top of page

Medical: Disaster Hubs and DMC-Focused Care

Anticipated Injuries and Minimum Level of Care

MRC Medical Professionals: MRC volunteers with medical degrees; MRC Nonprofessionals: MRC volunteers with WFR certification

Anticipated Medical Concerns	Minimum Level of Care expected at Disaster Hubs (if applicable)	Minimum Level of Care at Disaster Medical Center (DMC)
Neuro/Psych/Head Head, Neck, Face Injuries/Trauma Concussions Psychological Distress: Panic Attacks, Anxiety, Depression, PTSD, Aggression, Withdrawal Pain Substance Abuse	MRC Nonprofessionals PPE/Hand Hygiene Stop the Bleed Spinal Immobilization if applicable Head to Toe Physical Exam/Assessment Vital Signs Wound irrigation Dressings Psychological First Aid (PFA) Oral Fluids & Nourishment Preparation for Evacuation (if evac possible) Consider Evacuation for: Loss of consciousness or altered mental status Headache, nausea/vomiting, irritabilities, or other s/s of head injury not improving after 24 hours Patient is not A + O x 3 or 4 Distinctive changes in mental status S/s of head injury MRC Medical Professionals Reassessment Working Diagnosis (if within licensure scope) Pain medications (if available) Suturing (if within Licensure scope) Evacuation Evaluation	MRC Minimum Level of Care from the hubs plus continued monitoring, assessment and management Pain management (IV pain medications) Infection Prevention (IV antibiotic therapy) Suturing
Musculoskeletal Crush Injuries Fractures Sprains Dislocations Back & Nerve Injuries Open Wounds & Lacerations Puncture/Penetrating Wounds Bleeding Pain	MRC Nonprofessionals PPE/Hand Hygiene Stop the Bleed Chest Seal Head to Toe Physical Exam/Assessment Vital Signs Splinting/immobilization Wound irrigation Wound Dressing PFA Oral Fluids & Nourishment MRC Medical Professionals Reassessment Working Diagnosis (if within licensure scope) Pain medications (if available) Suturing (if within Licensure scope)	MRC Minimum Level of Care from the hubs plus continued monitoring, assessment, and management IV fluids Oral Antibiotics if suspected infection Pain management (IV and oral therapy)
Cardiac Heart Attack Shock Cardiac Arrest Heart Failure Dysrhythmias	MRC Nonprofessioanls CPR AED Treat obvious injuries (stop the bleed, shock, etc.) Vital Signs Prevention of Hypothermia PFA Oral Fluids MRC Medical Professionals Reassessment Working Diagnosis (if within licensure scope) Aspirin Nitroglycerin SL Oxygen (if available)	MRC Minimum Level of Care from the hubs plus continued monitoring, assessment and management IV fluids Oxygen Transcutaneous pacing Treatment for Dysrhythmias Continued monitoring (cardiac tele monitoring if resources available) Loop Diuretics (Heart Failure)
Respiratory Asthma Attack/Exacerbation Pulmonary Edema	MRC Nonprofessionals PFA Assistance in obtaining patients own rescue inhaler Slow breathing Vital Signs MRC Medical Professionals Reassessment Working Diagnosis (if within licensure scope) Short-acting rescue inhaler	MRC Minimum Level of Care from the hubs plus continued monitoring, assessment and management Inhaled corticosteroids (fluticasone/Flovent, budesonide/Pulmicort) Bronchodilators (albuterol/Ventolin) Anticholinergics (relax the airways) (ipratropium/Atrovent, tiotropium/Spiriva) Advanced airway (for Airway compromise)
Infectious Disease Wound Infections Animal Bite	MRC Nonprofessionals PPE/Hand Hygiene Wound irrigation Wound measurement Topical Antibiotics Dressing Consider Evacuation for: Severely infected wound, wound caused by an animal bite MRC Medical Professionals Continued monitoring/reassessment for infection Oral Antibiotics *Check for PCN allergy. [Avoid drugs in penicillin family, and cephalosporins]	MRC Minimum Level of Care from the hubs plus continued monitoring, assessment and management IV broad spectrum antibiotics (if indicated and available). Check for PCN allergy Pain management
