Texas A&M Veterinary Emergency Team: Academic Involvement in an Integrated Response Wesley Bissett, DVM, PhD Matt Cochran, DVM, MS
History Hurricane Rita Hurricane Ike
IMPACT Life changing Value of selfless service Career altering Hope
Deployment History 2009 Formed Deployable Team 2011 Grimes County Fire 2011 Bastrop Complex Wildfire 2012 Alzheimer s Patient search 2012 Large Animal rescues (calf, emu, pig) 2013 West, Texas Fertilizer Plant Explosion 2014 San Saba Missing Person search 2014 Buda Missing Person search 2014 Dallas County Ebola Exposed Dog 2014 Equine rescue (Brazos county) 5/1/2015 DRAFT 4
Exercises 2011 Disaster City/State Full Exercise (VMATs observing) 2012 Livestock Food Contamination Exercise (Amarillo) 2012 Disaster City/State Full Exercise (VMATs observing 2012 TDEM Multi-state Tornado exercise (Camp Swift) 2012 Brazos County wilderness search S&R support 2012 TxTF1 S&R canine training week 2013 Disaster City/State Full Exercise (VMATs observing) 2013 Washington county exercise wilderness search 2014 State Guard exercise shelter/tent training (Lubbock) 2014 TxTF1 S&R canine training at Fort Hood 2014 TxTF1 S&R FEMA canine training weekend(s) 2014 Disaster City/State Full Exercise (VMATs and FEMA) 2014 Large Animal Technical Rescue train the trainer (TAMU) 5
Prelude to a Disaster August 2010 July 2011 was the driest period on record in Texas Dry norther produced gusty North winds as it made its way across the state Labor Day weekend many people on holiday Initial fire started on September 4, 2011 from a dead tree falling on power lines due to the high winds 5/1/2015 6
Bastrop Complex Fire 5/1/2015 7
An Unprecedented Fire 32,400 acres burned (not the largest fire) but 1,723 structures burned between Sept 4-Oct 9 making it the largest Wildland-Urban interface (WUI) fire in Texas history It is the 3 rd largest WUI fire in American history 2 human lives lost and untold animals 5/1/2015 8
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Unpredictable
And Random
Bastrop Complex Wildfire The TAMU VET was mobilized on September 7 to support TxTF-1 S&R canines Our secondary missions were: Triage and stabilization of injured and ill animals presented to the base of operations Field triage and assessment of livestock and other species 5/1/2015 13
TxTF-1 S&R Canines were ready to deploy they had leather booties and other foot protection 5/1/2015 14
Initial Challenges Maintaining the ability of the S&R canines to work given the extreme environmental conditions The search manager predicted that given the extremely difficult conditions (heat and surface dangers for dogs while searching) the dogs would only be able to work 2 days before being rotated out 5/1/2015
Sarge and his protective booties developed by the VET team members and individualized for each dog 5/1/2015 16
Preventive Care 100 temps 5/1/2015 17
If you build it.
Integrated Response 5/1/2015 19
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IMPACT When I say this rotation changed me, it changed the way in which I perceive my duties within the veterinary profession. It has allowed me to take a step back from the algorithms of medicine and precision of surgery to ask myself, When the time comes, can I use my skills to help my neighbors? Will I? Veterinarians have the power to change people s lives and in turn save people s lives. 4 th Year Veterinary Student
Clinical Rotation Provide the nation s 1st and only required clinical rotation in emergency preparedness and response Partner with counties to develop preparedness plans for animal issues Senior veterinary students participate in simulated and actual deployments
Preparedness Students have the opportunity to: Work with county leaders Perform risk assessments, view local assets and discuss current plans (if any) Focus on preparing standard operating guidelines for either evacuation, sheltering or veterinary medical support in a disaster (depending on county needs)
Seven Core Competencies Leadership Collaboration Team, self, and systems management Communication Diversity and multicultural awareness Adapting to changing environments Commitment to service and life long learning
Lessons Learned Training our students (the next generation of veterinary first responders) is the most important mission for TAMU VET Giving our students the tools to be better prepared personally and professionally to deal with life s bumps, and to be leaders in their communities is essential to their success
2013 West, TX 5/1/2015 27
West, TX 5/1/2015 28
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West, TX 5/1/2015 32
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The Texas A&M VET proved instrumental in the reuniting of numerous pets with their owners in the West incident. They truly are a beacon of light in the darkest hours. Sgt. W. Patrick Swanton Waco Police Department 5/1/2015 34
West, TX Deployment Deployed on April 18 April 20, 2013 Triaged 122 animals (large, small and exotic) 62 animals triaged on 1 st day Team of 14 faculty, technicians and staff with 4 senior veterinary students 2 trailers and an ambulatory truck responded 5/1/2015 35
Dallas, Ebola and Bentley
The Situation Nurse Nina Pham diagnosed with Ebola Lives with her Cavalier King Charles spaniel, Bentley Concerns: dogs are known to seroconvert (make antibodies) and may potentially be fomites whether or not they get EVD and actively shed is not known (no clinical disease reported in dogs even those with ab)
Deployment Dallas Animal Services and City of Dallas take possession of Bentley Quarantine set up on abandoned military base TAMU VET called to provide care for Bentley and oversee development of protocol for management of problem if additional animals are identified Open-ended, unknown whether or not would expand, unknown what the level of risk
Assumptions Dogs can get infected Dogs can shed virus Dogs can transmit virus to people
Safety
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Bentley s Odyssey 21 day quarantine based on the disease in humans (this could be too long or too short) He was removed from the house October 13 (owner was in hospital on October 11) We deployed to Dallas October 16 he was cared for by Dr. Tammy Beckham on Oct 14, 15 Sampling for virus occurred on day 8 (Oct 21) and day 17 (Oct 29) samples included blood, urine and feces (rt-pcr for RNA of the virus)
Lessons Learned Although a few veterinarians locally offered to help take care of Bentley, in practicality the need for training and expertise in using and working level B or C PPE, the ability to support ones-self while deployed, the ability to protect your practice and livelihood, and the need for expertise in handling samples and infectious disease protocol made it essential that State resources (the TAMU VET) be the responders
TAMU VET Today 5/1/2015 59
Rev-1 5/1/2015 60
Rev-1: Operations 5/1/2015 61
Rev-2: Response Trailer 5/1/2015 DRAFT 62
Rev-2: Multipurpose 5/1/2015 DRAFT 63
Rev-3: Mobile Clinic 5/1/2015 64
Rev-3 in Action 5/1/2015 65
Rev 3 in Action
Rev-4 Surgery 5/1/2015 67
Rev 4 in Action
Rev-4 in Bastrop 5/1/2015 69
Ambulatory