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NDMS

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NDMS Information

THIS REFERENCE HAS BEEN EXCERPTED
FROM THE NDMS RADIO OPERATOR'S GUIDE

This section contain excerpts from the an original document published by Rick
Lapp, KC2FD, Joe Schimmel, W2HPM, Mario Maltese, WF2T and others for the
October 1990 NDMS exercise..

 TABLE OF CONTENTS

1        Introduction and Purpose 

            1.1     About NDMS
            1.1.1   Why create a NDMS ?
            1.1.2   The 3 objectives of NDMS 
            1.1.3   How is the NDMS activated ? 
            1.1.4   Some facts on the NDMS

2          The NDMS Communications Plan on Long Island
            2.1     Background 
            2.2     Communications Requirements 

3          Operating Procedures 
            3.1     Packet 
            3.1.1   Hospital packet operators guide 
            3.1.2   NDMS Packet Operators Checklist 
            3.1.3   Recommended tool kit for portable packet 
            3.2     Voice 
            3.2.1   Voice procedures for communications during an emergency 

           APPENDICES
            A.  Bed Availability Form 
            B.  Forms 
            C.  Radio and TNC wiring recommendations 


1.0  Introduction and Purpose

1.1  About NDMS
The following was distributed during a National Teleconference about the National
Disaster Medical System on June 7, 1989:

1.1.1  Why create a National Disaster Medical System?

Earthquakes, tidal waves, volcanic eruptions, storms, fires, industrial accidents,
and many other disasters have struck the United States. These have not caused
the massive casualties or similar incidents in other parts of the world.

The United States has never experienced the great disaster comparable to the
1988 Armenian earthquake, the 1984 Bhopal India toxic gas release or the 1985
Mexico City earthquake. 

But the United States is still susceptible to the kinds of catastrophic accidents
that occur elsewhere. For example, the 1857 earthquake (Richter magnitude 8+)
that destroyed Tejon, California, approximately 100 miles northwest of the center
of Los Angeles, caused negligible casualties.  Because the area has since
become densely populated, authorities estimate that a modern recurrence would
cause from 3,000 to 14,000 deaths and from 12,000 to 55,000 injuries requiring
hospital treatment. 

Such an event in Los Angeles could cause 201,000 deaths and close to 100,000
serious injuries. There is also a substantial risk of an earthquake in the Central
United States, which could devastate Memphis and St. Louis. No portion of the
United States is free of risk from a major earthquake. 

No single city or State can be fully prepared for such catastrophic events.
Although many cities of the Nation are well provided with health resources, those
resources would be overwhelmed by a sudden surge of disaster injuries
proportional to the population. The health resources in most States would be
simply overtaxed. 

The system for dealing with disaster casualties must therefore provide for mutual
aid among all parts of the Nation, and must be able to handle numbers of
patients which might result from a catastrophic incident.

In addition, in the event of a conventional overseas war involving American
forces, the military medical system could be overwhelmed by casualties returning
to the US for hospitalization. To meet the need, military casualties would need to
be distributed among Department of Defense (DoD), Department of Veterans
Affairs (VA) and the US non-Federal hospitals for treatment.

The National Disaster Medical System (NDMS) is a single system designed to
care for large numbers of casualties from either a domestic disaster or overseas
war.



1.1.2      THE 3 SYSTEM OBJECTIVES OF NDMS

1.    Medical Assistance to a disaster area in the form of Disaster                   
      Medical Assistance teams (DMAT) and Clearing-Staging Units (CSU)

2.    Evacuate Patients that cannot be cared for locally to designated              
       locations throughout the United States.

3.    Hospitalization in a national network of medical care facilities that            
       have agreed to accept patients.



1.1.3      HOW IS THE NDMS ACTIVATED?


- The Governor of a disaster-effected state may request Federal assistance, but 
the President makes the declaration.

- The Assistant Secretary of Health and Human Services (HHS), upon the request
of a State Health officer, under authority provide by the Public Health Service
Act.

- The Secretary of Defense, in the event of a national security emergency.


1.1.4      SOME FACTS ON THE NATIONAL DISASTER MEDICAL SYSTEM

* The NDMS is a cooperative effort of the Department of Health and Human
Services (HHS), the Department of Defense (DoD), the Department of Veterans
Affairs (VA), the Federal Emergency Management Agency (FEMA), state and local
governments, and the private sector.

* It is endorsed by: the American Hospital Association (AHA), the American
Medical Association (AMA), the American College of Emergency Physicians
(ACEP), the American College of Healthcare Executives (ACHE), the National
Association of State Emergency Medical Services Directors (NASEMSD), and key
State and local organizations.

