Staffing
Medical staffing for Carolinas MED-1 includes physicians, mid-level providers, nurses, and paramedics, all having extensive clinical emergency medical experience and all employed at an urban level-1 trauma center, Carolinas Medical Center, serving a large metropolitan city.  Physicians are board-certified in emergency medicine, general surgery, orthopaedic surgery, or anesthesiology. Nurses staff the trauma center’s emergency department or operating room and every paramedic is employed with the  Mecklenburg EMS Agency . Additional support staff includes administrative, maintenance, and logistics crews.  

Many off-line services are provided by staff from various departments at Carolinas Medical Center including laboratory services, radiology, pharmacy, clinical engineering, laundry facilities, public information, and administration. Another important component of the team is security.  Eight officers from the Charlotte-Mecklenburg Police Department have been assigned to the MED-1 program to ensure escort, safety, and protection.  All officers are active members of ALERT, SWAT, and all have been sworn as United States Marshals. All staff receive extensive training in chemical, biological, incendiary, radiological, and nuclear weapons, decontamination, triage, and treatment algorithms.   

 The Carolinas MED-1 Team is led by a Medical Director and assisted by a Nurse Manager and Operations Manager. An additional group of nurses has been selected to serve as Nursing Supervisors and a Paramedic Supervisor oversees the activities of the paramedics and support staff.  Selected members of the medical, support, and security staff are capable of serving in the Incident Command System. Each has received training in the IS 100, 200, 300, 400, and 700 courses under the National Incident Command System Program.

 The procedure used to identify and evaluate core competencies with the MED-1 staff is referenced in Carolinas Medical Center's Emergency Department Policies and Procedures and Carolinas Medical Center's Operating Room Policies and Procedures documents. Oversight of MED-1 training is the responsibility of the Medical Director and Nurse Manager.  The various training components are reviewed on an annual basis and additions/deletions to the current training procedures are made at that specific time.

Recently, MED-1 has aligned with the North Carolina State Medical Assistance Team, so healthcare providers throughout the southern piedmont region (Metrolina) may elect to participate in the program.

The specific number of staff required for a deployment will be determined by the Medical Director of MED-1 and others as deemed appropriate. The decision will depend on the magnitude or severity of the incident, thus determined at the time of deployment. There may be three levels of deployment for consideration:

1.   Full Deployment-Expanded
The expanded deployment strategy will consist of the MED-1 treatment facility with the expanded awning system. The total complement of beds will consist of up to 164 (Inside:  Two operating room/critical care, four critical care, seven general, one dental chair; Outside: 100-150 general).

2.   Full Deployment-Regular
The regular deployment strategy will consist of the Carolinas MED-1 treatment facility without the expanded awning system. The total complement of beds will consist of 14 (Two operating room/critical care, four critical care, seven general, one dental chair).

3.   Limited Deployment 
The Limited Deployment strategy will include the Regular Deployment strategy, with the exception of having limited staff. This strategy includes the use of local staff from the requesting jurisdiction.  Carolinas MED-1 staff would provide oversight and technical expertise only. 

Deployments may occur in one of several methods.  The two specific types of deployment that MED-1 has realized include the following:  
1.   Emergency Mutual Assistance Compact (EMAC) with the contract calling for staff from the parent organization.
2.   Direct contract with Governmental agency (Health and Human Services) with staff supplied by Government (US Public Health Service or Disaster Medical Assistance Teams) with oversight staff provided by parent organization.

 Any request for a deployment will be immediately forwarded to a point of contact at the parent facility (Administrator On-Call) for formal processing.  The point of contact will process the request using established administrative policy.  The deployment will be analyzed in order to approve or disapprove the request based on decision protocols and internal policies. Issues should include, but not be limited to the following:

1.   Magnitude of incident.
2.   Medical impact of the incident.
3.   Type of deployment, e.g. Federal, State, and Local.
4.   Type of deployment strategy.
5.   Impact on staffing at parent facility.
6.   Funding.
7.   Estimated time frame for initial deployment and duration.
8.   Availability.