Ambulances & Vehicle Ops, Major Incidents, Mass Casualty Incidents, Training

Suffolk County Enhances Large-Scale Incident Response with the MERV

Issue 1 and Volume 39.

Suffolk County, N.Y., is the most southeastern county in the state, home to 110 volunteer fire departments and 24 volunteer ambulance companies. It’s also vulnerable to a variety of large-scale incidents, from multi-vehicle pileups to hurricanes.

“In the past two years, we had Hurricane Sandy, several serious wildfires, a blizzard and a large-scale multi-vehicle accident on the Long Island Expressway,” says Joel Vetter, EMS coordinator for the county.

So, when EMS leaders started planning for the purchase of a new emergency response vehicle, they knew it would get a good workout.

Two years later, the result is MERV-1: a major emergency response vehicle (MERV) and medical ambulance bus (MAB) that significantly increases the county’s ability to respond to large incidents.

MERV multiple stretchers in rear interior

The rear interior of the vehicle features multiple stretchers.

Self-Sufficient Design
Suffolk County pursued regional funding to purchase the vehicle, but the plans took a leap forward when the county secured a $380,000 federal grant from the U.S. Department of Homeland Security.

“This is the first outside the City of New York within New York State and a joint effort by the regional Urban Area Security Initiative,” Vetter says. “The vehicle was a piggyback to the New York City order, but with our options installed and tailor-made for our use and capabilities.”

This specialty unit was built by Sartin Services in Archdale, N.C. (see “MERV Specs”). Sartin has built more than 50 similar units for services around the U.S.

Suffolk County EMS designed the vehicle to provide mass casualty incident response and transport, medical evacuations, on-site triage, firefighter and EMS rehab, and medical support for long-term incidents. In addition to emergency response, it operates at large-scale drills and training exercises run routinely throughout the county.

“We wanted the vehicle to be able to operate for 24-hour periods and also provide communication capabilities, as well as having telemetry connected to patients being treated onboard,” Vetter says. “The vehicle has VoIP (Voice Over Internet Protocol) capabilities, temperature control, wireless camera access, radiation and gas detection, and Wi-Fi access.” It can accommodate 20 patients on stretchers, and features metered oxygen and telemetered patient-monitoring equipment, as well as electrical capacity to supply power for all necessary medical equipment.

MERV interior includes oxygen canisters and individual telemetry setups

The interior includes oxygen canisters and individual telemetry setups for multiple patients.

MERV Protocol
After it took delivery of the unit, the county established a protocol for chief officers who need the services of the MAB. Upon request for the MERV, chiefs provide the following information:

  • Requesting agency and point of contact (POC);
  • Officer in charge;
  • Location of the command post;
  • Nature of the alarm and mission being requested to provide;
  • Whether the requesting agency will provide medical support staffing and equipment or also needs an EMS task force response;
  • Special routes or staging/reporting locations the MERV needs to take to access the incident or avoid while responding; and
  • Notification as to whether the county’s mobile command post or other county resources have been requested.

The vehicle responds with two drivers and a load specialist; an EMS supervisor will also respond along with the unit. Additional personnel and medical staff can be requested as needed. The unit is also available for mutual-aid response in the entire state of New York.

“So far the vehicle has been used extensively at various drills and training scenarios around the county and has responded to several large-scale fires and incidents,” Vetter says. “It has worked out well for us.”

MERV radio and computer

Multiple radios and a computer are within easy reach of the driver.

Roles & Responsibilities of Personnel
There are three primary roles for personnel operating the MERV: the loadmaster, the operator and the transport medical personnel.

  • The loadmaster is “captain of the ship.” They determine the tasking associated with the mission and delegate and communicate as necessary. They also serve as the crew safety officer and conduct a preflight preparation of the cabin.
  • The operator mans the vehicle. They’re responsible for safe operation of the MERV throughout the incident and for monitoring all mechanical systems and maintaining vehicle readiness. They also monitor condition of assigned patients, provide care and comfort measures during transport, complete proper documentation of care provided, coordinate with the loadmaster on patient placement within the vehicle, and ensure all stretchers are securely locked into place.
  • The transporting medical personnel oversee the equipment and setup of the MERV interior, configuring it for the specific response and ensuring all proper equipment is loaded. They assist the loadmaster with triage of patients, facilitate transfer of patients to MERV stretchers outside the vehicle, and monitor and provide care to patients once they’re loaded.

Make It Multipurpose
Vehicles built to respond to large-scale incidents or evacuate large numbers of patients require a lot of preplanning and outreach on behalf of your apparatus design committee. Working in a county or regional manner with neighboring counties or townships may improve your chance of obtaining a FEMA grant. The larger the area the vehicle will benefit, the better chance you’ll have to receive a grant. In addition, design your vehicle to be multipurpose and able to respond to different types of incidents. This will maximize the use and value of your vehicle.

MERV Specs

  • 2013 Thomas/Freightliner EFX commercial chassis
  • 41’8″ long, 96″ wide and 11’8″ high
  • GRVW: 36,000lbs
  • 260-hp Cummins ISB 6.7 L engine
  • Allison automatic transmission
  • 20-kW/1 GPH Cummins generator
  • 100-gallon fuel tank (8–10 mpg)
  • 5-gallon DEF tank
  • 30 “D” oxygen cylinders