* It is designed to care for 100,000 victims, that can be moved to participating
entities in 72 major metropolitan areas.        

THE NDMS COMMUNICATIONS NETWORK PLAN ON LONG ISLAND

2.1        BACKGROUND

The National Disaster Medical System (NDMS) provides the means for distributing
victims of major disasters to outlying areas. Hospitals in the immediate area of
disasters quickly become overloaded with victims.  NDMS affiliated hospitals
throughout the country have committed beds and other services during and
subsequent to a disaster in order to spread the burden of caring for large
numbers of victims.

Medically stabilized patients will be transported by military aircraft to 
metropolitan areas outside the disaster areas for treatment.

2.2        COMMUNICATIONS REQUIREMENTS

On Long Island, the primary receiving site has been designated to be Islip
MacArthur Airport (ISP). NDMS will set up a triage team at the airport to classify
and distribute the victims to 21 hospitals in Nassau and Suffolk counties. The
distribution will be under the control of the Suffolk MedCom office located in
Good Samaritan Hospital in Bay Shore. 

They will maintain a directory of beds available in both Suffolk and Nassau
hospitals. Our responsibility is to provide communications among the various
agencies and hospitals in both counties during any NDMS exercise or actual
emergency.

The following communications tasks have been identified:
2.2.1      Provide tactical voice links among the NDMS steering committee       
            officials.

2.2.2      Provide packet links between the NDMS affiliated hospitals and the    
            MedCom officials.

2.2.3      Provide packet links between the primary receiving site and the         
            MedCom officials.

2.2.4      Provide packet and voice links between MedCom officials and NDMS
             Area Headquarters at the Northport VA Hospital.

2.2.5      Provide packet and voice links between NDMS Area Headquarters and
             Nassau and Suffolk Emergency Operating Centers (EOCs).

2.2.6      Provide packet links between Nassau and Suffolk Red Cross           
             headquarters and the NDMS Area Headquarters.

2.2.7      Provide liaison between NDMS Area Headquarters and NDMS Regional 
             Headquarters Military Amateur Radio Service (MARS).



2.3        NETWORK IMPLEMENTATION


Three wide area radio repeaters will be used to provide dependable
communications links among the participating agencies. The Nassau County
RACES repeater located at EOC in Mineola will provide the voice links for
operators in the Nassau County area. Suffolk County voice links will use the
Grumman Amateur Radio Club repeater located in Hauppauge.  All packet
communications will use the K2VL repeater on Bald Hill in Farmingville. Liaison
between voice and packet communications will be provided at the two EOCs.


A voice operator will accompany each NDMS steering committee official and any
county official that requests our service. The voice control stations will be located
at the two EOCs, one for each county. A packet station at each EOC will maintain
liaison between the voice and packet networks.  The packet control station will
be located at Suffolk MedCom in Good Samaritan Hospital, Bay Shore.  Packet
stations will be set up in each of the NDMS affiliated hospitals and in Nassau
MedCom, East Meadow.  A packet station will be located at the arrival site at Islip
MacArthur Airport. 


Additional packet stations will be set up at the two Red Cross headquarters sites
and at the NDMS area headquarters in Northport. A MARS station at NDMS
headquarters will be set up in the immediate vicinity of the packet station so that
the operators can maintain liaison between the two services.  Additional voice
operators will be assigned to the affiliated hospitals and the arrival site as
available.

All repeater stations are equipped with back-up emergency power.  Also, there
are three back-up repeaters at different sites available to come on line if there is
a communications breakdown at the primary repeater stations.


3.0        OPERATING PROCEDURES



3.1        PACKET

3.1.1      HOSPITAL PACKET OPERATORS' GUIDE


* On arrival at the hospital, report to the NDMS contact

* Request Bed Check information and Emergency Room status for transmission
to MEDCOM HQ.

* Set up your equipment in the designated area.

* Load the computer with your terminal program and your TNC with your tactical
call and NDMS parameters.

* Send your arrival message to Control. Include names of all operators (voice
and packet) at your location.

* As soon as your NDMS contact at the hospital provides you with Bed Check
information, send it to Control.

* Stand by for information to your hospital containing the names and
identification of victims on the way from the arrival site.

* Advise Control when the victims arrive at your site.

* Transmit written requests from your NDMS contact to Control. Receive answers
as they become available.

* Monitor packet activity for messages or bulletins that concern your site.
Connect to Control to receive the messages or bulletins and then disconnect and
resume monitoring.

