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NDMS InformationTHIS 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
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