Rescuing a Nation: Post Earthquake Pharmacy Operations and Patient

Care Challenges in Haiti

LCDR Aaron Middlekauff – US Coast Guard

Air Station Miami, Florida

CPE Information and Disclosures

The American Pharmacist Association is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

LCDR Middlekauff declares no conflicts of interest, real or apparent, and no financial interests in any company, product, or service mentioned in this program, including grants, employment, gifts, stock holdings, and honoraria.

To receive credit for this activity, participants will be required to actively participate in the entire session and complete an online evaluation and CPE recording form using the voucher code assigned to this session.

Learning Objectives

1. Describe the roles and responsibilities of a Coast Guard pharmacist

2. Discuss collaborative inter-agency cooperation efforts

3. Describe pharmacy logistical and operational surge during relief operations

4. Identify limitations and opportunities to excel during a time of crisis

Self-Assessment Questions

1. The roles and responsibilities of a Coast Guard pharmacist are multi-faceted. True or False.

2. Personnel processing through Air Station Miami required:

a. Anti-malarial agent

b. H1N1

c. Typhoid

d. DEET

e. All of the above

3. The Coast Guard AOR expanded to include transiting cutters and personnel from other agencies downrange into theater operations. True or False.

Coast Guard Mission & Structure

• Forces - Active Duty (42,000), Reservists (7,500), Auxiliarists (29,000), Civilians (7,700)

• Primary Missions – Humanitarian, SAR, Law Enforcement, Alien Migrant Interdiction Operations, Port Security, Ice Operations, etc.

• Medical Structure – health care is provided

by Public Health Service Officers

- 60 Physicians

- 7 Mid-Level Providers (+30 CG)

- 55 Dentists

- 15 Pharmacists

- 675 Corpsmen

My Introduction to the Coast Guard

Coast Guard Assimilation

1.

2.

Coast Guard Pharmacy

• 15 pharmacists (13 field billets and 2 admin)

• Ambulatory Care Clinics

• Collateral duty assignments

• Regional Pharmacy

Executive (RPE) role

• Provide oversight for tech

training, P&T, CSAB, logistics,

inspections, AOR, and patient care.

Haiti Earthquake • 7.0 Magnitude

• 16 miles west of capital

• Tuesday 12 Jan 2010

• 52 aftershocks greater than 4.5 by 24 Jan

• Estimated 230,000 dead

• Essential services and damage to infrastructure

Presidential Palace Before and After

Cathedral Before and After

Coast Guard Response - Evolution

• 12 Jan 2010 – earthquake occurred

• 13 Jan 2010 – four CG cutters and nine aircraft operating aid

• 13 Jan 2010 – CO of AS Miami interviewed by multiple news networks

Coast Guard Response - Evolution

• 15 Jan 2010 – four simultaneous emergency prime vendor orders to meet mission requirements

• 15 Jan 2010 – CGC Tahoma & Mohawk feedback

• 19 Jan 2010 – collaborative delivery arranged from ASCW/ASCC/ASM

• ~20 Jan 2010 – USNS Comfort arrived on scene

Force Health Protection Guidance

• Anti-Malarial Medication

• Typhoid Vaccine

• DEET

• Sunscreen

• IV Fluids

• Oral Rehydration Packs

• AMIO Supplies

• Rabies Immunoglobulin/Vaccine

• H1N1 vaccine

Other Issues and Concerns

• Coordinating with D-7 Incident Management Team (IMT)

• Positive control of narcotic delivery into theater

• Accounting Issues

• Coast Guard Strategic Priorities

Medevac personnel

Conduct port assessment

Humanitarian supplies

Deter mass migration

Answers To Self-Assessment Questions

Closing Remarks and Questions

LCDR Aaron P. Middlekauff

USCG Air Station Miami

aaron.p.middlekauff@uscg.mil

786-999-4184