Please do not inquire about messages you have already sent. Answers to
messages will be transmitted from Control as soon as traffic will allow.



3.1.2 NDMS PACKET OPERATORS' CHECK LIST

You should have the following items with you when you arrive at your assigned
site:


3.1.2.1     Your Identification (ARES / RACES / NDMS)

3.1.2.2     The name and phone number of your hospital NDMS contact.

3.1.2.3     Your transceiver and power supply

3.1.2.4     Your interconnect cable - transceiver to TNC

3.1.2.5     Your TNC (if the hospital is not equipped with one)

3.1.2.6     Your RS232 cable

3.1.2.7     Copies of your terminal program, one on 5 1/4" and one on 3 1/2"
            diskettes, unless your SURE which one is needed at the Hospital.

3.1.2.8     Your portable computer, if the Hospital does not have a computer
               (Portable printer also if needed)

3.1.2.9     Your tool kit with tools and spares. 

3.1.2.10    A small portable tape recorder if available.

3.1.2.11    A portable antenna, if the hospital does not have an antenna.

3.1.2.12    An extension cord long enough to reach an emergency power outlet 

3.1.2.13    Your NDMS message forms or a disk file for printing on the 
                hospital's computer.

3.1.2.14    A blank formatted disk so you may keep a log of all transmissions 
               and reception. Alternately, keep a written log of all transactions. 


3.1.3      RECOMMENDED TOOL KIT FOR PORTABLE PACKET


The following tools and spares should be carried with you when on a field
assignment. Most if not all of them are already in your home inventory. They have
been chosen to keep the size of the kit as small and convenient as possible while
maximizing your ability to make repairs in the field.



HAND TOOLS

1 small blade screwdriver
1 small Phillips screwdriver
1 medium blade screwdriver
1 medium Philips screwdriver
1 small adjustable end wrench
1 medium slip joint pliers
1 diagonal cutting pliers
1 long nose or needle nose pliers
1 set jeweler screwdrivers
1 crimping tool
1 set nut drivers
1 small flashlight
1 electricians knife or similar
1 insulated alignment tool
1 small magnet
2 spring type clothes pins
1 small acid brush
1 small ball peen hammer
1 medium tweezers
1 magnifying glass or loop
1 six inch scale or ruler
1 pair small scissors
1 six foot retractable tape rule
1 butane powered soldering iron
1 set small Allen wrenches

Combination tools such as single handle with multiple blades or long nose pliers
with cutters can be substituted for individual tools. A rechargeable battery
operated soldering iron may be substituted for the butane powered one.



 EXPENDABLES

roll of black plastic tape 
roll of red plastic tape
rosin core solder
assorted crimp lugs
assorted screws and nuts 
roll desoldering braid
small can of butane (lighter fluid) for soldering iron
spare flashlight batteries
small hanks of colored insulated #24 or #26 wire
spare fuses .. one for each different value in your equipment
10 feet 1/4 inch to 1/2 inch copper braid or ground strap




OPERATIONAL SPARES

spare battery pack for each battery operated xcvr.
spare battery pack for laptop computer (if required).
battery pack for TNC
RS-232 cable with male DB-25 connectors each end.
DB-25 gender changers;
                    1 male to male 
                    1 female to female

DB-25 to DB-9 adapters;  
                   1 male to male
                   1 female to female

assorted coax adapters
spare TNC radio connector
multi-tap extension cord
10k Ohm potentiometer
spare Xcvr microphone connector 
two sets clip leads
six feet five conductor shielded cable




TEST EQUIPMENT

continuity checker
digital multimeter   
*Antenna Noise Bridge
*neon bulb      
*SWR bridge with co-ax extenders

* If available




3.1.3      RECOMMENDED TOOL KIT FOR POTABLE PACKET 

All of the above equipment can fit easily into a brief case or attache case. You
will find that most field repairs can be done with the articles recommended.
However, this is meant to be a minimum recommended list and you should add
anything you think might come in handy. Remember though, that anything you
add will make the kit less portable. If you have any suggestions as to additions
or deletions,
please let us know them. We will modify this list as we get inputs from field users.



3.2        VOICE 


3.2.1      PROCEDURES FOR VOICE OPERATION DURING AN EMERGENCY

3.2.1.1              Remember you're using a microphone - In the excitement of an
emergency, it's easy to forget!  Keep away from any touchtone switches you may
have while you speak. Also, some advise to actually talk across a mic rather than
into it, to avoid over sibilants, breath sounds, and popping of "p"s and other
consonants.

3.2.1.2              Speak slowly, distinctly, clearly, and do not let your voice trail
off at the end of words or sentences.