Antibiotics *Check for PCN allergy. [Avoid drugs in penicillin family, and cephalosporins]	Defer to MRC Medical Professionals	Commonly Prescribed Broad-Spectrum Antibiotics: Azithromycin, AKA: Z-pack- [Good for Gram Positive Infections] Drug Class: Macrolide Good for respiratory, enteric, and GU infections. Can also be used for STIs. Safe to use if patient has PCN allergy. Available in PO or IV form. Doxycycline [Good for gram-positive and gram-negative infections]. Drug Class: Tetracyclines Good for chest and dental infections, skin infections, STIs, UTIs, Intestinal infections, respiratory and eye infections. Safe to use if patient has PCN allergy. Available in PO or IV form. Ciprofloxacin [good for gram-positive and Gram-negative infections]. Drug Class: Fluoroquinolones Good for UTIs, chest infections (pneumonia), skin and bone infections, plague, typhoid fever, gonorrhea Safe to use if patient has PCN allergy. Available in PO or IV form. Amoxicillin/clavulanic acid (Augmentin). Good for sinusitis, pneumonia, ear infections, bronchitis, UTIs, skin & soft tissue infections CANNOT USE if patient has PCN allergy. Available in PO or IV form, but usually given PO Vancomycin [Good for Gram Positive infections, often reserved for drug resistant gram-positive infections]. Very strong. Drug Class: Glycopeptides Good for Staph, Streptococci, Listeria, C. Diff Safe to use if patient has PCN allergy Available in PO or IV form.
Environmental Burns Smoke Inhalation (I.e., building fire) Shock Contaminated water, food	MRC Nonprofessionals PPE/Hand Hygiene Head to Toe Physical Exam/Assessment Vital Signs Wound Cleansing Topical Antibiotics Burn Dressings/bandage PFA Oral Fluids & Nourishment Assessing need for evacuation Consider Evacuation for: Full-thickness burns, Partial-thickness burns to the hands, feet, face, armpits, groin Partial- or full-thickness burns that cover more than 10% of total body surface area (TBSA) Partial- or full-thickness circumferential burns Any patient in respiratory distress Airway burns Abdominal pain (persistent or worsening over 24 hours, fever, bloody diarrhea or dehydration, intolerance to fluids for > 48 hours, vomiting) MRC Medical Professionals Reassessment and evaluation of depth of tissue damage Silver Sulfadiazine cream for 2nd- and 3rd- degree burns (if available) Oral antibiotics Pain medications Evacuation evaluation	MRC Minimum Level of Care from the hubs plus continued monitoring, assessment and management IV fluids IV Antibiotics IV Pain medications Re-dressings as indicated. Airway Compromise and need for advanced airway
Heat Injury Heat Exhaustion Heat Stroke	MRC Nonprofessionals Head to Toe Physical Exam/Assessment Vital Signs Removing from heat source to cool shady area Rapid cooling Oral Fluids & Nourishment PFA Assessing need for evacuation Consider Evacuation for: No improvement in vital signs or condition with treatment Change in Mental Status MRC Medical Professionals Reassessment and evaluation of working diagnosis Evacuation evaluation	MRC Minimum Level of Care from the hubs plus continued monitoring, assessment and management IV cooling fluids
Cold Injury Mild hypothermia Moderate hypothermia Severe hypothermia Frost Bite	MRC Nonprofessionals Head to Toe Physical Exam/Assessment Vital Signs Removing cold/wet clothing and replacing with warm clothing Warming of patient Hypowrap Oral Fluids & Calorie Nourishment PFA Frostbite: rapid thawing by immersion in warm water bath Assessing need for evacuation Consider Evacuation for: No improvement in vital signs or condition with treatment Change in Mental Status MRC Medical Professionals Reassessment and evaluation of working diagnosis Evacuation evaluation	MRC Minimum Level of Care from the hubs plus continued monitoring, assessment and management IV warming fluids Blister management

bottom of page