I.  PURPOSE

1. To provide transport and treatment of injured in a large-scale disaster.
2. To dispose of large numbers of dead.
3. To control disease through sanitation and the prevention of water and food supply contamination during disaster response and in a post-disaster environment.

1. Two full-service hospitals, the Carlsbad Medical Center and the Artesia General Hospital serve Eddy County. The St. Francis Family Medical Center and the Surgical Center of Carlsbad, both in Carlsbad, also provide medical care to walk-in patients.
2. There are eight pharmacies located within the county. They provide the major local source of backup medical supplies.
3. The cities of Carlsbad and Artesia each operate ambulance services for their respective jurisdictions. Mutual aid agreements provide response coverage of the entire county. In south Eddy County, a private service provides non-emergency transport to facilities in and out of the county.
4. Air ambulance service is provided by private and military carriers. Both helicopters and fixed wing aircraft are available. Minimum response time for these services is one hour.
5. The Eddy County Field Health Office of the New Mexico Department of Health and Environment also administers health protection services to county residents.
6. The Medical Investigator assigned to the County from the State Medical Investigator’s Office provides coroner and morgue service.

1. This annex addresses mass casualty disasters that cause so many casualties or fatalities that available local medical, health and mortuary capabilities are exceeded.
2. If the mass-casualty disaster is localized (i.e., not state-wide or nationwide) medical assistance from adjoining locales and state resources may be provided.
3. If the mass-casualty disaster is state-, region- or nation-wide, outside assistance cannot be counted upon, and the county must organize all of its medical and mortuary capability, both public and private.

1. The Board of Commissioners of Eddy County, the County Manager, the municipal councils/commissions, mayors and city managers are vitally concerned and involved with the health of the population and with providing adequate medical care in event of disaster. They monitor medical needs closely through the EOC and assist the Health and Medical Coordinator in getting assistance from other departments/jurisdictions and private practitioners.
2. In an emergency or disaster, the major hospitals will provide complete emergency hospital services. The urgent care clinics within the county will provide medical care to the extent of their facilities, equipment and personnel capabilities.
3. In a mass-casualty disaster it may be the best use of trained medical personnel to have Emergency Medical Service ambulance crews perform triage duty on-scene, and assign non-medically trained personnel to transport the injured to hospitals or treatment centers. Public works vehicles, school buses and general-purpose vehicles may have to be used to transport the injured.
4. The American Red Cross is able to provide volunteer assistance. The majority of Red Cross resources are stationed throughout the United States, so response time must be considered.
5. In event of a localized mass-casualty disaster exceeding local medical capabilities, the CEO may request that the Governor's Office dispatch the NDMS DMAT team (a mobile surgical hospital) from Albuquerque.
6. Following the initial stabilization of casualties during a major disaster, Health Office attention must concentrate on community health and disease vector control. Provisions will be established to inoculate individuals, if warranted by the threat of disease.

A.  General

1. The Health and Medical Coordinator will assist in the assignment of personnel to medical centers and field teams to work disaster sites, triage areas, clinics and other medical facilities. The CEO/CAO appoints this Coordinator.
2. All medical releases and public health warnings and announcements will be released through the EOC and Public Information Officer.

B.  Specific Responsibilities

1.  The Health and Medical Coordinator directs medical and health response to a
     mass-casualty disaster from the EOC. The Coordinator will:

a.  Designate public and volunteer private medical personnel to perform key
     supervisory roles in event of a mass-casualty disaster.
b.  In a disaster, ensure a designated medical official establishes and assumes
     charge of an on-scene medical command post which will:

1. Establish a triage area.
2. Provide a holding area for those requiring immediate on-scene treatment.
3. Provide a staging area for those requiring transport to a hospital and a priority for transportation.
4. Work with the on-scene commander through the Incident Command System (ICS).

c.  Ensure ambulance and other patient transport to the on-scene medical
     command post.
d.  Coordinate with receiving hospitals.
e.  Coordinate air-ambulance and/or care-flight service.
f.   Establish procedures to identify the injured, and maintain a record showing type
     of injuries, condition, treatment and location (hospital) to which sent.
g.  Assign medical staff to reception and care locations if evacuation or relocation
     occurs.
h.  Coordinate with the medical investigator's office to address issues involving the
     deceased.
i.  Establish and operate emergency medical care centers for essential workers in
    evacuated area following evacuation of general public.

2.  The ambulance services within the county will:

1. Respond to a major disaster with all available ambulances.
2. Recall off-duty EMS trained personnel and assigns them to the triage center or as otherwise specified by the Health and Medical coordinator in the EOC.
3. Maintain field communications and coordination with other response forces, and communications with their parent organization.

