Mobile unit can be available quickly

When an ED is forced to close due to a disaster and requests delivery of a mobile unit called the Carolinas Mobile Emergency Department-1 (MED-1), "we like to think we can be mobile in 72 hours," says Tom Blackwell, MD, medical director for the Center for Pre-Hospital Medicine, Department of Emergency Medicine, at Carolinas Medical Center, Charlotte, NC, and one of the two physicians who spearheaded the development of the mobile unit.

Paperwork is the only limiting factor, he says. For example, when administrators at Columbus (IN) Regional Hospital called to make the request, they were directed to their state Emergency Management Agency (EMA) to request a contract. "They filled out a request form, the governor's office took the request, they send it to the Department of Health and Human Services in Washington, DC, who then forwarded it to the North Carolina EMA, who then called us," recalls Blackwell. "Within five days it was done, which is actually lighting speed." All the while, he adds, his team was "ramping up" the mobile unit — for example, loading it with enough pharmaceuticals for 72 hours.

The good news is this convoluted process means the ED will not have to bear the cost of the unit, Blackwell says. "When a site has been declared a disaster area by the president, this opens doors for resources," he explains. "The state of Indiana will pay us, and they will then get reimbursed by FEMA."