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Challenges of service coordination for evacuees of Hurricane Maria through the National Disaster Medical System

Neil M. Vora, MD, Aaron Grober, MPH, Bradley P. Goodwin, PhD, Michelle S. Davis, PhD, Chris McGee, LCSW-BCD, Sara E. Luckhaupt, MD, MPH, Jennifer A. Cockrill, MS, MPH, Selena Ready, PharmD, Laura Nichole Bluemle, DPT, Lauren Brewer, BSN, MPH, Angela Brown, EdD, Cassidy Brown, RN, MSHS, Julie Clement, DBH, PA-C, Diane L. Downie, MPH, Michael R. Garner, MPA, Ruby Lerner, RN, MS, Margaret Mahool, RN, BSN, Shirley A. Mojica, MEd, Leisha D. Nolen, MD, PhD, Melanie R. Pedersen, LCSW-BCD, Mary Jane Chappell-Reed, MS, RD, Edecia Richards, MSN, APRN, FNP-C, Jonathan Smith, RN, Kitichia C. Weekes, MA, Jeanette Dickinson, MPH, Charles Weir, PhD, Thomas I. Bowman, MS, Jeanne Eckes, RN MBA

Abstract


Objective: To describe the challenges of service coordination through the National Disaster Medical System (NDMS) for Hurricane Maria evacuees, particularly those on dialysis.

Design: Public health report.

Setting: Georgia.

Report: On November 25, 2017, there were 208 patients evacuated to Georgia in response to Hurricane Maria receiving NDMS support. Most were evacuated from the US Virgin Islands (97 percent) and the remaining from Puerto Rico (3 percent); 73 percent of these patients were on dialysis, all from the US Virgin Islands. From the beginning of the evacuation response through November 25, 2017, there were 282 patients evacuated to Georgia via NDMS, with a median length of coverage through NDMS for those on and not on dialysis of 60 and 16 days, respectively.

Conclusion: The limited capacity and capability of dialysis centers currently in the US Virgin Islands are delaying the return to home of many Hurricane Maria evacuees who are on dialysis.


Keywords


hurricane, dialysis, disaster, evacuation

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References


Zoraster R, Vanholder R, Sever MS: Disaster management of chronic dialysis patients. Am J Disaster Med. 2007; 2: 96-106.

Dossabhoy NR, Qadri M, Beal LM: Nephrologic impact of Hurricanes Katrina and Rita in areas not directly affected. J La State Med Soc. 2015; 167: 254-256.

Calling on NDMS: Available at https://www.phe.gov/Preparedness/responders/ndms/Pages/calling-ndms.aspx. Accessed 2017.

Coverage Guidelines: Available at https://www.phe.gov/Preparedness/responders/ndms/definitive-care/Pages/coverageguidelines.aspx. Accessed 2017.

National Disaster Medical System Federal Coordinating Center Guide: Available at https://www.hsdl.org/?view&did=27648. Accessed 2017.

US Public Health Service Access Teams: Available at https://www.phe.gov/Preparedness/planning/abc/Pages/sat.aspx. Accessed 2017.




DOI: https://doi.org/10.5055/jem.2018.0369

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