3.  The full-service hospitals in the county will:

1. Implement their disaster plans.
2. Provide medical guidance, as needed, to ambulance crews/EMS personnel operating field triage, collection or treatment centers.
3. Recall all staff, as needed, and provide medical personnel, supplies and equipment within the county as the EOC requests.
4. Provide necessary logistic support for food, water, supplies, instruments, emergency power, communications, fuel, etc. for staff, patients and response personnel at the hospitals.

4.  Deputy Medical Investigator for Eddy County will:

1. Coordinate local resources used for the collection, identification and disposition of deceased persons and human tissue.
2. Select qualified personnel to staff temporary morgue sites.
3. Determine cause of death.
4. If necessary, coordinate with the Public Health Office on the location of mass-burial sites, and with the public works department for earth moving equipment support.
5. During a localized disaster resulting in many deaths, request additional medical investigator support from the State Medical Investigator's Office in Albuquerque.
6. Protect the property and personal effects of the deceased.
7. Coordinate with the American Red Cross, ensuring relatives are notified.
8. Maintain a record of each deceased, cause of death, personal possessions and burial site if the remains were not released to relatives.

5.  The Public Health Field Office will:

1. Monitor, evaluate and correct environmental health risks or hazards.
2. Inspect food, water, medicine and other consumables for purity.
3. Coordinate with the water, public works, and/or sanitation departments to ensure available potable water, effective sewage system, sanitary garbage disposal and removal of dead animals.
4. Inspect sources of possible contamination.
5. Provide preventive health services including epidemiological surveillance, quarantine, control of communicable diseases, control of vectors (such as flies/rodents) and mass immunizations.
6. Monitor food handling and mass feeding sanitation service in field and emergency facilities, and increase monitoring of commercial feeding facilities.
7. Mobilize local veterinarians to assist in public health services, if necessary.

6.  Support Services

a.  The American Red Cross will:

1. Provide food for emergency workers and patients at field sites and temporary hospital facilities.
2. Provide blood products.
3. Provide assistance for the handicapped, elderly, orphans and children separated from parents.
4. Assist in notification of next-of-kin of injured and deceased.

b.  Mental Health Agencies will:

1. Provide professional psychological support to victims and personnel involved in a disaster.

c.  Other Services

1. All government departments will provide transportation for medical personnel, patients, medical supplies and equipment.
2. The patient population in nursing homes and other health care facilities will be reduced to extent possible in event of evacuation or mass-casualty disaster. Continued care must be provided for those who cannot be evacuated.

1. The full-service hospitals will provide necessary drugs, medical supplies and

equipment to on-scene treatment centers and coordinate medical resupply for all facilities.
2. Resupply difficulties and shortages will be reported to the Health and Medical Coordinator at the EOC for resolution.
3. Medical facilities and personnel will be included in disaster exercises in order to test and practice the implementation of this annex.

1. Responsibility for maintaining and updating this annex rests with the Health and Medical Coordinator.
2. This annex will be updated as needed and reviewed at least annually.
3. This annex will be exercised in accordance with the exercise schedule as presented in the preparedness section of this document.

Tab 1 Health and Medical Resources

Hospitals and Urgent Care Centers:

Nursing Homes:
 

Name	City	Address	Telephone Number
Artesia Good Samaritan	Artesia	1402 W. Gilchrist Ave.	505-748-1257
Lakeview Christian	Carlsbad	1300 N. Canal	505-885-4150
Landsun Homes	Carlsbad	1900 Westridge	505-885-8150

Pharmacies:
 

Name	City	Address	Telephone Number
Albertson’s Pharmacy	Carlsbad	808 N. Canal	505-887-5085
Furr’s Pharmacy	Carlsbad	809 W. Pierce	505-887-6664
Southwest Pharmacy	Carlsbad	2402 W. Pierce	505-887-6611
Walgreen Drug Store	Carlsbad	902 W. Pierce	505-887-0572
Wal-Mart Pharmacy	Carlsbad	2101 S. Canal	505-885-1029
Brown Drug	Artesia	322 W. Washington	505-746-3591
K-Mart Pharmacy	Artesia	2307 W. Main	505-746-2791
Lowell’s Pharmacy	Artesia	612 N. 13th	505-746-6681

Veterinary Hospitals/Clinics:
 

Name	City	Address	Telephone Number
Animal Care Center	Carlsbad	1302 S. Canal	505-885-5352
Carlsbad Animal Clinic	Carlsbad	103 E. Blodgett	505-887-3653
Animal Clinic	Artesia	3003 N. 13th	505-746-6167
Artesia Animal Clinic	Artesia	110 W. Mahone Dr.,	505-748-2042