Review Capacity and Standards of Local Emergency Medical Teams in the Post-Pandemic Period

Introduction: To review the capacity and standards for Victorian Medical Assistance Teams (VMATs) within the context of national Emergency Medical Team (EMT) benchmarks in Australia and internationally. The requirement for responsive, timely, agile, well-prepared, and scalable emergency medical responses has been demonstrated in recent years. Given ongoing climate and geopolitical challenges, the threat of civil conflict, and the stress on prehospital and health systems post-COVID, it is imperative that we ensure local EMTs are appropriately trained and prepared. In recent years, a focus for the WHO has been to build strong national disaster medical responses. Early national responses are considered most critical in major disasters and complex emergencies. Methods: The study reviewed a State-based jurisdictional program, the VMATs, and compared it with national and international standards. A cross-sectional survey of key VMAT management personnel and clinical leads was conducted, with follow-up site visits to audit the current state of staffing, cache, training, exercising, and mobilization. In addition, a literature review including Medline search, local and international policies and standards was conducted, with interviews of national and international exemplar EMTs. Ethics approval was obtained from the University of Melbourne. Results: Local EMTs reported substantial pressures that negatively impact training and exercising, challenges with staff turnover, maintenance of cache, and deployment challenges in the post-pandemic environment. Site visits following the online survey demonstrated improved compliance with training, exercising, and preparedness activities. Visits to other national and international teams demonstrated similar concerns more broadly. Conclusion: Due to consistently reported post-pandemic pressures, there were significant challenges to EMTs. Surveys followed by site visits seemed to be a catalyst for improved compliance with training, exercising, and preparedness. A state-based EMT working group considered rationalization of VMAT numbers and location of teams in order to facilitate best practice in team management and rapid mobilization of staff and equipment.