3.2.1.3              Hold the transmit button down for at least a second before
beginning your message. This will assure that the first part of the message is not
cut off by a slow squelch system on a radio or repeater.

3.2.1.4              Know what you're going to say before you push the button.
Don't clutter the airwaves with "uh"s and "duh"s.  It is very easy to confuse the
whole transmission if the operator does not have the facts right on the tip of the
tongue and ready to put out the message in a crisp and orderly fashion.

3.2.1.5              Make sure you're not on the air with someone else. Listen
before transmitting - the pause you hear from Net Control may be deliberate to
allow two other stations to complete a transmission.

3.2.1.6              Chewing gum, eating, and other activities with items in the
mouth tend to clutter up the clarity of your speech. Don't.

3.2.1.7              On VHF and UHF, look for a receiving "hot spot" and use it.
Don't walk around while in communications fringe areas.

3.2.1.8              Under stress, many operators have a tendency to talk fast. Even
if you are in the midst of the action, remember to talk slowly and clearly in order
to get the message across correctly. Accuracy first, speed second.
 
3.2.1.9              Avoid angry comments on the air at all costs. Obscene
statements are not required, and reflect on the Amateur Radio fraternity.
Remember there are many scanners in use by news media, unlicensed but
interested people and your operating techniques are under observation all the
time.

3.2.1.10             If you are relaying a message for another person be sure you
repeat the message exactly, word-for-word, as it is given to you. If it makes no
sense to you, get an explanation before you put it on the air. Refer the message
back to the originator for clarification.

3.2.1.11             Sound alert. Nothing destroys confidence as much as a bored
or weary-sounding operator.  If you are tired, get a relief operator.  While on duty,
listen carefully to the NCS. Don't have the NCS call you repeatedly because you
weren't listening when you were expected to.




NDMS - Appendix A NDMS

BED AVAILABILITY


HOSPITAL:_____________________________                          

HOSPITAL OFFICIAL:____________________

DATE: ___________________                          

TITLE/DEPT.: __________________________

TIME: ___________________                          

TELEPHONE EXT: ________________________



CATEGORY DESIGNATOR NUMBER OF BEDS 
SPINAL CORD (SC)

BURNS (SB)

SURGERY (SS)

ORTHOPEDIC (SO)

MEDICINE (NM)

OB/GYN (SG)

PSYCHIATRIC (MP)

PEDIATRIC (MC)






NDMS - APPENDIX B

ARRL RADIOGRAM FORM


Message from KC2FD to NDMS@KC2FD 
Ref: Sample NTS message format 

Date: 22 Aug 90 15:30:54 Z
From: KC2FD@KC2FD
To: NDMS@NLI
Subject: Sample NTS msg format

R:900822/0302z @:KC2FD.NY.USA.NA Coram, LI, NY #:14150 Z:11727

The following is a sample message that should be sent by each hospital at the
beginning of every NDMS event. The purpose of this "BED AVAILABILITY" form
is to notify NDMS management of each hospital's
capability to handle some quantity and types of injuries.

The information will be provided to you by a hospital administrator.

Forms will be provided to you in your NDMS PACKET OPERATORS MANUAL
specifically for this purpose. We expect these manuals to be mailed out within
two weeks.

Since ARRL NTS messages are in a standard, well known (no?) format, all of our
traffic will be contained within an NTS header. The only differences between our
daily use of NTS packet traffic and that used
during NDMS is that the "ST ZIPCODE @NTSNY" BBS command will NOT be
used to send the message and tactical call-signs WILL be used when operating
from the hospitals. The other important reason for using NTS
format is that this vital information may be passed at some point on a voice
channel, where it is imperative to have information such as the check and
date/time group.




The following is an example of how you would send a bed availability message
in NTS format:



S MDCMS 
[mdcms is the tactical callsign for Suffolk Medcom where the BBS will located
during an NDMS event. For at home drills, use S KC2FD]


ENTER TITLE: 
[bbs prompt for title]


BED AVAIL 8/25 CNESUF 
[this is the message title which should include your tactical callsign and date for
at home drills use callsign]

Enter text, end with ^Z or /EX 
[bbs prompt for text]

NR 6 R CENSUF 17 RIVERHEAD 1130Z AUG 25 [nts preamble]

MDCMS ["to" addressee]


BT [separator between preamble and text]

SC 6              [spinal cord]
SB 2              [burns]
SS 8              [surgery]
SO 4              [orthopedic]
MM 2              [medicine]
SG2               [ob/gyn]
MP 1              [psychiatric]
MC 2              [pediatric]

AUTHORITY

BT

ALICE STEVENS RN

^Z (OR /EX)          [this ends your message and stores it in the bbs~


Please retain this information for reference. You may be asked to use it during
future drills or events.
73 and thanks for your participation.
 



