 2010.By 24 January, at least 52 aftershocks...

. Twelve DMAT teams deployed to Haiti and between January 17 and February 22 they saw more than 31,300 patients including 167 surgical cases and delivered 45 babies.