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Contributing to the Volunteer Solution for Preparedness
TheTexas Medical Rangers
A Proud Unit of the Texas State Guard
If a terrorist attack, disaster or other large scale public health emergency happens in Texas…
A few critically important questions:
Who will be there to help? Who will treat those affected? Will there be enough people to respond
adequately?
PREPARATION PROCESS
Understanding Scenarios
• Plans – planning process, organizing coordination• People – gap analysis, training• Products – equipment, supplies, facilities• Practice – individual, system of systems interfaces
Types of Agents/Casualties
Weapon Potential Casualties
Duration
Chemical (Nerve) 100’s hours/days
Biological 100’s to 10,000’s weeks/months
Radiation 100’s Hours/delayed
Nuclear 100,000’s Immediate/months
Explosive 10’s to 100’s Immediate/days
Mass vaccination begins on Day 17:Effects on epidemic as function of % of population vaccinated
Daily Arrivals to HCM
0.0
50.0
100.0
150.0
200.0
1 12 23 34 45 56 67 78 89 100
111
122
133
144
155
166
177
Day
Sm
allp
ox
Vic
tim
s
270k @ 80% 100k @ 60% 100k @ 40%
Modeling a Smallpox Outbreak in San Antonio
WHO ModelBiologic Attack: City of 1,000,000
Agent Number of People at
Risk
Deaths Incapacitated
Anthrax 180,000 95,000 30,000
Plague 100,000 44,000 36,000
Tularemia 180,000 30,000 95,000
Pandemic Flu Outbreak6-12 months
15% Attack
Rate
35% Attack Rate
Fatalities 87,000 207,000
Hospitalizations 314,000 733,000
Self-Care ill 21 million 50 million
15 Kiloton “Hiroshima” Homemade Terrorist Bomb
New York City
Population: 8 million (1.5 million Manhattan)
Dead: 1,000,000
Injured: 1,000,000
Many Volunteer Organizations Are Available for Disasters
Volunteers are the Key Cog in the Preparedness Machine• American Red Cross (non-medical)• PROTECT TEXAS Volunteers• Ready Texas Nurses• Voluntary Organizations Active in Disaster (VOAD)• Medical Reserve Corps [civilian style]• Texas Medical Rangers – a military Medical
Reserve Corps that is part of the Texas State Guard
• TDH Volunteer Program Coordinators organize recruitment, orientation and training activities– In each of the 8 regional health departments, and– Within many local health departments
• Program Coordinators work routinely with concerned– Health education, emergency management and other experts– Disaster response and other community organizations– City and county officials
• Overall coordination of the PROTECT TEXAS Volunteer Program is at the state level of TDH
PROTECT TEXAS Volunteer Program
MissionTo serveTo serve the people of Texas by providing volunteer medical expertise of the highest reputation, and health service in support of public health emergencies, disasters, and other situations, at the call of the Governor.
TheTexas Medical Rangers
VisionTo be the most valuable, health-related,
statewide, volunteer organization in Texas and
The best Medical Reserve Corps in the Nation
ValuesResponsive, Professional, Adaptable
TheTexas Medical Rangers
Teams of organized, specially-trained volunteers from all health-related fields, including support skills, with verified licensure
The Medical Reserve Corps of the Texas State Guard
TheTexas Medical Rangers
A nationally recognized unit of the U.S. Surgeon General’s network of Medical Reserve Corps local volunteer citizen organizations.
• Not subject to authority of U.S. President.• Available for missions only within Texas, not
other states or foreign countries. • Available for missions expected to last a few
days to a few weeks.
TheTexas Medical Rangers
• No weapons, equipment, or supplies.• Just good people willing to be ready to give a little of
their time.• We support the plans of those authorities with
equipment, supplies and a short-term need for more people.
• Always at option of individual volunteer.• Most volunteer organizations are local, we can
support locally, regionally or statewide.
TheTexas Medical Rangers
(Characteristics Cont’d)
• Identifiable by military rank and uniform. • When on state active duty official mission.
– Texas HB 9 signed into law, effective 22 June 2003, provides immunity from civil liability.
– State Guard worker’s compensation.– Leave of absence (with or without pay).– Health Science Centers (state employees
maintain benefits and coverage).
(Characteristics Cont’d)
TheTexas Medical Rangers
GOVERNOR
ADJUTANTGENERAL
TEXAS ARMYNATIONAL GUARD
TEXAS AIRNATIONAL GUARD
TEXAS STATE GUARDCOMMANDER
------------------------------------------Texas Military Forces-----------------------------------
TEXAS MEDICALRANGERS
REGIONALGROUPS
TheTexas Medical Rangers
LEGEND
Company
Group
Headquarters
Groupsand
CompaniesEl Paso
Odessa/Midland
Amarillo
Lubbock
Laredo
Lower Rio Grande Valley
Corpus Christi
Victoria
Wichita Falls
Fort Worth
DallasTyler
College Station
Galveston
Houston
San Antonio
Fredericksburg Austin
Waco
TempleKilleen
TheTexas Medical Rangers
• 450 Volunteers Currently [Jan 2008]
• 1500 Volunteers desired eventually• Written into response plans by state, local
authorities and Texas Military Forces• Participating in exercises• Active program to train others • Participate in appropriate community events
TheTexas Medical Rangers
Operational Capabilities Target
Examples of Augmentation Service Missions
We are NOT First Responders
• Staff / Manage Acute Care Centers• Augment TDH, Metro Health Dept. Staff• Assist in Emer. Ops Centers / Staff Call Centers• Staff Mass Vaccination / Antibiotic Sites • Assist with Breakdown / Delivery of SNSP• Assist in Mass Triage / Mental Health Counseling• Veterinary and Dental Teams
TheTexas Medical Rangers
Missions Supported the 6th Civil Support Team (CST) in contingency
status for potential incidents during Super Bowl XXXVIII in Houston.
Supported a multi-state U.S. Northern Command sponsored UD04 exercise.
Participated in Operation Lone Star in the Lower Rio Grande Valley to provide medical care to thousands of indigent patients.
Provided medical expertise at the TXSG Health Risk Assessment Day at Camp Swift.
Participated in a multi-agency SNS exercise in Houston.
TheTexas Medical Rangers
“Come Ride with the Texas Medical Rangers”
Serving Texans with pride, competence and character
Houston: swc2.hccs.edu/texasmedicalrangers
Galveston: galvestontexasmedicalrangers.comStatewide: www.texasmedicalrangers.com
ContactInfo.
TheTexas Medical Rangers