NDMS Appendix C - Radio and TNC Recommended Wiring

PACKET EMERGENCY NETWORK RECOMMENDED RADIO POWER CONNECTOR

          FEMALE  SOCKETS
             \       /
       ___________________
      |                   \
      |     o      o       \
      |    
 <-- SMALLER SOLID NYLON PLUG  / 
** TO FUSE AND BATTERY ** + 
<-- LARGER HOLLOW NYLON SOCKET - ** TO RADIO **  MALE PINS 
1. USE RADIO SHACK PIN 274-222 FOR THE PAIR OF MOLEX STYLE CONNECTORS 
2. DON'T FORGET TO WIRE A FUSE BETWEEN THE BATTERY AND SMALL SOLID NYLON CONNECTOR RECOMMENDED 
TNC-TO-RADIO CABLE CONNECTORS 
PIN 1 TRANSMIT AUDIO TO RADIO 
PIN 2 GROUND 
PIN 3 PTT 
PIN 4 RECEIVE AUDIO FROM RADIO 
PIN 5 RADIO SQUELCH (NORMALLY NOT USED) 
MOST TNCs USE A STANDARD 5 PIN DIN CONNECTOR WITH FEMALE SOCKETS AT THE TNC. 
IF YOUR TNC DOES NOT USE A DIN CONNECTOR, MAKE UP THE FOLLOWING ADAPTER CABLE(S): 
YOUR TNC'S NORMAL DATA CONNECTOR <>  5 PIN INLINE FEMALE  
YOUR RADIO'S NORMAL MIC CONNECTOR  <->  5 PIN INLINE MALE 


1.       USE RADIO SHACK P/N 274-006 FOR THE INLINE FEMALE DIN          
         CONNECTOR

2.       USE RADIO SHACK P/N 42-2151 FOR THE INLINE MALE DIN             
         CONNECTOR            
         
         (TWO MALES ON 6 FOOT CORD - CUT IN HALF MAKES TWO)



NDMS Appendix C - Radio and TNC Wiring (continued) 


STANDARD RS-232 COMPUTER TO TNC DATA CABLE CONNECTIONS:


    D B - 2 5                                     
    
      1           FG                 FRAME GROUND
      2           TXD                TRANSMIT DATA
      3           RXD                RECEIVE DATA 
      4           RTS                REQUEST TO SEND 
      5           CTS                CLEAR TO SEND
      6           DSR                DATA SET READY
      7           SG                 SIGNAL GROUND 
      8           DCD                DATA CARRIER DETECT
      20          DTR                DATA TERMINAL READY 



    D B - 9


      N/C         FG                 FRAME GROUND 
      3           TXD                TRANSMIT DATA
      2           RXD                RECEIVE DATA 
      7           RTS                REQUEST TO SEND
      8           CTS                CLEAR TO SEND
      6           DSR                DATA SET READY
      5           SG                 SIGNAL GROUND
      1           DCD                DATA CARRIER DETECT
      4           DTR                DATA TERMINAL READY 


SOME CONNECTIONS WILL REQUIRE A "NULL MODEM" CONNECTION.
THIS IS WHERE TXD FROM ONE DEVICE IS SENT TO RXD ON THE OTHER.
AND RXD IS SENT TO TXD.

THE CONCEPT IS AS FOLLOWS; 
WHAT I SAY YOU HEAR (TXD -> RXD)
I HEAR WHAT YOU SAY (RXD -> TXD)

SOME COMPUTERS REQUIRE THAT DSR AND DTR BE JUMPED TOGETHER
(IF NOT ALREADY USED FOR HARDWARE FLOW-CONTROL)

SOME COMPUTERS REQUIRE THAT CTS AND RTS BE JUMPED TOGETHER
(IF NOT ALREADY USED FOR HARDWARE FLOW-CONTROL)

The Suffolk County R.A.C.E.S. Radio Officer is Bill Schiebel, N2NFI.
The Suffolk County A.R.E.S. District Emergency Coordinator is Bill Schiebel, N2NFI.
If you have info for or need info on A.R.E.S./ R.A.C.E.S. e-mail Bill.

Send Email to N2NFI


Webmaster: Walter Wenzel, KA2RGI
All rights are reserved and copyrighted 2004 and beyond by Suffolk County, Long Island, Amateur Radio Emergency Services.

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